La violenza sull'anziano: Aspetti medico-legali di una problematica sommersa

L’abuso dell’anziano è una condizione estremamente diffusa e ha un grande costo umano e finanziario. La dimensione reale del problema del maltrattamento dell’anziano non è stata correttamente definita, in particolare i casi segnalati ufficialmente di abuso sono solo la "punta dell'iceberg". In questi anni il problema è stato riconosciuto a livello internazionale come un fenomeno comune, che viene sottostimato e degno di attenzione da parte della comunità scientifica. In Italia non ci sono molti dati, la prevalenza degli abusi e maltrattamenti può essere circa il 5% e il problema è ampiamente sottovalutato, perché sono scarse le segnalazioni di abusi. Le evidenze disponibili dimostrano che l'abuso sugli anziani in Italia costituisce una questione pubblica, tuttavia, la legislazione e le politiche per affrontare il fenomeno sono scarse, riflettendo la mancanza di una strategia nazionale coerente e globale. Il codice civile italiano non contiene alcun riferimento esplicito a persone anziane, e pochi sono anche gli articoli del codice penale che riguardano le persone anziane. Gli articoli più rilevanti interessate sono le seguenti: art. 572: "Maltrattamenti contro familiari e conviventi" e art. 643: "circonvenzione di persone incapaci". Il presente studio ha lo scopo di analizzare la situazione attuale del fenomeno nel nostro Paese, al fine di valutare la dimensione del problema e le relazioni di abuso e maltrattamenti tra vittime, caregiver e operatori sanitari alle autorità.

Normare la vita. Biocontrollo e nuove tecnologie

Questa ricerca, suddivisa in due parti, si concentra sulle problematiche connesse alla normazione della vita e dei corpi delle donne al tempo delle biotecnologie. La Parte I è una genealogia filosofico-politica che ripercorre le tappe analitico-concettuali del dibattito intorno a biopolitica e tecnoscienza, a partire dai contributi teorici di poststrutturalismo e femminismo neomaterialista, e risponde alle domande: Cosa sono diventati i corpi nell’attuale società bio-info-modificata? Qual'è il ruolo delle scienze nelle metamorfosi che interessano soggettività e rapporti di potere? La Parte II è una cartografia dei modi in cui le biotecnologie, riguardanti i corpi delle donne, si sono sviluppate e diffuse. Essa indaga in modo transdisciplinare come in Italia, e più in generale in Europa, sono state normate le tecniche di interruzione volontaria di gravidanza e fecondazione in vitro. Ampio spazio è dedicato ai modi in cui gli attori della bioetica, istituzionale e non, i medici, laici e cattolici, e le case farmaceutiche hanno affrontato questi temi e quello della contraccezione ormonale maschile. Medicina riproduttiva e rigenerativa sono tematizzate sempre in relazione al quadro normativo, per mostrare in che modo esso influenzi l’accesso ai diritti alla salute e all’autodeterminazione delle donne. Il quadro normativo è analizzato, a sua volta, alla luce dei fatti storici più rilevanti e delle culture più diffuse. L’obiettivo della ricerca è duplice: da un lato essa ha il fine di mostrare il modo in cui i corpi delle donne, e la relativa potenza generatrice, siano diventati uno snodo fondamentale nell’articolazione del biocontrollo e nell'apertura dei nuovi mercati legati a medicina riproduttiva e rigenerativa; dall’altro si propone di argomentare come un biodiritto flessibile, a contenuto storico variabile, condiviso e partecipato, sia un’ipotesi praticabile e virtuosa, utile all'eliminazione del gender gap ancora esistente in materia di diritti riproduttivi e sessuali.

Still/moving images. Il rapporto dialettico tra cinema e fotografia nelle pratiche artistiche contemporanee.

