L'influenza del sonno sull'andamento temporale della consolidazione delle abilità procedurali

Background: It is well known, since the pioneristic observation by Jenkins and Dallenbach (Am J Psychol 1924;35:605-12), that a period of sleep provides a specific advantage for the consolidation of newly acquired informations. Recent research about the possible enhancing effect of sleep on memory consolidation has focused on procedural memory (part of non-declarative memory system, according to Squire’s taxonomy), as it appears the memory sub-system for which the available data are more consistent. The acquisition of a procedural skill follows a typical time course, consisting in a substantial practice-dependent learning followed by a slow, off-line improvement. Sleep seems to play a critical role in promoting the process of slow learning, by consolidating memory traces and making them more stable and resistant to interferences. If sleep is critical for the consolidation of a procedural skill, then an alteration of the organization of sleep should result in a less effective consolidation, and therefore in a reduced memory performance. Such alteration can be experimentally induced, as in a deprivation protocol, or it can be naturally observed in some sleep disorders as, for example, in narcolepsy. In this research, a group of narcoleptic patients, and a group of matched healthy controls, were tested in two different procedural abilities, in order to better define the size and time course of sleep contribution to memory consolidation. Experimental Procedure: A Texture Discrimination Task (Karni & Sagi, Nature 1993;365:250-2) and a Finger Tapping Task (Walker et al., Neuron 2002;35:205-11) were administered to two indipendent samples of drug-naive patients with first-diagnosed narcolepsy with cataplexy (International Classification of Sleep Disorder 2nd ed., 2005), and two samples of matched healthy controls. In the Texture Discrimination task, subjects (n=22) had to learn to recognize a complex visual array on the screen of a personal computer, while in the Finger Tapping task (n=14) they had to press a numeric sequence on a standard keyboard, as quickly and accurately as possible. Three subsequent experimental sessions were scheduled for each partecipant, namely a training session, a first retrieval session the next day, and a second retrieval session one week later. To test for possible circadian effects on learning, half of the subjects performed the training session at 11 a.m. and half at 17 p.m. Performance at training session was taken as a measure of the practice-dependent learning, while performance of subsequent sessions were taken as a measure of the consolidation level achieved respectively after one and seven nights of sleep. Between training and first retrieval session, all participants spent a night in a sleep laboratory and underwent a polygraphic recording. Results and Discussion: In both experimental tasks, while healthy controls improved their performance after one night of undisturbed sleep, narcoleptic patients showed a non statistically significant learning. Despite this, at the second retrieval session either healthy controls and narcoleptics improved their skills. Narcoleptics improved relatively more than controls between first and second retrieval session in the texture discrimination ability, while their performance remained largely lower in the motor (FTT) ability. Sleep parameters showed a grater fragmentation in the sleep of the pathological group, and a different distribution of Stage 1 and 2 NREM sleep in the two groups, being thus consistent with the hypothesis of a lower consolidation power of sleep in narcoleptic patients. Moreover, REM density of the first part of the night of healthy subjects showed a significant correlation with the amount of improvement achieved at the first retrieval session in TDT task, supporting the hypothesis that REM sleep plays an important role in the consolidation of visuo-perceptual skills. Taken together, these results speak in favor of a slower, rather than lower consolidation of procedural skills in narcoleptic patients. Finally, an explanation of the results, based on the possible role of sleep in contrasting the interference provided by task repetition is proposed.

