Cisto nasolabial bilateral como causa de obstrução nasal: relato de caso e revisão de literatura

INTRODUÇÃO: O cisto nasolabial é uma doença rara, normalmente unilateral, benigna, de origem embrionária, localizada em partes moles da região do sulco nasolabial e asa nasal. O diagnóstico é essencialmente clínico, levando em consideração a topografia do cisto, que geralmente é assintomático. OBJETIVO: Este artigo tem como objetivo principal à descrição de um caso incomum de cisto nasolabial bilateral com obstrução nasal, seu tratamento, aspectos anatomopatológicos e acompanhamento, além de revisão de literatura. RELATO DO CASO: Paciente do sexo feminino, parda, 24 anos de idade, apresentando abaulamento em região nasolabial e obstrução nasal. Exames físico e complementares compatíveis com cisto nasolabial. Indicado tratamento cirúrgico para exérese da lesão. CONSIDERAÇÕES FINAIS: O cisto nasolabial bilateral, apesar de raro, é uma possível causa de obstrução nasal, com boa resposta à terapia cirúrgica.

France, Germany and the United Kingdom Cooperation in Times of Turbulence

This thesis deals with cooperation between France, Germany and the United Kingdom within the area of foreign and security policy. Two case studies are presented, one of them concerning cooperation between the three states within and outside institutions in 1980 following the Soviet invasion of Afghanistan, and the other dealing with cooperation concerning the crisis in Macedonia in 2001. In accordance with the approach of neoliberal institutionalism the primary hypothesis is that cooperation is primarily determined by the interests of states but it is also limited by norms and affected by the institutions of which the three states are members. The study describes the large variety of forms of cooperation that exist between France, Germany and the United Kingdom, in which the United States also plays an important part, and which also includes their cooperation within a number of international institutions. The study also points to the new forms of interaction between states and institutions that have come about since the Cold War ended, and which give a stronger role to institutions and the cooperation between them. Still, however, states retain a decisive role in cooperation within the field of foreign and security policy.

Ni una más. International cooperation against gender-based discrimination: the femicide case in Ciudad Juárez, Chihuahua, Mexico

The femicide in Ciudad Juárez is a story made of extreme violence against women for different reasons, by different actors, under different circumstances, and following different behavioural patterns. All within a gender discrimination frame based on the idea that women are inferior, interchangeable and disposable according to the patriarchal hierarchy still present in Mexico, but strongly reinforced by a sort of conspiracy of silence provoked either by the high impunity rate, the governmental incompetence to solve the crimes, or the general indifference of the population. It is the story of hundreds of kidnapped, raped, in many cases tortured, and murdered young women in the border between Mexico and the United States. The murders first came into light in 1993 and up to now young women continue to “disappear” without any hope of bringing the perpetrators to justice, stopping impunity, convicting the assassins, and bringing justice to the families of the deceased girls and women. The main questions about femicide in Ciudad Juárez seem to be: why were they brutally assassinated?, why most of the crimes have not been solved yet?, why and how is Ciudad Juárez different from other border cities with the same characteristics?, which powers are behind those crimes in a city that implies mainly women as its labor force, and which has the lowest unemployment rate in the whole country? But there are also many other questions dealing more with the context, the Juarences’ lifestyles, the eventual hidden powers behind the crimes, the possible murderers’ reasons, the response of the local civil society, or the international community actions to fight against femicide there, among many other things, that are still waiting for an answer and that this paper will ‘narrate’ in order to provide a holistic panorama for the readers. But above all there is the need to remember that every single woman or girl assassinated there had a name, an identity, a family, a story to be told time after time and as many times as necessary, in order to avoid accepting these crimes just as statistics, as cold numbers that might make us forget the human tragedy that has been flagellating the city since 1993. We must remember as well that their deaths express gender oppression, the inequality of the relations between what is male and what is female, a manifestation of domination, terror, social extermination, patriarchal hegemony, social class and impunity. The city is the perfect mirror where all the contradictions of globalization get reflected. It is there where all the globalization evils are present and survive by sucking their women’s blood. It is a city where some concepts such as gender, migration and power are closely related with a negative connotation.