Tra le plurime conseguenze dell’avvento del digitale, la riarticolazione dei rapporti tra immagine statica e immagine in movimento è certamente una delle più profonde. Sintomatica dei cambiamenti in atto sia nei film studies sia nella storia dell’arte, tale riarticolazione richiede un ripensamento dei confini disciplinari tradizionali entro cui il cinema e la fotografia sono stati affrontati come oggetti di studio separati e distinti. Nell’adottare un approccio molteplice, volto a comprendere prospettive provenienti dalla New Film History e dalla media archaeology, dalla teoria dell’arte e dagli studi visuali, questo lavoro esplora l’esistenza di una relazione dialettica tra il cinema e la fotografia intesa in modo duplice: come tensione costitutiva tra due media indissolubilmente connessi – non tanto in considerazione di un medesimo principio realistico di rappresentazione quanto, piuttosto, in virtù di uno scambio incessante nella modellizzazione di categorie quali il tempo, il movimento, l’immobilità, l’istante, la durata; come istanza peculiare della pratica artistica contemporanea, paradigma di riferimento nella produzione estetica di immagini. La tesi si suddivide in tre capitoli. Il primo si concentra sul rapporto tra l’immobilità e il movimento dell’immagine come cifra in grado di connettere l’estetica delle attrazioni e la cronofotografia a una serie di esperienze filmiche e artistiche prodotte nei territori delle avanguardie. Il secondo capitolo considera l’emergenza, dagli anni Novanta, di pratiche artistiche in cui l’incontro intermediale tra film e fotografia fornisce modelli di analisi volti all’indagine dell’attuale condizione estetica e tecnologica. Il terzo offre una panoramica critica su un caso di studio, la GIF art. La GIF è un formato digitale obsoleto che consente di produrre immagini che appaiono, simultaneamente, come fisse e animate; nel presente lavoro, la GIF è discussa come un medium capace di contraddire i confini attraverso cui concepiamo l’immagine fissa e in movimento, suggerendo, inoltre, un possibile modello di pensiero storico-cronologico anti-lineare.

The Representation of Motherhood in Polish Cinema

The project aimed to analyse representations of motherhood in Polish cinema as a special case of a more general system within the representation of women. It concentrated on the image of the Polish Mother created during the 19th century in Polish culture under the influence of specific political, social and religious factors. Ms. Ostrowska's initial hypothesis was that this symbolic image became one of the most stable elements in Polish cinema and as her research revealed, it was valuable for the preservation of national identity but nevertheless a fiercely constraining model for Polish femininity. In order to fully understand the nature of this persistent image it was initially necessary to related it to broader contexts and issues in representation. These included the image of the Polish Mother within general mythological structures (using the notion of myth in the Barthesian sense). Following her initial research Ms. Ostrowska felt that it was most appropriate to view the myth of the Polish Mother as a dominant ideological structure in the discourse of motherhood within Polish culture. An analysis of the myth of the Polish Mother can provide an insight into how Polish society sees itself at different periods in time and how a national identity was constructed in relation to particular ideological demands stemming from concrete historical and political situations. The analysis of the film version of this myth also revealed some aspects of the national character of Polish cinema. There the image of woman has become enshrined as the "eternal feminine", with virtues which are inevitably derived directly from Catholicism, particularly in relation to the networks of meanings around the central figure of Mary, Mother of God. In 19th century Poland these were linked with patriotic values and images of woman became part of the defence of the very idea of Poland and Polishness. After World War Two, this religious-political image system was adapted to the demands of the new communist ideology. The possibility of manipulating the ideological dimensions of the myth of the Polish Mother is due to the very nature of the image, which as a symbol of civil religion had been able to function independently of any particular state or church institution. Although in communist ideology the stress was on the patriotic aspect of the myth, its pronounced religious aspect was also transmitted, consciously or not, in the denotation process, this being of great significance in the viewer's response to the female character. This appropriation of elements derived from the national patriotic tradition into the discourse of communist ideology was a very efficient strategy to establish the illusion of continuity in national existence, which was supposed to convince society of the rightness of the new political situation. The analysis of films made in the post-war period showed the persistence of this discourse on motherhood in a range of cinematic texts regardless of the changing political situation. Ms. Ostrowska claims that the stability of this discursive formation is to a certain extent the result of the mythological aspect of the mother figure. This mythological structure also belongs to the ideology of Romanticism which in general continues to prevail in Polish cultural discourse as a meta-language of national community. The analysis of the films confirmed the hypothesis of the Polish Mother as a myth-sign whose signifier is stable whereas the signified depends on the specific historical conditions in which it is set. Therefore in the famous propaganda documentary Kobiety naszych dni (Women of Our Days, 1951) by Jan Zelnik, and in other films made after the October 1956 "thaw" it functions as an "empty sign. She concludes that it would be difficult to deny that the myth of the Polish Mother has offered Polish women a special role in national life, granting them a high moral position in the social, hierarchy. However the processes of idealisation involved have resulted in a deprivation of her subjectivity and the right to decide about her own life. This idealisation also served to strengthen traditional patriarchal structures through this set of female obligations to the mother land. In Polish ideology it is not a man who demands sacrifice from a woman but the motherland, which, deprived of the institutions of male power for nearly 150 years, had functioned as a feminine structure. That is why oppressive aspects of the myth have been obscured for so long. While Polish women were doubtless able to accept the constrictions because of their sense of national duty and any misgivings were overridden by the argument of the cause, it is important to recognise that the strength of these constructions, compounded by the ways in which they spoke of and continue to speak of a certain perfection, make them persist into contemporary Poland. Poland is however no longer embattled and the signs that made these meanings are potentially empty. This space for meaning will be and is already being contested and increasingly colonised by current western models of femininity. Ms. Ostrowska's final question is whether this will help to prevent a possible resentful victimisation of the silent and noble Polish Mother.