Relazione gestante-feto, modalità del parto e sviluppo fisico del bambino

Extensive literature outlined that the quality of the mother-foetus relationship is considered the main feature with regard to the quality of postnatal mother-infant interaction and also to the child’s psychical development. Nowadays the relationship between the pregnant woman and her foetus is viewed as the central factor of the somatic dialogue between the functioning of the maternal and the foetal organisms. This dialogue is responsible for the physic development of the child, as well as of its psychosomatic structure. Therefore the research area has necessarily had to extend to the analysis of psychological processes concerning: the pregnancy, the couple that is bound by parenthood, the influence of intergenerational dynamics. In fact, the formation of maternal identity, as well as that of the relationship between the woman and the foetus, refers to the pregnant woman’s relationship with her parents, especially with her mother. The same pregnancy, considered as a psychosomatic event, is directly influenced by relational, affective and social factors, particularly by the quality of the interiorized parental relations and the quality of the current relationships (such as that with her partner and with her family of origin). Some studies have begun to investigate the relationship between the pregnant woman and the foetus in term of “prenatal attachment” and its relationship with socio-demographic, psychological e psychopathological aspects (such as pre and post partum depression), but the research area is still largely unexplored. The present longitudinal research aimed to investigate the quality of the pregnant womanfoetus relationship by the prenatal attachment index, the quality of the interiorized relationship with woman’s parents, the level of alexithymic features and maternity social support, in relation with the modulation of the physiology of delivery and of postpartum, as well as of the physical development of the child. A consecutive sample of 62 Italian primipara women without any kind of pathologies, participated in the longitudinal study. In the first phase of this study (third trimester of the pregnancy), it has investigated the psychological processes connected to the affective investment of the pregnant women towards the unborn baby (by Prenatal Attachment Inventory), the mothers’ interiorized relationship with their own parents (by Parental Bonding Instrument), the social and affective support from their partner and their family of origin are able to supply (by Maternity Social Support Scale), and the level of alexithymia (by 20-Toronto Alexithymia Scale). In the second phase of this study, some data concerning the childbirth course carried out from a “deliverygram” (such as labour, induction durations and modalities of delivery) and data relative to the newborns state of well-being (such as Apgar and pH indexes). Finally, in the third phase of the study women have been telephoned a month after the childbirth. The semistructured interview investigated the following areas: the memory concerning the delivery, the return to home, the first interactions between the mother and the newborn, the breastfeeding, the biological rhythms achieved from newborns. From the data analysis a sample with a good level of prenatal attachment and of support social and a good capability to mental functioning emerged. An interesting result is that the most of the women have a great percentage of “affectionless control style” with both parents, but data is not sufficient to interpret this result. Moreover, considering the data relative to the delivery, medical and welfare procedures, that have been necessary, are coherent with the Italian mean, while the percentage of the caesarean section (12.9%) is inferior to the national percentage (30%). The 29% of vaginal partum has got epidural analgesia, which explains the high number (37%) of obstetrician operations (such as Kristeller). The data relative to the newborn (22 male, 40 female) indicates a good state of well-being because Apgar and pH indexes are superior to 7 at first and fifth minutes. Concerning the prenatal phase, correlation analysis showed that: the prenatal attachment scores positively correlated with the expected social support and negatively correlated with the “externally oriented thinking” dimension of alexithymia; the maternity social support negatively correlated with total alexithymia score, particularly with the “externally oriented thinking” dimension, and negatively correlated with maternal control of parental bonding. Concerning the delivery data, there are many correlations (after all obvious) among themselves. The most important are that the labour duration negatively correlated with the newborn’s index state of well-being. Finally, concerning the data from the postpartum phase the women’ assessments relative to the partum negatively correlated with the duration of the delivery and positively correlated with the assessment relative to the return to home and the interaction with the newborn. Moreover the length of permanence in the hospital negatively correlated with women’s assessments relative to the return to home that, in turn, positively correlated with the quality of breastfeeding, the interaction between the mother and the newborn and the biological regulation of the child. Finally, the women’ assessments relative to breastfeeding positively correlated with the mother-child interactions and the biological rhythms of children. From the correlation analysis between the variables of the prenatal phase and the data relative to the delivery, emerged that the prenatal attachment scores positively correlated with the dilatation stage scores and with the newborn’s Apgar index at first minute, the paternal care dimension of parental bonding positively correlated with the lengths of the various periods of childbirth like so the paternal control dimension with placental stage. Moreover, emerged that the expected social support positively correlated with the lengths of the various periods of childbirth and that the global alexithymia scores, particularly “difficulty to describe emotions” dimension, negatively correlated with total childbirth scores. From the correlation analysis between the variables of the prenatal phase and variable of the postpartum phase emerged that the total alexithymia scores positively correlated with the time elapsed from the childbirth to the breastfeeding of the child, the difficulty to describe emotions dimension of the alexithymia negatively correlated with the quality of the breastfeeding, the “externally oriented thinking” dimension of the alexithymia negatively correlated with mother-child interactions, and finally the paternal control dimension of the parental bonding negatively correlated with the time elapsed from the child to the breastfeeding of the child. Finally, from the analysis of the correlation between the data of the partum and the women’s assessments of the postpartum phase, emerged the negative correlation between the woman’s assessment relative to the delivery and the quantitative of obstetrician operations and the lengths of the various periods of childbirth, the positive correlation between the women’s assessment about the length of delivery periods and the real lengths of the same ones, the positive relation between woman’s assessment relative to the delivery and the Apgar index of children. In conclusion, there is a remarkable relation between the quality of the relationship the woman establishes with the foetus that influences the course of the pregnancy and the delivery that, in turn, influences the postpartum outcome, particularly relative to the mother-children relationship. Such data should be confirmed by heterogeneous populations in order to identify vulnerable women and to project focused intervention.