Evolutionary methods for self-organizing cooperation in peer-to-peer networks

The Peer-to-Peer network paradigm is drawing the attention of both final users and researchers for its features. P2P networks shift from the classic client-server approach to a high level of decentralization where there is no central control and all the nodes should be able not only to require services, but to provide them to other peers as well. While on one hand such high level of decentralization might lead to interesting properties like scalability and fault tolerance, on the other hand it implies many new problems to deal with. A key feature of many P2P systems is openness, meaning that everybody is potentially able to join a network with no need for subscription or payment systems. The combination of openness and lack of central control makes it feasible for a user to free-ride, that is to increase its own benefit by using services without allocating resources to satisfy other peers’ requests. One of the main goals when designing a P2P system is therefore to achieve cooperation between users. Given the nature of P2P systems based on simple local interactions of many peers having partial knowledge of the whole system, an interesting way to achieve desired properties on a system scale might consist in obtaining them as emergent properties of the many interactions occurring at local node level. Two methods are typically used to face the problem of cooperation in P2P networks: 1) engineering emergent properties when designing the protocol; 2) study the system as a game and apply Game Theory techniques, especially to find Nash Equilibria in the game and to reach them making the system stable against possible deviant behaviors. In this work we present an evolutionary framework to enforce cooperative behaviour in P2P networks that is alternative to both the methods mentioned above. Our approach is based on an evolutionary algorithm inspired by computational sociology and evolutionary game theory, consisting in having each peer periodically trying to copy another peer which is performing better. The proposed algorithms, called SLAC and SLACER, draw inspiration from tag systems originated in computational sociology, the main idea behind the algorithm consists in having low performance nodes copying high performance ones. The algorithm is run locally by every node and leads to an evolution of the network both from the topology and from the nodes’ strategy point of view. Initial tests with a simple Prisoners’ Dilemma application show how SLAC is able to bring the network to a state of high cooperation independently from the initial network conditions. Interesting results are obtained when studying the effect of cheating nodes on SLAC algorithm. In fact in some cases selfish nodes rationally exploiting the system for their own benefit can actually improve system performance from the cooperation formation point of view. The final step is to apply our results to more realistic scenarios. We put our efforts in studying and improving the BitTorrent protocol. BitTorrent was chosen not only for its popularity but because it has many points in common with SLAC and SLACER algorithms, ranging from the game theoretical inspiration (tit-for-tat-like mechanism) to the swarms topology. We discovered fairness, meant as ratio between uploaded and downloaded data, to be a weakness of the original BitTorrent protocol and we drew inspiration from the knowledge of cooperation formation and maintenance mechanism derived from the development and analysis of SLAC and SLACER, to improve fairness and tackle freeriding and cheating in BitTorrent. We produced an extension of BitTorrent called BitFair that has been evaluated through simulation and has shown the abilities of enforcing fairness and tackling free-riding and cheating nodes.

Longterm peripheral baroreflex and chemoreflex function after bilateral eversion carotid endarterectomy

