Italian Practice Research Articles

The Field of Cloth of Gold by Glenn Richardson

Reviewed by: The Field of Cloth of Gold by Glenn Richardson Brian Brege (bio) Henry VIII, Francis I, Charles V, Field of Cloth of Gold, Renaissance Diplomacy, Court Culture, Jousting, Renaissance Spectacle, Summit Diplomacy, Machiavelli Glenn Richardson. The Field of Cloth of Gold. New Haven: Yale University Press, 2013. 288 pages + xii. $65.00. Between May 26 and July 13, 1520, three young monarchs met near the shores of the English Channel where their lands converged. The papal proclamation of Universal Peace, which provided the respite enabling these meetings, was to have constituted the prelude to a united front against the rapidly expanding Ottoman Empire, fresh from its conquest of Egypt and knocking upon Europe's door.1 In celebration of both this Universal Peace and peace between France and England, Francis I and Henry VIII had long agreed to meet.2 Meanwhile, however, newly elected Emperor Charles V harbored fears that the weakest of the three monarchs, Henry VIII, would join his mighty rival Francis I in alliance against him and his possessions. Consequently, Charles arranged to meet Henry in May and again in July on both sides of Henry's summit with Francis in June.3 Amid intense dynastic and national competition and a rising tide of religious conflict, the grandly proclaimed peace would prove fleeting. In the following years not only would these three rulers repeatedly [End Page 123] find themselves at war, but Henry VIII would also famously break with the Papacy, and France would join in alliance with Suleiman the Magnificent's Ottoman Empire. Pope Leo X and Cardinal Wolsey's vision for Universal Peace had proved a chimera. Surely, then, the Field of Cloth of Gold, the grand Anglo-French tournament-cum-summit-meeting meant to seal the Peace, must have been no more than an extravagantly wasteful party marred by duplicity and empty rhetoric. This line of criticism dates back nearly to the event itself and was expressed cogently in a 1532 sermon by Bishop Fisher that set the tone for subsequent historiography.4 In a well-researched and perceptive history of the vast spectacle, The Field of Cloth of Gold, Glenn Richardson argues, however, that the failure of the aspiration to Universal Peace does not mean that the participants in the Field were insincere or unserious or that their extravagant spending was frivolous, but merely that they were unsuccessful.5 Richardson bookends his analysis with summaries of the political and diplomatic context that explain the rationale for the Field and the political stakes for all involved. Chapter 1, "European War and 'Universal Peace,'" sets the stage with an apposite passage from Shakespeare's Henry VIII. It then briefly introduces the major characters, the dramatic political context of the Italian Wars, and Charles V's contested Imperial election.6 Nearly in passing, Richardson notes that it was in 1519, in the context of preparing for the Field of Cloth of Gold, that resident ambassadors were first exchanged between France and England.7 Resident ambassadors perform a starring role in the traditional narrative of the development of modern diplomacy. In Richardson's account, the ambassadors play an essential part in organizing the Field, sending and receiving gifts, allaying concerns, relaying information, and serving as honorable proxies. The heralds who regularly appear—Garter King of Arms, Orléans King of Arms, Norroy King of Arms, and so on—have an unresolved relationship to the new resident ambassadors borrowed from fifteenth-century Italian practice.8 Greater reflection on the interaction of old and new, whether with cannons and knights or resident ambassadors and heralds, would have been welcome. Richardson's argument instead concentrates on likening the Field to modern patterns. He adopts Peter Gwyn's description of Cardinal Wolsey doing "'shuttle diplomacy'" avant la lettre and makes comparisons with the Beijing Olympics.9 Above all, Richardson characterizes the Field as a prototype of summit diplomacy, citing the modern litany from the Big Three at Tehran, Potsdam, and Yalta through Nixon in China to Reagan and Gorbachev in Reykjavik.10 [End Page 124] Richardson begins with the simple, yet powerful "premise that people do not generally spend huge amounts of money on major social and political events...

Italian Practice in the Implementation of International Targeted Sanctions: Enhanced Protection or Additional Complexities?

