La valorizzazione della professionalità nella contrattazione collettiva: sistemi classificatori e percorsi di mobilità professionale

La tesi, che si articola in tre capitoli, analizza la rilevanza della professionalità del lavoratore nell’ambito del rapporto di lavoro subordinato con particolare riferimento all’interesse mostrato da parte della contrattazione collettiva nel settore privato e pubblico nella definizione dei sistemi classificatori e di inquadramento del personale. Nel primo capitolo, si dà conto dei fattori che hanno determinato l’emersione della professionalità quale bene giuridico meritevole di tutela da parte dell’ordinamento: si analizzano in particolare le trasformazioni organizzative e produttive, nonché le indicazioni provenienti dal testo costituzionale che si riverberano di poi nella legislazione ordinaria. Nel secondo si analizza quanto la professionalità, o le singole voci che la compongono, rilevi a fini classificatori: dunque in che termini le competenze, le conoscenze del lavoratore rilevino quali criteri classificatori. Nel terzo capitolo, viceversa, si pone maggiore attenzione rispetto all’ “importanza” della professionalità quale fattore che incide su meccanismi di progressione retributiva e in genere professionale (assumendosi tale espressione come una sorta di sinonimo del termine carriera, rispetto al quale si differenzia quanto al contesto organizzativo e produttivo in cui si svolge) del lavoratore. In un assetto simile, centrale è il rilievo della valutazione del lavoratore. I contratti collettivi analizzati sono per il settore privato quelli delle categorie chimici, terziario e tessile; per il settore pubblico, quelli del comparto sanità e regioni ed autonomie locali.

Eterogeneità delle proprietà fisico – chimiche della proteina prionica patologica e variabilità fenotipica ceppo specifica nella malattia di Creutzfeldt – Jakob

Transmissible spongiform encephalopathies (TSEs), or prion diseases, are neurodegenerative disorders that affect humans and mammals. Creutzfeldt-Jakob disease (CJD), the most common TSE in humans, can be sporadic (sCJD), genetic (gCJD), or acquired by infection. All TSEs are characterised by the accumulation of PrPSc, a misfolded form of the cellular protein PrPC. PrPSc is insoluble in detergents, partially resistant to proteolysis and shows a highly enriched β-sheet secondary structure. Six clinico-pathological phenotypes of sCJD have been characterized which correlate at the molecular level with two types (1 or 2) of PrPSc with distinctive physicochemical properties and the genotype at the polymorphic (methionine or valine) codon 129 of the prion protein gene. According to the protein-only hypothesis, which postulates that prions are composed exclusively of PrPSc, the strains of prions that are largely responsible for the wide spectrum of TSE phenotypes are enciphered in PrPSc conformation. In support to this view, studies mainly conducted in experimental scrapie, have shown that several prion strains can be identified based on distinguishing PrPSc biochemical properties. To further contribute to the understanding of the molecular basis of strains and to develop more sensitive strain typing assays in humans we have analyzed PrPSc biochemical properties in two experimental setting. In the first we compared the size of the core after protease digestion and the glycoform pattern of PrPSc before and after transmission of human prions to non human primates or bank voles, whereas in the second we analyzed the conformational stability of PrPSc associated with sCJD, vCJD or fCJD using guanidine hydrochloride (GdnHCl) as denaturant. Combining the results of the two studies, we were able to distinguish five human strains for at least one biochemical property. The present data extend our knowledge about the extent of strain variation and its relationship with PrPSc properties in human TSEs.