Introduction The “eversion” technique for carotid endarterectomy (e-CEA), that involves the transection of the internal carotid artery at the carotid bulb and its eversion over the atherosclerotic plaque, has been associated with an increased risk of postoperative hypertension possibly due to a direct iatrogenic damage to the carotid sinus fibers. The aim of this study is to assess the long-term effect of the e-CEA on arterial baroreflex and peripheral chemoreflex function in humans. Methods A retrospective review was conducted on a prospectively compiled computerized database of 3128 CEAs performed on 2617 patients at our Center between January 2001 and March 2006. During this period, a total of 292 patients who had bilateral carotid stenosis ≥70% at the time of the first admission underwent staged bilateral CEAs. Of these, 93 patients had staged bilateral e-CEAs, 126 staged bilateral s- CEAs and 73 had different procedures on each carotid. CEAs were performed with either the eversion or the standard technique with routine Dacron patching in all cases. The study inclusion criteria were bilateral CEA with the same technique on both sides and an uneventful postoperative course after both procedures. We decided to enroll patients submitted to bilateral e-CEA to eliminate the background noise from contralateral carotid sinus fibers. Exclusion criteria were: age >70 years, diabetes mellitus, chronic pulmonary disease, symptomatic ischemic cardiac disease or medical therapy with b-blockers, cardiac arrhythmia, permanent neurologic deficits or an abnormal preoperative cerebral CT scan, carotid restenosis and previous neck or chest surgery or irradiation. Young and aged-matched healthy subjects were also recruited as controls. Patients were assessed by the 4 standard cardiovascular reflex tests, including Lying-to-standing, Orthostatic hypotension, Deep breathing, and Valsalva Maneuver. Indirect autonomic parameters were assessed with a non-invasive approach based on spectral analysis of EKG RR interval, systolic arterial pressure, and respiration variability, performed with an ad hoc software. From the analysis of these parameters the software provides the estimates of spontaneous baroreflex sensitivity (BRS). The ventilatory response to hypoxia was assessed in patients and controls by means of classic rebreathing tests. Results A total of 29 patients (16 males, age 62.4±8.0 years) were enrolled. Overall, 13 patients had undergone bilateral e-CEA (44.8%) and 16 bilateral s-CEA (55.2%) with a mean interval between the procedures of 62±56 days. No patient showed signs or symptoms of autonomic dysfunction, including labile hypertension, tachycardia, palpitations, headache, inappropriate diaphoresis, pallor or flushing. The results of standard cardiovascular autonomic tests showed no evidence of autonomic dysfunction in any of the enrolled patients. At spectral analysis, a residual baroreflex performance was shown in both patient groups, though reduced, as expected, compared to young controls. Notably, baroreflex function was better maintained in e-CEA, compared to standard CEA. (BRS at rest: young controls 19.93 ± 2.45 msec/mmHg; age-matched controls 7.75 ± 1.24; e-CEA 13.85 ± 5.14; s-CEA 4.93 ± 1.15; ANOVA P=0.001; BRS at stand: young controls 7.83 ± 0.66; age-matched controls 3.71 ± 0.35; e-CEA 7.04 ± 1.99; s-CEA 3.57 ± 1.20; ANOVA P=0.001). In all subjects ventilation (VÝ E) and oximetry data fitted a linear regression model with r values > 0.8. Oneway analysis of variance showed a significantly higher slope both for ΔVE/ΔSaO2 in controls compared with both patient groups which were not different from each other (-1.37 ± 0.33 compared with -0.33±0.08 and -0.29 ±0.13 l/min/%SaO2, p<0.05, Fig.). Similar results were observed for and ΔVE/ΔPetO2 (-0.20 ± 0.1 versus -0.01 ± 0.0 and -0.07 ± 0.02 l/min/mmHg, p<0.05). A regression model using treatment, age, baseline FiCO2 and minimum SaO2 achieved showed only treatment as a significant factor in explaining the variance in minute ventilation (R2= 25%). Conclusions Overall, we demonstrated that bilateral e-CEA does not imply a carotid sinus denervation. As a result of some expected degree of iatrogenic damage, such performance was lower than that of controls. Interestingly though, baroreflex performance appeared better maintained in e-CEA than in s-CEA. This may be related to the changes in the elastic properties of the carotid sinus vascular wall, as the patch is more rigid than the endarterectomized carotid wall that remains in the e-CEA. These data confirmed the safety of CEA irrespective of the surgical technique and have relevant clinical implication in the assessment of the frequent hemodynamic disturbances associated with carotid angioplasty stenting.

The social construction of cooperation: exchange, identification and collective intentions within the organization