The proliferation of UN and EU targeted sanctions and their potential impact on individual rights and private interests require constantly monitoring how Member States implement such restrictive measures within their own domestic legal systems. This article focuses specifically on Italian practice in the implementation of UN and EU-mandated targeted sanctions. In so doing, it first dissects the relevant legal framework currently in place at the domestic level, taking into particular account the main novelties brought about by legislative decree (D. Lgs.) No. 90/2017. It then underscores some critical issues and shortcomings potentially stemming from its practical application. Finally, this article purports to examine the recent institution of a “domestic sanctions regime” and questions whether it might, in practice, end up rising additional grounds of concern, other then those already emerging from the implementation of UN and EU-mandated targeted sanctions, especially in terms of lack of adequate procedural guarantees for alleged human rights violations.

Italian Judges and Judicial Practice in Libya: A Legal Experiment in Multinormativity

Italian Judges and Judicial Practice in Libya: A Legal Experiment in Multinormativity

Funds Reimbursement of High-Cost Drugs in Gastrointestinal Oncology: An Italian Real Practice 1 Year Experience at the National Cancer Institute of Naples.

Introduction: The therapeutic scenario of Oncology is enriching of innovative agents which are determining an increase in public expenditure because of their high cost. In Italy, a web-based government Registry is used to monitor the clinical use of these drugs and, in later phases, to obtain funds reimbursement according to specific economic agreements with companies.Methods: A health policy expert Pharmacist was included in the multidisciplinary team of the Department of Abdominal Oncology of the National Cancer Institute (NCI) of Naples “G. Pascale Foundation” in order to improve the management of the Registry for oncologic drugs monitoring. Pharmacist activities were: basal data registration, prescription appropriateness, drug request, response monitoring, toxicity reporting, follow-up, reimbursement request. These activities were conducted in strict interrelation with clinicians. The source of data were medical records and a web-based national reimbursement platform. The analysis of the economic impact of this strategy was descriptive and it was indicated as resources recovery comparing 2 years: 2015 vs. 2016. The currency reference used was the Euro (€).Results: A total of 932 patients were followed-up and registered, 365 treatments are ongoing at the Department of Abdominal Oncology (NCI of Naples, Italy). The most prescribed biologic drug in advanced gastrointestinal cancers was bevacizumab. Compared to the year 2015, in 2016 we recorded a strong increase of reimbursements: EUR 881.712,42 vs. EUR 214.554,98.Conclusions: We suggest that the reimbursement process can be improved when a health policy reimbursement professional Pharmacist is integrated in the multidisciplinary team along with clinicians.

Subcutaneous implantable cardioverter defibrillator implantation: An analysis of Italian clinical practice and its evolution

BackgroundThe subcutaneous implantable cardioverter defibrillator (S-ICD) is a relatively novel alternative to the transvenous ICD for the treatment of life-threatening ventricular arrhythmias, and is currently used in the clinical practice of several centers. The aim of this analysis was to describe current Italian practice regarding S-ICD implantation and its evolution over the years. MethodsWe analyzed 607 consecutive patients (78% male, 48 ± 16 years) who underwent S-ICD implantation in 39 Italian centers from 2013 to 2017. ResultsStructural cardiomyopathy was present in 78% of patients and 30% of patients received their device for secondary prevention. The proportion of patients with dilated cardiomyopathy and with left ventricular ejection fraction ≤35% increased from ≤2014 to 2017 (from 38% to 58%, from 33% to 53%, respectively; both p < 0.05). Almost all procedures (97%) were performed in electrophysiology laboratories. Over the last 4 years, the 2-incision implantation technique has been widely adopted, with sub- or inter-muscular positioning of the generator, under local anesthesia or deep sedation (≤2014 versus 2017: all p < 0.001). Defibrillation testing was performed in 81% of patients. Shock energy of ≤65 J was successful in 93.9% of patients and the overall cardioversion success rate at ≤80 J was 99.8%. ConclusionsOur analysis confirmed that the S-ICD continues to be preferentially used in specific patients (younger, less frequently with dilated cardiomyopathy and low ejection fraction.). Nonetheless, we noted a trend toward the wider use of S-ICD in patients with dilated cardiomyopathy and systolic dysfunction over the years. Novel approaches have been adopted while the acute efficacy of the system has remained stably high.

