Journal articles on the topic 'Metodo dei momenti'

Michele De Lucchi racconta che la presenza di due maestri come Ettore Sottsass e Achille Castiglioni gli ha permesso di coniugare il disegno alla riflessione, insegnandogli da un lato l'importanza di fissare sulla carta l'idea quando giunge nella mente e dall'altro l'amore per il dialogo e l'ironia che fa crescere le idee per farle diventare progetti. La duplice influenza del mondo anglosassone e del mondo latino, che il suo studio ha sempre voluto avere, consente di mantenere separati o di unire, a seconda delle esigenze, momenti razionali e momenti istintivi: un team internazionale mantiene in equilibrio i due aspetti del fare progettuale. Il processo di costruzione di un'architettura, che spontaneamente porterebbe subito a una risoluzione formale, deve invece essere condotta lungo i binari della definizione funzionale, distributiva, degli spazi e dei percorsi. L'insegnamento č stato intrapreso da Michele De Lucchi come mezzo di sintesi e definizione del proprio metodo progettuale. Il nuovo modello che egli vuole trasmettere č quello dell'uomo artigiano, descritto da Richard Sennet: nel lavoro che svolge il progettista deve mettere un impegno personale che lo conduca alla gratificazione emotiva.

Dino Buzzati e Tawfiq al-Hakim si sono accorti di una delle sfide umane cioè la battaglia fatale contro il tempo. La sconfitta cui sono predestinati gli uomini, più che altro la gente della caverna e Drogo, i quali -grazie alla loro vita legata a momenti storici critici oppure a ruoli di maggiore importanza rispetto agli altri- indirizzano l’attenzione a questa lotta contro il tempo. Ogni autore ha scelto un genere e un metodo diverso per presentare la propria visione impiegando protagonisti di particolari caratteristiche, il suo bagaglio culturale, sociale e le sue esperienze private. Il mio metodo è basato su uno studio comparativo. La tesi cerca di specificare i punti che accomunano due culture, quella araba e italiana, e di mettere in rilievo le differenze alla pari. Il paragone fatto nella tesi è stato autenticato dalla lettura delle monografie e dei libri più importanti che riguardavano gli autori studiati. Inoltre ho analizzato le diverse idee delle opere in modo da evidenziare il concetto della lotta secondo gli scrittori, i quali impiegano quest’idea per trasmetterci le loro prospettive di vita e i loro pensieri.

Fra le arti figurative comprese in quelle cosiddette “belle”, cioè le forme di attività che, secondo l'opinione del Vasari, hanno esclusivamente un fine di bellezza, un valore estetico, come l'architettura, la danza, la poesia, la pittura, la scultura e la musica, in questo articolo focalizziamo l'attenzione sulla pittura e su di una sua particolare espressione e manifestazione, irripetibile ed originalissima.Le composizioni pittoriche che rappresentano eventi e situazioni di vita vissuta o configurazioni di ambienti costituiscono tutte una fonte conoscitiva di inestimabile valenza. Agli attenti osservatori esse costituiscono archivi storici e giacimenti culturali di particolare ampiezza ed intensità.D'altra parte è arte anche il complesso delle tecniche, degli strumenti e dei loro metodi d'uso concernenti una realizzazione, un'applicazione pratica nel campo dell'operare umano; cosicché è possibile scrivere di arte riferendosi ora ad un mestiere ora ad una professione. Si ha così l'arte medica, l'arte forense, etc., ma anche l'arte contabile, quella cioè esercitata da coloro che si mostrano capaci di memorizzare e di sistematizzare, seguendo un metodo preordinato e rigoroso, i fatti amministrativi, ridotti in termini quantitativi – monetari, che caratterizzano l'attività economico – finanziaria realizzata da una qualunque azienda, in modo da offrire al gestore informazioni determinanti per il buon governo dell'azienda medesima.L'obiettivo conoscitivo dell'arte contabile rimane costante nel tempo, ma gli strumenti ed il loro metodo d'uso, relativi a quell'arte, cambiano mano a mano aumenta il bagaglio delle conoscenze concernenti l'efficace utilizzo a fini gestionali dei risultati contabili rilevati periodicamente. Nel nostro studio intendiamo riferirci all'arte contabile esercitata nel Medioevo nell'ambito di famiglie di mercanti, banchieri, amministrazioni comunali, ospedali, opere pie e congregazioni religiose. In particolare, vogliamo trattare dell'ufficio della Biccherna del Comune di Siena preposto alla gestione delle pubbliche risorse finanziarie. Esso era composto da un “presidente” - il Camarlingo - e da quattro Provveditori in carica per sei mesi.I registri contabili sui quali il Camarlingo annotata giornalmente le varie operazioni finanziarie erano a fogli mobili e, pertanto, inizialmente venivano tenuti assieme da un foglio più grande sul quale veniva scritto il periodo di riferimento ed il nome del Camarlingo. Successivamente, per tenere uniti i numerosi fogli contabili si incominciò ad usare del materiale rigido, appunto delle tavolette di legno, la cui consistenza e rigidezzarendevano più agevole l'adozione e la consultazione dell'insieme dei fogli contabili relativi ai vari semestri.Le due tavolette, quella superiore e l'altra inferiore, erano legate da lacci di cuoio che costituivano la costola e sul davanti veniva posta una fibbia di chiusura, in modo da formare un vero e proprio “libro”. Fu proprio per sopperire all'anonimicità ed alla ripetitività di quei libri che, almeno a Siena, si affermò l'uso, a partire dal 1257, di far dipingere le tavolette di legno che tenevano legate e congiunte le pagine del libro contabile.Molti e di grande fama furono i pittori senesi che dipinsero le tavolette della Biccherna: Duccio di Boninsegna, Ambrogio Lorenzetti, Giovanni di Paolo, Sano di Pietro, Domenico Beccafumi e molti altri. I pittori per lo più disegnavano l'ambiente principale della Biccherna, quello in cui si svolgevano le transazioni finanziarie e, talvolta, gli operatori dell'ufficio: il Camarlingo, i Provveditori e qualche cittadino raffigurato mentre pagava le imposte. Sul tavolo da lavoro si disegnavano spesso gli strumenti per l'esercizio dell'arte contabile: libri, penna, calamaio, grattino, forbici, monete, borse etc.È così che scorrendo le numerose rappresentazioni pittoriche delle tavolette, raccolte per lo più nell'Archivio di Stato di Siena, altre fanno bella mostra di sé nei maggiori musei del mondo, possiamo leggere, in estrema sintesi, alcuni significativi aspetti dell'evoluzione culturale della comunità medievale senese. Da esse possiamo trarre informazioni immediate non solo dei cambiamenti nell'arte pittorica adottata dagli autori dei dipinti, ma anche sull'organizzazione dell'Ufficio finanziario del Comune, la Biccherna appunto, e l'importanzasempre maggiore che veniva attribuita agli strumenti indispensabili per esercitare l'arte contabile. Possiamo acquisire informazioni concernenti l'evoluzione del “metodo” adottato nell'annotare i dati finaqnziari relativi all'attività della Biccherna solo dalla lettura dei fogli compresi nei vari “libri”, ma tale obiettivo conoscitivo è complementare e collaterale rispetto a quello principale che ci siamo posti. Insomma, osservando in ordine cronologico le tavolette di Biccherna, si “legge il tempo” nella contemporaneità dei momenti di vita vissuta da Siena, dalla sua comunità e in particolare dal suo più importante Ufficio finanziario pubblico, la Biccherna.Lo studio intende evidenziate appunto la correlazione fra arte figurativa e arte contabile attraverso le tavolette dipinte dei libri contabili della Biccherna senese.

Il termine LISREL e l'acronimo di LInear Structural RELationship ed è nato inizialmente come nome di un software messo a punto dallo svedese Karl Joreskog e dai suoi collaboratori nei primi anni '70 per stimare, col metodo della massima verosimiglianza, i coefficienti strutturali dei modelli basati su sistemi di equazioni strutturali.Tali modelli, nella elaborazione tramite il LISREL, rappresentano la sistemazione logica, prima ancora che statistica o computeristica, di tecniche di analisi multivariata le cui prime proposte risalgono all'ininzio del secolo; riconducendo ad un unico modello che ne costituisce una geniale sintesi, approcci ed itinerari scientifici fino ad allora distinti e non comunicanti, quali l'analisi fattoriale, i modelli causali e i modelli di misurazione. In particolare rappresentano in questo momento la più completa e sistematica risposta al problema di operazionalizzare in termini di ricerca e di verifica empirica, nel campo delle scienze sociali, la controversa, ma non per questo meno fondamentale, nozione di causalità. Essi sono quindi la reinterpretazione, sistemazione e soprattutto generalizzazione di quelli che negli anni '60 venivano chiamati i modelli causali e che nella prima metà degli anni '70 avevano conosciuto una notevole popolarità fra i sociologi soprattutto attraverso la tecnica della path analysis.

L’Autore affronta la questione del metodo nella prospettiva personalista. Dopo aver chiarito che non esiste un metodo specifico della bioetica, se non nel senso che la bioetica non fa altro che assumere il metodo di indagine che è specifico della riflessione etica dalla quale dipende, l’Autore sottolinea che l’originalità della bioetica rispetto all’etica sta nell’insieme dei contenuti che essa affronta, ossia azioni e processi mediati dalla conoscenza scientifica e dalla prassi tecnologica. In particolare, viene proposta una riflessione su come è articolato il metodo triangolare proposto da Elio Sgreccia nel suo noto Manuale di Bioetica. Questo metodo si distingue dal proceduralismo di altre prospettive, sia per la sua connotazione contenutistica, che ha il suo perno in una concezione sostanzialistica della persona umana, sia per la sua struttura critica o dialettica. Nella connessione tra il dato medico-scientifico, il dato antropologico e il momento etico emerge il significato analogo della verità, concetto non confinato soltanto nel campo delle scienze sperimentali ma efficace anche sul piano etico. In tal senso, la bioetica emerge come una disciplina che si costituisce attraverso un percorso (il itriangolo) che ha il suo esito laddove il giudizio di coscienza è formulato in base alle verità acquisite ed integrate, in base ai diversi beni messi in gioco. Il momento prescrittivo, quello decisivo dell’indagine bioetica, non è assimilabile ad una pura deduzione dai principi morali ma si costituisce all’interno di un complesso itinerario teorico che tiene conto dei diversi approcci alla realtà.

RIASSUNTOScopo – L'analisi del rapporto tra costi di trattamento e gravità dei pazienti psichiatrici, raggruppati in classi omogenee. Disegno – Rilevazione prospettica dei costi e della gravità di 1371 pazienti psichiatrici adulti, in carico presso 2 Unità Operative di Psichiatria, osservati per un periodo medio di circa 9 mesi. I dati raccolti riguardano tutti i servizi psichiatrici delle Unità Operative, che comprendono quelli ambulatoriali, quelli residenziali e semi-residenziali e i Servizi Psichiatrici di Diagnosi e Cura degli ospedali per acuti. Setting – Le Unità Operative Psichiatriche di Magenta (MI) e di Desio (MI). Metodo – La gravità di ogni paziente è stata misurata attraverso la scheda HoNOS. La compilazione di questa scheda è stata effettuata al momento del reclutamento e in seguito con una cadenza mediamente trimestrale. Oltre alle schede trimestrali sono state previste compilazioni al momento dell'ammissione e della dimissione dai reparti ospedalieri di psichiatria, dai Centri Residenziali di Terapie psichiatriche e di risocializzazione e dalle Comunità Protette. Tutti i pazienti osservati sono stati raggruppati in base alla diagnosi principale (ICD-10) e al livello massimo di gravità dei problemi presentati durante l'intero periodo di osservazione. I costi presi in considerazione sono i soli costi diretti sostenuti dai servizi psichiatrici pubblici. La loro attribuzione ai singoli pazienti è avvenuta sulla base di costi standard o di tariffe (procedure diagnostiche), applicati alle quantità rilevate prospetticamente attraverso il Registro regionale, integrato con apposite schede. Risultati – Il costo complessivo realizzato dai 1371 pazienti osservati è risultato pari a 9771.1 milioni di lire, con un costo medio per paziente di 7127000 lire (ds 19499400). Il costo totale per giornat'a di osservazione è risultato pari a 27172 lire (ds 68358) e non risulta correlato alia durata del periodo di osservazione. La gravità media dei pazienti risulta pari a 4.26 punti (ds 3.73) al momento dell'arruolamento e pari a 3.19 punti (ds 3.26) al termine dello studio. Quella media, misurata attraverso i valori massimi della HoNOS osservati sull'intero periodo, risulta pari a 6.00 punti (ds 4.64). Gravità e costo del trattamento per singolo caso risultano direttamente correlati (r = 0.626, p = 0.0001). II raggruppamento dei pazienti ha portato a definire delle classi che presentano un punteggio medio di gravità complessivamente diverso (p = 0.0001). Diversi nel loro insieme risultano anche i costi medi di trattamento per classe (p = 0.0001). Conclusioni Tutti i pazienti psichiatrici adulti possono essere raggruppati in classi relativamente omogenee rispetto alia gravità e con costi di trattamento almeno in parte diversi. Uno studio più ampio forse potrebbe migliorare i risultati ottenuti e fornire la base per una diversa modalità di finanziamento dei servizi psichiatrici.

INTRODUZIONE:Stante come il numero degli accessi dei pazienti in un dipartimento di emergenza (ED) non possa essere pianificato con precisione, le risorse disponibili possono essere talvolta sovraccariche ("affollamento"), con conseguenti rischi per la sicurezza dei pazienti. OBIETTIVO:L’obiettivo del presente studio è stato quello di valutare l’efficacia di nuovo sistema di valutazione di triage presso il Pronto Soccorso di un’azienda ospedaliera italiana. MATERIALI E METODI: Studio pilota a due bracci; assegnazione ai due gruppi (valutazione standard –codice a 4 vs valutazione sperimentale – codice 5 colori) attraverso randomizzazione semplice. Sono state confrontate le valutazioni infermieristiche al momento del triage di ammissione con quelle al momento della dimissione.RISULTATI:Sono stati arruolati 1060 soggetti con “dolore toracico non traumatico” e 960 inquadrati come “disturbi neurologici acuti”; l’adozione del nuovo codice colore ha permesso una valutazione corretta del grado di gravità in oltre l’86% dei casi “cardiologici” e il 93% dei casi “neurologici”; il metodo standard ha permesso una valutazione corretta inferiore all’83% nei casi cardiologici e al 77% in quelli neurologici.CONCLUSIONI:I risultati emersi depongono a favore del nuovo sistema valutazione in triage infermieristico a cinque livelli; approfondimenti su campioni più ampi sono auspicabili.

Abstract: Golden moment is a term that refers to someone’s or church’s achievement and glory. It is not the utopian concept, yet a conviction and expectation based on God’s promise for His people. Some factors are required to achieve the golden moment, one of them is a Golden Seed. Imago Dei is a golden seed which gives an opportunity to the golden moment. This article has a purpose to gice a biblical view of imago Dei which is inside of every human. This article used a bible exposition method on Genesis 1:26, which explained that human was created in a frame of Imago Dei. The conclusion is, that imago Dei is a golden seed which enables every people has the golden moment. Abstrak: Golden moment merupakan istilah untuk menunjukkan sebuah masa keemasan seseorang atau gereja, seperti masa kejayaan atau pencapaian. Golden moment bukanlah konsep utopis, melainkan sebuah keyakinan dan pengharapan berdasarkan janji Tuhan bagi umat pilihan-Nya. Ada banyak faktor yang dibutuhkan untuk seseorang mencapai golden moment, salah satunya adalah: Golden Seed atau benih emas. Imago Dei merupakan benih emas yang dapat memberikan kesempatan setiap orang mencapai golden moment. Artikel ini bertujuan untuk memberikan pandangan biblikal tentang Imago Dei yang ada pada diri setiap manusia secara hakiki. Metode yang digunakan adalah eksposisi Kejadian 1:26, di mana menjelaskan tentang manusia diciptakan dalam kerangka imago Dei. Kesimpulannya, imago Dei merupakan benih emas yang memungkinkan setiap orang memiliki golden moment.

Il tema dell'umanizzazione è ormai entrato a pieno titolo tra quelli che una nuova cultura dell'assistenza sanitaria si sforza di promuovere. In quest'ambito un ruolo di primo piano spetta all'umanizzazione dell'assistenza alla nascita. E' un settore in cui si rilevano ancora insufficienze e inadeguatezze dovute a molteplici condizionamenti storici. Un globale progetto di umanizzazione dovrà tenere conto dei vari momenti che il nascere comporta. Innanzitutto il tempo dell'attesa, con le sue ansie, le sue difficoltà decisionali, le sue incertezze. Poi il momento del parto con i problemi relativi a una diversa accoglienza alla nascita, alla scelta tra i vari metodi di analgesia, al luogo in cui dare alla luce. E infine il "dopo" con le tipiche reazioni da adattamento psichico. Un panorama complesso, quindi, in cui a dir il vero qualcosa è già stato fatto ma molto resta ancora da fare.