My aim is to develop a theory of cooperation within the organization and empirically test it. Drawing upon social exchange theory, social identity theory, the idea of collective intentions, and social constructivism, the main assumption of my work implies that both cooperation and the organization itself are continually shaped and restructured by actions, judgments, and symbolic interpretations of the parties involved. Therefore, I propose that the decision to cooperate, expressed say as an intention to cooperate, reflects and depends on a three step social process shaped by the interpretations of the actors involved. The first step entails an instrumental evaluation of cooperation in terms of social exchange. In the second step, this “social calculus” is translated into cognitive, emotional and evaluative reactions directed toward the organization. Finally, once the identification process is completed and membership awareness is established, I propose that individuals will start to think largely in terms of “We” instead of “I”. Self-goals are redefined at the collective level, and the outcomes for self, others, and the organization become practically interchangeable. I decided to apply my theory to an important cooperative problem in management research: knowledge exchange within organizations. Hence, I conducted a quantitative survey among the members of the virtual community, “www.borse.it” (n=108). Within this community, members freely decide to exchange their knowledge about the stock market among themselves. Because of the confirmatory requirements and the structural complexity of the theory proposed (i.e., the proposal that instrumental evaluations will induce social identity and this in turn will causes collective intentions), I use Structural Equation Modeling to test all hypotheses in this dissertation. The empirical survey-based study found support for the theory of cooperation proposed in this dissertation. The findings suggest that an appropriate conceptualization of the decision to exchange knowledge is one where collective intentions depend proximally on social identity (i.e., cognitive identification, affective commitment, and evaluative engagement) with the organization, and this identity depends on instrumental evaluations of cooperators (i.e., perceived value of the knowledge received, assessment of past reciprocity, expected reciprocity, and expected social outcomes of the exchange). Furthermore, I find that social identity fully mediates the effects of instrumental motives on collective intentions.

Effetti degli accordi Euro-Mediterrani sul comparto dell'ortofrutta fresca

In 1995, the European Union (EU) Member States and 12 Mediterranean countries launched in Barcelona a liberalization process that aims at establishing a free trade area (to be realized by 2010) and at promoting a sustainable and balanced economic development by the adoption of a new generation of Agreements: the Euro-Mediterranean Agreements (EMA). For the Mediterranean partner countries, the main concern is a better access for their fruit and vegetable exports to the European market. These products represent the main exports of these countries, and the EU is their first trading partner. On the other side, for the EU the main issue is not only the promotion of its products, but also the protection of its fruit and vegetables producers. Moreover, the trade with third countries is the key element of the Common Market Organization of the sector. Fruit and vegetables represent a very sensitive sector since their high seasonality, high perishability, and especially since the production of the Mediterranean countries is often similar to the European Mediterranean’s countries one. In fact, the agreements define preferences at the entrance of the EU market providing limited concessions for each partner, for specific products, limited quantities and calendars. This research tries to analyze the bilateral trade volume for fresh fruit and vegetables in the European and Italian markets in order to assess the effects of Mediterranean liberalization on this sector. Free trade of agricultural products represents a very actual topic in international trade and the Mediterranean countries, recognised as big producers of fruit and vegetables, as big exporters of their crops and actually significantly present on the European market, could be high competitors with the inward production because the outlet could be the same. The goal of this study is to provide some considerations about the competitiveness of mediterranean fruit and vegetables productions after Barcelona Process, in a first step for the European market and then also for the Italian one. The aim is to discuss the influence of the euro-mediterranean agreements on the fruit and vegetables trade between 10 foreign Mediterranean countries (Algeria, Egypt, Israel, Jordan, Libya, Lebanon, Morocco, Tunisia, Syria, and Turkey) and 15 EU countries in the period 1995-2007, by means of a gravity model, which is a widespread methodology in international trade analysis. The basic idea of gravity models is that bilateral trade from one country to another (as the dependent variable) can be explained by a set of factors: - factors that capture the potential of a country to export goods and services; - factors that capture the propensity of a country to imports goods and services; - any other forces that either attract or inhibit bilateral trade. This analysis compares only imports’ flows by Europe and by Italy (in volumes) from Mediterranean countries, since the exports’ flows toward those foreign countries are not significant, especially for Italy. The market of fruit and vegetables appears as a high heterogeneous group so it is very difficult to show a synthesis of the analysis performed and the related results. In fact, this sector includes the so called “poor products” (such as potatoes and legumes), and the “rich product”, such as nuts or exotic fruit, and there are a lot of different goods that arouse a dissimilar consumer demand which directly influence the import requirements. Fruit and vegetables sector includes products with extremely different biological cycles, leading to a very unlike seasonality. Moreover, the Mediterranean area appears as a highly heterogeneous bloc, including countries which differ from the others for economic size, production potential, capability to export and for the relationships with the EU. The econometric estimation includes 68 analyses, 34 of which considering the European import and 34 the Italian import and the products are examined in their aggregated form and in their disaggregated level. The analysis obtains a very high R2 coefficient, which means that the methodology is able to assess the import effects on fruit and vegetables associated to the Association Agreements, preferential tariffs, regional integration, and others information involved in the equation. The empirical analysis suggests that fruits and vegetables trade flows are well explained by some parameters: size of the involved countries (especially GDP and population of the Mediterranean countries); distances; prices of imported products; local production for the aggregated products; preferential expressed tariffs like duty free; sub-regional agreements that enforce the export capability. The euro-mediterranean agreements are significant in some of the performed analysis, confirming the slow and gradual evolution of euro- Mediterranean liberalization. The euro-mediterranean liberalization provides opportunities from one side, and imposes a new important challenge from the other side. For the EU the chance is that fruit and vegetables imported from the mediterranean area represent a support for local supply and a possibility to increase the range of products existing on the market. The challenge regards the competition of foreign products with the local ones since the types of productions are similar and markets coincide, especially in the Italian issue. We need to apply a strategy based not on a trade antagonism, but on the realization of a common plane market with the Mediterranean countries. This goal could be achieved enhancing the industrial cooperation in addition to commercial relationships, and increasing investments’ flows in the Mediterranean countries aiming at transforming those countries from potential competitors to trade partners and creating new commercial policies to export towards extra European countries.

