L'evoluzione della tutela cautelare nel processo amministrativo

L’effettività della tutela cautelare, intesa come tutela tempestiva, adeguata e piena, è stata la linea cardine dell’evoluzione della giustizia amministrativa, che, nel corso di un periodo durato più di un secolo, grazie all’opera della giurisprudenza e della dottrina, si è strutturata oggi su un vero processo. Approdo recente, e allo stesso tempo, simbolo di questa evoluzione, è sicuramente il Codice del processo amministrativo emanato con il d. lgs. 2 luglio 2010, n. 104. La ricerca, di cui questo contributo costituisce un resoconto, è iniziata contestualmente all’entrata in vigore del nuovo testo, e quindi è stata anche l’occasione per vederne le prime applicazioni giurisprudenziali. In particolare la lettura del Codice, prescindendo da una mera ricognizione di tutto il suo lungo articolato, è stata fatta alla luce di una ponderazione, nell’attualità, non solo del principio di effettività, ma anche del principio di strumentalità che lega tradizionalmente la fase cautelare con la fase di merito. I risultati della ricerca manifestano la volontà del legislatore di confermare questo rapporto strumentale, per fronteggiare una deriva incontrollata verso una cautela dagli effetti alle volte irreversibili, quale verificatasi nell’applicazione giurisprudenziale, ma contestualmente evidenziano la volontà di estendere la portata della tutela cautelare. Guardando a cosa sia diventata oggi la tutela cautelare, si è assistito ad un rafforzamento degli effetti conformativi, tipici delle sentenze di merito ma che si sono estesi alla fase cautelare. I giudici, pur consapevoli che la tutela cautelare non sia una risposta a cognizione piena, bensì sommaria, intendono comunque garantire una tutela tempestiva ed effettiva, anche per il tramite di tecniche processuali particolari, come quella del remand, cui, all’interno della ricerca, viene dedicato ampio spazio. Nella sua ultima parte la ricerca si è focalizzata, sempre volendo guardare in maniera globale agli effetti della tutela cautelare, sul momento dell’esecuzione e quindi sul giudizio di ottemperanza.

Flessibilità e controllo sindacale nel mercato del lavoro contemporaneo: il caso del contratto a tempo determinato

Il lavoro di ricerca che si presenta è suddiviso in tre capitoli nei quali, da altrettanti punti di osservazione, è analizzato il tema della instabilità del lavoro. Nel primo capitolo, il candidato evidenzia le cause che hanno determinato il vorticoso aumento di utilizzo dei contratti di lavoro flessibili e, a tal proposito, da un prospettiva extra-nazionale, analizza le direttive europee e, i principi comuni e le guidelines che, nel percorso di sviluppo della strategia europea per l’occupazione, hanno posto la flexicurity come modello di mercato europeo tipico; dalla medesima prospettiva, prendendo spunto dai cambiamenti del mercato globale, si pone attenzione all’analisi economica del diritto del lavoro e, in particolare, alle conseguenze che le trasformazioni economiche generano sulla capacità di questa materia di tenere elevato il grado di sicurezza occupazionale connesso alla stipula dei contratti di lavoro. Il secondo capitolo è dedicato al ruolo svolto in Italia dai sindacati sul tema della flessibilità. In tal senso, l’autore evidenzia come la funzione “istituzionale” cui sono chiamate anche le organizzazioni dei lavoratori abbia caratterizzato le scelte di politica sindacale in materia di lavori temporanei; è così preso in esame il concetto di flessibilità “contrattata”, come già emerso in dottrina, e si teorizza la differenza tra rinvii “aperti” e rinvii “chiusi”, quali differenti forme di delega di potere normativo alle parti sociali in materia di flessibilità. Nel terzo ed ultimo capitolo l’autore tenta di evidenziare i vantaggi e le funzioni che derivano dall’utilizzo del contratto a termine, quale principale forma di impiego flessibile del nostro mercato del lavoro. Premessi tali benefici viene formulato un giudizio critico rispetto al grado di liberalizzazione che, con le ultime riforme, è stato ammesso per questo istituto sempre più strumento di arbitrio del datore di lavoro nella scelta della durata e delle condizioni di svolgimento della prestazione di lavoro.