Abstract P4-21-11: T-DM1 in HER2 positive advanced breast cancer patients: Real world practice from a multicenter observational study

Abstract Background: T-DM1 showed remarkable activity in metastatic HER-2 positive breast cancer (mBC) and it was recently approved for clinical use in patients (pts) who previously failed Trastuzumab- and Taxanes-based therapies. Currently, little is known on the performance of T-DM1 in a “real life” scenario. Therefore, we investigated effectiveness and safety of T-DM1 in Italian daily practice. Methods: Pts baseline characteristics and clinical outcome of pts with HER-2 positive mBC treated with T-DM1 between 2013 and 2015 at 20 Italian Institutions were retrospectively collected and analyzed. Results: 300 pts were included in our analysis. Median age was 51 years (27-78); visceral metastases were present in 204 (68%) pts and brain metastases in 86 (29%). It is noteworthy that 111 (37%) pts received T-DM1 as pure second line, 83 (28%) as third line and 96 (32%) as further lines. Moreover 10 (3%) pts had T-DM1 as first line because disease recurrence occurred during or adjuvant trastuzumab of within 6 months of its completion. The overall response rate (ORR) was 40%, global disease control rate (gDCR) 64%, median progression-free survival (PFS) 7.0 months (C.I.95%: 5.6-8.4) and overall survival (OS) at 2 years 63%. Pts with 1, 2 and 3 or more metastatic site had OS at 2 years of 87%, 67% and 46%, respectively (p&amp;lt;0.0001). When T-DM1 was given as second line the PFS was 8.0 months and beyond second-line was 6.8 months. Interestingly, for 38 (13%) pts who progressed after Pertuzumab-plus trastuzumab and taxanes as first line treatment, ORR and gDCR were similar to pertuzumab-naïve patients (38% and 62%, respectively) However PFS was 5.0 months (C.I.95%: 4.3-5.7) compared to 9.0 (95% C.I. 5.5-12.4) achieved in pts not receiving a previous pertuzumab-based treatment. Most frequent grade ≥3 toxicities were thrombocytopenia (2.6%), alopecia (2.1%), hypertransaminasemia (2.2%), neutropenia (1.3%), asthenia (1.3%) and diarrhea (0.4%). Conclusions: To our knowledge, this is the first real life, multicenter retrospective analysis evaluating efficacy and safety of T-DM1 in pretreated HER-2 positive mBC pts. We observed remarkable results in terms of PFS and OS, especially when T-DM1 was given early in the course of metastatic disease. Shortened PFS in patients progressing after pertuzumab suggest further analyses to better define possible molecular mechanisms of cross-resistences between two molecules. As a whole there was no evidence of significant or unexpected toxicities. Although these findings should be taken with caution due to the retrospective analysis and the different lines of previous treatment considered, we confirmed the potential therapeutic role of T-DM1 across a heterogeneous population of HER-2 positive mBC patients. The final analysis will be presented to the meeting. Citation Format: Fabi A, De Laurentiis M, Caruso M, Valle E, Moscetti L, Santini D, Cannita K, Carbognin L, Ciccarese M, Rossello R, Arpino G, Leonardi V, Montemurro F, La Verde N, Generali DG, Zambelli A, Scandurra G, Russillo M, Paris I, D'Ottavio AM, Filippelli G, Giampaglia M, Stani S, Fabbri A, Alesini D, Giannarelli D, Cognetti F. T-DM1 in HER2 positive advanced breast cancer patients: Real world practice from a multicenter observational study [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P4-21-11.

The Role of Premiums and Discounts in Business Valuation: Evidence from the Italian Context

The valuation of a (non-totalitarian) shareholding in capital stock is characterized by some critical conditions, which are mainly related to the fact that the transfer or acquisition of the same can determine the transfer of control from one subject to another. It follows that the value of the investment can not simply be equal to the proportional value of the share capital, but should include premiums or discounts. Discounts and premiums do not just affect the value of a company; they play a crucial role in influencing a host of other factors and conditions that can make or break a deal. When it comes to business valuations, it is the business appraiser’s responsibility to be intimately knowledgeable with every aspect of discounts and premiums: the different types, the situations when they may or may not apply, and how to quantify them. The paper has a twofold approach: on the one hand, it analyzes the main reference literature on the definition and characteristics of premiums and discounts and the recognition and quantification of the same; on the other, subsequently, it examines the behavior adopted by the Italian professional practice in recognition and appreciation of prizes and discounts.