Abstracttitle RIASSUNTO /title L'articolo esamina il dibattito sulla metodologia dell'economia politica che anim i circoli intellettuali anglicani degli inizi del diciannovesimo secolo. Ad Oxford, l'approccio all'economia politica era fortemente condizionato dalla riflessione critica sulle proposte epistemologiche avanzate da Dugald Stewart nel suo Elements of the Philosophy of the Human Mind. I pensatori dell'Oriel College che presero parte al dibattito erano preoccupati dal processo di rapida trasformazione della societ inglese, e dall'emergere di fonti di autorit culturale indipendenti dalla, se non apertamente contrarie alla Chiesa Anglicana ed alle Universit. La discussione della metodologia dell'economia politica investiva dunque diversi aspetti della vita sociale ed intellettuale del tempo. Il dibattito oxoniense ruotava intorno al parallelismo che molti credevano di notare tra il metodo della meccanica razionale e quello dell'economia politica. Pur avallando le pretese di scientificit avanzate dagli economisti classici, i docenti di Oxford negavano che i risultati ottenuti in economia politica fossero immediatamente applicabili alla realt sociale: al pari dei cultori della meccanica razionale, l'economista doveva tenere presenti le frizioni generate dalle esistenti strutture politiche e sociali. A Cambridge, William Whewell e Richard Jones valutavano con preoccupazione la difesa dell'economia politica elaborata dai colleghi di Oxford. A loro avviso, gli studiosi dell'Oriel College concedevano troppo all'economia politica ricardiana. Alla fine degli anni venti del diciannovesimo secolo, gli intellettuali cantabrigensi sottoposero a critica severa il preteso parallelismo tra meccanica razionale ed economia politica che i seguaci di Ricardo e i ?CTRLerr type="1" mess="Doute Cars isoles avec recollage" ?docenti di Oxford ponevano al centro delle loro riflessioni. L'economia politica, si diceva a Cambridge, era una disciplina troppo giovane per poter assumere procedure assiomatico-deduttive. Laboriose ricerche erano ancora da intraprendere, prima che si potesse procedere alla costruzione di un sistema di economia teorica. Il presente saggio sottolinea la centralit di Dugald Stewart nel dibattito sulla metodologia dell'economia politica dei primi decenni del diciannovesimo secolo. Si sostiene inoltre che la lettura critica delle tesi epistemologiche avanzate dallo Stewart rappresent un momento cruciale nella elaborazione della metodologia dell'economia politica proposta da John Stuart Mill. I risultati di questo studio impongono una revisione delle interpretazioni classiche dei dibattiti filosofici e culturali in genere del primo Ottocento inglese.

Superficie e profonditŕ indicano una dimensionalitŕ dal fuori al dentro, che richiama la topica di Freud e ha rapporti con alcune immagini derivate dalla fenomenologia di Husserl, che riguardano una concezione stratificata della psiche. I manuali diagnostici come i DSM esigono obbedienza e concedono come premio l'esattezza diagnostica, nei limiti della loro criteriologia. Essi provengono dalle concezioni di un empirista logico, Carl Hempel, e si basano sulla rinuncia alla validitŕ per accontentarsi del piů modesto criterio della affidabilitŕ tra osservatori. Se solo, perň, consultassimo un buon dizionario per esaminare i nostri termini, che, crediamo, in buona fede, neutri, ci accorgeremmo che corriamo il rischio di seppellire il nostro paziente in un nulla di parole artificiose, dal momento che il conoscere, nel nostro campo, non č solo sapere, ma ha la vibrazione del sentire. Siamo cioč costretti, in fondo, ad eleggere la soggettivitŕ a conoscenza, cercando di dare ad essa una consistenza. Karl Jaspers č partito da questo per forgiare il metodo psicopatologico della fenomenologia comprensiva, che ha per base uno strumento, la comprensione, Verstehen, vale a dire la capacitŕ dell'osservatore di mettersi al posto del paziente, grazie alle autodescrizioni, e, per empatia, cogliere i suoi vissuti, rivivendoli. Accanto a questa fenomenologia soggettiva, c'č quella oggettiva, che vuole accedere direttamente ai fenomeni psicopatologici. L'indagine fenomenologica obiettiva ha per momento iniziale la "riduzione", da intendersi come il metodo per il quale metto momentaneamente tra parentesi ogni teoria data, in modo da cercare di raggiungere una descrizione "pura" dei fenomeni. Metto tra parentesi e conservo: il metodo fenomenologico non č qui inteso come un rifiutare il sapere psichiatrico e psicoanalitico, ma come un esercizio, che permette di avvicinarsi a quella conoscenza implicita che non nega la conoscenza abituale. Si cerca quello che giŕ si sa, senza averne conoscenza esplicita e questo sapere implicito lo scopriamo in modo semplice e rigoroso, con uno sguardo attento alla descrizione di superficie. «Nel lavoro scientifico, dice Freud, č piů promettente affrontare il materiale che ci sta di fronte, per la cui indagine si apre uno spiraglio. Se lo si fa con scrupolo, senza ipotesi o aspettative preconcette, e se si ha fortuna, anche da un lavoro cosě privo di pretese puň scaturire l'appiglio allo studio dei grandi problemi, grazie al nesso che lega tutto con tutto, anche il piccolo col grande». Questo potrŕ forse dispiacere a chi ama le scorribande avventurose nello psichismo arcaico, ma forse la superficie puň dare piů interrogativi e celare piů misteri di quanto una teoretica dei primi palpiti di vita possa immaginare e permette comunque di stare col paziente nello stesso luogo in una prossimitŕ di incontro.

IntroduzionePer molto tempo, con il termine comparazione si individua il momento centrale dell'argomentazione razionale e soprattutto si afferma la direzione della riflessione logica sulla pratica di ricerca. Di conseguenza, si sostiene che i ricercatori dipendono dai logici, e sono questi che definiscono preventivamente le regole del corretto metodo di ricerca. Tale metodo consiste, per i razionalisti, nel piò e nel meno (cioè nella quantificazione). I logici cartesiani, infatti, usavano chiamare comparazione il confronto per appurare se qualcosa sia maggiore o minore, migliore o peggiore, di un'altra. Nella Logique de Port Royal, viene chiamato comparativo il giudizio per valutare se una cosa è piò o meno di un'altra (1662, II, X; 1969, 199). Questa definizione di comparazione non è dissimile dal «giudizio di confronto» della scolastica tomistica. Tuttavia, la differenza è nella maggiore enfasi posta sul concetto di quantità (il piò o il meno). Una simile definizione è strettamente connessa al tentativo di Cartesio (condiviso dai cartesiani di Port-Royal) di sviluppare la matematica come modello metodologico e come significato ultimo della natura. A proposito della metodologia cartesiana, essa ritiene indispensabile, all'esattezza di ogni raffronto, che ambedue i termini considerati consentano un piò o un meno, e quindi rientrino nel concetto generale di grandezza

RiassuntoScopo - (I) Operare una revisione critica degli studi che hanno indagato la frequenza dei disturbi psichici tra i pazienti della medicina generale, utilizzando come criterio un'intervista psichiatrica standardizzata; (II) discutere i possibili fattori all'origine delle diverse frequenze riscontrate; (III) mettere in luce il ruolo di primaria importanza che possono assolvere in questo campo gli studi multicentrici condotti grazie a programmi di collaborazione internazionale. Metodo - sono stati selezionati i lavori pubblicati nella letteratura internazionale tra il 1970 ed il 1993. La selezione è stata effettuata grazie ad una ricerca computerizzata, nel corso della quale sono stati incrociati i databases MEDLINE e Psychological Abstracts; questa è stata a sua volta integrata da una ricerca manuale, consistente neU'esame delle bibliografie contenute nei lavori cosi individuati e nella consultazione degli indici analitici delle principal! riviste psichiatriche internazionali. Infine, è stata consultata la bibliografia commentata, curata da Wilkinson (1985), relativa a lavori di interesse e pertinenza psichiatrici condotti nella medicina generale e pubblicati tra il 1977 ed il 1985. Risultati - Sono stati individuati 30 lavori, ma 9 sono stati esclusi, dal momento che replicavano dati già riportati in letteratura o presentavano limiti metodologici. È emerso cosi che indagini sulla frequenza complessiva dei disturbi psichici tra i soggetti che si rivolgevano ai servizi di medicina generale sono state finora condotte secondo procedure standardizzate solo in 13 Paesi. La frequenza dei disturbi psichici variava tra il 10% ed il 50% circa. Le possibili ragioni all'origine dellem diverse frequenze riscontrate sono state discusse alia luce di tre fattori: I) le caratteristiche dell'indagine; II) l'affidabilità e la confrontabilità delle categorie diagnostiche e dei sistemi nosografici utilizzati; e III) la diversa organizzazione dei servizi sanitari nei vari Paesi. Conclusioni - alia luce delle difficoltà che si incontrano quando si tenta di confrontare i risultati forniti da studi indipendenti condotti in Paesi diversi o perfino nello stesso Paese viene suggerito il ruolo di primaria importanza che possono assolvere in questo campo gli studi multicentrici condotti grazie a programmi di collaborazione internazionale.

I minori che entrano nel percorso di affido e adozione si trovano a dover affrontare la rottura del primo legame affettivo con la loro famiglia d'origine e l'inizio di un nuovo legame con quello dei genitori adottivi. In molti casi i minori prima di essere adottati, hanno inoltre transitato in diverse case famiglie, e/o sono passati da una o più esperienze di affido. In generale a una iniziale fase di "buon adattamento" del bambino seguono momenti di forte crisi (Brodzinsky et al., 1990). Alla luce di questo, i percorsi e i programmi rivolti alla tutela del minore e delle famiglie devono assumere dei metodi per la valutazione delle competenze genitoriali e la scelta di programmi di supporto e trattamento che siano rivolti alla relazione (Steele et al., 2003), alla costruzione dei legami affettivi (Hill & Schore, 2015), e informati sugli esiti del trauma (Porges, 2004), per evitare il ripetersi di esperienze dalla valenza abbandonica e traumatica per il minore stesso. L'obiettivo del presente articolo è quello di introdurre la Theraplay (Booth & Jernberg, 2010) e la Terapia diadica dello sviluppo, DDP (Huges, 2007; Huges et al., 2019) come piani di trattamento integrabili fra di loro, nelle diverse fasi del processo adottivo, che promuovono la connessione e il suo recupero a fronte di rotture nella relazione genitore bambino, attraverso sedute alternate di gioco strutturate, di dialogo, in un clima comunicativo di tipo affettivo e riflessivo basato sulla giocosità, amorevolezza, accettazione ed empatia e curiosità fra le parti (Lender, et al., 2005).

- Una formazione moderna e culturalmente aperta č uno degli strumenti fondamentali per garantire alla magistratura un livello professionale adeguato e, conseguentemente, la credibilitŕ di cui ha bisogno. Per questo, nel momento in cui sta per vedere la luce la Scuola della magistratura, č utile uno sguardo alle esperienze dei Paesi a noi vicini. Anzitutto a quella francese, che conosce una fra le piů riuscite e originali strutture formative. Ma anche a quelle di altre realtŕ europee di recente analizzate in una interessante ricerca dell'Institut des Hautes Etudes sur la Justice. Comuni a tutte queste esperienze sono l'applicazione di metodi formativi partecipati e l'attenzione anche a discipline non giuridiche e al rapporto con soggetti esterni alla magistratura.

In questo articolo, viene presentato un approccio pragmatico alla pratica di lavoro in NPI, che si propone di fondere e adattare al contesto dei servizi di NPI due strumenti - il SAT di Klagsbrun e Bowlby e il metodo invariabile di Selvini e Prata - eterogenei per concezione teorica sottostante e per obiettivi, nonché ispirati a paradigmi conoscitivi diversi. I vincoli definiti dal contesto sono visti infatti come prioritari rispetto alla teoria e agli strumenti diagnostici e terapeutici, in modo tale che ogni operatore deve adattare al contesto gli strumenti disponibili e quanto sa fare, non viceversa. Poiché la prassi della NPI in Italia č largamente basata sulla separazione tra genitori e bambini, sia nel momento diagnostico che terapeutico, questo formato č stato rispettato fondendo tra loro due strumenti che hanno in comune il tema della separazione. Le soluzioni adottate sono illustrate attraverso la sintetica presentazione della sintesi di due casi clinici.

Negli ultimi anni, nell’ambito delle ricerche per la Regolazione Naturale della Fertilità (RNF) si sono sviluppate diverse tecniche diagnostiche riguardanti i dosaggi ormonali, le sostanze contenute nel muco cervicale e la viscosità del muco: al fine di trovare un indicatore della fertilità semplice ed accurato, di cui la donna potesse servirsi. Il Monitor Ovarico ideato da Brown, attualmente usato in diversi Centri internazionali di insegnamento dei MN, è uno degli strumenti più precisi, attualmente disponibili, per monitorare l’attività ovarica; esso è in grado di individuare l’evento ovulatorio in un arco di 12 ore, e dimostra senza dubbi il momento in cui l’ovulazione è avvenuta. È uno strumento diagnostico di laboratorio che può essere utilizzato sia da coppie che desiderano distanziare una gravidanza, sia da quelle che la stanno ricercando, nel desiderio di aderire generosamente al Progetto di Dio sulla loro unione coniugale. Tuttavia, ogni strumento tecnico-diagnostico che studia la fertilità è da considerare un supporto scientifico ai Metodi Naturali (MN), ma non è in grado, da solo, di sostituirsi ad essi. La tecnologia, infatti, va accompagnata dalla proposta di un cammino di riflessione sul vero significato della Procreazione Responsabile. È l’insegnante dei MN che trasmette alla coppia quello “stile” di rispetto e attenzione per l’altro e di accoglienza della fecondità come dono, aiutandola a crescere nell’amore e nell’apertura alla vita.

Recenti dibattiti sulla Evidence-Based Policy hanno discusso le sue ipotesi metodologiche su come stabilire l'evidenza, e cioč la gerarchia della robustezza dei metodi nella valutazione degli effetti dele politiche. Minore attenzione č stata dedicata al modo in cui una politica č concepita all'interno di questo approccio, vale a dire come trattamento somministrato ad un paziente (target), al fine di ottenere uno specifico risultato, con l'obiettivo poi di essere generalizzato. Questa concezione si esprime in un quadro epidemiologico come ambito disciplinare, e presuppone un'analisi controfattuale come gold standard, che ignora il processo decisionale e di attuazione, e il ruolo degli stakeholders. Sia questo modo di concepire la politica, che quello di affrontare le diverse fasi del ciclo delle decisioni politiche sono in contrasto con altre metodologie basate su differenti presupposti disciplinari e teorici, in gran parte provenienti dalle scienze politiche. Gli approcci basati sulla "razionalitŕ sinottica" considerano le politiche come interventi basati su una logica di obiettivi-mezzi-risultati, prendendo in considerazione le tre fasi, come momenti separati, e seguono una valutazione basata sugli obiettivi (goal-oriented evaluation). Gli approcci basati sulla "razionalitŕ incrementale" guardano alle politiche come ad un insieme di relazioni complesse che si sviluppano durante l'implementazione, durante la quale le politiche vengono ri-definite. I diversi approcci sono confrontati sulla base del loro modo di considerare ciň che accade durante il processo decisionale, l'attuazione del programma e la valutazione; qual č il significato di valutare gli effetti (causalitŕ), il loro modo di affrontare il contesto, e il modo in cui consentono la partecipazione dei beneficiari.

L'eziologia della disabilitŕ cognitiva grave č molto complessa, tanto che la causa di questa condizione clinica rimane ancora oggi non identificabile nel 40% circa dei casi. L'inquadramento diagnostico č perň un'esigenza concreta delle famiglie, per tentare di avere piů informazioni possibili sulla prognosi della patologia, sulle possibilitŕ e metodi terapeutici piů appropriati, sui rischi di ricorrenza familiare. I metodi utilizzati per l'inquadramento diagnostico sono di tipo clinico, strumentale e laboratoristico citogenetico-molecolare. Dal punto di vista clinico l'approccio prevede la ricostruzione dell'anamnesi familiare, la raccolta di dati sul decorso della gravidanza, sul periodo neonatale e sulla storia clinica dalla nascita al momento dell'osservazione. Si stima che il 4-35% (in media 15%) dei casi di disabilitŕ cognitiva sia riconducibile ad eziologia cromosomica. Le tecniche di citogenetica molecolare sono progressivamente migliorate negli ultimi anni, con la possibilitŕ di aumentare la sensibilitŕ di diagnosi per le sindromi da microanomalia cromosomica (con la tecnica CH-Array). La sindrome dell'X fragile costituisce una delle piů frequenti cause di disabilitŕ cognitiva nei soggetti di sesso maschile, specialmente nei casi a ricorrenza familiare della patologia. Il numero delle sindromi monogeniche associate a disabilitŕ cognitiva č altissimo, e si tratta sempre di patologie singolarmente rare. In questo ambito č importante saper identificare caratteristiche cliniche che possano orientare verso una patologia specifica, allo scopo di poter ipotizzare una diagnosi clinica ed eventualmente mirare i test genetici nei casi di sindromi ad eziologia attualmente nota. Sono utili, in questo ambito, il riscontro di dismorfie particolari orientative per una sindrome specifica, la caratterizzazione anatomica delle malformazioni associate o l'eventuale presenza di epilessia, la definizione di un fenotipo comportamentale e cognitivo specifico. Č importante anche la rivalutazione clinica nel tempo, per cogliere segni di significato diagnostico che possono comparire in etŕ diverse della vita di un bambino.