La valutazione degli strumenti per la diagnosi sociale della genitorialita'. Uno studio di caso sulla provincia di Bologna

La ricerca dottorale che ho sviluppato si propone di analizzare il percorso di valutazione della genitorialità recentemente delineato dai servizi sociali territoriali della provincia di Bologna attraverso la sperimentazione di strumenti per la diagnosi sociale, valutando gli esiti dell’applicazione, anche in confronto all’utilizzo di metodi tradizionali. Il progetto ha il suo fulcro tematico, nel qualificare le pratiche professionali, con il fine ultimo di giungere ad un percorso di diagnosi sociale scientificamente fondato. Il mio obbiettivo quindi non è stato analizzare in termini astratti e idealtipici le metodologie professionali di riferimento per i 32 operatori coinvolti, quanto piuttosto di formarli all’utilizzo di una serie di strumenti elaborati nelle fasi precedenti del progetto, e condurre una ricerca empirica su un numero, sufficientemente ampio, di “casi concreti” costituito da nuclei familiari in carico ai servizi sociali. Più precisamente l'ambito privilegiato d’analisi è stato individuato nel rapporto tra operatore ed utente, allo scopo di evidenziare pregi e difetti dell'utilizzo di strumenti professionali finalizzati alla diagnosi sociale. Inoltre va sottolineato che l’analisi della letteratura sul tema ha evidenziato l’esistenza di un numero molto limitato di studi empirici sulle metodologie di servizio sociale, condotti peraltro su un numero di casi e di variabili molto ristretto, e per lo più in territorio statunitense, dove il sistema di Welfare si caratterizza per una impostazione tale da rendere veramente difficile la comparazione con la realtà italiana. Quello a cui ho inteso pervenire non è un giudizio ultimo sull’efficacia di questa specifica metodologia tout-court, ma piuttosto analizzare, attraverso l’utilizzo di materiali quanti-qualitativi derivati dalla sperimentazione, quelle che sono le condizioni che si vengono a determinare quando, nel percorso di presa in carico sociale, vengono introdotti strumenti specifici, metodologia chiara e alto coinvolgimento delle componenti relazionali del processo: operatori, familiari e rete sociale allargata.

Law, Informal Institutions and Trust: an Experimental Perspective

This dissertation has studied how legal and non-legal mechanisms affect the levels of trust and trustworthiness in an economy, and whether and when subtle psychological factors are crucial for establishing trust and even for recovering trust from a breach of contract. The first Chapter has addressed the question of whether formal legal enforcement crowds out or crowds in the amount of trust in a society. We find that formal legal mechanisms, especially formal contracts backed by a powerful authority, normally undermine trust except when they are perceived as legitimate, or when there are no strong social norms of fairness (i.e. the population in a society is considerably heterogeneous), or when the environment in which repeated commercial relationships take place becomes highly uncertain. The second Chapter has examined whether the endogenous adoption of a collective punishment institution can help a society coordinate on an efficient outcome, characterized by high levels of trust and trustworthiness. The experimental results show that the endogenous introduction of collective punishment by means of a majority-voting rule does not significantly improve coordination on the efficient equilibrium. Not all subjects seem to be able to anticipate the change in behavior induced by the introduction of the mechanism, and a majority of them vote against it. The third Chapter has explored whether high-trustors adapt their behavior in response to others’ trustworthiness or untrustworthiness more quickly, which in turn supports them to maintain higher default expectations of others’ trustworthiness relative to low-trustors. Our experimental results reveal that high-trustors are better than low-trustors at predicting others’ trustworthiness because they are less susceptible to the anticipated aversive emotions aroused by the potential betrayal and thereby have a higher willingness to acquire the valuable information about their partner’s actions.