Mozart’s Italianate Response to Haydn’s Opus 33

It has become a commonplace that the publication of Haydn’s string quartets Op. 33 prompted Mozart’s return to this genre in 1782. The latter’s Op. 10 quartets have been considered as attempts either to imitate or to contradict Haydn’s ‘models’. The present article, in contrast, focuses on the Italian influence on Mozart’s string quartets, from the ‘Lodi’ quartet K. 80 and the ‘Milanese’ series to his Haydn dedication set. In the context of a mostly unknown contemporary Italian repertory, several aspects of Mozart’s seemingly personal genre conception can now be related to Italian practice. Features of his early works are still extant in his ‘Viennese’ and ‘Haydn’ quartet series. In the latter, they coexist with the demonstrable influence of Haydn’s Op. 33. In comparison to Haydn, Mozart came from a different, probably Italianate tradition of quartet writing, to which he remained largely true.

‘Representations and Warranties’ in Sale and Purchase Agreements : The Italian Perspective

This article examines the Italian practice with respect to ‘Representations and Warranties’ in Sale and Purchase Agreements (SPA). The author has also analysed theories and case law referred in this article in another paper published in Italian language on a leading Italian review, namely Salatino, ‘Patto di garanzia’ nel contratto di acquisizione (‘Sale Purchase Agreement’), in Giurisprudenza Commerciale 891/II (2015), no. 5. In particular, this article is a simplified version of the Italian one, and its aim is to share the analysis with non-Italian speaking practitioners to provide general information on compliance with Italian law that provisions contained in representations and warranties may trigger, and how to resolve such issues.

Current status of laparoscopy for acute abdomen in Italy: a critical appraisal of 2012 clinical guidelines from two consecutive nationwide surveys with analysis of 271,323 cases over 5years.

Several authors have demonstrated the safety and feasibility of laparoscopy in selected cases of abdominal emergencies. The aim of the study was to analyse the current Italian practice on the use of laparoscopy in abdominal emergencies and to evaluate the impact of the 2012 national guidelines on the daily surgical activity. Two surveys (42 closed-ended questions) on the use of laparoscopy in acute abdomen were conducted nationwide with an online questionnaire, respectively, before (2010) and after (2014) the national guidelines publication. Data from two surveys were compared using Chi-square or Fisher's exact test, and data were considered significant when p<0.05. Two-hundred and one and 234 surgical units answered to the surveys in 2010 and 2014, respectively. Out of 144,310 and 127,013 overall surgical procedures, 23,407 and 20,102, respectively, were abdominal emergency operations. Respectively 24.74% (in 2010) versus 30.27% (in 2014) of these emergency procedures were approached laparoscopically, p=0.42. The adoption of laparoscopy increased in all the considered clinical scenarios, with statistical significance in acute appendicitis (44 vs. 64.7%; p=0.004). The percentage of units approaching Hinchey III acute diverticulitis with laparoscopy in 26-75% of cases (14.0 vs. 29.7%; p=0.009), those with >25% of surgeons confident with laparoscopic approach to acute diverticulitis (29.9 vs. 54%; p=0.0009), the units with >50% of surgeons confident with laparoscopic approach to acute appendicitis, cholecystitis and perforated duodenal ulcer, all significantly increased in the time frame. The majority of respondents declared that the 2012 national guidelines influenced their clinical practice. The surveys showed an increasing use of laparoscopy for patients with abdominal emergencies. The 2012 national guidelines profoundly influenced the Italian surgical practice in the laparoscopic approach to the acute abdomen.

The Masters of the Bolognese Orthopaedic School.

Bologna is one of the most ancient cradles of medical knowledge, as the city hosts one of the oldest medical faculties in the world. Among its best known institutions there is the Rizzoli Orthopaedic Institute, founded in the late nineteenth century, whose history is strictly connected with the evolution and development of the Italian orthopaedic practice of the last 120 years. The present manuscript acknowledges the main contributions by Francesco Rizzoli, Alessandro Codivilla and Vittorio Putti, who prompted the foundation and the international recognition of the Rizzoli Institute and the related Bolognese Orthopaedic School.