Introduzione. Le linee guida sono delle raccomandazioni con diversi livelli di evidenza scientifica messe a punto dagli esperti individuati dalle Autorità Regolatorie e dalle Società Professionali per consentire i migliori standard di intervento diagnostico e terapeutico al momento disponibili. Con la Legge 24/2017 in Italia sono diventate di osservanza giurisprudenziale, anche se a tutt’oggi mancano ancora le raccomandazioni ministeriali previste. Scopo. L’obiettivo dello studio è la valutazione nella pratica ambulatoriale cardiologica corrente dell’adesione alle linee guida della Società Europea di Cardiologia (ESC) riguardo i 3 principali fattori di rischio cardiovascolare: quelle sull’ipertensione del 2018, sulle dislipidemie e diabete mellito del 2019. Sono state valutate le criticità cliniche, amministrative ed organizzative che rendono difficoltosa la loro applicazione. Metodi e risultati. I target di valori pressori raccomandati dalle linee guida europee nei pazienti con sindrome coronarica cronica ipertesi comportano difficoltà decisionali soprattutto riguardanti la persistenza di valori di pressione sistolica elevata ≥ 140 mmHg con diastolica < 70 mmHg, ritenuti pericolosi dalle linee guida, valori di sistolica < 130 mmHg nelle persone di età ≥ 65 anni e in quelle con valori < 120 mmHg di età inferiore. Sempre in questi pazienti, con dislipidemia, la normativa vigente non prevede la rimborsabilità dei farmaci inibitori PCSK9 nei pazienti con livelli di LDL superiori all’obiettivo indicato di 55 mg/dl ma inferiore a 100 mg/dl. Nei pazienti diabetici a rischio molto elevato non è prevista la possibilità prescrittiva del cardiologo e dei medici di medicina generale degli ipoglicemizzanti appartenenti alle categorie degli SGLT2-i e GLP1-ar nonostante questi farmaci siano raccomandati in classe I A. Per le difficoltà organizzative riscontrate la prescrizione è limitata al 15-20% dei pazienti a rischio cardiovascolare molto elevato. Conclusioni. Le linee guida rappresentano le raccomandazioni per la migliore terapia a disposizione da parte della medicina ufficiale. Esse aiutano il medico a prendere la decisione terapeutica più congrua allo stato dell’arte. Problematiche di ordine clinico, amministrativo ed organizzativo rendono difficili gli adeguati percorsi diagnosticoterapeutici ed assistenziali necessari per la loro applicazione nella pratica clinica rendendo non ottimale il trattamento dei tre principali fattori di rischio cardiovascolare. L’inerzia terapeutica conseguente alla fatica burocratica potrebbe esporre il medico a problematiche medico-legali imputabili più a meccanismi di sistema che alla sua competenza professionale.

Introduzione. Le linee guida sono delle raccomandazioni con diversi livelli di evidenza scientifica messe a punto dagli esperti individuati dalle Autorità Regolatorie e dalle Società Professionali per consentire i migliori standard di intervento diagnostico e terapeutico al momento disponibili. Con la Legge 24/2017 in Italia sono diventate di osservanza giurisprudenziale, anche se a tutt’oggi mancano ancora le raccomandazioni ministeriali previste. Scopo. L’obiettivo dello studio è la valutazione nella pratica ambulatoriale cardiologica corrente dell’adesione alle linee guida della Società Europea di Cardiologia (ESC) riguardo i 3 principali fattori di rischio cardiovascolare: quelle sull’ipertensione del 2018, sulle dislipidemie e diabete mellito del 2019. Sono state valutate le criticità cliniche, amministrative ed organizzative che rendono difficoltosa la loro applicazione. Metodi e risultati. I target di valori pressori raccomandati dalle linee guida europee nei pazienti con sindrome coronarica cronica ipertesi comportano difficoltà decisionali soprattutto riguardanti la persistenza di valori di pressione sistolica elevata ≥ 140 mmHg con diastolica < 70 mmHg, ritenuti pericolosi dalle linee guida, valori di sistolica < 130 mmHg nelle persone di età ≥ 65 anni e in quelle con valori < 120 mmHg di età inferiore. Sempre in questi pazienti, con dislipidemia, la normativa vigente non prevede la rimborsabilità dei farmaci inibitori PCSK9 nei pazienti con livelli di LDL superiori all’obiettivo indicato di 55 mg/dl ma inferiore a 100 mg/dl. Nei pazienti diabetici a rischio molto elevato non è prevista la possibilità prescrittiva del cardiologo e dei medici di medicina generale degli ipoglicemizzanti appartenenti alle categorie degli SGLT2-i e GLP1-ar nonostante questi farmaci siano raccomandati in classe I A. Per le difficoltà organizzative riscontrate la prescrizione è limitata al 15-20% dei pazienti a rischio cardiovascolare molto elevato. Conclusioni. Le linee guida rappresentano le raccomandazioni per la migliore terapia a disposizione da parte della medicina ufficiale. Esse aiutano il medico a prendere la decisione terapeutica più congrua allo stato dell’arte. Problematiche di ordine clinico, amministrativo ed organizzativo rendono difficili gli adeguati percorsi diagnosticoterapeutici ed assistenziali necessari per la loro applicazione nella pratica clinica rendendo non ottimale il trattamento dei tre principali fattori di rischio cardiovascolare. L’inerzia terapeutica conseguente alla fatica burocratica potrebbe esporre il medico a problematiche medico-legali imputabili più a meccanismi di sistema che alla sua competenza professionale.

Abstract: This study aims to determine the relationship between intensity of using social media with interpersonal communication. The initial hypothesis of this study is that there is a positive significant relationship between the intensity of using social media with interpersonal communication. The population in this study amounted to 474 students. The sample selection using stratified random sampling with proportional allocation method and the result of class X 33 students, class XI 33 students and class XII 34 students. Data collection use scale, interview, and documentation. Method of data analysis using prerequisite analysis test (normality test and linierity test) and hypothesis test using pearson’s product moment correlation. Based on the results obtained statistical calculation of corrrelation coefficient (rxy) = 0.057 with p = 0.574 ( p> 0.05), the concluded of this study there is no relationship positive significant between the intensity of using social media with interpersonal communication of students SMAN 1 Depok Sleman D.I Yogyakarta.Keyword: Interpersonal Communication, Intensity Of Using Social MediaAbstrak: Penelitian ini bertujuan untuk mengetahui hubungan antara intensitas penggunaan media sosial dengan komunikasi interpersonal. Hipotesis awal penelitian ini adalah terdapat hubungan positif yang signifikan antara intensitas penggunaan media sosial dengan komunikasi interpersonal. Populasi dalam penelitian ini berjumlah 474 siswa. Pemilihan sampel menggunakan teknik Stratified Random Sampling metode alokasi proporsional dengan hasil kelas X 33 siswa, kelas XI 33 siswa dan kelas XII 34 siswa. Alat pengumpulan data menggunakan skala, wawancara dan dokumentasi. Metode analisis data menggunakan pengujian prasyarat analisis (uji normalitas dan uji linieritas) dan uji hipotesis menggunakan Pearson’s Product Moment Correlation. Berdasarkan hasil perhitungan statistik didapatkan perolehan koefisien korelasi (rxy) = 0.057 dengan p = 0.574 ( p > 0.05 ), artinya tidak ada hubungan positif signifikan antara intensitas penggunaan media sosial dengan komunikasi interpersonal siswa SMAN 1 Depok Sleman D.I Yogyakarta.

Introduzione. L'Organizzazione Mondiale della Sanit&agrave; (OMS) definisce la Comorbilit&agrave; o Doppia Diagnosi come la coesistenza nel medesimo individuo di un disturbo dovuto al consumo di sostanze psicoattive ed un altro disturbo psichiatrico (OMS, 1995). Per quanto piuttosto criticata tale definizione consente di individuare una popolazione di pazienti le cui caratteristiche psicopatologiche appaiono peculiari e molto spesso di difficile ed non univoca interpretazione diagnostica; da tali difficolt&agrave; discendono frequentemente diatribe ideologico culturali e reali difficolt&agrave; di intervento terapeutico che mantengono queste persone in una condizione di equilibrio precario con elevati costi in termini sanitari e di mancata produttivit&agrave; lavorativa. In letteratura sono presenti numerosi lavori che cercano di coniugare ipotesi etiopatogenetiche di area psichiatrica con vie neurotrasmettitoriali pi&ugrave; tipicamente associate al mondo delle dipendenze patologiche, delineando una specifica cultura psicopatologica che cerchi di dare risposte a quesiti diagnostici di difficile soluzione. Tra i vari modelli che cercano di chiarire le associazioni etiopatogenetiche comuni a dipendenze ed altri disturbi mentali quello che forse appare pi&ugrave; completo &egrave; l'ipotesi della "disregolazione omeostatica edonica" (la disedonia), correlato fenomenologico delle dipendenze e della malattia mentale che allo stesso momento spiegherebbe la maggiore frequenza di dipendenza nei soggetti con spettro bipolare (inteso anche come tratto temperamentale) come anche del discontrollo degli impulsi o dell'incapacit&agrave; a prevedere le conseguenze dei propri agiti. In questo solco si inserisce il nostro studio con l'intento di fornire un contributo alla creazione di un linguaggio neurocomportamentale specifico per il mondo delle dipendenze. &nbsp; Scopo e Metodi End point primario del nostro studio &egrave; quello di identificare attraverso la frequenza nel SCL-90R, di specifiche dimensioni sintomatologiche attribuibili a specifiche popolazioni di pazienti. In seconda istanza abbiamo indagato l'eventuale esistenza di caratteristiche psicopatologiche comuni tra pazienti con patologia di spettro bipolare e dipendenza; in ultimo abbiamo valutato l'impatto della doppia diagnosi sul funzionamento globale dell'individuo. Abbiamo arruolato tre coorti di pazienti: soggetti eroinomani senza altra psicopatologia, eroinomani con disturbo bipolare, soggetti affetti da disturbo bipolare senza dipendenza, tutti provenienti dai Ser.D e DSM della provincia di (…...) La diagnosi &egrave; stata formulata attraverso il criterio dell'osservazione clinica, supportata da strumenti psicodiagnostici (MMPI-1, SCID 2) ed esami laboratoristici (esami tossicologici urinari). Le dimensioni sintomatologiche prevalenti sono state indagate con la SCL 90R. &nbsp; Risultati Non sono emersi dati significativi relativi ad una specifica dimensione psicopatologica per i soggetti affetti da Disturbo da uso di sostanze. Tra le sottoscale del SCL-90, l'ANX &egrave; la dimensione comune rilevata tra eroinomani bipolari (doppia diagnosi) e bipolari. Nel confronto tra i tre gruppi (eroinomani senza comorbilit&agrave;, eroinomani bipolari, bipolari) valutati globalmente, il gruppo meno disfunzionale &egrave; risultato quello degli eroinomani. La ridotta estensione dei campioni esaminati non ci permette di pervenire a risultati definitivi richiedendo ulteriori studi in tal senso.

The real estate market is affected by great uncertainty due to the nexus of various factors: a) the specificity of the assets traded, which are illiquid, unique and very hetherogeneous from each other; b) the ‘structural disequilibrium’ of the market caused by the differences emerging in elasticity of supply with respect to demand; c) the non-competitiveness of the market, which often turns into a bilateral monopoly; d) the great variability of market prices. Since the subprime mortgage crisis that broke out at the end of 2006 in the United States, it has clearly emerged that, in a sector that represents about a third of world wealth, it is necessary, on the one hand, to implement proper and increasingly sophisticated valuation tools, to support the design of effective risk management strategies and, on the other hand, to improve the reliability of real estate data, in order to allow for a more robust verification of the hypotheses on the trend of the cash flows generated by the investment and a more accurate valuation of the investment risk and, consequently, of the project expected rate of return. The main objective of this work is to investigate the accuracy and robustness of the estimates of real estate investors of the expected returns on an urban development project in a medium-sized city representative of the North East of Italy. Using a simulation-based approach, the gap between the observed internal rate of return, estimated ex post on the basis of the actual trend of the parameters that influence investment returns, and the expected internal rate of return, calculated ex ante on the basis of the information available at the time of the investment decision. Firstly, we constructed the time series from 1995 to 2015 of the expected and observed internal rates of return of investments in the residential sector. We obtained the time series of the cash flows generated by the investment under investigation by implementing a simulation-based approach. Starting from the comparison between observed internal rate of return and expected internal rates of return, we identified ex post the risk implicitly assumed by the investor at the time of the decision to undertake the investment. Secondly, the effectiveness of the Capital Asset Pricing Model as a method for estimating the return on a property investment was verified, by comparing the project’s observed (ex post) internal rate of return with its ex ante rate of return, estimated through the Capital Asset Pricing Model. To carry out the above analyses, we constructed the time series of observed and expected internal rate of returns from 1995 to 2015 of investments in the residential sector. The time series of the internal rate of returns of real estate investments were obtained by implementing a simulation-based approach to determine the cash flows of real estate investments representative of the context under investigation and by adopting as model inputs the parameters usually adopted in ex-ante and ex-post real estate valuations. Starting from the comparison between observed and expected internal rate of returns, we identified ex-post the risk implicitly assumed by the developer at the time of the decision to undertake the investment. Finally, by investigating the determinants of the divergence between the investment’s observed and expected internal rate of return and cyclical variables, we identified the factors (i.e., the macroeconomic fundaments) which, in the period under investigation, affected investment risk and, consequently, investment return. Finally, by investigating the relationships that account for the difference between the observed and expected internal rate of return and the economic factors that can determine the current stage in economic cycles, we identified the determinants of invetment risk and returns. Il mercato immobiliare è affetto da grande incertezza dovuta a una concatenazione di diversi fattori: a) la specificità dei beni scambiati che sono illiquidi, unici e molto eterogenei tra loro; b) il “disequilibrio strutturale” del mercato causato dalla diversa elasticità del- l’offerta rispetto alla domanda; c) la non concorrenzialità del mercato che, assume spesso le caratteristiche del monopolio bilaterale; d) la grande variabilità dei prezzi di mercato. A partire dalla crisi dei mutui sub- prime scoppiata alla fine del 2006 negli Stati Uniti, è emerso chiaramente come, in un settore che rappresenta circa un terzo della ricchezza mondiale, sia necessario, da un lato, operare con strumenti valutativi adeguati e sempre più sofisticati, in grado di suppor- tare l’individuazione di strategie efficaci di gestione dei rischi e, dall’altro, migliorare l’affidabilità dei dati immobiliari, in modo da consentire una verifica più ro- busta delle ipotesi sull’andamento dei flussi di cassa generati e una stima più accurata del rischio e, conseguentemente, del tasso di rendimento atteso. Obiettivo principale del presente lavoro è di investigare l’accuratezza delle previsioni effettuate da un ipotetico operatore immobiliare sul rendimento di un investi- mento a sviluppo in una città di medie dimensioni rap- presentativa della provincia dell’Italia settentrionale. Attraverso un approccio basato sulla simulazione, è stato calcolato lo scarto fra il tasso interno di rendimento effettivo, stimato ex post in base all’andamento effettivo dei parametri influenti sul rendimento stesso, e il tasso interno di rendimento atteso, calcolato ex ante sulla base delle informazioni disponibili al mo- mento della decisione d’investimento. In primo luogo, è stata costruita la serie storica dal 1995 al 2015 dei tassi interni di rendimento attesi ed effettivi dell’investi- mento immobiliare residenziale a sviluppo. Le serie storiche sono state ottenute mediante la simulazione dei flussi di cassa di investimenti immobiliari rappresentativi della realtà indagata. A partire dal confronto fra tassi interni di rendimento effettivi e tassi interni di rendimento attesi è stato individuato, ex post, il rischio assunto implicitamente dall’investitore al momento della decisione di intraprendere l’investimento stesso. In secondo luogo, è stata verificata la bontà del Capital Asset Pricing Model come metodo di stima del rendi- mento di un investimento immobiliare a sviluppo, confrontando il tasso interno di rendimento effettivo e il tasso di rendimento ex ante stimato attraverso il Capi- tal Asset Pricing Model stesso. Infine, indagando sulle relazioni che intercorrono fra lo scarto fra tasso di rendimento interno effettivo e atteso e le variabili congiunturali, sono stati individuati i fattori che, nel periodo considerato, hanno maggiormente influito sul rischio al quale si è esposto l’investitore al momento di investire.