International cooperation in endourology: percutaneous and flexible ureteroscopic treatment of lower pole kidney stones

Introduction Lower pole kidney stones represent at time a challenge for the urologist. The gold standard treatment for intrarenal stones <2 cm is Extracorporeal Shock Wave Lithotripsy (ESWL) while for those >2 cm is Percutaneous Nephrolithotomy (PCNL). The success rate of ESWL, however, decreases when it is employed for lower pole stones, and this is particularly true in the presence of narrow calices or acute infundibular angles. Studies have proved that ureteroscopy (URS) is an efficacious alternative to ESWL for lower pole stones <2 cm, but this is not reflected by either the European or the American guidelines. The aim of this study is to present the results of a large series of flexible ureteroscopies and PCNLs for lower pole kidney stones from high-volume centers, in order to provide more evidences on the potential indications of the flexible ureteroscopy for the treatment of kidney stones. Materials and Methods A database was created and the participating centres retrospectively entered their data relating to the percutaneous and flexible ureteroscopic management of lower pole kidney stones. Patients included were treated between January 2005 and January 2010. Variables analyzed included case load number, preoperative and postoperative imaging, stone burden, anaesthesia (general vs. spinal), type of lithotripter, access location and size, access dilation type, ureteral access sheath use, visual clarity, operative time, stone-free rate, complication rate, hospital stay, analgesic requirement and follow-up time. Stone-free rate was defined as absence of residual fragments or presence of a single fragment <2 mm in size at follow-up imaging. Primary end-point was to test the efficacy and safety of flexible URS for the treatment of lower pole stones; the same descriptive analysis was conducted for the PCNL approach, as considered the gold standard for the treatment of lower pole kidney stones. In this setting, no statistical analysis was conducted owing to the different selection criteria of the patients. Secondary end-point consisted in matching the results of stone-free rates, operative time and complications rate of flexible URS and PCNL in the subgroup of patients harbouring lower pole kidney stones between 1 and 2 cm in the higher diameter. Results A total 246 patients met the criteria for inclusion. There were 117 PCNLs (group 1) and 129 flexible URS (group 2). Ninety-six percent of cases were diagnosed by CT KUB scan. Mean stone burden was 175±160 and 50±62 mm2 for groups 1 and 2, respectively. General anaesthesia was induced in 100 % and 80% of groups 1 and 2, respectively. Pneumo-ultrasonic energy was used in 84% of cases in the PCNL group, and holmium laser in 95% of the cases in the flexible URS group. The mean operative time was 76.9±44 and 63±37 minutes for groups 1 and 2 respectively. There were 12 major complications (11%) in group 1 (mainly Grade II complications according to Clavidien classification) and no major complications in group 2. Mean hospital stay was 5.7 and 2.6 days for groups 1 and 2, respectively. Ninety-five percent of group 1 and 52% of group 2 required analgesia for a period longer than 24 hours. Intraoperative stone-free rate after a single treatment was 88.9% for group 1 and 79.1% for group 2. Overall, 6% of group 1 and 14.7% of group 2 required a second look procedure. At 3 months, stone-free rates were 90.6% and 92.2% for groups 1 and 2, respectively, as documented by follow-up CT KUB (22%) or combination of intra-venous pyelogram, regular KUB and/or kidney ultrasound (78%). In the subanalysis conducted comparing 82 vs 65 patients who underwent PCNL and flexible URS for lower pole stones between 1 and 2 cm, intreoperative stone-free rates were 88% vs 68% (p= 0.03), respectively; anyway, after an auxiliary procedure which was necessary in 6% of the cases in group 1 and 23% in group 2 (p=0.03), stone-free rates at 3 months were not statistically significant (91.5% vs 89.2%; p=0.6). Conversely, the patients undergoing PCNL maintained a higher risk of complications during the procedure, with 9 cases observed in this group versus 0 in the group of patients treated with URS (p=0.01) Conclusions These data highlight the value of flexible URS as a very effective and safe option for the treatment of kidney stones; thanks to the latest generation of flexible devices, this new technical approach seems to be a valid alternative in particular for the treatment of lower pole kidney stones less than 2 cm. In high-volume centres and in the hands of skilled surgeons, this technique can approach the stone-free rates achievable through PCNL in lower pole stones between 1 and 2 cm, with a very low risk of complications. Furthermore, the results confirm the high success rate and relatively low morbidity of modern PCNL for lower pole stones, with no difference detectable between the prone and supine position.