Hepatitis C viraemia after apparent spontaneous clearance

Vertical transmission of hepatitis C virus (HCV) from infected mothers to their infants occurs in less than 10% of cases, but is the main route of infection in children today following eff ective screening of blood and blood products. Diagnosis is made by detection of HCV RNA in blood at 4–12 weeks of age or at 12 months. Spontaneous seroconversion in this group, defi ned as absence of detectable HCV RNA on two occasions 6 months apart, is less than 10% in the UK, and to date has been considered to be permanent. In The Lancet, Indolfi and colleagues report an unusual case in which a child who was infected with HCV genotype 2a from his mother underwent spontaneous seroconversion at 55 months of age, but relapsed 3 years later. The authors discount reinfection because there were no relevant risk factors and the child’s mother had been successfully treated and was no longer infectious. Genetic sequencing confi rmed only minor changes in the viral genotype so the relapse was not due to a de-novo infection, and they found no evidence of immunodefi ciency or autoimmune disease, which might encourage latent infection to emerge. So what lies behind the relapse and what are its implications for current practice? The fi gure shows that HCV RNA was detected at 3 months of age when alanine transaminases (ALT) were normal. Over the next 52 months, there were fl uctuations of raised ALT associated with a steady fall in viral load until HCV RNA became undetectable. This clinical course would be compatible with the acute hepatitis described in adults and infants and could represent the activation of HCVcell mediated immunity seen in transiently infected children, which might not be present in tolerant children without evidence of hepatic injury. Although 40% of adults with acute hepatitis C seroconvert, these data are not available for infants in the UK because guidelines— unlike those in Italian practice—recommend testing only at 4–12 weeks of age and then annually, so would miss this clinical pattern. The child’s HCV RNA became undetectable by the assay used, and whether his immune status changed to allow more effi cient viral replication, or whether the infection was latent, is diffi cult to prove. It might be that the child did not seroconvert but the level of HCV RNA was too low for detection during that time, but this is less likely. This single case report is insuffi cient evidence to change practice, but if similar cases are reported, HCV RNA that is negative for more than 6 months might be a more reliable proof of seroconversion. While the child was negative for HCV RNA, the ALT levels remained normal and did not rise again until the HCV viral load rose substantially. The authors are planning to treat the child with invasive antiviral therapy, but my recommendation would be to wait and see a little longer because the hepatic infl ammation might again revive the child’s immunity and he could seroconvert once again.

Detecting a Feminist Reading Model:

ABSTRACT: This article demonstrates how Chilean Marcela Serrano's fiction posits a political value for women readers in bonding through texts. It argues there is clear evidence of a project to model text-mediated relationships with and among her readers that can encourage women to construct more rewarding self-definitions. This project's logistical hub resides in Serrano's Nuestra Señora de la Soledad (1999), a novel that features a female detective and exhibits for women readers a step-by-step approach toward establishing empowering connections. This article examines this process of reading-to-connect as instantiating the feminist model of reading based on intersubjective encounters among woman reader, text, and woman writer discussed in Schweickart (1986), drawing on Adrienne Rich's search for connection with Emily Dickinson. To provide insight into the dynamics of cultivating reading-based bonds, both within and beyond Serrano's text, this articles uses conceptual tools from Italian feminism's practice of relations. To assess Serrano's putative project of connecting women through the writing and reading of female characters' life stories, it adduces results from a reader response questionnaire conducted with a sample of Serrano's readers. Their responses indicate that reading Serrano's fiction can open up for women readers a space of female sociality that validates and encourages female desires.

How ‘il caffé sospeso’ became ‘suspended coffee’: The neo-liberal re-‘invention of tradition’ from Bourdieu to Bourdieu

Abstract This article analyses the way in which il caffè sospeso, an old Italian tradition of giving needy people a free coffee, has become ‘suspended coffee’, a current trend in the United States. This study explains the Italian phenomenon through Bourdieu’s ‘classic’ theory linked to food as provider of social distinction, distance from reality and culinary capital. To explain the new American model, this article builds on Bourdieu’s later work on neo-liberalism. This double theoretical approach enables a double methodological approach. The old Italian practice is investigated through Bourdieu’s historical field analysis. The American, neo-liberal model is studied through political economy analysis of websites owned by the companies supporting suspended coffee. The results show that in Italy il caffè sospeso was an opportunity for the donor to gain social distinction thanks to distance from reality, not providing the poor with something more necessary than a coffee. In the United States, private companies have taken hold of this tradition and altered the old relationship between donor and receiver. Giving is no longer spontaneous. Companies advise/force their clients to donate and confer culinary capital to ‘elected’ customers on their websites, with texts aiming to advertise rather than to inform. In conclusion, neo-liberalism exploits old traditions for commercial reasons.