Relationship between the logistic EuroSCORE and the Society of Thoracic Surgeons Predicted Risk of Mortality score in patients implanted with the CoreValve ReValving system--a Bern-Rotterdam Study

Background Surgical risk scores, such as the logistic EuroSCORE (LES) and Society of Thoracic Surgeons Predicted Risk of Mortality (STS) score, are commonly used to identify high-risk or “inoperable” patients for transcatheter aortic valve implantation (TAVI). In Europe, the LES plays an important role in selecting patients for implantation with the Medtronic CoreValve System. What is less clear, however, is the role of the STS score of these patients and the relationship between the LES and STS. Objective The purpose of this study is to examine the correlation between LES and STS scores and their performance characteristics in high-risk surgical patients implanted with the Medtronic CoreValve System. Methods All consecutive patients (n = 168) in whom a CoreValve bioprosthesis was implanted between November 2005 and June 2009 at 2 centers (Bern University Hospital, Bern, Switzerland, and Erasmus Medical Center, Rotterdam, The Netherlands) were included for analysis. Patient demographics were recorded in a prospective database. Logistic EuroSCORE and STS scores were calculated on a prospective and retrospective basis, respectively. Results Observed mortality was 11.1%. The mean LES was 3 times higher than the mean STS score (LES 20.2% ± 13.9% vs STS 6.7% ± 5.8%). Based on the various LES and STS cutoff values used in previous and ongoing TAVI trials, 53% of patients had an LES ≥15%, 16% had an STS ≥10%, and 40% had an LES ≥20% or STS ≥10%. Pearson correlation coefficient revealed a reasonable (moderate) linear relationship between the LES and STS scores, r = 0.58, P < .001. Although the STS score outperformed the LES, both models had suboptimal discriminatory power (c-statistic, 0.49 for LES and 0.69 for STS) and calibration. Conclusions Clinical judgment and the Heart Team concept should play a key role in selecting patients for TAVI, whereas currently available surgical risk score algorithms should be used to guide clinical decision making.

Treatment issues in spontaneous cervicocephalic artery dissections

The management of cervicocephalic arterial dissections raises many unsolved issues such as: how to best acutely treat patients who present with ischemic stroke or occasionally with sub-arachnoid hemorrhage? How to best prevent ischemic stroke in patients who present with purely local signs such as headache, painful Horner Syndrome or neck pain? How long and how should patients be treated after cervicocephalic arterial dissections? Can patients resume their sports activities and when? The consensus is that, given the well-established initial thromboembolic risk, an urgent antithrombotic treatment is required in patients with a recent nonhemorrhagic cervicocephalic arterial dissection, but the type of antithrombotic treatment - anticoagulants or aspirin - as well as the indication for a local arterial treatment such as angioplasty/stenting remain debated. Evidence from a randomized clinical trial would be welcome but such a trial raises major issues of methodology, feasibility and funding. Meanwhile, cervicocephalic arterial dissection remains a situation when a bedside clinician should use, on a case-by-case basis, best clinical judgment and adopt a stepped care approach in the minority of patients who deteriorate despite initial treatment.

The Politics of Accountability and Teacher Preparation: A Case Study from Pennsylvania

In an effort to understand some of the ways that accountability-based reform efforts have influenced teacher education, this article details the politics of accountability in Pennsylvania that motivated sweeping changes in the policies governing teacher preparation in 2006. This case study provides a poignant example of the kind of complex accountability systems now being constructed across the United States in an effort to change teacher preparation. By analyzing primary documents including the legal statutes governing teacher preparation in Pennsylvania, correspondence from the Pennsylvania Department of Education, related newsletters, memos, reports, transcripts of meetings, and testimony before the Pennsylvania House of Representatives, the complex nature of the conflicts underlying the development and implementation of teacher education reform is brought into focus. The study's findings suggest that a deep and uncritical acceptance of accountability-based teacher education reform on the part of educational policy makers is likely to do more harm than good. The article concludes by outlining a framework for developing more intelligent measures of accountability that might preserve professional autonomy and judgment.