AbstrakPenelitian ini menganalisis dampak fiskal Otonomi Khusus (Otsus) Provinsi Papua, Papua Barat, dan Aceh terhadap efisiensi pemberian layanan publik, serta implikasinya pada pertumbuhan PDRB per kapita, dengan metode Data Envelopment Analysis (DEA) dan model estimasi Dynamic Generalized Method of Moment (DGMM). Hasil penelitian menunjukkan, bahwa di tingkat provinsi dan kabupaten/kota, penerimaan Otsus berpengaruh negatif pada efisiensi belanja pendidikan, kesehatan, dan infrastruktur publik, namun terhadap efisiensi belanja layanan umum dan layanan publik lainnya berdampak positif di tingkat provinsi, dan berdampak negatif secara terbatas pada tingkat kabupaten/kota. Di tingkat provinsi, efisiensi pada semua jenis belanja publik berdampak positif terhadap pertumbuhan PDRB per kapita, sementara di level kabupaten/kota, efisiensi belanja pendidikan, kesehatan, dan infrastruktur publik berdampak positif terhadap pertumbuhan PDRB per kapita, kecuali efisiensi belanja layanan umum dan layanan publik lainnya berpengaruh negatif terhadap pertumbuhan PDRB per kapita.Kata kunci: Dampak Fiskal, Otonomi Khusus, Efisiensi, Pemberian Layanan Publik, PDRB per Kapita AbstractThis study evaluates the fiscal impact of Special Autonomy in Papua, West Papua and Aceh Provinces on the efficiency of public services delivery and its implications on the growth of GRDP per capita through Data Envelopment Analysis (DEA) and Dynamic Generalized Method of Moment (DGMM) method. The results show that, both at the provincial and district/city level, the Special Autonomy revenue has a negative effect on the efficiency of education, health and public infrastructure spending; but its impact on the efficiency of general and other public services spending is positive at provincial level and limited negative effect at district/city level. At the provincial level, efficiency in all types of public service spending has a positive impact on the growth of GRDP per capita. At the district/city level, on the other hand, the efficiency of education, health, and public infrastructure spending has a positive impact on GRDP per capita growth, except for the efficiency of general and other public services spending, which influence negatively GRDP per capita growth.Key words: Fiscal Impact, Special Autonomy, Efficiency, Public Service Delivery

La presente ricerca affronta i problemi clinici e sociali che riguardano lo sviluppo linguistico e cognitivo nei bambini sordi. Attualmente, lo sviluppo della “Teoria della mente” rappresenta un importante campo di ricerca nello studio della sordità. Questi studi internazionali hanno evidenziato nei bambini sordi una significativa alterazione nello sviluppo della “Teoria della Mente”, soprattutto in caso di perdita congenita o preverbale dell’udito. In particolare, la ricerca si concentra sulle competenze dei bambini sordi nel riconoscere emozioni e desideri, attraverso metodi sia cognitivi che percettivi, per la valutazione delle capacità psico-cognitiva attraverso una serie di domande composte da alcuni test adeguati, da somministrare ai pazienti con perdita uditiva. L’esperimento è stato condotto su un gruppo composto da 10 bambini (5 maschi e 5 femmine), di età compresa tra 4 e 9 anni e tra 54 e 108 mesi), affetti da perdita uditiva congenita bilaterale (da grave a cofosi), o da perdita uditiva preverbale sviluppata sia in bambini che attendono l’ultimo anno prima di frequentare la scuola elementare, sia in quelli che frequentano il quarto anno di scuola elementare. I criteri di selezione sono stati basati su: valutazione audiologica, somministrazione di test neuropsicologici al fine di valutare, in generale, le capacità cognitive e percettive e osservazioni cliniche effettuate, al fine di valutare la psicopatologia del campione, attraverso dei test che valutano più facilmente lo sviluppo sia della percettività visiva (Coloured Progressive Matrices), sia della rappresentazione grafica (Test di disegno sulla figura umana e il Test di disegno sulla famiglia). Lo strumento di misurazione “cognitiva” è stato il “Deaf Children Series”, test strutturato da noi, che consiste in un esame dello stato mentale (MSE), capace di valutare: il livello di capacità cognitiva (conoscenza-correlato), l’umore e modelli di discorso e di pensiero di un paziente al momento della valutazione. I bambini sordi mostrano sul lato percettivo una sensibilità ridotta alle espressioni di tristezza. Nel test possiamo osservare un meccanismo di difesa psicodinamico per quanto riguarda la prestazione percettiva. Al contrario, per quanto riguarda i bambini normoudenti, la paura è l’emozione più difficile da identificare. I bambini sordi sembrano essere maggiormente predisposti al riconoscimento di emozioni visive. Inoltre, i bambini sordi presentano notevoli capacità di “problem solving”, capacità di riconoscimento emotivo, probabilmente a causa del loro problema.

Riassunto: La recente pubblicazione in Italia della traduzione de La llegenda del llibreter assassí di Ramon Miquel i Planas offre lo spunto per un confronto con alcune precedenti traduzioni in castigliano e per una breve riflessione di metodo sulla traduzione. Le due versioni spagnole (1991 e 2011) si configurano infatti, a differenza di quella italiana, come libere rielaborazioni dell’originale dal momento che ne alterano la struttura, trasformando il testo e piegandolo a nuove finalità. L’elemento di interesse di questa «manipolazione» risiede nel fatto che essa è in qualche modo autorizzata dalla stessa natura miscellanea dell’opera di Miquel i Planas, al contempo libro erudito e antologia di materiali narrativi diversi, e dalle variegate forme di trasmissione dei materiali leggendari raccolti dallo studioso catalano. Le versioni della Llegenda consentono così d’iscrivere la riflessione sul tradurre nell’ambito della ricezione e dell’influsso esercitato dalla tradizione di un testo sulle sue modalità di traduzione. Parole chiave: Miquel i Planas; traduzione; rifacimento; tradizione Abstract: The recent publication of the Italian translation of La llegenda del llibreter assassí by Ramon Miquel i Planas provides an opportunity to make a comparison with some previous Spanish translations and to reflect briefly on translation methods. The two Spanish versions (1991 and 2011), unlike the Italian one, are free reworkings of the original, in the sense that they alter the structure, transform the text and shape it to new ends. What is interesting about this «manipulation» is that it is in some way legitimised by the heterogeneous nature of Miquel i Planas’s work, which is both an erudite volume and an anthology of different narrative materials, as well as by the varied ways in which the Catalan scholar handles materials relating to legends. The versions of Llegenda thus permit the inclusion of this reflection on translation in the sphere of the reception of a text and of the influence exerted by the tradition surrounding a text on the ways it is translated. Keywords: Miquel i Planas; translation; rewriting; tradition

La presión sanguínea alta se defi ne como una elevacióon crónica de la presión sistólica y diastólica y representa una enfermedad común en la humanidad.Algunos de los factores que pueden causar presión arterial alta en personas entre 18 y 65 años son: edad, raza, sexo, consumo de cigarrillo, consumo de alcohol, y obesidad.OBJETIVOS El objetivo del presente estudio fue determinar los niveles altos de presión arterial y factores de riesgo asociados en el personal administrativo de la Universidad de Manizales.MATERIALES Y METODOS De las 151 personas que en ese momento laboraban como personal administrativo de la Universidad de Manizales participaron en el estudio 143 reprentando el 94,7% de la población total, con un rango de edades comprendido entre 18 y 62 años, con un promedio de 37.9 años. Se empleó una encuesta para clasifi carlos de acuerdo a sexo, edad, seguridad social, consumo de bebidas alcohólicas, consumo de cigarrillo, historia patológica familiar ypersonal, actividad física, conocimientos sobre su propia presión arterial, peso. Se emplearon las guías del WHO (World health organization) para efectuar la medida de la presión arterial.RESULTADOS Y DISCUSION El trabajo se llevó a cabo en tres meses. Los resultados fueron estadísticamente signifi cativos. Se confi rmó la dependencia con algunos factores de riesgo (sexo, consumo de alcohol, historia patológica familiar y personal, dieta, índice de masa corporal, edad) de los niveles de presión arterial. No se encontró en esta población relación entre los niveles de presión arterial y consumo de cigarrillo.

Nel 2010 è stata emanata in Italia la Legge 38, che punta a migliorare formazione e tirocini nel campo delle cure palliative, sebbene al momento non esista un sistema nazionale di monitoraggio di tali pratiche su scala nazionale. A livello internazionale l’eutanasia si è andata sempre più configurando come trattamento possibile fra le cure di fine vita, mentre in Italia resta formalmente illegale. Esistono alcuni studi italiani sulle prospettive dei pazienti rispetto alle cure palliative e all’eutanasia, ma la letteratura relativa alla percezione degli operatori sanitari palliativisti è esigua. Scopo del presente studio è l’indagine di tali percezioni, sia rispetto alla qualità delle cure palliative sia al potenziale ruolo dell’eutanasia nelle cure di fine vita in Italia. La ricerca è stata condotta in tre hospice romani. È stato sviluppato e somministrato un questionario con 75 item graduati secondo la scala Likert a 5 punti, utilizzando come metodi di analisi l’analisi fattoriale e, per la parte statistica, SPSS. Il questionario è stato completato da 56 soggetti. Nella percezione dei partecipanti, i fattori rilevanti per la qualità delle cure palliative sono risultati sette: sofferenza fisica e sociale, benessere psicologico e spirituale, benessere emozionale, partecipazione alle decisioni, compassione, speranza ed empatia. Inoltre, le cure palliative ridurrebbero il desiderio di morte e di eutanasia. I fattori più importanti che emergono dal lavoro sono la sofferenza o il benessere sociali, fisici e psicologici. Gli operatori sanitari coinvolti nello studio non sostengono l’ipotesi dell’eutanasia e anzi ritengono che le cure palliative riducano il desiderio di ottenerla. ---------- In 2010, the State Law no 38 was enacted in Italy, seeking to improve palliative care education and training. There is currently no national monitoring system for palliative care practices in Italy. Euthanasia has become increasingly available internationally as an alternative amidst end-of-life care options, although in Italy this is not the case, and it is formally illegal. Although there are a few studies regarding patients’ perspectives regarding the issue of palliative care and euthanasia in Italy, there is limited literature focused on the perspectives of palliative care health care professionals. The purpose of this study is to explore the perspectives of hospice workers regarding both the quality of palliative care and the potential role of euthanasia in end-of-life care in Italy. This research was conducted with hospice clinicians in three hospices in Rome. A 75 item 5-point Likert scale questionnaire was developed and administered. Factor analysis was used, and descriptive statistics were performed using SPSS. Fifty-six respondents completed the questionnaire. From participants’ perspectives, there are seven significant factors explaining the quality of palliative care in Italy: social and physical suffering, psychological and spiritual well-being, emotional well-being, participation in decision making, compassion, hope, and empathy in care, while reducing patients’ desire for death and euthanasia. The most important of these factors regard social, physical and psychological suffering and well-being. Hospice workers in this study did not support euthanasia and felt that palliative care decreases the patient’s desire for euthanasia. * The manuscript was presented as an abstract in an International Congress on Palliative Care.

Penelitian ini di latarbelakangi oleh fenomena beberapa mahasiswa yang bekerja dan beberapa mahasiswa yang tidak sambil bekerja. Masa sekarang adalah masa yang penuh dengan persaingan di berbagai aspek dan bidang kehidupan termasuk di dalamnya bidang pekerjaan. Kesempatan untuk mendapatkan pekerjaan akan lebih mudah bila seorang pencari kerja mempunyai latar belakang pendidikan yang tinggi, hal tersebut disebabkan karena melalui pendidikan, individu akan mampu meningkatkan kualitas sumber daya manusia. Oleh sebab itu seorang tenaga kerja harus menempuh pendidikan di seluruh perguruan tinggi atau Universitas, pendidikan tinggi yang berkualitas dengan hasil yang memuaskan sangat diharapkan oleh seluruh mahasiswa. Namun di zaman krisis seperti sekarang ini, biaya pendidikan sangatlah mahal dan belum tentu sebanding dengan hasilnya sehingga hal tersebut memunculkan suatu fenomena yang telah berkembang luas dan telah menyebar dikalangan mahasiswa yaitu banyak mahasiswa yang kuliah sambil bekerja. Universitas Islam Negeri (UIN) Sulthan Thaha Saifuddin Jambi peneliti ambil sebagai contoh khusus Pendekatan penelitian yang penulis gunakan pendekatan deskriptif kuantitatif. metode penelitian kuantitatif adalah suatu proses untuk mendapatkan kejelasan mengenai hasil yang ingin diketahui, adapun data yang diperoleh adalah dai hasil penyebaran angket kepada mahasiswa yang sambil bekerja dan tidak sambil bekerja, kemudian data di tabulasi dan di olah dengan pendekatan korelasi yang bertujuan untuk mengetahui ada tidaknya pengaruh atau hubungan antara motivasi mahasiswa/i dalam perkuliahan baik yang sambil bekerja maupun yang tidak sambil bekerja terhadap kemandirian mahasiswa/i. Tekhnik korelasi yang digunakan adalah korelasi product moment. Hasilnya penulis menemukan bahwa motivasi kuliah mahasiswa sambil bekerja yaitu berjumlah rata-rata 60,72 lebih rendah dibandingkan dengan motivasi kuliah mahaiswa tidak sambil bekerja yaitu berjumlah rata-rata 61,45. Kemandirian mahasiswa sambil bekerja yaitu berjumlah rata-rata 60,28 lebih tinggi dibandingkan dengan kemandirian mahasiswa tidak sambil bekerja yaitu berjumlah rata-rata 59,03. Pengaruh motivasi kuliah terhadap kemandirian mahasiswa sambil bekerja yaitu 0,3892 lebih rendah dibandingkan dengan pengaruh motivasi kuliah terhadap kemandirian mahasiswa tidak sambil bekerja yaitu 0,4101. Hal tersebut menunjukkan bahwa terdapat hubungan positif antara motivasi kuliah dan kemandirian mahasiswa. Artinya jika motivasi kuliah rendah maka kemandirian mahasiswa rendah.

Scopo del nostro studio osservazionale cross-sectional è di studiare la consapevolezza di malattia, la conoscenza delle procedure cliniche e delle dichiarazioni anticipate di trattamento in pazienti italiani affetti da patologie croniche progressive. Metodo. Sono stati valutati 115 soggetti (23 con Sclerosi Laterale Amiotrofica – SLA; 30 con Scompenso Cardiaco Cronico – SCC; 32 con Insufficienza Renale Cronica – IRC; 30 con Tumore Avanzato –TA) su: conoscenza sui temi della salute, diritto ad essere informati, significato delle Direttive Anticipate (DA) e delle Dichiarazioni Anticipate di Trattamento (DAT). Risultati. 86% dei pazienti hanno evidenziato il diritto di conoscere diagnosi e prognosi e di essere informati sull’evoluzione di malattia. Molti pazienti non conoscevano il significato di procedura invasiva (52%) o di trattamento aggressivo (81%). Il 72% non conosceva il significato di DA e di DAT; il 94% riteneva che le DA o le DAT potessero parzialmente o totalmente garantire il desiderio del paziente di prendere parte alle decisioni sulla gestione del fine vita. Una volta informati sul significato delle AD (vincolanti) e delle DAT (non vincolanti) I pazienti con SLA preferivano la scelta di direttive vincolanti rispetto ai pazienti con TA e con SCC (SLA vs SCC p=.005; SLA vs TA p=.001). I pazienti con IRC preferivano direttive vincolanti rispetto ai pazienti con SCC (p=.02). Conclusioni. Deve essere parte integrante nella pratica clinica l’informare e il guidare il paziente dal momento della diagnosi fino alle fasi ultime di vita. ---------- Introduction. Many steps forward within the legal field to facilitate end-of-life communication have been taken, but Mediterranean countries can be considered as a step back. Aim of our observational cross-sectional study is to observe disease awareness, knowledge of clinical procedures and of advanced directives in patients with chronic progressive diseases in Italy. Methods. 115 subjects (23 with Amyotrophic Lateral Sclerosis – ALS, 30 with Chronic Heart Failure - CHF, 32 with Chronic Kidney Failure – CKF, and 30 with Advanced Cancer – AC) were assessed on health literacy, their right to be informed and meaning of Advance Directives (AD) and of Advance Declaration of Treatment (ADT). Results. 86% of patients claimed the right to know diagnosis and prognosis and to be informed of disease progression. Patients did not know the meaning of invasive therapy (52%) and of aggressive treatment (81%). 72% did not know the meaning of AD and of ADT; 94% believed that AD or ADT could partially or totally guarantee patient’s will to make decisions on end-of-life, with frequency difference on AD or ADT efficiency between CHF and ALS patients (p=.01). Once informed on the definitions of AD (legally binding) and ADT (not legally binding), ALS patients preferred legally binding directives, compared to patients with AC and with CHF (ALS vs CHF p=.005; ALS vs AC p=.001). Patients with CKF would prefer legally binding proposal compared to CHF patients (p=.02). Conclusion. To inform and to guide patients from diagnosis to end-of-life should be an integral part of medical practice.