Death to Tyrants! Ancient Greek Democracy and the Struggle against Tyranny by David A. Teegarden

BOOK REVIEWS/COMPTES RENDUS 181 and Italian), but because—with the exception of the “mask” of the “furious mother”— the similarity between dogs and women in ancient Greece is not confined to qualities attributed to female dogs (bitches) as such. Rather, it is dogs as a class that are culturally gendered as feminine, in structural opposition to the “masculinity” of wild beasts such as the wolf (142–153). (One might compare the modern English construction of cats as “feminine” as opposed to the “masculine” dog.) This makes perfect sense, yet “bitch” keeps intruding, starting with the dust jacket, which asserts, bafflingly, that in ancient Greece “the word bitch” was “exclusively figured as female.” In the book itself, “she-dog” and “bitch” sometimes appear on the same page in a way that seems arbitrary (e.g., 125). And what are we to make of “bitchiness” and “bitchy” on 153? The word and its cognates would have been better avoided entirely. Such quibbles aside, Shameless not only translates but supersedes the Italian original. It has been significantly updated and revised, and also sports a substantial new Appendix. This explains the project’s genesis and methodology and provides a valuable introduction to the field of animal studies, with a useful survey of the relevant scholarly literature (including the decade subsequent to the Italian edition). Much of this is introductory in a methodological sense, and as such will be of great interest to classicists (and others) who may be entering this burgeoning subfield for the first time. I wish, in fact, that Franco had used this material to create a new introduction to the book, relegating just the survey of literature to the Appendix. That would have been a more effective way to invite her readers into the world of animal studies and locate this particular project in its larger intellectual framework. The English edition does, however, have a new Preface. Here Franco explains that she has eschewed the “British and American” practice of “setting out one’s thesis statements at the head of the work,” in favor of the allegedly Italian practice of presenting one’s hypothesis as a “riddle,” making the path to the conclusion “both more enjoyable and more informative” (vii–viii). Disoriented readers are therefore advised to start with the Conclusion. But this is completely unnecessary, even for a died-in-the-wool AngloAmerican like myself. The argument is perfectly clear from the outset (even in the Italian edition), and the structure of the book will pose no obstacle to Anglophone readers. I very much hope that no reader is deterred by the oddly defensive tone of this Preface. Shameless is an exceptional book that should be read not only by students of gender and/or animal studies, but by anyone with a scholarly interest in ancient Greek cultural history or literature. The University of California Press is to be applauded for making this remarkable and ground-breaking work available to an Anglophone audience. University of Washington Ruby Blondell Death to Tyrants! Ancient Greek Democracy and the Struggle against Tyranny. By David A. Teegarden. Princeton and Oxford: Princeton University Press. 2014. Pp. xiv, 261. In this study, David Teegarden examines the ancient Greek legislation on tyrannicide . Beginning with the observation that the number of democracies increased during the classical and early hellenistic periods, he concludes that pro-democratic agents had developed effective methods to sustain local democratic regimes over time and identifies tyrant-killing legislation as one of their core measures. By encouraging bold individuals 182 PHOENIX to kill (potential) tyrants and by convincing others that such actions were acceptable, the laws and decrees against tyrants facilitated mobilization in the face of anti-democratic threats. To verify these assumptions, Teegarden analyzes six cases: tyrant-killing laws from Athens, Eretria, and Ilion, the Anti-Tyranny Dossier from Eresos and the Philites Stele from Erythrai. Unquestionably, an up-to-date study of tyrant-killing legislation was necessary. The last contribution to this subject by Hans Friedel was published in 19371 and two relevant inscriptions have been discovered since then. Moreover, while Friedel locates the tyrantkilling laws within the broader context of anti-tyranny discourses in ancient Greece, Teegarden recreates the historical and...

Sacral neuromodulation and Botulinum toxin A for refractory idiopathic overactive bladder: a cost-utility analysis in the perspective of Italian Healthcare System.