Dutch boundaries

In many schools of architecture the 1970s have been an important watershed for the way in which architecture was taught. For example, recent studies have stressed the importance of Aldo Rossi for the changes in the teaching of architec-ture at the ETH in Zürich that before was based on orthodox modern principles. A similar struggle between an orthodox conception of modernity and its criticism took place at the architectural faculty of Delft, in the Netherlands. Although Delft is an important European school of architecture, the theoretical work produced during this period is not largely known outside the Netherlands. This is perhaps due to the fact that most studies were published in Dutch. With this article, I intend to make the architectural theory developed during this period known to a larger public. The article describes the intellectual journey made by Dutch stu-dents of architecture in the 1970s and 1980s. This was the quest to receive recognition for the intellectual substance of architecture: the insight architecture could be a discourse and a form of knowledge and not only a method of building. Specifically, the work of the architectural theoretician Wim Nijenhuis is highlight-ed. However, as I point out in this article, the results of this journey also had its problematic sides. This becomes clear from the following sentence taken from the dissertation of Wim Nijenhuis: "The search for metaphysical fiction and the tendency towards a technological informed absolute through fully transparent and simultaneous information, should be contested by a fantasy dimension, that does not wish to 'overcome' a given situation and that does not rely on 'creativi-ty' (that would still be historical and humanistic)." Texts like this have a hermet-ic quality that is not easy to comprehend for an architectural public. Even more, there is an important debate looming behind these sentences. As an important outcome of their quest the architectural students in Delft asked themselves: how do we give form to architectural theory once its claim to truth is exposed as an illusion? For Nijenhuis, the discourse about architecture is a mere 'artful game with words': a fiction, besides other forms of fiction like poetry or literature. The question is then if we have not entered the realm of total subjectivity and relativ-ism with this position. From what can the discourse of architecture derive its authority after the death of God?

Retention in care of HIV-infected children from HIV test to start of antiretroviral therapy: systematic review

BACKGROUND In adults it is well documented that there are substantial losses to the programme between HIV testing and start of antiretroviral therapy (ART). The magnitude and reasons for loss to follow-up and death between HIV diagnosis and start of ART in children are not well defined. METHODS We searched the PubMed and EMBASE databases for studies on children followed between HIV diagnosis and start of ART in low-income settings. We examined the proportion of children with a CD4 cell count/percentage after after being diagnosed with HIV infection, the number of treatment-eligible children starting ART and predictors of loss to programme. Data were extracted in duplicate. RESULTS Eight studies from sub-Saharan Africa and two studies from Asia with a total of 10,741 children were included. Median age ranged from 2.2 to 6.5 years. Between 78.0 and 97.0% of HIV-infected children subsequently had a CD4 cell count/percentage measured, 63.2 to 90.7% of children with an eligibility assessment met the eligibility criteria for the particular setting and time and 39.5 to 99.4% of the eligible children started ART. Three studies reported an association between low CD4 count/percentage and ART initiation while no association was reported for gender. Only two studies reported on pre-ART mortality and found rates of 13 and 6 per 100 person-years. CONCLUSION Most children who presented for HIV care met eligibility criteria for ART. There is an urgent need for strategies to improve the access to and retention to care of HIV-infected children in resource-limited settings.