Componenti spaziali della rappresentazione cognitiva della grandezza del numero

The humans process the numbers in a similar way to animals. There are countless studies in which similar performance between animals and humans (adults and/or children) are reported. Three models have been developed to explain the cognitive mechanisms underlying the number processing. The triple-code model (Dehaene, 1992) posits an mental number line as preferred way to represent magnitude. The mental number line has three particular effects: the distance, the magnitude and the SNARC effects. The SNARC effect shows a spatial association between number and space representations. In other words, the small numbers are related to left space while large numbers are related to right space. Recently a vertical SNARC effect has been found (Ito & Hatta, 2004; Schwarz & Keus, 2004), reflecting a space-related bottom-to-up representation of numbers. The magnitude representations horizontally and vertically could influence the subject performance in explicit and implicit digit tasks. The goal of this research project aimed to investigate the spatial components of number representation using different experimental designs and tasks. The experiment 1 focused on horizontal and vertical number representations in a within- and between-subjects designs in a parity and magnitude comparative tasks, presenting positive or negative Arabic digits (1-9 without 5). The experiment 1A replied the SNARC and distance effects in both spatial arrangements. The experiment 1B showed an horizontal reversed SNARC effect in both tasks while a vertical reversed SNARC effect was found only in comparative task. In the experiment 1C two groups of subjects performed both tasks in two different instruction-responding hand assignments with positive numbers. The results did not show any significant differences between two assignments, even if the vertical number line seemed to be more flexible respect to horizontal one. On the whole the experiment 1 seemed to demonstrate a contextual (i.e. task set) influences of the nature of the SNARC effect. The experiment 2 focused on the effect of horizontal and vertical number representations on spatial biases in a paper-and-pencil bisecting tasks. In the experiment 2A the participants were requested to bisect physical and number (2 or 9) lines horizontally and vertically. The findings demonstrated that digit 9 strings tended to generate a more rightward bias comparing with digit 2 strings horizontally. However in vertical condition the digit 2 strings generated a more upperward bias respect to digit 9 strings, suggesting a top-to-bottom number line. In the experiment 2B the participants were asked to bisect lines flanked by numbers (i.e. 1 or 7) in four spatial arrangements: horizontal, vertical, right-diagonal and left-diagonal lines. Four number conditions were created according to congruent or incongruent number line representation: 1-1, 1-7, 7-1 and 7-7. The main results showed a more reliable rightward bias in horizontal congruent condition (1-7) respect to incongruent condition (7-1). Vertically the incongruent condition (1-7) determined a significant bias towards bottom side of line respect to congruent condition (7-1). The experiment 2 suggested a more rigid horizontal number line while in vertical condition the number representation could be more flexible. In the experiment 3 we adopted the materials of experiment 2B in order to find a number line effect on temporal (motor) performance. The participants were presented horizontal, vertical, rightdiagonal and left-diagonal lines flanked by the same digits (i.e. 1-1 or 7-7) or by different digits (i.e. 1-7 or 7-1). The digits were spatially congruent or incongruent with their respective hypothesized mental representations. Participants were instructed to touch the lines either close to the large digit, or close to the small digit, or to bisected the lines. Number processing influenced movement execution more than movement planning. Number congruency influenced spatial biases mostly along the horizontal but also along the vertical dimension. These results support a two-dimensional magnitude representation. Finally, the experiment 4 addressed the visuo-spatial manipulation of number representations for accessing and retrieval arithmetic facts. The participants were requested to perform a number-matching and an addition verification tasks. The findings showed an interference effect between sum-nodes and neutral-nodes only with an horizontal presentation of digit-cues, in number-matching tasks. In the addition verification task, the performance was similar for horizontal and vertical presentations of arithmetic problems. In conclusion the data seemed to show an automatic activation of horizontal number line also used to retrieval arithmetic facts. The horizontal number line seemed to be more rigid and the preferred way to order number from left-to-right. A possible explanation could be the left-to-right direction for reading and writing. The vertical number line seemed to be more flexible and more dependent from the tasks, reflecting perhaps several example in the environment representing numbers either from bottom-to-top or from top-to-bottom. However the bottom-to-top number line seemed to be activated by explicit task demands.