Cooperation and competition in the air transport market: current scenario, possible evolutions and analytical tools

dall'avvento della liberalizzazione, aeroporti e vettori hanno vissuto cambiamenti. Il maggior miglioramneto nella gestione degli aeroporti è una gestione più commerciale ed efficiente. Le forme di regolazione economica e le caratteristiche della gestione manageriale sono state indagate. Dodici paesi sono stati scelti per indagare la situazione del trasporto aereo mondiale, fra questi sia paesi con un sistema maturo sia paesi emergenti. La distribuzione del traffico è stata analizzata con l'indice HHI per evidenziare aeroporti con concentrazione maggiore di 0,25 (in accordo con la normativa statunitense); il sistema aeroportuale è stato analizzato con l'indice di Gini e con l'indice di dominanza. Infine, la teoria dei giochi si è dimostrata un valido supporto per studiare il mercato del trasporto aereo anche con l'uso di giochi di tipo DP

Demokratie, good governance und Entwicklung: Eine quantitative Analyse für 191 Staaten im Zeitraum 1996 bis 2005

Das Jahr 1989 markiert nicht nur den Beginn entscheidender geopolitischer Veränderungen, sondern gleichzeitig den Ursprung eines bedeutsamen Wandels in der internationalen Entwicklungszusammenarbeit. Mit der viel beachteten Studie ‚Sub-Saharan Africa – From Crisis to Sustainable Growth’ initiierte die Weltbank eine Debatte über die Relevanz institutioneller Faktoren für wirtschaftliche Entwicklung, die in den folgenden Jahren unter dem Titel ‚Good Governance’ erhebliche Bedeutung erlangte. Nahezu alle zentralen Akteure begannen, entsprechende Aspekte in ihrer praktischen Arbeit zu berücksichtigen, und entwickelten eigene Konzepte zu dieser Thematik. Wenn auch mit der Konzentration auf Institutionen als Entwicklungsdeterminanten eine grundlegende Gemeinsamkeit der Ansätze festzustellen ist, unterscheiden sie sich jedoch erheblich im Hinblick auf die Einbeziehung politischer Faktoren, so dass von einem einheitlichen Verständnis von ‚Good Governance’ nicht gesprochen werden kann. Während die meisten bilateralen Akteure sowie DAC und UNDP Demokratie und Menschenrechte explizit als zentrale Bestandteile betrachten, identifiziert die Weltbank einen Kern von Good Governance, der unabhängig von der Herrschaftsform, also sowohl in Demokratien wie auch in Autokratien, verwirklicht werden kann. Die Implikationen dieser Feststellung sind weit reichend. Zunächst erlaubt erst diese Sichtweise der Bank überhaupt, entsprechende Aspekte aufzugreifen, da ihr eine Berücksichtigung politischer Faktoren durch ihre Statuten verboten ist. Bedeutsamer ist allerdings, dass die Behauptung der Trennbarkeit von Good Governance und der Form politischer Herrschaft die Möglichkeit eröffnet, Entwicklung zu erreichen ohne eine demokratische Ordnung zu etablieren, da folglich autokratische Systeme in gleicher Weise wie Demokratien in der Lage sind, die