Temporal trends in the characteristics of children at antiretroviral therapy initiation in southern Africa: the IeDEA-SA Collaboration

BACKGROUND Since 2005, increasing numbers of children have started antiretroviral therapy (ART) in sub-Saharan Africa and, in recent years, WHO and country treatment guidelines have recommended ART initiation for all infants and very young children, and at higher CD4 thresholds for older children. We examined temporal changes in patient and regimen characteristics at ART start using data from 12 cohorts in 4 countries participating in the IeDEA-SA collaboration. METHODOLOGY/PRINCIPAL FINDINGS Data from 30,300 ART-naïve children aged <16 years at ART initiation who started therapy between 2005 and 2010 were analysed. We examined changes in median values for continuous variables using the Cuzick's test for trend over time. We also examined changes in the proportions of patients with particular disease severity characteristics (expressed as a binary variable e.g. WHO Stage III/IV vs I/II) using logistic regression. Between 2005 and 2010 the number of children starting ART each year increased and median age declined from 63 months (2006) to 56 months (2010). Both the proportion of children <1 year and ≥10 years of age increased from 12 to 19% and 18 to 22% respectively. Children had less severe disease at ART initiation in later years with significant declines in the percentage with severe immunosuppression (81 to 63%), WHO Stage III/IV disease (75 to 62%), severe anemia (12 to 7%) and weight-for-age z-score<-3 (31 to 28%). Similar results were seen when restricting to infants with significant declines in the proportion with severe immunodeficiency (98 to 82%) and Stage III/IV disease (81 to 63%). First-line regimen use followed country guidelines. CONCLUSIONS/SIGNIFICANCE Between 2005 and 2010 increasing numbers of children have initiated ART with a decline in disease severity at start of therapy. However, even in 2010, a substantial number of infants and children started ART with advanced disease. These results highlight the importance of efforts to improve access to HIV diagnostic testing and ART in children.

When to start antiretroviral therapy in children aged 2-5 years: a collaborative causal modelling analysis of cohort studies from southern Africa

BACKGROUND There is limited evidence on the optimal timing of antiretroviral therapy (ART) initiation in children 2-5 y of age. We conducted a causal modelling analysis using the International Epidemiologic Databases to Evaluate AIDS-Southern Africa (IeDEA-SA) collaborative dataset to determine the difference in mortality when starting ART in children aged 2-5 y immediately (irrespective of CD4 criteria), as recommended in the World Health Organization (WHO) 2013 guidelines, compared to deferring to lower CD4 thresholds, for example, the WHO 2010 recommended threshold of CD4 count <750 cells/mm(3) or CD4 percentage (CD4%) <25%. METHODS AND FINDINGS ART-naïve children enrolling in HIV care at IeDEA-SA sites who were between 24 and 59 mo of age at first visit and with ≥1 visit prior to ART initiation and ≥1 follow-up visit were included. We estimated mortality for ART initiation at different CD4 thresholds for up to 3 y using g-computation, adjusting for measured time-dependent confounding of CD4 percent, CD4 count, and weight-for-age z-score. Confidence intervals were constructed using bootstrapping. The median (first; third quartile) age at first visit of 2,934 children (51% male) included in the analysis was 3.3 y (2.6; 4.1), with a median (first; third quartile) CD4 count of 592 cells/mm(3) (356; 895) and median (first; third quartile) CD4% of 16% (10%; 23%). The estimated cumulative mortality after 3 y for ART initiation at different CD4 thresholds ranged from 3.4% (95% CI: 2.1-6.5) (no ART) to 2.1% (95% CI: 1.3%-3.5%) (ART irrespective of CD4 value). Estimated mortality was overall higher when initiating ART at lower CD4 values or not at all. There was no mortality difference between starting ART immediately, irrespective of CD4 value, and ART initiation at the WHO 2010 recommended threshold of CD4 count <750 cells/mm(3) or CD4% <25%, with mortality estimates of 2.1% (95% CI: 1.3%-3.5%) and 2.2% (95% CI: 1.4%-3.5%) after 3 y, respectively. The analysis was limited by loss to follow-up and the unavailability of WHO staging data. CONCLUSIONS The results indicate no mortality difference for up to 3 y between ART initiation irrespective of CD4 value and ART initiation at a threshold of CD4 count <750 cells/mm(3) or CD4% <25%, but there are overall higher point estimates for mortality when ART is initiated at lower CD4 values. Please see later in the article for the Editors' Summary.