Assumendo l’intrinseca democraticità della svolta performativa delle arti – la quale eccede il principio della proprietà privata sia per l’artista che per il fruitore – il presente contributo intende esplorare le esperienze in cui la creazione dell’artista si realizza nella sua abilitazione alla creazione collettiva, mobilitando il concetto di liveness come presenza e partecipazione. Il contributo, a seguito di una tipizzazione delle varie possibili declinazioni della pratica di squatting, intende restringere il focus sulla sua versione culturale, in quanto metodo performativo teso ad obiettivi estetici, comunicativi e politici. Attraverso l’interpretazione ermeneutica dei presupposti e del funzionamento di tali esperienze, nonchè il riferimento – seppur sintetico, per motivi di economicità della ricerca – a casi di cultural squatting sul territorio italiano, sarà restituita una lettura di questi che li propone come momenti di attivazione e spazi d’intersezione dei diversi livelli di liveness, messi a disposizione nell’abilitazione dell’agency culturale e politica del pubblico in quanto collettività.

Abstract: The purpose of this study was to determine the efficiency level and the performance of sharia banking in Indonesia and the correlation between efficiency and performance of sharia banking in Indonesia. The type of this study was descriptive research. The object of this study was financial statements of 10 sharia banks in Indonesia. The data analysis methods used were data envelopment analysis (DEA), CAMELS ratio analysis of, and product moment correlation ana-lysis. The result of this study showed that based on DEA analysis there were four sharia banks that showed the efficiency level reaching 100% or in the efficient level. On CAMELS ratio analysis showed that sharia banks were in good financial ratio condition. However, the value of ratios showed a fluctuation from year to year in the research period. Correlation analysis between CAMELS and DEA showed that there was no financial ratio that gave a result in line with DEA analysis because the significance level of correlation coefficient showed a value that was not significant statistically. Keywords: efficiency, performance, sharia banking Abstrak: Tujuan penelitian ini adalah untuk mengetahui tingkat efisiensi dan kinerja perbankan syariah di Indonesia serta korelasi antara efisiensi dan kinerja perbankan syariah di Indonesia. Jenis penelitian ini adalah penelitian deskriptif. Objek penelitian ini adalah laporan keuangan 10 bank syariah di Indonesia. Metode analisis data yang digunakan adalah data envelopment analysis (DEA), CAMELS ratio analysis, dan product moment correlation analysis. Hasil peneliti-an menunjukkan bahwa berdasarkan analisis DEA terdapat empat bank syariah yang menunjukkan tingkat efisiensi mencapai 100% atau pada tingkat yang efisi-en. Dalam analisis rasio CAMELS, menunjukkan bahwa bank syariah berada da-lam kondisi rasio keuangan yang baik. Namun, nilai rasio menunjukkan fluktuasi dari tahun ke tahun dalam periode penelitian. Analisis korelasi antara CAMELS dan DEA menunjukkan bahwa tidak ada rasio keuangan yang memberikan hasil sesuai dengan analisis DEA karena tingkat signifikansi koefisien korelasi menun-jukkan nilai yang tidak signifikan secara statistik. Kata Kunci: efisiensi, kinerja, bank syariah

Obiettivo: svelare i fattori che giustificano l’importanza di una sorveglianza epidemiologica efficiente per il controllo della febbre gialla nel paese. Metodo: ricerca esplorativa, bibliografica, qualitativa e descrittiva. Risultati: le ultime indagini epidemiologiche indicano che il numero di casi di febbre gialla selvatica registrati in Brasile è molto variabile, quindi, se si ritiene che per ogni caso rilevabile ci siano altri 10 casi di evoluzione subclinica, le cifre effettive possono essere molto più grandi di quelli registrati dalle agenzie sanitarie. Conclusione: La febbre gialla, come malattia infettiva acuta, è una zoonosi difficile da controllare, in quanto è in grado di causare epidemie imprevedibili nelle popolazioni umane, un esempio è il momento vissuto dallo Stato di Minas Gerais, che soffre di un’epidemia di malattie, motivate da condizioni di squilibrio ambientale che favoriscono lo sviluppo e la proliferazione dei vettori, cooperando per il verificarsi di centinaia di decessi solo nei primi mesi del 2017. Parole chiave: controllo, febbre gialla, diagnosi, sorveglianza epidemiologica.

In Italia, tra il 1945 e il 1947, furono pubblicate più di cinquanta testimonianze sulla deportazione, tra cui solo alcune appartengono al genere narrativo. Tra i testi narrativi se ne contano sette di autori italo-ebrei: Lazzaro Levi, Primo Levi, Giuliana Tedeschi, Liana Millu, Luciana Nissim, Frida Misul e Alba Valech Capozzi. Se Liana Millu e Giuliana Tedeschi iniziarono a scrivere nell’immediato dopoguerra e riscrissero le loro testimonianze in un secondo momento, Luciana Nissim nei suoi saggi sulla psicanalisi (degli anni settanta in poi) non ritrattò il tema della deportazione su cui sono invece incentrati i racconti testimoniali scritti a ridosso della liberazione. Passando dal racconto testimoniale a una narrativa che possiamo definire “analitica”, Nissim – medico e psicoanalista di professione – sviluppò una riflessione che investe il ruolo dell’analista e, più specificamente, le modalità dell’ascolto. Traendo ispirazione dal metodo dell’intervista multipla dello psicologo clinico Henry Greenspan, si confrontano in questo studio le tre versioni della relazione dal titolo Ricordi della casa dei morticonservate presso il Centro Bibliografico dell’Unione delle Comunità Ebraiche Italiane a Roma, la versione a stampa dall’omonimo titolo edita da Ramella (1946), nonché i saggi scientifici di Nissim sulla psicanalisi, le varie interviste rilasciate dopo la morte di Primo Levi, e la corrispondenza con il marito Franco Momigliano.Attraverso una lettura diacronica della produzione narrativa e scientifica dell’autrice viene analizzata la funzione dei singoli testi – nella loro specificità memoriale o narrativa – alla luce di una dinamica che considera il trauma in quanto processo.

Contesto: Il lutto č un'esperienza universale e la sua associazione con morbilitŕ e mortalitŕ in eccesso č ben definita. Tuttavia, il lutto diventa una seria preoccupazione per la salute in una minoranza di casi. Per tali individui l'intenso cordoglio persiste, č doloroso e invalidante e puň soddisfare i criteri di un disturbo mentale distinto. Al momento, il lutto non č riconosciuta come un disturbo mentale nel DSM-IV o nell'ICD-10. L'obiettivo di questo studio č di determinare la validitŕ psicometrica dei criteri del disturbo da lutto prolungato (Prolonged Grief Disorder, PGD) per migliorare la rilevazione e il trattamento potenziale degli individui in lutto a maggiore rischio di dolore persistente e disfunzioni. Metodi e Risultati: Un totale di 291 soggetti in lutto č stato intervistato per tre volte, raggruppato in gruppi da 0-6, 6-12 e 12-24 mesi post-perdita. Le analisi della Item Response Theory (IRT) hanno fornito i sintomi del PGD maggiormente informativi e obiettivi. Le analisi combinatorie hanno individuato l'algoritmo del PGD piů sensibile e specifico che č stato poi testato per valutarne la validitŕ psicometrica. I criteri richiedono reazioni ad una perdita significativa che includa l'esperienza dello struggimento (ad esempio, la sofferenza fisica o emotiva come un risultato del ricongiungimento voluto, ma incompiuto, con il defunto) e almeno cinque dei seguenti nove sintomi sperimentati almeno quotidianamente o in maniera invalidante: sentirsi emotivamente intorpiditi, storditi, o che la vita č priva di senso; vivere sfiduciati; amarezza per la perdita, difficoltŕ ad accettare la perdita; confusione di identitŕ; evitamento della realtŕ della perdita, o difficoltŕ di proseguire con la vita. I sintomi devono essere presenti a livelli sufficientemente alti da almeno sei mesi dalla morte ed essere associati ad una compromissione funzionale. Conclusioni: I criteri fissati per il PGD sembrano in grado di identificare le persone in lutto con un maggiore rischio di dolore e disfunzione permanente. I risultati confermano la validitŕ psicometrica dei criteri del PGD che proponiamo per l'inclusione nel DSM-V e nell'ICD-11.

Premessa: Nonostante una generale giustificabilità sul piano etico, la sedazione palliativa (SP) presenta ancora numerosi aspetti controversi che richiedono un ulteriore dibattito e chiarificazione. Dal punto di vista pratico, inoltre, si osserva una notevole variabilità per quanto riguarda la procedura clinica della SP e un confine tra la SP alla fine della vita e l’eutanasia involontaria sempre più sottile e incerto. Questa situazione rende particolarmente necessaria l’elaborazione di percorsi decisionali trasparenti, anche nella forma di linee-guida locali, che chiariscano le procedure e le implicazioni etiche della sedazione palliativa. Obiettivi: Lo scopo di questo lavoro è di presentare le principali caratteristiche del percorso decisionale e assistenziale per la SP elaborato presso il Policlinico Universitario “Campus Bio-Medico” di Roma. Metodi: L’elaborazione della proposta presentata è stata preceduta da uno studio, attraverso la somministrazione di questionari semistrutturati, sulle conoscenze del personale medico e infermieristico in merito alla SP e da uno studio retrospettivo sulle cartelle cliniche, per verificare le modalità di utilizzo della SP all’interno dell’ospedale. Risultati: Il percorso decisionale ed assistenziale elaborato considera non solo gli aspetti farmacologici, ma affronta con chiarezza anche le implicazioni etiche e legali della procedura di SP, e in particolare la comunicazione, la cura dei familiari e degli operatori sanitari, la possibilità di avvalersi della consulenza di etica clinica nei casi più complessi o nei quali è difficile raggiungere una decisione condivisa. Si sottolinea, inoltre, come l’applicazione di un percorso decisionale e assistenziale per la SP debba essere supportata da momenti formativi e di confronto attivo tra gli operatori sanitari, per favorire l’adeguata comprensione e il corretto utilizzo di tali strumenti operativi, ma anche per assicurare il rispetto della coscienza degli operatori sanitari coinvolti. Conclusioni: È raccomandabile che tutte le istituzioni sanitarie producano percorsi decisionali ed assistenziali per la SP, attenti non solo agli standard scientifici, ma anche alla sensibilità etica e culturale del contesto in cui verranno utilizzate. Percorsi decisionali ed assistenziali così strutturati forniscono non solo un orientamento operativo e formativo per l’agire clinico, ma costituiscono anche un doveroso strumento di trasparenza nei confronti dei pazienti, dei loro familiari, della stessa struttura sanitaria e di tutta la società. ---------- Background: Despite a general ethical basis for justification, palliative sedation (PS) still has many controversial aspects that require further discussion and clarification. From a practical standpoint, moreover, there is considerable variability in the clinical procedure and an increasingly uncertain boundary between PS and involuntary euthanasia. This situation makes it necessary to develop local guidelines to clarify the procedures and the ethical implications of PS. Purpose: The aim of this paper is to present the main features of the ethical and clinical decision-making process for PS developed at the University Hospital “Campus Bio-Medico”, in Rome. Methods: The development of the present proposal was preceded by a survey, through a questionnaire, on the knowledge of medical and nursing staff on PS, and a retrospective study on medical records, to see how PS is used inside the hospital. Results: The benefit of this decision-making process is that it considers the pharmacological aspects, but also clearly addresses the ethical and legal procedure of PS, communication, the care for family members and health workers, the possibility of taking advantage of a clinical ethics consultation in complex cases or where it is difficult to reach a joint decision. We also emphasize that the application of the decision-making process must be supported by training sessions and active confrontation, to promote proper understanding and correct use of the guidelines themselves, but also to ensure respect for the conscience of health care professionals who are involved in the procedures of PS. Conclusions: It is recommended that all health care institutions produce local guidelines for PS, attentive to scientific standards, but also sensitive to the ethical and cultural context in which they are used. Ethical and clinical guidelines provide not only a well-structured operational guidance and training for clinical work, but are also a necessary tool for transparency with regard to all society.

Lo scopo di questo articolo è quello di mostrare il volto sconosciuto dei metodi artificiali di riproduzione umana. In generale, le cliniche per la fecondazione umana mostrano solo il volto più attraente della fecondazione in vitro: il neonato. Eppure, non hanno mai mostrato l’altra faccia di essa: la procedura lunga e drammatica che sta dietro. Dopo aver fatto un breve cenno alla attribuzione del Premio Nobel per la Medicina 2010 Robert Edwards, padre della fecondazione in vitro, analizziamo le due radici che sostengono il grande albero di metodi artificiali di riproduzione umana: lo scientismo e il sentimentalismo. Poi si studia l’aspetto etico di queste procedure. Siamo giunti ad un giudizio eticamente negativo su queste tecniche, dal momento che snaturano il significato della sessualità umana e l’atto coniugale. Subito dopo, analizziamo alcune delle conseguenze più frequenti di tali metodi: “la mortalità embrionale” associata con tali tecniche; “il congelamento degli embrioni in eccesso”; “i rischi per la salute”, sia del neonato così come quella della donna. Tutti questi sono elementi che la coppia deve prendere in considerazione al fine di prendere la decisione più libera e più responsabile possibile. Infine, spieghiamo il “pendio scivoloso” relativo all’uso di queste tecniche (il bambino medicalizzato, i bambini à la carte, la maternità surrogata e il mercantilismo riproduttivo): ciò che è stato sviluppato con uno intento ben preciso, per risolvere il problema di infertilità, ha sicuramente aperto nuove importanti questioni etiche. ---------- The purpose of this article is to show the unknown face of artificial human reproduction methods. Generally, human fertilization clinics only show the most attractive face of in vitro fertilization: the newborn. Yet, they never show the other face of it: the long and dramatic procedure behind it. After briefly mentioning the 2010 Nobel Medicine Award granted to Robert Edwards, the father of in vitro fertilization, we analyze the two roots that support the big tree of artificial human reproduction methods: scientism and sentimentalism. Then we study the ethical aspect of these procedures. We come to the conclusion that these techniques are ethically negative since they denaturalize the meaning of human sexuality and the conjugal act. Right after that, we analyze some of the most frequent consequences of such methods: “embryonic mortality” and directly related to it exceeding “embryo freezing”; “the risks for the health”, both of the newborn as well as that of the woman. All those are elements that the couple must take into consideration in order to make the freest and most responsible decision possible. Finally, we explain the “slippery slope” effect in the use of these techniques (medicine babies, babies a la carte, surrogate maternity and reproductive mercantilism): what was developed with a very specific aim in mind, to remedy the infertility problem, has definitely open new and important ethical concerns.