institutionellen Voraussetzungen zu verwirklichen, welche als zentrale Determinanten für wirtschaftlichen Fortschritt identifiziert wurden. Damit entfällt nicht nur ein bedeutsamer Rechtfertigungsgrund für demokratische Herrschaft als solche, sondern rekurrierend auf bestimmte, dieser zu attestierende, entwicklungshemmende Charakteristika können Autokratien nun möglicherweise als überlegene Herrschaftsform verstanden werden, da sie durch jene nicht gekennzeichnet sind. Die Schlussfolgerungen der Weltbank unterstützen somit auch die vor allem im Zusammenhang mit der Erfolgsgeschichte der ostasiatischen Tigerstaaten vertretene Idee der Entwicklungsdiktatur, die heute mit dem Aufstieg der Volksrepublik China eine Renaissance erlebt. Der wirtschaftliche Erfolg dieser Staaten ist danach auf die überlegene Handlungsfähigkeit autokratischer Systeme zurückzuführen, während Demokratien aufgrund der Verantwortlichkeitsbeziehungen zwischen Regierenden und Regierten nicht in der Lage sind, die notwendigen Entscheidungen zu treffen und durchzusetzen. Die dargestellte Sichtweise der Weltbank ist allerdings von verschiedenen Autoren in Zweifel gezogen worden, die auch für ein im Wesentlichen auf technische Elemente beschränktes Good Governance-Konzept einen Zusammenhang mit der Form politischer Herrschaft erkennen. So wird beispielsweise vertreten, das Konzept der Bank bewege sich ausdrücklich nicht in einem systemneutralen Vakuum, sondern propagiere zumindest implizit die Etablierung demokratischer Regierungsformen. Im Übrigen steht die aus den Annahmen der Weltbank neuerlich abgeleitete Idee der Entwicklungsdiktatur in einem erheblichen Widerspruch zu der von multilateralen wie bilateralen Akteuren verstärkt verfolgten Förderung demokratischer Herrschaft als Mittel für wirtschaftliche Entwicklung sowie der fortschreitenden Verbreitung der Demokratie. Besteht nun doch ein Einfluss der Herrschaftsform auf die Verwirklichung von Good Governance als zentraler Entwicklungsdeterminante und kann zudem davon ausgegangen werden, dass Demokratien diesbezüglich Vorteile besitzen, dann ist eine Entwicklungsdiktatur keine denkbare Möglichkeit, sondern im Gegenteil demokratische Herrschaft der gebotene Weg zu wirtschaftlichem Wachstum bzw. einer Verbesserung der Lebensverhältnisse. Aufgrund der mit den Schlussfolgerungen der Weltbank verbundenen bedeutsamen Implikationen und der bisher weitestgehend fehlenden ausführlichen Thematisierung dieses Gegenstands in der Literatur ist eine detaillierte theoretische Betrachtung der Zusammenhänge zwischen den zentralen Elementen von Good Governance und demokratischer Herrschaft notwendig. Darüber hinaus sollen die angesprochenen Beziehungen auch einer empirischen Analyse unterzogen werden. Gegenstand dieser Arbeit ist deshalb die Fragestellung, ob Good Governance eine von demokratischer Herrschaft theoretisch und empirisch unabhängige Entwicklungsstrategie darstellt.