Melody recognition at fast and slow tempos: Effects of age, experience, and familiarity

Eighty-one listeners defined by three age ranges (18–30, 31–59, and over 60 years) and three levels of musical experience performed an immediate recognition task requiring the detection of alterations in melodies. On each trial, a brief melody was presented, followed 5 sec later by a test stimulus that either was identical to the target or had two pitches changed, for a same–different judgment. Each melody pair was presented at 0.6 note/sec, 3.0 notes/sec, or 6.0 notes/sec. Performance was better with familiar melodies than with unfamiliar melodies. Overall performance declined slightly with age and improved substantially with increasing experience, in agreement with earlier results in an identification task. Tempo affected performance on familiar tunes (moderate was best), but not on unfamiliar tunes. We discuss these results in terms of theories of dynamic attending, cognitive slowing, and working memory in aging.

Morphological and functional 3-Tesla magnetic resonance imaging of saphenous vein coronary artery bypass grafts

Evaluation of a novel non-invasive tool for postoperative follow-up of patients postelective saphenous vein coronary artery bypass graft (CABG) was performed. Ten patients were included. Their bypass grafts supplied the right coronary artery (7), marginal branches (1), diagonal branches (2), and the circumflex artery (n=1). Each bypass was examined intraoperatively using Doppler flow measurement. Patients were examined with a 3-Tesla magnetic resonance imaging (MRI) scanner (MAGNETOM Verio, Siemens, Erlangen, Germany) within one week postsurgery using MR-angiography with an intravasal contrast agent and velocity encoded phase-contrast flow measurements. Intraoperative Doppler flow measurements revealed regular flow patterns in all vascular territories supplied. The median intraoperative flow rate was 50 ml/min with an inter-quartile range (IQR) of 42-70 ml/min. The clinical postoperative course was uneventful. MRI showed all grafts to be patent. The median postoperative flow rate was 50 ml/min (IQR: 32-65 ml/min). MRI flow rates agreed well with intraoperative Doppler flow measurements (mean difference: -2.8±20.1 ml/min). This initial study demonstrates that 3-Tesla MRI flow measurements correlated well with Doppler thus reconfirming the graft patency postCABG. Further refinement and broader application of this technique may facilitate follow-up postCABG potentially replacing empiric clinical judgment by reliable non-invasive imaging.

The Politics of Accountability and Teacher Preparation

In an effort to understand some of the ways that accountability-based reform efforts have influenced teacher education, this article details the politics of accountability in Pennsylvania that motivated sweeping changes in the policies governing teacher preparation in 2006. This case study provides a poignant example of the kind of complex accountability systems now being constructed across the United States in an effort to change teacher preparation. By analyzing primary documents including the legal statutes governing teacher preparation in Pennsylvania, correspondence from the Pennsylvania Department of Education, related newsletters, memos, reports, transcripts of meetings, and testimony before the Pennsylvania House of Representatives, the complex nature of the conflicts underlying the development and implementation of teacher education reform is brought into focus. The study's findings suggest that a deep and uncritical acceptance of accountability-based teacher education reform on the part of educational policy makers is likely to do more harm than good. The article concludes by outlining a framework for developing more intelligent measures of accountability that might preserve professional autonomy and judgment.