Introduction In November 2020, upon learning that the company’s Covid-19 vaccine trial had been successful, the head of Pfizer’s Vaccine Research and Development, Kathrin Jansen, celebrated with champagne – “some really good stuff” (Cohen). Bubbles seem to go naturally with celebration, and champagne is fundamentally associated with bubbles. Yet, until the late-seventeenth century, champagne was a still wine, and it only reached the familiar levels of bubbliness in the late-nineteenth century (Harding). During this period and on into the early twentieth century, “champagne” was in many ways created, defined, and defended. A “champagne bubble” was created, within which the “nature” of champagne was contested and constructed. Champagne today is the result of hundreds of years of labour by many sorts of bubble-makers: those who make the bubbly drink, and those who construct, maintain, and defend the champagne bubble. In this article, I explore some elements of the champagne bubble, in order to understand both its fragility and rigidity over the years and today. Creating the Champagne Bubble – the Labour of Centuries It is difficult to separate the physical from the mythical as regards champagne. Therefore the categorisations below are always overlapping, and embedded in legal, political, economic, and socio-cultural factors. Just as assemblage – the mixing of wine from different grapes – is an essential element of champagne wine, the champagne bubble may be called heterogeneous assemblage. Indeed, the champagne bubble, as we will see below, is a myriad of different sorts of bubbles, such as terroir, appellation, myth and brand. And just as any assemblage, its heterogeneous elements exist and operate in relation to each other. Therefore the “champagne bubble” discussed here is both one and many, all of its elements fundamentally interconnected, constituting that “one” known as “champagne”. It is not my intention to be comprehensive of all the elements, historical and contemporary. Indeed, that would not be possible within such a short article. Instead, I seek to demonstrate some of the complexity of the champagne bubble, noting the elaborate labour that has gone into its creation. The Physical Champagne and Champagne – from Soil to Bubbles Champagne means both a legally protected geographical area (Champagne), and the wine (here: champagne) produced in this area from grapes defined as acceptable: most importantly pinot noir, pinot meunier (“black” grapes), and chardonnay (“white” grape). The method of production, too, is regulated and legally protected: méthode champenoise. Although the same method is used in numerous locations, these must be called something different: metodo classico (Italy), método tradicional (Spain), Methode Cap Classique (South Africa). The geographical area of Champagne was first legally defined in 1908, when it only included the areas of Marne and Aisne, leaving out, most importantly, the area of Aube. This decision led to severe unrest and riots, as the Aube vignerons revolted in 1911, forcing the inclusion of “zone 2”: Aube, Haute-Marne, and Seine-et-Marne (Guy). Behind these regulations was a surge in fraudulent production in the early twentieth century, as well as falling wine prices resulting from increasing supply of cheap wines (Colman 18). These first appellations d’origine had many consequences – they proved financially beneficial for the “zone 1”, but less so for the “zone 2”. When both these areas were brought under the same appellation in 1927, the financial benefits were more limited – but this may have been due to the Great Depression triggered in 1929 (Haeck et al.). It is a long-standing belief that the soil and climate of Champagne are key contributors to the quality of champagne wines, said to be due to “conditions … most suitable for making this type of wine” (Simon 11). Already in the end of the nineteenth century, the editor of Vigneron champenois attributed champagne’s quality to “a fortunate combination of … chalky soil … [and] unrivalled exposure [to the sun]” (Guy 119) among other things. Factors such as soil and climate, commonly included in and expressed through the idea of terroir, undoubtedly influence grapes and wines made thereof, but the extent remains unproven. Indeed, terroir itself is a very contested concept (Teil; Inglis and Almila). It is also the case that climate change has had, and will continue to have, devastating effects on wine production in many areas, while benefiting others. The highly successful English sparkling wine production, drawing upon know-how from the Champagne area, has been enabled by the warming climate (Inglis), while Champagne itself is at risk of becoming too hot (Robinson). Champagne is made through a process more complicated than most wines. I present here the bare bones of it, to illustrate the many challenges that had to be overcome to enable its production in the scale we see today. Freshly picked grapes are first pressed and the juice is fermented. Grape juice contains natural yeasts and therefore will ferment spontaneously, but fermentation can also be started with artificial yeasts. In fermentation, alcohol and carbon dioxide (CO2) are formed, but the latter usually escapes the liquid. The secret of champagne is its second fermentation, which happens in bottles, after wines from different grapes and/or vineyards have been blended for desired characteristics (assemblage). For the second fermentation, yeast and sugar are added. As the fermentation happens inside a bottle, the CO2 that is created does not escape, but dissolves into the wine. The average pressure inside a champagne bottle in serving temperature is around 5 bar – 5 times the pressure outside the bottle (Liger-Belair et al.). The obvious challenge this method poses has to do with managing the pressure. Exploding bottles used to be a common problem, and the manner of sealing bottles was not very developed, either. Seventeenth-century developments in bottle-making, and using corks to seal bottles, enabled sparkling wines to be produced in the first place (Leszczyńska; Phillips 137). Still today, champagne comes in heavy-bottomed bottles, sealed with characteristically shaped cork, which is secured with a wire cage known as muselet. Scientific innovations, such as calculating the ideal amount of sugar for the second fermentation in 1836, also helped to control the amount of gas formed during the second fermentation, thus making the behaviour of the wine more predictable (Leszczyńska 265). Champagne is characteristically a “manufactured” wine, as it involves several steps of interference, from assemblage to dosage – sugar added for flavour to most champagnes after the second fermentation (although there are also zero dosage champagnes). This lends champagne particularly suitable for branding, as it is possible to make the wine taste the same year after year, harvest after harvest, and thus create a distinctive and recognisable house style. It is also possible to make champagnes for different tastes. During the nineteenth century, champagnes of different dosage were made for different markets – the driest for the British, the sweetest for the Russians (Harding). Bubbles are probably the most striking characteristic of champagne, and they are enabled by the complicated factors described above. But they are also formed when the champagne is poured in a glass. Natural impurities on the surface of the glass provide channels through which the gas pockets trapped in the wine can release themselves, forming strains of rising bubbles (Liger-Belair et al.). Champagne glasses have for centuries differed from other wine glasses, often for aesthetic reasons (Harding). The bubbles seem to do more than give people aesthetic pleasure and sensory experiences. It is often claimed that champagne makes you drunk faster than other drinks would, and there is, indeed, some (limited) research showing that this may well be the case (Roberts and Robinson; Ridout et al.). The Mythical Champagne – from Dom Pérignon to Modern Wonders Just as the bubbles in a champagne glass are influenced by numerous forces, so the metaphorical champagne bubble is subject to complex influences. Myth-creation is one of the most significant of these. The origin of champagne as sparkling wine is embedded in the myth of Dom Pérignon of Hautvillers monastery (1638–1715), who according to the legend would have accidentally developed the bubbles, and then enthusiastically exclaimed “I am drinking the stars!” (Phillips 138). In reality, bubbles are a natural phenomenon provoked by winter temperatures deactivating the fermenting yeasts, and spring again reactivating them. The myth of Dom Pérignon was first established in the nineteenth century and quickly embraced by the champagne industry. In 1937, Moët et Chandon launched a premium champagne called Dom Pérignon, which enjoys high reputation until this day (Phillips). The champagne industry has been active in managing associations connected with champagne since the nineteenth century. Sparkling champagnes had already enjoyed fashionability in the later seventeenth and early eighteenth century, both in the French Court, and amongst the British higher classes. In the second half of the nineteenth century, champagne found ever increasing markets abroad, and the clientele was not aristocratic anymore. Before the 1860s, champagne’s association was with high status celebration, as well as sexual activity and seduction (Harding; Rokka). As the century went on, and champagne sales radically increased, associations with “modernity” were added: “hot-air balloons, towering steamships, transcontinental trains, cars, sports, and other ‘modern’ wonders were often featured in quickly proliferating champagne advertising” (Rokka 280). During this time, champagne grew both drier and more sparkling, following consumer tastes (Harding). Champagne’s most important markets in later nineteenth century included the UK, where the growing middle classes consumed champagne for both celebration and hospitality (Harding), the US, where (upper) middle-class women were served champagne in new kinds of consumer environments (Smith; Remus), and Russia, where the upper classes enjoyed sweeter champagne – until the Revolution (Phillips 296). The champagne industry quickly embraced the new middle classes in possession of increasing wealth, as well as new methods of advertising and marketing. What is remarkable is that they managed to integrate enormously varied cultural thematics and still retain associations with aristocracy and luxury, while producing and selling wine in industrial scale (Harding; Rokka). This is still true today: champagne retains a reputation of prestige, despite large-scale branding, production, and marketing. Maintaining and Defending the Bubble: Formulas, Rappers, and the Absolutely Fabulous Tipplers The falling wine prices and increasing counterfeit wines coincided with Europe’s phylloxera crisis – the pest accidentally brought over from North America that almost wiped out all Europe’s vineyards. The pest moved through Champagne in the 1890s, killing vines and devastating vignerons (Campbell). The Syndicat du Commerce des vins de Champagne had already been formed in 1882 (Rokka 280). Now unions were formed to fight phylloxera, such as the Association Viticole Champenoise in 1898. The 1904 Fédération Syndicale des Vignerons was formed to lobby the government to protect the name of Champagne (Leszczyńska 266) – successfully, as we have seen above. The financial benefits from appellations were certainly welcome, but short-lived. World War I treated Champagne harshly, with battle lines stuck through the area for years (Guy 187). The battle went on also in the lobbying front. In 1935, a new appellation regime was brought into law, which came to be the basis for all European systems, and the Comité National des appellations d'origine (CNAO) was founded (Colman 1922). Champagne’s protection became increasingly international, and continues to be so today under EU law and trade deals (European Commission). The post-war recovery of champagne relied on strategies used already in the “golden years” – marketing and lobbying. Advertising continued to embrace “luxury, celebration, transport (extending from air travel to the increasingly popular automobile), modernity, sports” (Guy 188). Such advertisement must have responded accurately to the mood of post-war, pre-depression Europe. Even in the prohibition US it was known that the “frivolous” French women might go as far as bathe in champagne, like the popular actress Mistinguett (Young 63). Curiously, in the 1930s Soviet Russia, “champagne” (not produced in Champagne) was declared a sign of good living, symbolising the standard of living that any Soviet worker had access to (at least in theory) (Gronow). Today, the reputation of champagne is fiercely defended in legal terms. This is not only in terms of protection against other sparkling wine making areas, but also in terms of exploitation of champagne’s reputation by actors in other commercial fields, and even against mass market products containing genuine champagne (Mahy and d’Ath; Schneider and Nam). At the same time, champagne has been widely “democratised” by mass production, enabled partly by increasing mechanisation and scientification of champagne production from the 1950s onwards (Leszczyńska 266). Yet champagne retains its association with prestige, luxury, and even royalty. This has required some serious adaptation and flexibility. In what follows, I look into three cultural phenomena that illuminate processes of such adaptation: Formula One (F1) champagne spraying, the 1990s sitcom Absolutely Fabulous, and the Cristal racism scandal in 2006. The first champagne bottle is said to have been presented to F1 grand prix winner in Champagne in 1950 (Wheels24). Such a gesture would have been fully in line with champagne’s association with cars, sport, and modernity. But what about the spraying? Surely that is not in line with the prestige of the wine? The first spraying is attributed to Jo Siffert in 1966 and Dan Gurney in 1967, the former described as accidental, the latter as a spontaneous gesture of celebration (Wheels24; Dobie). Moët had become the official supplier of F1 champagnes in 1966, and there are no signs that the new custom would have been problematic for them, as their sponsorship continued until 1999, after which Mumm sponsored the sport for 15 years. Today, the champagne to be popped and sprayed is Chanson, in special bottles “coated in the same carbon fibre that F1 cars are made of” (Wheels24). Such an iconic status has the spraying gained that it features in practically all TV broadcasts concerning F1, although non-alcoholic substitute is used in countries where sale of alcohol is banned (Barker et al., “Quantifying”; Barker et al., “Alcohol”). As disturbing as the champagne spraying might look for a wine snob, it is perfectly in line with champagne’s marketing history and entrepreneurial spirit shown since the nineteenth century. Nor is it unheard of to let champagne spray. The “art” of sabrage, opening champagne bottle with a sable, associated with glamour, spectacle, and myth – its origin is attributed to Napoleon and his officers – is perfectly acceptable even for the snob. Sparkling champagne was always bound up with joy and celebration, not a solemn drink, and the champagne bubble was able to accommodate middle classes as well as aristocrats. This brings us to our second example, the British sitcom Absolutely Fabulous. The show, first released in 1992, featured two women, “Eddy” (Jennifer Saunders) and “Patsy” (Joanna Lumley), who spent their time happily smoking, taking drugs, and drinking large quantities of “Bolly” (among other things). Bollinger champagne may have initially experienced “a bit of a shock” for being thus addressed, but soon came to see the benefits of fame (French). In 2005, they hired PR support to make better use of the brand’s “Ab Fab” recognisability, and to improve its prestige reputation in order to justify their higher price range (Cann). Saunders and Lumley were warmly welcomed by the Bollinger house when filming for their champagne tour Absolutely Champers (2017). It is befitting indeed that such controversial fame came from the UK, the first country to discover sparkling champagne outside France (Simon 48), and where the aspirational middle classes were keen to consume it already in the nineteenth century (Harding). More controversial still is the case of Cristal (made by Louis Roederer) and the US rap world. Enthusiastically embraced by the “bling-bling” world of (black) rappers, champagne seems to fit their ethos well. Cristal was long favoured as both a drink and a word in rap lyrics. But in 2006, the newly appointed managing director at the family owned Roederer, Frédéric Rouzaud, made comments considered racist by many (Woodland). Rouzard told in an interview with The Economist that the house observed the Cristal-rap association “with curiosity and serenity”. He reportedly continued: “but what can we do? We can’t forbid people from buying it. I’m sure Dom Pérignon or Krug would be delighted to have their business”. It was indeed those two brands that the rapper Jay-Z replaced Cristal with, when calling for a boycott on Cristal. It would be easy to dismiss Rouzard’s comments as snobbery, or indeed as racism, but they merit some more reflection. Cristal is the premium wine of a house that otherwise does not enjoy high recognisability. While champagne’s history involves embracing new sorts of clientele, and marketing flexibly to as many consumer groups as possible (Rokka), this was the first spectacular crossing of racial boundaries. It was always the case that different houses and their different champagnes were targeted at different clienteles, and it is apparent that Cristal was not targeted at black rap artists. Whereas Bollinger was able to turn into a victory the questionable fame brought by the white middle-class association of Absolutely Fabulous, the more prestigious Cristal considered the attention of the black rapper world more threatening and acted accordingly. They sought to defend their own brand bubble, not the larger champagne bubble. Cristal’s reputation seems to have suffered little – its 2008 vintage, launched in 2018, was the most traded wine of that year (Schultz). Jay-Z’s purchase of his own champagne brand (Armand de Brignac, nicknamed Ace of Spades) has been less successful reputation-wise (Greenburg). It is difficult to break the champagne bubble, and it may be equally difficult to break into it. Conclusion In this article, I have looked into the various dilemmas the “bubble-makers” of Champagne encountered when fabricating what is today known as “champagne”. There have been moments of threat to the bubble they formed, such as in the turn of nineteenth and twentieth centuries, and eras of incomparable success, such as from the 1860s to 1880s. The discussion has demonstrated the remarkable flexibility with which the makers and defenders of champagne have responded to challenges, and dealt with material, socio-cultural, economic, and other problems. It feels appropriate to end with a note on the current challenge the champagne industry faces: Covid-19. The pandemic hit champagne sales exceptionally hard, leaving around 100 million bottles unsold (Micallef). This was not very surprising, given the closure of champagne-selling venues, banning of public and private celebrations, and a general mood not particularly prone to (or even likely to frown upon) such light-hearted matters as glamour and champagne. Champagne has survived many dramatic drops in sales during the twentieth century, such as the Great Depression of the 1930s, and the post-financial crisis collapse in 2009. Yet they seem to be able to make astonishing recoveries. Already, there are indicators that many people consumed more champagne during the festive end-of-year season than in previous years (Smithers). For the moment, it looks like the champagne bubble, despite its seeming fragility, is practically indestructible, no matter how much its elements may suffer under various pressures and challenges. References Barker, Alexander, Magdalena Opazo-Breton, Emily Thomson, John Britton, Bruce Granti-Braham, and Rachael L. Murray. “Quantifying Alcohol Audio-Visual Content in UK Broadcasts of the 2018 Formula 1 Championship: A Content Analysis and Population Exposure.” BMJ Open 10 (2020): e037035. <https://bmjopen.bmj.com/content/10/8/e037035>. Barker, Alexander B., John Britton, Bruce Grant-Braham, and Rachael L. Murray. “Alcohol Audio-Visual Content in Formula 1 Television Broadcasting.” BMC Public Health 18 (2018): 1155. <https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-018-6068-3>. Campbell, Christy. 