L'amministrazione Johnson e le origini della distensione. 1964-1968

La tesi analizza una parte della politica estera dell’amministrazione Johnson, e più specificamente l’avvio del dialogo con l’Urss in materia di non proliferazione e controllo degli armamenti e la revisione della China policy, inquadrando entrambe nell’adattamento della cold war strategy all’evoluzione sistema internazionale, argomentando che la distensione intesa come rilassamento delle tensioni e ricerca di terreno comune per il dialogo, fosse perlomeno uno degli strumenti politici che l’amministrazione scelse di usare. Il primo capitolo analizza i cambiamenti che interessarono il Blocco sovietico e il movimento comunista internazionale tra la fine degli anni Cinquanta e l’inizio degli anni Sessanta, soprattutto la rottura dell’alleanza sino-sovietica, e l’impatto che essi ebbero sul sistema bipolare su cui si basava la Guerra Fredda. Il capitolo secondo affronta più specificamente l’evoluzione delle relazioni tra Stati Uniti e Unione Sovietica, il perseguimento di una politica di distensione, dopo la crisi dei missili cubani, e in che relazione si trovasse ciò con lo status della leadership sovietica a seguito dei cambiamenti che avevano avuto luogo. Soffermandosi sulla questione del controllo degli armamenti e sul percorso che portò alla firma del Trattato di Non-proliferazione, si analizza come la nuova rotta intrapresa col dialogo sulle questioni strategiche sia stato anche un cambiamento di rotta in generale nella concezione della Guerra Fredda e l’introduzione della distensione come strumento politico. Il terzo capitolo affronta la questione della modifica della politica verso Pechino e il processo tortuoso e contorto attraverso cui l’amministrazione Johnson giunse a distaccarsi dalla China policy seguita sino ad allora.

Building Peace and/or Gender Equality. Changing Attitudes around Peace, Development and Security in International Cooperation in Rwanda.

The times following international or civil conflicts but also violent revolutions often come with unequal share of the peace dividend for men and women. Delusions for women who gained freedom of movement and of roles during conflict but had to step back during reconstruction and peace have been recorded in all regions of the world. The emergence of peacebuilding as a modality for the international community to ensure peace and security has slowly incorporated gender sensitivity at the level of legal and policy instruments. Focusing on Rwanda, a country that has obtained significant gender advancement in the years after the genocide while also obtaining to not relapse into conflict, this research explores to what extent the international community has contributed to this transformation. From a review of evaluations, findings are that many of the interventions did not purse gender equality, and overall the majority understood gender and designed actions is a quite superficial way which would hardly account for the significative advancement in combating gender discrimination that the Government, for its inner political will, is conducting. Then, after a critique from a feminist standpoint to the concept of human security, departing from the assumption (sustained by the Governemnt of Rwanda as well) that domestic violence is a variable influencing level of security relevant at the national level, a review of available secondary data on GBV is conducted an trends over the years analysed. The emerging trends signal a steep increase in prevalence of GBV and in domestic violence in particular. Although no conclusive interpretation can be formulated on these data, there are elements suggesting the increase might be due to augmented reporting. The research concludes outlining possible further research pathways to better understand the link in Rwanda between the changing gender norms and the GBV.

Preoperative MRI findings and functional outcome after selective dorsal rhizotomy in children with bilateral spasticity

PURPOSE: To identify MRI characteristics that may predict the functional effect of selective dorsal rhizotomy (SDR) in children with bilateral spastic paresis. METHODS: We performed SDR in a group of 36 patients. The gross motor functioning measure-66 (GMFM-66) was applied before and after SDR. Available cerebral MRIs were retrospectively classified into three diagnostic groups: periventricular leucomalacia (PVL; n = 10), hydrocephalus (n = 2), and normal (n = 6). In patients with PVL, we scored the severity of the MR abnormalities. We compared the changes in the GMFM-66 after SDR in the diagnostic groups. In patients with PVL, we correlated the severity of the MR abnormalities with the changes in the GMFM-66. RESULTS: The mean follow-up period was 5 years and 4 months (range, 1 year and 1 month to 9 years). The best improvement in gross motor function was observed in patients with normal MRI, and the slightest improvement was observed in patients with hydrocephalus. The severity of the PVL did correlate with the GMFM-66 score before SDR but not with the functional effect of SDR. CONCLUSION: We conclude that with respect to gross motor skills, the improvements after SDR are good in patients with no MRI abnormalities. In the patients with hydrocephalus, the improvements after SDR were insignificant. In patients with PVL, the improvements were intermediate and did not correlate with the degree of PVL.