L'attrazione sessuale: processi psichici e strumenti di indagine. L'adattamento italiano del Cuestionario de Atraccion sexual

The sexual attraction is a complex emotional event, with somatic modifications, that like all the emotions, belongs to the psychic dimension and that, too much simply, can be led back, from a explicative point of view, to biological and psychical causes. The sexual attraction represents a personal experience, that is difficult to record, but of which every adult is able to delineate a correspondence with own “lived”. In the within of biological sciences, many experimental studies were been conducted with the aim to know which chemistries substances and cerebral zones are involved in front of a stimulus assessed like sexually attractive. Contrarily, there are little researches conducted in psychological field, aimed to the understanding the psychical factors, often unconscious, tinged to the subjective processes of sexual attraction: the sexual attraction remains an unexplored psychological event and unprovided of adapted instruments of assessment. The present thesis is oriented in primis to examine the existing scientific literature, in order to provide an exhaustive picture of the sexual attraction and to analyze the instruments of survey available for the empirical assessment of it. Secondly, the thesis is oriented to introduce two studies: the first study is aimed to adapt the Cuestionario de Atracción Sexual - CAS (Fernández ET to, 2006a; 2006b; 2006c) to the Italian language; the second study is aimed to assess the attitudes towards the sexual attraction in a sample of university students, in order to establish if some differences or association with some psychological dimensions (attachment stiles and alexithymia) exist.