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What creative techniques of resistance are available to a female filmmaker when she is the victim of a violent event and filmed at her most vulnerable? This article uses an autoethnographic lens to discuss my experience of a serious car crash my family and I were inadvertently involved in due to police negligence and a criminal act. Employing Creative Analytical Practice (CAP) ethnography, a reflexive form of research which recognises that the creative process, producer and product are “deeply intertwined” (Richardson, “Writing: A Method” 930), I investigate how the crash’s violent affects crippled my agency, manifested in my creative praxis and catalysed my identification of latent forms of institutionalised violence in film culture, its discourse and pedagogy that also contributed to my inertia. The article maps my process of writing a feature length screenplay during the aftermath of the crash as I set out to articulate my story of survival and resistance. Using this narrative inquiry, in which we can “investigate how we construct the world, ourselves, and others, and how standard objectifying practices...unnecessarily limit us” (Richardson, “Writing: A Method” 924), I outline how I attempted to disrupt the entrenched power structures that exist in dominant narratives of violence in film and challenge my subjugated positioning as a woman within this canon. I describe my engagement with the deconstructionist practices of writing the body and militant feminist cinema, which suggest subversive opportunities for women’s self-determination by encouraging us to embrace our exiled positioning in dominant discourse through creative experimentation, and identify some of the possibilities and limitations of this for female agency. Drawing on CAP ethnography, existentialism, film feminism, and narrative reframing, I assert that these reconstructive practices are more effective for the creative enfranchisement of women by not relegating us to the periphery of social systems and cultural forms. Instead, they enable us to speak back to violent structures in a language that has greater social access, context and impact.My strong desire to tell screen stories lies in my belief that storytelling is a crucial evolutionary mechanism of resilience. Narratives do not simply represent the social world but also have the ability to change it by enabling us to “try to figure out how to live our lives meaningfully” (Ellis 760). This conviction has been directly influenced by my personal story of trauma and survival when myself, my siblings, and our respective life partners became involved in a major car crash. Two police officers attending to a drunken brawl in an inner city park had, in their haste, left the keys in the ignition of their vehicle. We were travelling across a major intersection when the police car, which had subsequently been stolen by a man involved in the brawl – a man who was wanted on parole, had a blood alcohol level three times over the legal limit, and was driving at speeds exceeding 110kms per hour - ran a red light and crossed our path, causing us to crash into his vehicle. From the impact, the small four-wheel drive we were travelling in was catapulted metres into the air, rolling numerous times before smashing head on into oncoming traffic. My heavily pregnant sister was driving our vehicle.The incident attracted national media attention and our story became a sensationalist spectacle. Each news station reported erroneous and conflicting information, one stating that my sister had lost her unborn daughter, another even going so far as to claim my sister had died in the crash. This tabloidised, ‘if it bleeds, it leads’, culture of journalism, along with new digital technologies, encourages and facilitates the normalisation of violent acts, often inflicted on women. Moreover, in their pursuit of high-rating stories, news bodies motivate dehumanising acts of citizen journalism that see witnesses often inspired to film, rather than assist, victims involved in a violent event. Through a connection with someone working for a major news station, we discovered that leading news broadcasters had bought a tape shot by a group of men who call themselves the ‘Paparazzi of Perth’. These men were some of the first on the scene and began filming us from only a few metres away while we were still trapped upside down and unconscious in our vehicle. In the recording, the men are heard laughing and celebrating our tragedy as they realise the lucrative possibilities of the shocking imagery they are capturing as witnesses pull us out of the back of the car, and my pregnant sister incredibly frees herself from the wreckage by kicking out the window.As a female filmmaker, I saw the bitter irony of this event as the camera was now turned on me and my loved ones at our most vulnerable. In her discussion of the male gaze, a culturally sanctioned form of narrational violence against women that is ubiquitous in most mainstream media, Mulvey proposes that women are generally the passive image, trapped by the physical limits of the frame in a permanent state of powerlessness as our identity is reduced to her “to-be-looked-at-ness” (40). For a long period of time, the experience of performing the role of this commodified woman of a weaponised male gaze, along with the threat of annihilation associated with our near-death experience, immobilised my spirit. I felt I belonged “more to the dead than to the living” (Herman 34). When I eventually returned to my creative praxis, I decided to use scriptwriting as both my “mode of reasoning and a mode of representation” (Richardson, Writing Strategies 21), test whether I could work through my feelings of alienation and violation and reclaim my agency. This was a complex and harrowing task because my memories “lack[ed] verbal narrative and context” (Herman 38) and were deeply rooted in my body. Cixous confirms that for women, “writing and voice...are woven together” and “spring from the deepest layers of her psyche” (Moi 112). For many months, I struggled to write. I attempted to block out this violent ordeal and censor my self. I soon learnt, however, that my body could not be silenced and was slow to forget. As I tried to write around this experience, the trauma worked itself deeper inside of me, and my physical symptoms worsened, as did the quality of my writing.In the early version of the screenplay I found myself writing a female-centred film about violence, identity and death, using the fictional narrative to express the numbness I experienced. I wrote the female protagonist with detachment as though she were an object devoid of agency. Sartre claims that we make objects of others and of ourselves in an attempt to control the uncertainty of life and the ever-changing nature of humanity (242). Making something into an object is to deprive it of life (and death); it is our attempt to keep ourselves ‘safe’. While I recognise that the car crash’s reminder of my mortality was no doubt part of the reason why I rendered myself, and the script’s female protagonist, lifeless as agentic beings, I sensed that there were subtler operations of power and control behind my self-objectification and self-censorship, which deeply concerned me. What had influenced this dea(r)th of female agency in my creative imaginings? Why did I write my female character with such a red pen? Why did I seem so compelled to ‘kill’ her? I wanted to investigate my gender construction, the complex relationship between my scriptwriting praxis, and the context within which it is produced to discover whether I could write a different future for myself, and my female characters. Kiesinger supports “contextualizing our stories within the framework of a larger picture” (108), so as to remain open to the possibility that there might not be anything ‘wrong’ with us, per se, “but rather something very wrong with the dynamics that dominate the communicative system” (109) within which we operate: in the case of my creative praxis, the oppressive structures present in the culture of film and its pedagogy.Pulling FocusWomen are supposed to be the view and when the view talks back, it is uncomfortable.— Jane Campion (Filming Desire)It is a terrible thing to see that no one has ever taught us how to develop our vision as women neither in the history of arts nor in film schools.— Marie Mandy (Filming Desire)The democratisation of today’s media landscape through new technologies, the recent rise in female-run production companies (Zemler) in Hollywood, along with the ground-breaking #MeToo and Time’s Up movements has elevated the global consciousness of gender-based violence, and has seen the screen industry seek to redress its history of gender imbalance. While it is too early to assess the impact these developments may have on women’s standing in film, today the ‘celluloid ceiling’ still operates on multiple levels of indoctrination and control through a systemic pattern of exclusion for women that upholds the “nearly seamless dialogue among men in cinema” (Lauzen, Thumbs Down 2). Female filmmakers occupy a tenuous position of influence in the mainstream industry and things are not any better on the other side of the camera (Lauzen, The Celluloid Ceiling). For the most part, Hollywood’s male gaze and penchant for sexualising and (physically or figuratively) killing female characters, which normalises violence against women and is “almost inversely proportional to the liberation of women in society” (Mandy), continues to limit women to performing as the image rather than the agent on screen.Film funding bodies and censorship boards, mostly comprised of men, remain exceptionally averse to independent female filmmakers who go against the odds to tell their stories, which often violate taboos about femininity and radically redefine female agency through the construction of the female gaze: a narrational technique of resistance that enables reel woman to govern the point of view, imagery and action of the film (Smelik 51-52). This generally sees their films unjustly ghettoised through incongruent classification or censorship, and forced into independent or underground distribution (Sexton-Finck 165-182). Not only does censorship propose the idea that female agency is abject and dangerous and needs to be restrained, it prevents access to this important cinema by women that aims to counter the male gaze and “shield us from this type of violence” (Gillain 210). This form of ideological and institutional gatekeeping is not only enforced in the film industry, it is also insidiously (re)constituted in the epistemological construction of film discourse and pedagogy, which in their design, are still largely intrinsically gendered institutions, encoded with phallocentric signification that rejects a woman’s specificity and approach to knowledge. Drawing on my mutually informative roles as a former film student and experienced screen educator, I assert that most screen curricula in Australia still uphold entrenched androcentric norms that assume the male gaze and advocate popular cinema’s didactic three-act structure, which conditions our value systems to favour masculinity and men’s worldview. This restorative storytelling approach is argued to be fatally limiting to reel women (Smith 136; Dancyger and Rush 25) as it propagates the Enlightenment notion of a universal subjectivity, based on free will and reason, which neutralises the power structures of society (and film) and repudiates the influence of social positioning on our opportunity for agency. Moreover, through its omniscient consciousness, which seeks to efface the presence of a specific narrator, the three-act method disavows this policing of female agency and absolves any specific individual of responsibility for its structural violence (Dyer 98).By pulling focus on some of these problematic mechanisms in the hostile climate of the film industry and its spaces of learning for women, I became acutely aware of the more latent forms of violence that had conditioned my scriptwriting praxis, the ambivalence I felt towards my female identity, and my consequent gagging of the female character in the screenplay.Changing Lenses How do the specific circumstances in which we write affect what we write? How does what we write affect who we become?— Laurel Richardson (Fields of Play 1)In the beginning, there is an end. Don’t be afraid: it’s your death that is dying. Then: all the beginnings.— Helene Cixous (Cixous and Jensen 41)The discoveries I made during my process of CAP ethnography saw a strong feeling of dissidence arrive inside me. I vehemently wanted to write my way out of my subjugated state and release some of the anguish that my traumatised body was carrying around. I was drawn to militant feminist cinema and the French poststructuralist approach of ‘writing the body’ (l’ecriture feminine) given these deconstructive practices “create images and ideas that have the power to inspire to revolt against oppression and exploitation” (Moi 120). Feminist cinema’s visual treatise of writing the body through its departure from androcentric codes - its unformulaic approach to structure, plot, character and narration (De Lauretis 106) - revealed to me ways in which I could use the scriptwriting process to validate my debilitating experience of physical and psychic violence, decensor my self and move towards rejoining the living. Cixous affirms that, “by writing her self, woman will return to the body which has been more than confiscated from her, which has been turned into…the ailing or dead figure” (Cixous, The Laugh of the Medusa 880). It became clear to me that the persistent themes of death that manifested in the first draft of the script were not, as I first suspected, me ‘rehearsing to die’, or wanting to kill off the woman inside me. I was in fact “not driven towards death but by death” (Homer 89), the close proximity to my mortality, acting as a limit, was calling for a strengthening of my life force, a rebirth of my agency (Bettelheim 36). Mansfield acknowledges that death “offers us a freedom outside of the repression and logic that dominate our daily practices of keeping ourselves in order, within the lines” (87).I challenged myself to write the uncomfortable, the unfamiliar, the unexplored and to allow myself to go to places in me that I had never before let speak by investigating my agency from a much more layered and critical perspective. This was both incredibly terrifying and liberating and enabled me to discard the agentic ‘corset’ I had previously worn in my creative praxis. Dancyger and Rush confirm that “one of the things that happens when we break out of the restorative three-act form is that the effaced narrator becomes increasingly visible and overt” (38). I experienced an invigorating feeling of empowerment through my appropriation of the female gaze in the screenplay which initially appeased some of the post-crash turmoil and general sense of injustice I was experiencing. However, I soon, found something toxic rising inside of me. Like the acrimonious feminist cinema I was immersed in – Raw (Ducournau), A Girl Walks Home at Night (Amirpour), Romance (Breillat), Trouble Every Day (Denis), Baise-Moi (Despentes and Thi), In My Skin (Van), Anatomy of Hell (Breillat) – the screenplay I had produced involved a female character turning the tables on men and using acts of revenge to satisfy her needs. Not only was I creating a highly dystopian world filled with explicit themes of suffering in the screenplay, I too existed in a displaced state of rage and ‘psychic nausea’ in my daily life (Baldick and Sartre). I became haunted by vivid flashbacks of the car crash as abject images, sounds and sensations played over and over in my mind and body like a horror movie on loop. I struggled to find the necessary clarity and counterbalance of stability required to successfully handle this type of experimentation.I do not wish to undermine the creative potential of deconstructive practices, such as writing the body and militant cinema, for female filmmakers. However, I believe my post-trauma sensitivity to visceral entrapment and spiritual violence magnifies some of the psychological and physiological risks involved. Deconstructive experimentation “happens much more easily in the realm of “texts” than in the world of human interaction” (hooks 22) and presents agentic limitations for women since it offers a “utopian vision of female creativity” (Moi 119) that is “devoid of reality...except in a poetic sense” (Moi 122). In jettisoning the restorative qualities of narrative film, new boundaries for women are inadvertently created through restricting us to “intellectual pleasure but rarely emotional pleasure” (Citron 51). Moreover, by reducing women’s agency to retaliation we are denied the opportunity for catharsis and transformation; something I desperately longed to experience in my injured state. Kaplan acknowledges this problem, arguing that female filmmakers need to move theoretically beyond deconstruction to reconstruction, “to manipulate the recognized, dominating discourses so as to begin to free ourselves through rather than beyond them (for what is there ‘beyond’?)” (Women and Film 141).A potent desire to regain a sense of connectedness and control pushed itself out from deep inside me. I yearned for a tonic to move myself and my female character to an active position, rather than a reactive one that merely repeats the victimising dynamic of mainstream film by appropriating a reversed (female) gaze and now makes women the violent victors (Kaplan, Feminism and Film 130). We have arrived at a point where we must destabilise the dominance-submission structure and “think about ways of transcending a polarity that has only brought us all pain” (Kaplan, Feminism and Film 135). I became determined to write a screen narrative that, while dealing with some of the harsh realities of humanity I had become exposed to, involved an existentialist movement towards catharsis and activity.ReframingWhen our stories break down or no longer serve us well, it is imperative that we examine the quality of the stories we are telling and actively reinvent our accounts in ways that permit us to live more fulfilling lives.— Christine Kiesinger (107)I’m frightened by life’s randomness, so I want to deal with it, make some sense of it by telling a film story. But it’s not without hope. I don’t believe in telling stories without some hope.— Susanne Bier (Thomas)Narrative reframing is underlined by the existentialist belief that our spiritual freedom is an artistic process of self-creation, dependent on our free will to organise the elements of our lives, many determined out of our control, into the subjective frame that is to be our experience of our selves and the world around us (107). As a filmmaker, I recognise the power of selective editing and composition. Narrative reframing’s demand for a rational assessment of “the degree to which we live our stories versus the degree to which our stories live us” (Kiesinger 109), helped me to understand how I could use these filmmaking skills to take a step back from my trauma so as to look at it objectively “as a text for study” (Ellis 108) and to exercise power over the creative-destructive forces it, and the deconstructive writing methods I had employed, produced. Richardson confirms the benefits of this practice, since narrative “is the universal way in which humans accommodate to finitude” (Writing Strategies 65).In the script’s development, I found my resilience lay in my capacity to imagine more positive alternatives for female agency. I focussed on writing a narrative that did not avoid life’s hardships and injustices, or require them to be “attenuated, veiled, sweetened, blunted, and falsified” (Nietzsche and Hollingdale 68), yet still involved a life-affirming sentiment. With this in mind, I reintroduced the three-act structure in the revised script as its affectivity and therapeutic denouement enabled me to experience a sense of agentic catharsis that turned “nauseous thoughts into imaginations with which it is possible to live” (Nietzsche 52). Nevertheless, I remained vigilant not to lapse into didacticism; to allow my female character to be free to transgress social conventions surrounding women’s agency. Indebted to Kaplan’s writing on the cinematic gaze, I chose to take up what she identifies as a ‘mutual gaze’; an ethical framework that enabled me to privilege the female character’s perspective and autonomy with a neutral subject-subject gaze rather than the “subject-object kind that reduces one of the parties to the place of submission” (Feminism and Film 135). I incorporated the filmic technique of the point of view (POV) shot for key narrative moments as it allows an audience to literally view the world through a character’s eyes, as well as direct address, which involves the character looking back down the lens at the viewer (us); establishing the highest level of identification between the spectator and the subject on screen.The most pertinent illustration of these significant scriptwriting changes through my engagement with narrative reframing and feminist film theory, is in the reworking of my family’s car crash which became a pivotal turning point in the final draft. In the scene, I use POV and direct address to turn the weaponised gaze back around onto the ‘paparazzi’ who are filming the spectacle. When the central (pregnant) character frees herself from the wreckage, she notices these men filming her and we see the moment from her point of view as she looks at these men laughing and revelling in the commercial potential of their mediatised act. Switching between POV and direct address, the men soon notice they have been exposed as the woman looks back down the lens at them (us) with disbelief, reproaching them (us) for daring to film her in this traumatic moment. She holds her determined gaze while they glance awkwardly back at her, until their laughter dissipates, they stop recording and appear to recognise the culpability of their actions. With these techniques of mutual gazing, I set out to humanise and empower the female victim and neutralise the power dynamic: the woman is now also a viewing agent, and the men equally perform the role of the viewed. In this creative reframing, I hope to provide an antidote to filmic violence against and/or by women as this female character reclaims her (my) experience of survival without adhering to the culture of female passivity or ressentiment.This article has examined how a serious car crash, being filmed against my will in its aftermath and the attendant damages that prevailed from this experience, catalysed a critical change of direction in my scriptwriting. The victimising event helped me recognise the manifest and latent forms of violence against women that are normalised through everyday ideological and institutional systems in film and prevent us from performing as active agents in our creative praxis. There is a critical need for more inclusive modes of practice – across the film industry, discourse and pedagogy – that are cognisant and respectful of women’s specificity and our difference to the androcentric landscape of mainstream film. We need to continue to exert pressure on changing violent mechanisms that marginalise us and ghettoise our stories. As this article has demonstrated, working outside dominant forms can enable important emancipatory opportunities for women, however, this type or deconstruction also presents risks that generally leave us powerless in everyday spaces. While I advocate that female filmmakers should look to techniques of feminist cinema for an alternative lens, we must also work within popular film to critique and subvert it, and not deny women the pleasures and political advantages of its restorative structure. By enabling female filmmakers to (re)humanise woman though encouraging empathy and compassion, this affective storytelling form has the potential to counter violence against women and mobilise female agency. Equally, CAP ethnography and narrative reframing are critical discourses for the retrieval and actualisation of female filmmakers’ agency as they allow us to contextualise our stories of resistance and survival within the framework of a larger picture of violence to gain perspective on our subjective experiences and render them as significant, informative and useful to the lives of others. This enables us to move from the isolated margins of subcultural film and discourse to reclaim our stories at the centre.ReferencesA Girl Walks Home at Night. Dir. Ana Lily Amirpour. Say Ahh Productions, 2014.Anatomy of Hell. Dir. Catherine Breillat. Tartan Films, 2004. Baise-Moi. Dirs. Virginie Despentes and Coralie Trinh Thi. FilmFixx, 2000.Baldick, Robert, and Jean-Paul Sartre. Nausea. 