Il Nilotinib nella terapia di prima linea della leucemia mieloide cronica

Background: Nilotinib is a potent and selective BCR-ABL inhibitor. The phase 3 ENESTnd trial demonstrated superior efficacy nilotinib vs imatinib, with higher and faster molecular responses. After 24 months, the rates of progression to accelerated-blastic phase (ABP) were 0.7% and 1.1% with nilotinib 300mg and 400mg BID, respectively, significantly lower compared to imatinib (4.2%). Nilotinib has been approved for the frontline treatment of Ph+ CML. With imatinib 400mg (IRIS trial), the rate of any event and of progression to ABP were higher during the first 3 years. Consequently, a confirmation of the durability of responses to nilotinib beyond 3 years is extremely important. Aims: To evaluate the response and the outcome of patients treated for 3 years with nilotinib 400mg BID as frontline therapy. Methods: A multicentre phase 2 trial was conducted by the GIMEMA CML WP (ClinicalTrials.gov.NCT00481052). Minimum 36-month follow-up data for all patients will be presented. Definitions: Major Molecular Response (MMR): BCR-ABL/ABL ratio <0,1%IS; Complete Molecular Response (CMR): undetectable transcript levels with ≥10,000 ABL transcripts; failures: according to the revised ELN recommendations; events: failures and treatment discontinuation for any reason. All the analysis has been made according to the intention-to-treat principle. Results: 73 patients enrolled: median age 51 years; 45% low, 41% intermediate and 14% high Sokal risk. The cumulative incidence of CCgR at 12 months was 100%. CCgR at each milestone: 78%, 96%, 96%, 95%, 92% at 3, 6, 12, 18 and 24 months, respectively. The overall estimated probability of MMR was 97%, while the rates of MMR at 3, 6, 12, 18 and 24 months were 52%, 66%, 85%, 81% and 82%, respectively. The overall estimated probability of CMR was 79%, while the rates of CMR at 12 and 24 months were 12% and 27%, respectively. No patient achieving a MMR progressed to AP. Only one patient progressed at 6 months to ABP and subsequently died (high Sokal risk, T315I mutation). Adverse events were mostly grade 1 or 2 and manageable with appropriate dose adaptations. During the first 12 months, the mean daily dose was 600-800mg in 74% of patients. The nilotinib last daily dose was as follows: 800mg in 46 (63%) patients, 600mg in 3 (4%) patients and 400mg in 18 (25%), 6 permanent discontinuations. Detail of discontinuation: 1 patient progressed to ABP; 3 patients had recurrent episodes of amylase and/or lipase increase (no pancreatitis); 1 patient had atrial fibrillation (unrelated to study drug) and 1 patient died after 32 months of mental deterioration and starvation (unrelated to study drug). Two patients are currently on imatinib second-line and 2 on dasatinib third-line. With a median follow-up of 39 months, the estimated probability of overall survival, progression-free survival and failure-free survival was 97%, the estimated probability of event-free survival was 91%. Conclusions: The rate of failures was very low during the first 3 years. Responses remain stable. The high rates of responses achieved during the first 12 months are being translated into optimal outcome for most of patients.

Ruolo delle specie reattive dell'ossigeno e di caveole/raft lipidici nella biosegnalazione in linee cellulari umane

Membrane lipid rafts are detergent-resistant microdomains containing glycosphingolipids, cholesterol and glycosylphosphatidylinositol-linked proteins; they seem to be actively involved in many cellular processes including signal transduction, apoptosis, cell adhesion and migration. Lipid rafts may represent important functional platforms where redox signals are produced and transmitted in response to various agonists or stimuli. In addition, a new concept is emerging that could be used to define the interactions or amplification of both redox signalling and lipid raft-associated signalling. This concept is characterized by redox-mediated feed forward amplification in lipid platforms. It is proposed that lipid rafts are formed in response to various stimuli; for instance, NAD(P)H oxidase (Nox) subunits are aggregated or recruited in these platforms, increasing Nox activity. Superoxide and hydrogen peroxide generation could induce various regulatory activities, such as the induction of glucose transport activity and proliferation in leukaemia cells. The aim of our study is to probe: i) the involvement of lipid rafts in the modulation of the glucose transporter Glut1 in human acute leukemia cells; ii) the involvement of plasma membrane caveolae/lipid rafts in VEGF-mediated redox signaling via Nox activation in human leukemic cells; iii) the role of p66shc, an adaptor protein, in VEGF signaling and ROS production in endothelial cells (ECs); iv) the role of Sindecan-2, a transmembrane heparan sulphate proteoglycan, in VEGF signaling and physiological response in ECs and v) the antioxidant and pro-apoptotic activities of simple dietary phenolic acids, i. e. caffeic, syringic and protocatechuic acids in leukemia cells, characterized by a very high ROS content. Our results suggest that the role played by NAD(P)H oxidase-derived ROS in the regulation of glucose uptake, proliferation and migration of leukaemia and endothelial cells could likely occur through the control of lipid raft-associated signalling.

Studio analitico della cultura materiale fra VII e IX secolo d.C. nella Regione di Samarcanda (Uzbekistan): analisi morfo-tipologica, produzione e commercio della ceramica di Kafir Kala

Kafir Kala is a key-site to understand the historical dynamics of the Samarkand Region in the Early Middle Ages (5th - 8th centuries CE). The site is clearly associated with a Sogdian occupation, as both literature and archaeological research testify. But the chronological phase that follows the Sogdian period, as the Islamic occupation became stable, is still little known. Structures and finds (an hoard of 133 silver coins, in particular) clearly testify a new occupation of some parts of the citadel; and some rooms, dug in the northern side of it, present structures and materials connected with an Islamic activity. The study of material culture from these rooms, and from more ancient contexts, will help to understand the eventual continuity of traditions and the new productions. Besides the citadel, as a matter of fact, also some kilns have been dug, near the main site. Their material culture is very interesting because it represents an example of the typical Sogdian production (ceramics covered with white mica, and stamped). The work on the ceramic material has consisted in cataloguing and classifying all the diagnostics. Three main morphological classes have been individuated: cooking, coarse and table ware), and some other ones (lamps, ossuaries). A catalogue of the finds organized them in a typological system based on their morphology, function, fabric, and eventually decoration style. Crossing the stratigraphical data with information from this typological study, it has been possible to provide a chronological arrangement of the sites investigated by the italo-uzbek archaeological mission from 2001 to 2008.