Il ruolo del collicolo superiore nell'orientamento spaziale

This thesis was aimed at verifying the role of the superior colliculus (SC) in human spatial orienting. To do so, subjects performed two experimental tasks that have been shown to involve SC’s activation in animals, that is a multisensory integration task (Experiment 1 and 2) and a visual target selection task (Experiment 3). To investigate this topic in humans, we took advantage of neurophysiological finding revealing that retinal S-cones do not send projections to the collicular and magnocellular pathway. In the Experiment 1, subjects performed a simple reaction-time task in which they were required to respond as quickly as possible to any sensory stimulus (visual, auditory or bimodal audio-visual). The visual stimulus could be an S-cone stimulus (invisible to the collicular and magnocellular pathway) or a long wavelength stimulus (visible to the SC). Results showed that when using S-cone stimuli, RTs distribution was simply explained by probability summation, indicating that the redundant auditory and visual channels are independent. Conversely, with red long-wavelength stimuli, visible to the SC, the RTs distribution was related to nonlinear neural summation, which constitutes evidence of integration of different sensory information. We also demonstrate that when AV stimuli were presented at fixation, so that the spatial orienting component of the task was reduced, neural summation was possible regardless of stimulus color. Together, these findings provide support for a pivotal role of the SC in mediating multisensory spatial integration in humans, when behavior involves spatial orienting responses. Since previous studies have shown an anatomical asymmetry of fibres projecting to the SC from the hemiretinas, the Experiment 2 was aimed at investigating temporo-nasal asymmetry in multisensory integration. To do so, subjects performed monocularly the same task shown in the Experiment 1. When spatially coincident audio-visual stimuli were visible to the SC (i.e. red stimuli), the RTE depended on a neural coactivation mechanism, suggesting an integration of multisensory information. When using stimuli invisible to the SC (i.e. purple stimuli), the RTE depended only on a simple statistical facilitation effect, in which the two sensory stimuli were processed by independent channels. Finally, we demonstrate that the multisensory integration effect was stronger for stimuli presented to the temporal hemifield than to the nasal hemifield. Taken together, these findings suggested that multisensory stimulation can be differentially effective depending on specific stimulus parameters. The Experiment 3 was aimed at verifying the role of the SC in target selection by using a color-oddity search task, comprising stimuli either visible or invisible to the collicular and magnocellular pathways. Subjects were required to make a saccade toward a target that could be presented alone or with three distractors of another color (either S-cone or long-wavelength). When using S-cone distractors, invisible to the SC, localization errors were similar to those observed in the distractor-free condition. Conversely, with long-wavelength distractors, visible to the SC, saccadic localization error and variability were significantly greater than in either the distractor-free condition or the S-cone distractors condition. Our results clearly indicate that the SC plays a direct role in visual target selection in humans. Overall, our results indicate that the SC plays an important role in mediating spatial orienting responses both when required covert (Experiments 1 and 2) and overt orienting (Experiment 3).

La caratterizzazione endofenotipica del rimuginio

Rumination, defined as the tendency to think about the negative affect evoked by stressful events, has been identified as potentially playing a role in the development of cardiovascular diseases. Specifically, recent studies suggest that ruminative thoughts might be mediators of the prolonged physiological effects of stress. The main goal of this research was to study the effect of rumination, evoked in the laboratory, during the subsequent 24 hours. As rumination has been associated with the activity of several physiological systems, including the cardiovascular, endocrine, and immune system, we also aimed at studying the process from a psychoneuroendocrine point of view. Levels of anxiety, depression, anger, hostility, and trait rumination were assessed by the use of validated questionnaires. Impedance cardiography-derived measures, skin conductance, respiration, and beat-to-beat blood pressure (BP) were monitored continuously in 60 subjects during baseline, the Anger Recall Inteview, a reading task and two recovery periods. Half of the sample was randomly assigned to a distracter condition after the Anger Recall Inteview. Cortisol, plasma concentrations of epinephrine, norepinephrine, and inflammatory biomarkers (CRP, sICAM-1) were also obtained at baseline and at the end of the session. Then, all subjects were asked to wear an ambulatory BP monitor for 24 hours. Results show that the distracter was effective in stopping rumination in the laboratory but did not have a long-lasting effect in the subsequent 24 hours. Rumination was associated with prolonged sympathetic activity, vagal withdrawal, cortisol secrection, pro-inflammatory reaction and mood impairment compared to the reading task. After controlling for age and body mass index, rumination also proved to be a strong predictor of daily moods, and ambulatory HR and BP. Personality traits did not have an effect in determining the frequency or duration of daily rumination. Findings suggest that perseverative cognition can prolong stress- related affective and physiological activation and might act directly on somatic disease via the cardiovascular, immune, endocrine, and neurovisceral systems.