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Introduction: Bubbles and Sport The ephemeral materiality of bubbles – beautiful, spectacular, and distracting but ultimately fragile – when applied to protect or conserve in the interests of sport-media profit, creates conditions that exacerbate existing inequalities in sport and society. Bubbles are usually something to watch, admire, and chase after in their brief yet shiny lives. There is supposed to be, technically, nothing inside them other than one or more gasses, and yet we constantly refer to people and objects being inside bubbles. The metaphor of the bubble has been used to describe the life of celebrities, politicians in purpose-built capital cities like Canberra, and even leftist, environmentally activist urban dwellers. The metaphorical and material qualities of bubbles are aligned—they cannot be easily captured and are liable to change at any time. In this article we address the metaphorical sporting bubble, which is often evoked in describing life in professional sport. This is a vernacular term used to capture and condemn the conditions of life of elite sportspeople (usually men), most commonly after there has been a sport-related scandal, especially of a sexual nature (Rowe). It is frequently paired with connotatively loaded adjectives like pampered and indulged. The sporting bubble is rarely interrogated in academic literature, the concept largely being left to the media and moral entrepreneurs. It is represented as involving a highly privileged but also pressurised life for those who live inside it. A sporting bubble is a world constructed for its most prized inhabitants that enables them to be protected from insurgents and to set the terms of their encounters with others, especially sport fans and disciplinary agents of the state. The Covid-19 pandemic both reinforced and reconfigured the operational concept of the bubble, re-arranging tensions between safety (protecting athletes) and fragility (short careers, risks of injury, etc.) for those within, while safeguarding those without from bubble contagion. Privilege and Precarity Bubble-induced social isolation, critics argue, encourages a loss of perspective among those under its protection, an entitled disconnection from the usual rules and responsibilities of everyday life. For this reason, the denizens of the sporting bubble are seen as being at risk to themselves and, more troublingly, to those allowed temporarily to penetrate it, especially young women who are first exploited by and then ejected from it (Benedict). There are many well-documented cases of professional male athletes “behaving badly” and trying to rely on institutional status and various versions of the sporting bubble for shelter (Flood and Dyson; Reel and Crouch; Wade). In the age of mobile and social media, it is increasingly difficult to keep misbehaviour in-house, resulting in a slew of media stories about, for example, drunkenness and sexual misconduct, such as when then-Sydney Roosters co-captain Mitchell Pearce was suspended and fined in 2016 after being filmed trying to force an unwanted kiss on a woman and then simulating a lewd act with her dog while drunk. There is contestation between those who condemn such behaviour as aberrant and those who regard it as the conventional expression of youthful masculinity as part of the familiar “boys will be boys” dictum. The latter naturalise an inequitable gender order, frequently treating sportsmen as victims of predatory women, and ignoring asymmetries of power between men and women, especially in homosocial environments (Toffoletti). For those in the sporting bubble (predominantly elite sportsmen and highly paid executives, also mostly men, with an array of service staff of both sexes moving in and out of it), life is reflected for those being protected via an array of screens (small screens in homes and indoor places of entertainment, and even smaller screens on theirs and others’ phones, as well as huge screens at sport events). These male sport stars are paid handsomely to use their skill and strength to perform for the sporting codes, their every facial expression and bodily action watched by the media and relayed to audiences. This is often a precarious existence, the usually brief career of an athlete worker being dependent on health, luck, age, successful competition with rivals, networks, and club and coach preferences. There is a large, aspirational reserve army of athletes vying to play at the elite level, despite risks of injury and invasive, life-changing medical interventions. Responsibility for avoiding performance and image enhancing drugs (PIEDs) also weighs heavily on their shoulders (Connor). Professional sportspeople, in their more reflective moments, know that their time in the limelight will soon be up, meaning that getting a ticket to the sporting bubble, even for a short time, can make all the difference to their post-sport lives and those of their families. The most vulnerable of the small minority of participants in sport who make a good, short-term living from it are those for whom, in the absence of quality education and prior social status, it is their sole likely means of upward social mobility (Spaaij). Elite sport performers are surrounded by minders, doctors, fitness instructors, therapists, coaches, advisors and other service personnel, all supporting athletes to stay focussed on and maximise performance quality to satisfy co-present crowds, broadcasters, sponsors, sports bodies and mass media audiences. The shield offered by the sporting bubble supports the teleological win-at-all-costs mentality of professional sport. The stakes are high, with athlete and executive salaries, sponsorships and broadcasting deals entangled in a complex web of investments in keeping the “talent” pivotal to the “attention economy” (Davenport and Beck)—the players that provide the content for sale—in top form. Yet, the bubble cannot be entirely secured and poor behaviour or performance can have devastating effects, including permanent injury or disability, mental illness and loss of reputation (Rowe, “Scandals and Sport”). Given this fragile materiality of the sporting bubble, it is striking that, in response to the sudden shutdown following the economic and health crisis caused by the 2020 global pandemic, the leaders of professional sport decided to create more of them and seek to seal the metaphorical and material space with unprecedented efficiency. The outcome was a multi-sided tale of mobility, confinement, capital, labour, and the gendering of sport and society. The Covid-19 Gilded Cage Sociologists such as Zygmunt Bauman and John Urry have analysed the socio-politics of mobilities, whereby some people in the world, such as tourists, can traverse the globe at their leisure, while others remain fixed in geographical space because they lack the means to be mobile or, in contrast, are involuntarily displaced by war, so-called “ethnic cleansing”, famine, poverty or environmental degradation. The Covid-19 global pandemic re-framed these matters of mobilities (Rowe, “Subjecting Pandemic Sport”), with conventional moving around—between houses, businesses, cities, regions and countries—suddenly subjected to the imperative to be static and, in perniciously unreflective technocratic discourse, “socially distanced” (when what was actually meant was to be “physically distanced”). The late-twentieth century analysis of the “risk society” by Ulrich Beck, in which the mysterious consequences of humans’ predation on their environment are visited upon them with terrifying force, was dramatically realised with the coming of Covid-19. In another iteration of the metaphor, it burst the bubble of twenty-first century global sport. What we today call sport was formed through the process of sportisation (Maguire), whereby hyper-local, folk physical play was reconfigured as multi-spatial industrialised sport in modernity, becoming increasingly reliant on individual athletes and teams travelling across the landscape and well over the horizon. Co-present crowds were, in turn, overshadowed in the sport economy when sport events were taken to much larger, dispersed audiences via the media, especially in broadcast mode (Nicholson, Kerr, and Sherwood). This lucrative mediation of professional sport, though, came with an unforgiving obligation to generate an uninterrupted supply of spectacular live sport content. The pandemic closed down most sports events and those that did take place lacked the crucial participation of the co-present crowd to provide the requisite event atmosphere demanded by those viewers accustomed to a sense of occasion. Instead, they received a strange spectacle of sport performers operating in empty “cathedrals”, often with a “faked” crowd presence. The mediated sport spectacle under the pandemic involved cardboard cut-out and sex doll spectators, Zoom images of fans on large screens, and sampled sounds of the crowd recycled from sport video games. Confected co-presence produced simulacra of the “real” as Baudrillardian visions came to life. The sporting bubble had become even more remote. For elite sportspeople routinely isolated from the “common people”, the live sport encounter offered some sensory experience of the social – the sounds, sights and even smells of the crowd. Now the sporting bubble closed in on an already insulated and insular existence. It exposed the irony of the bubble as a sign of both privileged mobility and incarcerated athlete work, both refuge and prison. Its logic of contagion also turned a structure intended to protect those inside from those outside into, as already observed, a mechanism to manage the threat of insiders to outsiders. In Australia, as in many other countries, the populace was enjoined by governments and health authorities to help prevent the spread of Covid-19 through isolation and immobility. There were various exceptions, principally those classified as essential workers, a heterogeneous cohort ranging from supermarket shelf stackers to pharmacists. People in the cultural, leisure and sports industries, including musicians, actors, and athletes, were not counted among this crucial labour force. Indeed, the performing arts (including dance, theatre and music) were put on ice with quite devastating effects on the livelihoods and wellbeing of those involved. So, with all major sports shut down (the exception being horse racing, which received the benefit both of government subsidies and expanding online gambling revenue), sport organisations began to represent themselves as essential services that could help sustain collective mental and even spiritual wellbeing. This case was made most aggressively by Australian Rugby League Commission Chairman, Peter V’landys, in contending that “an Australia without rugby league is not Australia”. In similar vein, prominent sport and media figure Phil Gould insisted, when describing rugby league fans in Western Sydney’s Penrith, “they’re lost, because the football’s not on … . It holds their families together. People don’t understand that … . Their life begins in the second week of March, and it ends in October”. Despite misgivings about public safety and equality before the pandemic regime, sporting bubbles were allowed to form, re-form and circulate. The indefinite shutdown of the National Rugby League (NRL) on 23 March 2020 was followed after negotiation between multiple entities by its reopening on 28 May 2020. The competition included a team from another nation-state (the Warriors from Aotearoa/New Zealand) in creating an international sporting bubble on the Central Coast of New South Wales, separating them from their families and friends across the Tasman Sea. Appeals to the mental health of fans and the importance of the NRL to myths of “Australianness” notwithstanding, the league had not prudently maintained a financial reserve and so could not afford to shut down for long. Significant gambling revenue for leagues like the NRL and Australian Football League (AFL) also influenced the push to return to sport business as usual. Sport contests were needed in order to exploit the gambling opportunities – especially online and mobile – stimulated by home “confinement”. During the coronavirus lockdowns, Australians’ weekly spending on gambling went up by 142 per cent, and the NRL earned significantly more than usual from gambling revenue—potentially $10 million above forecasts for 2020. Despite the clear financial imperative at play, including heavy reliance on gambling, sporting bubble-making involved special licence. The state of Queensland, which had pursued a hard-line approach by closing its borders for most of those wishing to cross them for biographical landmark events like family funerals and even for medical treatment in border communities, became “the nation's sporting hub”. Queensland became the home of most teams of the men’s AFL (notably the women’s AFLW season having been cancelled) following a large Covid-19 second wave in Melbourne. The women’s National Netball League was based exclusively in Queensland. This state, which for the first time hosted the AFL Grand Final, deployed sport as a tool in both national sports tourism marketing and internal pre-election politics, sponsoring a documentary, The Sporting Bubble 2020, via its Tourism and Events arm. While Queensland became the larger bubble incorporating many other sporting bubbles, both the AFL and the NRL had versions of the “fly in, fly out” labour rhythms conventionally associated with the mining industry in remote and regional areas. In this instance, though, the bubble experience did not involve long stays in miners’ camps or even the one-night hotel stopovers familiar to the popular music and sport industries. Here, the bubble moved, usually by plane, to fulfil the requirements of a live sport “gig”, whereupon it was immediately returned to its more solid bubble hub or to domestic self-isolation. In the space created between disciplined expectation and deplored non-compliance, the sporting bubble inevitably became the scrutinised object and subject of scandal. Sporting Bubble Scandals While people with a very low risk of spreading Covid-19 (coming from areas with no active cases) were denied entry to Queensland for even the most serious of reasons (for example, the death of a child), images of AFL players and their families socialising and enjoying swimming at the Royal Pines Resort sporting bubble crossed our screens. Yet, despite their (players’, officials’ and families’) relative privilege and freedom of movement under the AFL Covid-Safe Plan, some players and others inside the bubble were involved in “scandals”. Most notable was the case of a drunken brawl outside a Gold Coast strip club which led to two Richmond players being “banished”, suspended for 10 matches, and the club fined $100,000. But it was not only players who breached Covid-19 bubble protocols: Collingwood coaches Nathan Buckley and Brenton Sanderson paid the $50,000 fine imposed on the club for playing tennis in Perth outside their bubble, while Richmond was fined $45,000 after Brooke Cotchin, wife of team captain Trent, posted an image to Instagram of a Gold Coast day spa that she had visited outside the “hub” (the institutionally preferred term for bubble). She was subsequently distressed after being trolled. Also of concern was the lack of physical distancing, and the range of people allowed into the sporting bubble, including babysitters, grandparents, and swimming coaches (for children). There were other cases of players being caught leaving the bubble to attend parties and sharing videos of their “antics” on social media. Biosecurity breaches of bubbles by players occurred relatively frequently, with stern words from both the AFL and NRL leaders (and their clubs) and fines accumulating in the thousands of dollars. Some people were also caught sneaking into bubbles, with Lekahni Pearce, the girlfriend of Swans player Elijah Taylor, stating that it was easy in Perth, “no security, I didn’t see a security guard” (in Barron, Stevens, and Zaczek) (a month later, outside the bubble, they had broken up and he pled guilty to unlawfully assaulting her; Ramsey). Flouting the rules, despite stern threats from government, did not lead to any bubble being popped. The sport-media machine powering sporting bubbles continued to run, the attendant emotional or health risks accepted in the name of national cultural therapy, while sponsorship, advertising and gambling revenue continued to accumulate mostly for the benefit of men. Gendering Sporting Bubbles Designed as biosecurity structures to maintain the supply of media-sport content, keep players and other vital cogs of the machine running smoothly, and to exclude Covid-19, sporting bubbles were, in their most advanced form, exclusive luxury camps that illuminated the elevated socio-cultural status of sportsmen. The ongoing inequalities between men’s and women’s sport in Australia and around the world were clearly in evidence, as well as the politics of gender whereby women are obliged to “care” and men are enabled to be “careless” – or at least to manage carefully their “duty of care”. In Australia, the only sport for women that continued during the height of the Covid-19 lockdown was netball, which operated in a bubble that was one of sacrifice rather than privilege. With minimum salaries of only $30,000 – significantly less than the lowest-paid “rookies” in the AFL – and some being mothers of small children and/or with professional jobs juggled alongside their netball careers, these elite sportswomen wanted to continue to play despite the personal inconvenience or cost (Pavlidis). Not one breach of the netballers out of the bubble was reported, indicating that they took their responsibilities with appropriate seriousness and, perhaps, were subjected to less scrutiny than the sportsmen accustomed to attracting front-page headlines. National Netball League (also known after its Queensland-based naming rights sponsor as Suncorp Super Netball) players could be regarded as fortunate to have the opportunity to be in a bubble and to participate in their competition. The NRL Women’s (NRLW) Premiership season was also completed, but only involved four teams subject to fly in, fly out and bubble arrangements, and being played in so-called curtain-raiser games for the NRL. As noted earlier, the AFLW season was truncated, despite all the prior training and sacrifice required of its players. Similarly, because of their resource advantages, the UK men’s and boy’s top six tiers of association football were allowed to continue during lockdown, compared to only two for women and girls. In the United States, inequalities between men’s and women’s sports were clearly demonstrated by the conditions afforded to those elite sportswomen inside the Women’s National Basketball Association (WNBA) sport bubble in the IMG Academy in Florida. Players shared photos of rodent traps in their rooms, insect traps under their mattresses, inedible food and blocked plumbing in their bubble accommodation. These conditions were a far cry from the luxury usually afforded elite sportsmen, including in Florida’s Walt Disney World for the men’s NBA, and is just one of the many instances of how gendered inequality was both reproduced and exacerbated by Covid-19. Bursting the Bubble As we have seen, governments and corporate leaders in sport were able to create material and metaphorical bubbles during the Covid-19 lockdown in order to transmit stadium sport contests into home spaces. The rationale was the importance of sport to national identity, belonging and the routines and rhythms of life. But for whom? Many women, who still carry the major responsibilities of “care”, found that Covid-19 intensified the affective relations and gendered inequities of “home” as a leisure site (Fullagar and Pavlidis). Rates of domestic violence surged, and many women experienced significant anxiety and depression related to the stress of home confinement and home schooling. During the pandemic, women were also more likely to experience the stress and trauma of being first responders, witnessing virus-related sickness and death as the majority of nurses and care workers. They also bore the brunt of much of the economic and employment loss during this time. Also, as noted above, livelihoods in the arts and cultural sector did not receive the benefits of the “bubble”, despite having a comparable claim to sport in contributing significantly to societal wellbeing. This sector’s workforce is substantially female, although men dominate its senior roles. Despite these inequalities, after the late March to May hiatus, many elite male sportsmen – and some sportswomen - operated in a bubble. Moving in and out of them was not easy. Life inside could be mentally stressful (especially in long stays of up to 150 days in sports like cricket), and tabloid and social media troll punishment awaited those who were caught going “over the fence”. But, life in the sporting bubble was generally preferable to the daily realities of those afflicted by the trauma arising from forced home confinement, and for whom watching moving sports images was scant compensation for compulsory immobility. The ethical foundation of the sparkly, ephemeral fantasy of the sporting bubble is questionable when it is placed in the service of a voracious “media sports cultural complex” (Rowe, Global Media Sport) that consumes sport labour power and rolls back progress in gender relations as a default response to a global pandemic. Covid-19 dramatically highlighted social inequalities in many areas of life, including medical care, work, and sport. For the small minority of people involved in sport who are elite professionals, the only thing worse than being in a sporting bubble during the pandemic was not being in one, as being outside precluded their participation. Being inside the bubble was a privilege, albeit a dubious one. But, as in wider society, not all sporting bubbles are created equal. Some are more opulent than others, and the experiences of the supporting and the supported can be very different. The surface of the sporting bubble may be impermanent, but when its interior is opened up to scrutiny, it reveals some very durable structures of inequality. Bubbles are made to burst. They are, by nature, temporary, translucent structures created as spectacles. As a form of luminosity, bubbles “allow a thing or object to exist only as a flash, sparkle or shimmer” (Deleuze, 52). In echoing Deleuze, Angela McRobbie (54) argues that luminosity “softens and disguises the regulative dynamics of neoliberal society”. The sporting bubble was designed to discharge that function for those millions rendered immobile by home confinement legislation in Australia and around the world, who were having to deal with the associated trauma, risk and disadvantage. 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