La definizione di criminalità organizzata nella letteratura giuridica e nella normativa interna ed internazionale

Non può dirsi ancora raggiunta una completa, appagante e condivisa definizione di criminalità organizzata: eppure tale concetto viene ampiamente utilizzato, entrando nel linguaggio comune e –soprattutto- in quello normativo e giurisprudenziale. Attraverso il susseguirsi di numerosi interventi legislativi, abbiamo assistito alla progressiva elaborazione del c.d. doppio binario: di una normativa, cioè, ad hoc per i reati di criminalità organizzata, caratterizzata da un rilevante arretramento delle ordinarie soglie di garanzia previste dall’ordinamento giuridico. Alla luce di prioritarie esigenze di legalità si giustifica l’impellente necessità di giungere alla elaborazione di una precisa definizione di criminalità organizzata. A tale fine, nel corso del presente lavoro, sono stati esaminati i principali approcci definitori individuati a livello socio-criminologico, giurisprudenziale ed in ambito normativo, con particolare attenzione al diritto penale e processual-penalistico; si è inoltre proceduto all’analisi delle principali definizioni riscontrabili a livello comunitario ed internazionale.

Ruolo di interleuchina-33 sull'espressione di geni profibrotici e sull'ipertrofia dei miofibroblasti nella fibrosi intestinale

Background: Intestinal fibrosis is a serious complication of IBD, with more than a third of Crohn’s disease (CD) patients developing a fibrostenosing phenotype with formation of strictures that will require surgical intervention. Remarkably, SAMP1/YitFc (SAMP) mice, a spontaneous model of CD, develop gut fibrosis; similar to IBD patients, the pathophysiology of SAMP fibrosis is unknown. IL-33 is a member of the IL-1 cytokine family and increased expression is associated with IBD. Emerging evidence suggests its potential role in liver and cutaneous fibrosis, as well as myofibroblast-associated colonic ulcerations . Aim: The aim of this study was to evaluate the role of IL-33 as a potential mediator of profibrotic events leading to intestinal fibrosis and possible stricture formation. Methods: A detailed histologic time course study, with collagen-specific Masson trichrome staining and IHC for ST2 (IL-33 receptor), was performed on SAMP and control AKR (parental strain) mice. qRT-PCR was done on full-thickness ilea for the profibrogenic genes, collagen (coll)-1, coll-3, connective tissue growth factor (CTGF) and insulin-like growth factor 1 (IGF-1). Exogenous IL-33 (33 μg/kg, i.p.) or vehicle was administered daily for 7d to SAMP and AKR mice (N=6/exp group), and ileal tissues evaluated as above. Finally, microarray analysis was performed on full-thickness ilea from SAMP and AKR mice, and IL-33 stimulated subepithelial myofibroblasts (SEMFs). Results: SAMP mice displayed ileal skip lesions with randomly distributed strictures, preceded by typical pre-stricture dilations of the ileum. Ileal wall was visibly thickened with hypertrophy of the serosa, muscularis mucosa, muscularis propria, within which intense collagen deposition was observed, and inflammatory infiltrates in segments showing strictures. Interestingly, intense ST2 staining was present within the inflamed lamina propria of SAMP, notably localized to SEMFs. Fibrosis was first observed at 20 wks, and reached its peak by 50 wks of age. mRNA expression of coll-1 (4.74±0.69-fold; P=0.001), coll-3 (4.92±1.05-fold; P=0.01), IGF1 (12.9±3.45; P=0.006), and CTGF (3.29±0.69; P=0.004) was dramatically elevated in SAMP vs. AKR ilea. IL-33 treatment of AKR mice induced a marked increase in muscle fiber/myofibroblast cellularity and hypertrophy of the muscularis propria (4.13±0.74-fold; P<0.0001), and mRNA expression of coll-1 (5.16±0.89-fold; P=0.0009), coll-3 (1.97±0.14-fold; P=0.01), IGF-1 (9.32±2.27-fold; P=0.004), and CTGF (1.43±0.31-fold; P=0.006) vs. vehicle controls. Microarray data from SAMP ilea and IL-33-treated SEMFs confirmed these trends, displaying a global increase in profibrogenic gene expression. Conclusion: These data suggest an important role for IL-33 in intestinal fibrosis, and may represent a potential target for the treatment of IBD-associated fibrosis and stricture formation.