Hearing in the mind's ear: A PET investigation of musical imagery and perception

Neuropsychological studies have suggested that imagery processes may be mediated by neuronal mechanisms similar to those used in perception. To test this hypothesis, and to explore the neural basis for song imagery, 12 normal subjects were scanned using the water bolus method to measure cerebral blood flow (CBF) during the performance of three tasks. In the control condition subjects saw pairs of words on each trial and judged which word was longer. In the perceptual condition subjects also viewed pairs of words, this time drawn from a familiar song; simultaneously they heard the corresponding song, and their task was to judge the change in pitch of the two cued words within the song. In the imagery condition, subjects performed precisely the same judgment as in the perceptual condition, but with no auditory input. Thus, to perform the imagery task correctly an internal auditory representation must be accessed. Paired-image subtraction of the resulting pattern of CBF, together with matched MRI for anatomical localization, revealed that both perceptual and imagery. tasks produced similar patterns of CBF changes, as compared to the control condition, in keeping with the hypothesis. More specifically, both perceiving and imagining songs are associated with bilateral neuronal activity in the secondary auditory cortices, suggesting that processes within these regions underlie the phenomenological impression of imagined sounds. Other CBF foci elicited in both tasks include areas in the left and right frontal lobes and in the left parietal lobe, as well as the supplementary motor area. This latter region implicates covert vocalization as one component of musical imagery. Direct comparison of imagery and perceptual tasks revealed CBF increases in the inferior frontal polar cortex and right thalamus. We speculate that this network of regions may be specifically associated with retrieval and/or generation of auditory information from memory.

The role of warning behaviors in threat assessment: an exploration and suggested typology

The concept of warning behaviors offers an additional perspective in threat assessment. Warning behaviors are acts which constitute evidence of increasing or accelerating risk. They are acute, dynamic, and particularly toxic changes in patterns of behavior which may aid in structuring a professional's judgment that an individual of concern now poses a threat - whether the actual target has been identified or not. They require an operational response. A typology of eight warning behaviors for assessing the threat of intended violence is proposed: pathway, fixation, identification, novel aggression, energy burst, leakage, directly communicated threat, and last resort warning behaviors. Previous research on risk factors associated with such warning behaviors is reviewed, and examples of each warning behavior from various intended violence cases are presented, including public figure assassination, adolescent and adult mass murder, corporate celebrity stalking, and both domestic and foreign acts of terrorism. Practical applications and future research into warning behaviors are suggested. Copyright © 2011 John Wiley & Sons, Ltd.

[Assessment of musculoskeletal pain]

The rationale for a successful treatment of musculoskeletal pain is an adequate initial assessment. Standardized questionnaires, modern imaging modalities such as computed tomography, magnetic resonance imaging and musculoskeletal ultrasound or electrophysiology have enriched our armamentarium in the last decades. Pain inducing pathologies can often be identified and treated in a targeted way due to these procedures. But none of these techniques allows an adequate judgment of the acquired findings. Supplementary tests have to be indicated and interpreted in the context of the patient's entire history and the clinical findings. These two remain to be the cornerstones of the assessment of painful musculoskeletal disorders.

Quantitative PCR to diagnose Pneumocystis pneumonia in immunocompromised non-HIV patients

The utility of quantitative Pneumocystis jirovecii PCR in clinical routine for diagnosing Pneumocystis pneumonia (PCP) in immunocompromised non-HIV patients is unknown. We analysed bronchoalveolar lavage fluid with real-time quantitative P. jirovecii PCR in 71 cases with definitive PCP defined by positive immunofluorescence (IF) tests and in 171 randomly selected patients with acute lung disease. In those patients, possible PCP cases were identified by using a novel standardised PCP probability algorithm and chart review. PCR performance was compared with IF testing, clinical judgment and the PCP probability algorithm. Quantitative P. jirovecii PCR values >1,450 pathogens·mL(-1) had a positive predictive value of 98.0% (95% CI 89.6-100.0%) for diagnosing definitive PCP. PCR values of between 1 and 1,450 pathogens·mL(-1) were associated with both colonisation and infection; thus, a cut-off between the two conditions could not be identified and diagnosis of PCP in this setting relied on IF and clinical assessment. Clinical PCP could be ruled out in 99.3% of 153 patients with negative PCR results. Quantitative PCR is useful for diagnosing PCP and is complementary to IF. PCR values of >1,450 pathogens·mL(-1) allow reliable diagnosis, whereas negative PCR results virtually exclude PCP. Intermediate values require additional clinical assessment and IF testing. On the basis of our data and for economic and logistical limitations, we propose a clinical algorithm in which IF remains the preferred first test in most cases, followed by PCR in those patients with a negative IF and strong clinical suspicion for PCP.