Rechtsmittel gegen Entscheide des juge d'appui bei der internationalen Schiedsgerichtsbarkeit der Schweiz

The author examines whether and by which means the decisions handed down by the State judge giving his support to the arbitral proceeding (juge d'appui) may be appealed. Every relevant Article in the PILA (Private International Law Act) is addressed and analyzed in this regard (Art. 179(2) and (3), Art. 180(3), Art. 183(2), Art. 184(3) and Art. 185) by reference to the present legal doctrine and case law. Concerning the stages of appeal, the view is held that by direct or analogous application of Art. 356(2) CPC (Civil Procedure Code) the juge d'appui has jurisdiction as the sole instance of the Canton to render decisions in support of the arbitral tribunal. On the federal level however, the parties shall have the right to appeal against these decisions by filing a civil law appeal before the Swiss Federal Supreme Court, with the exception of most decisions given by juge d'appui within the meaning of Art. 180(3) PILA. As to this federal appeal, it is established that the case law of the Swiss Federal Supreme Court under the FTA (Act on the Federal Tribunal) indicates the Court's inclination to qualify both negative and positive decisions issued by the juge d'appui as final decisions in terms of Art. 90 FTA. In reference to the upcoming revision of the PILA's 12th Chapter the author concludes that the legislator might implement some clarifications in the current legal framework. It seems particularly advisable to ensure that all relevant Articles in the PILA regarding decisions of the juge d'appui explicitly reference to Art. 356(2) CPC. Moreover, the author is of the opinion that it would also be expedient to specify the

History of Medicine Schedule 2010-2011

William Osler (1849-1919): America’s Most Famous Physician (Robert E. Rakel) The Assassination of John F. Kennedy: A Neurosurgeon’s Eyewitness Account of the Medical Aspect of the Events of November 22, 1963 (Robert G. Grossman) Making Cancer History: Disease and Discovery at the University of Texas M.D. Anderson Cancer Center (James S. Olson) The History of Pathology as a Biological Science and Medical Specialty (L. Maximillian Buja) “Medicine in the Mid-19th Century America” (Student Essay Contest Winner) (David Hunter) The Achievements and Enduring Relevance of Rudolph Virchow (Nathan Grohmann) Medicine: Perspectives in History and Art (Robert E. Greenspan) What Every Physician Should Know: Lessons from the Past (Robert E. Greenspan) Medicine in Ancient Mesopotamia (Sajid Haque) The History of Texas Children’s Hospital (B. Lee Ligon) Visualizing Disease: Motion Pictures in the History of Medical Education (Kirsten Ostherr)

Baylor History of Medicine Society Schedule 2007-2008

"Medicine: Perspectives in History and Art" (Robert E. Greenspan) Eight Practical Lessons from Osler That Will Better Your Life (Bryan Boutwell) History of the American Mental Hospital: From networking to not working & Back (Ed Fann) Ambiguities and Amputations: Methods, mishaps, and the surgical quest to cure breast cancer (Student Essay Contest Winner) (Matt Luedke) An Automated, Algorithmic, Retrospective Analysis of the Growing Influence of Statistics in Medicine (Student Essay Contest Winner) (Ryan Rochat) What’s Special about William Osler? (Charles S. Bryan) The Virtuous Physician: Lessons from Medical Biography (Charles S. Bryan) Legacy: 50 Years of Loving Care – The History of Texas Children’s Hospital, 1954-2004 (Betsy Parish) The Education of a University President: Edgar Odell Lovett of Rice University (John B. Boles) Artists and Illness: The Effect of Illness on an Artist’s Work (David Bybee)