Child Abuse: il ruolo del medico legale nell'assistenza, nella prevenzione e nella preparazione di linee guida

Con questo mio lavoro di tesi ho voluto esplorare il fenomeno del maltrattamento e dell’abuso sui minori delineandone, sulla base della letteratura scientifica nazionale ed internazionale, gli aspetti clinici, epidemiologici ed i fattori di rischio. Un breve excursus giuridico illustrerà, poi, gli articoli di legge relativi alla tutela dei minori; in particolare, ci si soffermerà ad illustrare quegli articoli che normano i doveri dei sanitari nei confronti dell’autorità giudiziaria nel caso si sospetti un abuso su minori. La conoscenza della semeiotica dell’abuso, il suo riconoscimento all’interno di una diagnostica differenziale clinico-forense, la corretta repertazione e la consapevolezza che, un approccio autenticamente tutelante verso la vittima, deve sempre realizzarsi all’interno di una cornice giuridica fanno si che, il ruolo della medicina legale, competente in tutti questi ambiti, diventi senza ombra di dubbio “primum inter pares” all’interno dei team multidisciplinari ed interistituzionali che si occupano di minori vitti. Il gruppo scientifico in cui sono stata inserita e con cui si è proceduto alla redazione del manuale è il Gruppo di lavoro per l’abuso e il maltrattamento dell’infanzia coordinato dalla dott.ssa Maria Rosa Giolito ed ha coinvolto professionisti italiani afferenti a tre differenti aree sanitarie: quella ginecologica, quella medico-legale e quella pediatrica. Il testo elaborato è stato immaginato come un aiuto ai professionisti medici che si trovano a valutare un soggetto prepubere con sospetto di abuso sessuale. Non costituisce una linea-guida per la diagnosi di abuso sessuale, ma definisce alcuni requisiti essenziali e diffonde alcune conoscenze per evitare errori che possano ripercuotersi negativamente sulla valutazione clinica e sull’eventuale conseguente iter giudiziario.

La salute detenuta: tra diritto e sicurezza”. Un’ indagine nella Casa Circondariale di Rimini.

The survey approachs the issue of health and the problem of its effective protection in a context of deprivation of liberty and coercion, which is the prison. The theoretical reflection born from the reform of the Legislative Decree 230/99 which marked the transition from an employee by the Prison Health within prison a fully integrated in the National Health Service. The comparison between an institution of health promotion and institution of punishment which may operate on the same subject held produces multiple attrits, making their relationship problematic. The work shows the daily difficulties in the management of prison health within the institution, physician-patient between different health care roles, and between the latter and prison workers. The coexistence, in fact, is not always harmonious though quite often it is common sense and the willingness of operators to reduce barriers: overcrowding, limited resources and insufficient staff make the application of the rule and therefore the right to goal a difficult to be pursued. It is designed for a scheme of semi-structured interview essay is divided into 3 sections covering: "staff and its functions", "health reform" and "health of the prisoner"; questions were directed to doctors, nurses and psychologists engaged inside the prison of Rimini with the specific aim of examining the ambivalent relationship between the demand for health care in prisons and the need for security and a clear - albeit partial - point of view. We tried to reconstruct the situation of prison health care through the perception of prison operators, capturing the problematic issues that deal on both issues is instrumental to the experience of persons detained by analyzing, in terms of operators , what happens inside of a prison institution in everyday health care.

Produzione automatizzata per nastratura di componenti strutturali in materiale composito

Questa dissertazione tratterà l’argomento dello studio di metodi di progettazione e processi tecnologici innovativi per l’industrializzazione in medio-grande serie di componenti strutturali in materiale composito. L’interesse della ricerca verso questo ambito è suscitato dai notevoli vantaggi che l’utilizzo di materiali dall’alto rapporto prestazioni meccaniche/peso danno nella ricerca di elevate prestazioni in applicazioni sportive e diminuzione dei consumi ed emissioni inquinanti in mezzi di trasporto di grande serie. Lo studio di componenti in materiale composito è caratterizzato dalla peculiarità di non poter disgiungere la progettazione della geometria della parte da quella del materiale e del processo, ed in questo senso nella figura del progettista si vanno a riassumere sinergicamente competenze riguardanti i tre ambiti. Lo scopo di questo lavoro è la proposizione di una metodologia di progettazione e produzione di componenti strutturali che permetta l’utilizzazione ottimale della natura fibrosa del materiale composito sia dal punto di vista del trasferimento dei carichi tra diversi componenti, sia dal punto di vista del processo di laminazione che avviene per nastratura automatizzata. Lo studio è volto a mostrare in quali termini tale tecnologia sia potenzialmente in grado di superare i vincoli di forma ed i limiti di efficienza meccanica delle giunzioni tra le parti e di garantire maggiore produttività e costi inferiori rispetti ai diversi metodi di produzione che rappresentano oggi lo stato dell’arte dell’industrializzazione in medio-grande serie. Particolare attenzione verrà posta sull’utilizzo della tecnologia oggetto di studio per la produzione di telai automobilistici.