Sviluppo, Basi Neurali e Patologie del Sé corporeo

Il presente elaborato ha per oggetto la tematica del Sé, in particolar modo il Sé corporeo. Il primo capitolo illustrerà la cornice teorica degli studi sul riconoscimento del Sé corporeo, affrontando come avviene l’elaborazione del proprio corpo e del proprio volto rispetto alle parti corporee delle altre persone. Il secondo capitolo descriverà uno studio su soggetti sani che indaga l’eccitabilità della corteccia motoria nei processi di riconoscimento sé/altro. I risultati mostrano un incremento dell’eccitabilità corticospinale dell’emisfero destro in seguito alla presentazione di stimoli propri (mano e cellulare), a 600 e 900 ms dopo la presentazione dello stimolo, fornendo informazioni sulla specializzazione emisferica substrati neurali e sulla temporalità dei processi che sottendono all’elaborazione del sé. Il terzo capitolo indagherà il contributo del movimento nel riconoscimento del Sé corporeo in soggetti sani ed in pazienti con lesione cerebrale destra. Le evidenze mostrano come i pazienti, che avevano perso la facilitazione nell’elaborare le parti del proprio corpo statiche, presentano tale facilitazione in seguito alla presentazione di parti del proprio corpo in movimento. Il quarto capitolo si occuperà dello sviluppo del sé corporeo in bambini con sviluppo atipico, affetti da autismo, con riferimento al riconoscimento di posture emotive proprie ed altrui. Questo studio mostra come alcuni processi legati al sé possono essere preservati anche in bambini affetti da autismo. Inoltre i dati mostrano che il riconoscimento del sé corporeo è modulato dalle emozioni espresse dalle posture corporee sia in bambini con sviluppo tipico che in bambini affetti da autismo. Il quinto capitolo sarà dedicato al ruolo dei gesti nel riconoscimento del corpo proprio ed altrui. I dati di questo studio evidenziano come il contenuto comunicativo dei gesti possa facilitare l’elaborazione di parti del corpo altrui. Nella discussione generale i risultati dei diversi studi verranno considerati all’interno della loro cornice teorica.

Stili cognitivi e sofisticazione politica, un approccio sperimentale allo studio del comportamento di voto dei giovani elettori Italiani e Bielorussi

L’oggetto della nostra ricerca è l’opinione pubblica e il comportamento dell’elettore in una prospettiva comparata. L’obiettivo della ricerca è stato analizzare la relevanza degli approcci psicologici per una migliore comprensiore della partecipazione politica, delle opinioni e delle scelte elettorali degli studenti Italiani e Bielorussi. Nella parte teorica, noi discutiamo i modelli dell'approccio cognitivo al comportamento di voto. Discutiamo inoltre il concetto dello stile cognitivo e le sue cinque categorie: stile sintetico, idealistico, pragmatico, analitico o realistico, come descritti da A.Harrison and R.M. Branson e adattati da A. Alexeev and L. Gromova. Nonostante il fatto che la ricerca tratta il caso degli studenti, noi crediamo che i risultati siano pertinenti per un’ulteriore ricerca dell’auditorio più vasto e variegato.

Cáncer y tratamiento oncológico: Representaciones sociales de la población general, el paciente oncológico y miembros del equipo de salud

Se realizaron tres estudios cualitativos que tuvieron como propósito conocer las representaciones que ha construido la población general, los pacientes oncológicos y los profesionales de la salud, sobre el cáncer, la quimioterapia y el trasplante de médula ósea y realizar un análisis sobre las semejanzas y diferencias entre ellos. Se realizó en la ciudad de Bogotá (Colombia) con 55 personas: 20 pacientes con cáncer en proceso de trasplante de médula ósea, 20 personas no diagnosticadas con cáncer y 15 personas que trabajan en la atención de pacientes con cáncer. Se realizó una entrevista en profundidad con todos los participantes y asociaciones libres, clásicas y por sustitución sobre las palabras “cáncer”, “quimioterapia” y “trasplante de médula”. Los datos conseguidos se analizaron a la luz de la Teoría de las Representaciones Sociales (TRS). El análisis de la información siguió la técnica de análisis cualitativo de contenido para encontrar significados simbólicos y construir, denominar y definir categorías. Para los tres grupos el cáncer es una enfermedad terrible, que puede llevar a la muerte. El personal de salud y la población general creen que la enfermedad genera terror, angustia y miedo. Los pacientes tienen conciencia de la gravedad y del temor consecuente por una enfermedad que lo cambia todo, produce sufrimiento, dolor, obliga a depender de alguien y puede conducir a la muerte. El personal de salud considera que los pacientes lo pueden vivir como un castigo y la población general que puede ser la consecuencia de estilos de vida poco saludables. Para todos, la quimioterapia es un tratamiento para la enfermedad, que por un lado presenta efectos colaterales difíciles y visibles y que producen sentimientos negativos de temor y de angustia y al mismo tiempo constituye una opción y posibilidad de curación. El Trasplante de Médula Ósea representa para todos una oportunidad.