Der erste Mord. Der Tod des Apsyrtos als Schlüsselmoment für moderne Interpretationen des Medea-Mythos: Jahnn, Pasolini, Wolf, Loher

Murderous Medea – following Euripides’ seminal tragedy countless authors and artists have depicted Medea as child-slaughtering outlaw and avenger. But the Medea myth is much more diverse and holds more depth than this. Medea’s path through her career as princess, magician, wife, mother and avengress opens with another abominable death: that of her brother Apsyrtos. This article focuses on how and why the death of Medea’s brother Apsyrtos has been examined and instrumentalised in modern adaptions of the myth by Hans Henny Jahnn, Pier Paolo Pasolini, Christa Wolf and Dea Loher. Whether guilty as charged but with sensible intentions to gain self-rule and show herself trustworthy or innocent of crime or murder but stricken with guilt and alienation, Medea’s involvement in her brother’s death seems to hold the key to modern interpretations of antiquity’s different strands of the Medea myth and its adaptability to modern concerns of subjectivity and emancipation.

On the Limits of Greenwich Mean Time, or The Failure of a Modernist Revolution

On the Limits of Greenwich Mean Time, or The Failure of a Modernist Revolution From the introduction of World Standard Time in 1884 to Einstein’s theory of relativity, the nature and regulation of time was a highly contested issue in modernism, with profound political, social and epistemological consequences. Modernist aesthetic sensibilities widely revolted against the increasingly strict rule of the clock, which, as Georg Simmel observed in “The Metropolis and Mental Life,” was established as the necessary basis of a capitalist, urban life. This paper will focus on the contending conceptions of time arising in key modernist texts by authors like Joyce, Woolf and Conrad. I will argue that the uniformity and regularity of time necessary to a rising capitalist society came under attack in a similar way by both modernist literary aesthetics and new scientific discoveries. However, while Einstein’s theory of relativity may have led to a subsequent change of paradigm in scientific thought, it has failed to significantly alter social and popular conceptions of time. Although alternative ways of thinking and living with time are proposed by modernist authors, they remain isolated aesthetic experiments, ineffectual against the regulatory pressure of economic and social structures. In this struggle about the nature of time, so I suggest, science and literature join force against a society that is increasingly governed by economic reason. The fact that they lost this struggle can serve as a striking illustration of an increasing shift of social influence from science and art towards economy.

Ciudadanía, educación y medios : la encrucijada del nuevo siglo

La escuela y el discurso constituían las formas modernas de organización de la subjetividad y la ciudadanía. Las sociedades actuales apelan a dispositivos y modos diferentes: medios masivos, imágenes, propaganda. En este marco, la pregunta que nos hacemos gira en torno de si los medios pueden, efectivamente, tras la crisis de la escuela, contribuir a la formación ciudadana y a la consolidación de la democracia. Nuestra posición sostiene que necesitamos una concepción estratégica que articule las diferentes modalidades de ciudadanía en los viejos y nuevos escenarios del Estado y el mercado pero estructurados complementaria e innovadoramente.

Iverna Codina en su novela

Con La luna ha muerto, Iverna Codina escritora chileno-argentina inicia un camino de búsqueda del sentido de su obra y de su responsabilidad social como novelista. Parte del axioma de que la literatura es expresión de la vida humana, una vida que siempre es lucha y agonía. En una estructura ramificada de trama y cotramas, los personajes - Claudio, Valentina, Ariel, Marcelo, Felipe y otros, todos artistas- se cuestionan permanentemente acerca de su destino personal, pero también sobre las distintas formas de encarar la literatura y el arte. En estos dilemas es evidente la influencia de La gaviota de Chejov. Las indagaciones existenciales de los personajes -diversas según la personalidad de cada uno- se manifiestan por medio de las peripecias narrativas, del diálogo entre personajes y de los símbolos de la luna y del ascenso al Aconcagua. Por su parte, la novelista, en su propia búsqueda,toma la decisión de ser una escritora comprometida con el ser humano sufriente, como su personaje Valentina.