To assess the relative cost-effectiveness of two therapeutic strategies: one starting with sacral neuromodulation (SNM) versus one starting with Botulinum toxin A (BTX-A) for the management of refractory incontinent idiopathic overactive bladder (OAB) patients, from the perspective of the Italian National Health Service (INHS). Direct medical costs (<euro>2011) and benefits (quality-adjusted life years-QALYs) were assessed over a ten-year time frame adapting to the Italian practice a published Markov model. Clinical inputs were based on the published literature and on the expert opinion. Resource consumption rates were provided by clinical experts; unit costs were collected from a single hospital accounting and from standard tariff lists and public prices. Interventional procedures and management of adverse events were costed through a micro-costing approach. The primary outcome was incremental costs per QALYs gained (i.e. differential costs divided by differential benefits). Deterministic (DSA) and probabilistic (PSA) sensitivity analyses were conducted to assess the robustness of the model. Starting with SNM appears to be cost effective (i.e. under <euro>40.000/QALY) from year three (<euro>21,259/QALY) onwards and becomes dominant (i.e. more effective and less costly) at year ten: cumulative costs were <euro>32,975 for early SNM and <euro>33,309 for early BTX-A, while cumulative QALYs were 7.52 and 6.93, respectively. At year ten, DSA suggests the results robustness and 99.8 % of the PSA iterations fell within the cost-effectiveness threshold. A therapeutic strategy starting with SNM may be considered cost effective in the midterm and cost saving in the long-term treatment of idiopathic OAB from the INHS perspective.

Susan Byrne Law and History in Cervantes’ Don QuixoteLaw and History in Cervantes’ Don Quixote. Susan Byrne. Toronto: University of Toronto Press, 2012. Pp. xiv+240.

<i>Susan Byrne</i> Law and History in Cervantes’ <i>Don Quixote</i><i>Law and History in Cervantes’ <i>Don Quixote</i></i>. Susan Byrne. Toronto: University of Toronto Press, 2012. Pp. xiv+240.

Seismic performance of ductile connections between precast beams and roof elements

The seismic vulnerability of precast reinforced concrete buildings is often governed by the performance of mechanical connections between precast elements. This aspect was highlighted by recent seismic events in Italy, where several collapses were registered among industrial buildings typical of Italian practice. The building damage was related to failure of connections between beams and columns and between beams and roof elements, which led to the loss of support of the structural elements. Starting from the results of an experimental campaign, the present work investigates the use of ductile connections between precast beams and roof elements suitable for both new structures and as a retrofit measure of existing ones. These connections are able to transfer the horizontal inertial loads and to accommodate deformations arising from seismic displacement compatibility. The relative rotation between the end of the roof elements and the beam, owing to seismic displacement demand, could lead to their contact. This leads to a load increase in rigid connections, which can cause their premature failure, or to horizontal relative displacements as in the ductile connections considered herein. Moreover, the connections investigated could be used to dissipate seismic energy.

Valutazione economica in base allo studio NAVoTRIAL01 con riferimento al contesto sanitario italiano: Vinorelbine orale e Cisplatino o Pemetrexed e Cisplatino seguiti da mantenimento rispettivamente con Vinorelbine orale e Pemetrexed nel trattamento del Carcinoma Polmonare Non a Piccole Cellule Non Squamoso (NS-NSCLC) in stadio avanzato

Background Vinorelbine and Cisplatin is a standard treatment in non small cell lung cancer; oral Vinorelbine is registered in 45 countries. Pemetrexed and Cisplatin are recommended in front-line chemotherapy of non-squamous non small cell lung cancer (NS-NSCLC). An economic evaluation of oral Vinorelbine plus Cisplatin and Pemetrexed plus Cisplatin was implemented in NS-NSCLC patients, adopting specific costs and clinical settings reflecting the Italian practice.

Implementing Strategic Environmental Assessment of spatial planning tools: A study on the Italian provinces

After more than a decade from the publication of the European Directive 2001/42/CE (Directive) on Strategic Environmental Assessment (SEA), the design and construction of the interested spatial planning instruments has gone through a variety of changes and integrations in European and in world states. This inhomogeneous panorama can be explained with a pattern of institutional structures that have so far affected the implementation of the Directive. The aim of this paper is to investigate the level of implementation of the Directive in Italy by developing a comparative analysis of the quality of integration of SEA within the design of the spatial coordination plan of a set of Italian provinces. Italian practice is analyzed in the framework of a comparative study of worldwide SEA implementation within spatial and land use planning. The results reveal strengths and weaknesses in SEA implementation at the provincial level and, in particular, the emergence of critical areas of research concerning institutional context, public participation, monitoring, and observatory of the spatial transformations.