Representaciones Sociales de la Medicina Popular en el paciente oncológico adulto, la familia del paciente y los miembros del equipo de salud

Esta investigación tuvo como objetivo general develar las representaciones sociales sobre la Medicina Popular en tres grupos poblacionales, pacientes oncológicos (n=100), familiares de los pacientes (n=25) y miembros del equipo de salud (n=26). Para ello, se realizaron tres estudios cualitativos con cada grupo poblacional y un cuarto en el que se describen las similitudes y las diferencias entre ellos en relación con el objeto de representación. En general, se utilizaron entrevistas en profundidad, ejercicios de asociaciones libres y grupos focales (7 con 62 pacientes). Resultados: paciente oncológico: Medicina Popular representada como una salida optimista a la angustiante situación que está viviendo frente al cáncer; una apuesta a la vida. Para la familia: una contra capaz de mantener con vida y fortaleza al paciente y para el equipo de salud, una realidad incombatible de los pacientes y de la familia, que tiene efecto placebo sobre ellos y que está relacionada con el pensamiento mágico religioso, la fé y la ignorancia de quienes la realizan. En cuanto a las diferencias, el paciente y la familia consideran que la Medicina Popular es una alternativa en la que depositan su fé y confianza; el personal de salud no cree en sus efectos sobre el cáncer y la considera como estafa y engaño para el paciente. En las similitudes, todos coinciden en que es una alternativa, generadora de esperanza, basada en compuestos naturales que le permiten al paciente contribuir a la curación del cáncer y a sobrellevar el malestar provocado por la quimioterapia. Finalmente, se presentan conclusiones generales, se discuten algunos de los hallazgos y la importancia de las RS de la Medicina Popular y su impacto sobre la atención y la calidad de vida del paciente y se plantean algunos interrogantes que podrían favorecer el desarrollo de una línea de investigación en el tema.

Quantificazione del rischio occupazionale: Indicatori, indici e metodologia fuzzy

La tesi affronta il concetto di esposizione al rischio occupazionale e il suo scopo è quello di indagare l’ambiente di lavoro e il comportamento dei lavoratori, con l'obiettivo di ridurre il tasso di incidenza degli infortuni sul lavoro ed eseguire la riduzione dei rischi. In primo luogo, è proposta una nuova metodologia denominata MIMOSA (Methodology for the Implementation and Monitoring of Occupational SAfety), che quantifica il livello di "salute e sicurezza" di una qualsiasi impresa. Al fine di raggiungere l’obiettivo si è reso necessario un approccio multidisciplinare in cui concetti d’ingegneria e di psicologia sono stati combinati per sviluppare una metodologia di previsione degli incidenti e di miglioramento della sicurezza sul lavoro. I risultati della sperimentazione di MIMOSA hanno spinto all'uso della Logica Fuzzy nel settore della sicurezza occupazionale per migliorare la metodologia stessa e per superare i problemi riscontrati nell’incertezza della raccolta dei dati. La letteratura mostra che i fattori umani, la percezione del rischio e il comportamento dei lavoratori in relazione al rischio percepito, hanno un ruolo molto importante nella comparsa degli incidenti. Questa considerazione ha portato ad un nuovo approccio e ad una seconda metodologia che consiste nella prevenzione di incidenti, non solo sulla base dell'analisi delle loro dinamiche passate. Infatti la metodologia considera la valutazione di un indice basato sui comportamenti proattivi dei lavoratori e sui danni potenziali degli eventi incidentali evitati. L'innovazione consiste nell'applicazione della Logica Fuzzy per tener conto dell’"indeterminatezza" del comportamento umano e del suo linguaggio naturale. In particolare l’applicazione è incentrata sulla proattività dei lavoratori e si prefigge di impedire l'evento "infortunio", grazie alla generazione di una sorta d’indicatore di anticipo. Questa procedura è stata testata su un’azienda petrolchimica italiana.