Metodi molecolari nello studio della variabilità genetica di Tuber borchii

Tuber borchii (Ascomycota, order Pezizales) is highly valued truffle sold in local markets in Italy. Despite its economic importance, knowledge on its distribution and population variation is scarce. The objective of this work was to investigate the evolutionary forces shaping the genetic structure of this fungus using coalescent and phylogenetic methods to reconstruct the evolutionary history of populations in Italy. To assess population structure, 61 specimens were collected from 11 different Provinces of Italy. Sampling was stratified across hosts and habitats to maximize coverage in native oak and pine stands and both mychorrizae and fruiting bodies were collected. Samples were identified considering anatomo-morphological characters. DNA was extracted and both multilocus (AFLP) and single-locus (18 loci from rDNA, nDNA, and mtDNA) approaches were used to look for polymorphisms. Screening AFLP profiles, both Jaccard and Dice coefficients of similarity were utilized to transform binary matrix into a distance matrix and then to desume Neighbour-Joining trees. Though these are only preliminary examinations, phylogenetic trees were totally concordant with those deriving from single locus analyses. Phylogenetic analyses of the nuclear loci were performed using maximum likelihood with PAUP and a combined phylogenetic inference, using Bayesian estimation with all nuclear gene regions, was carried out. To reconstruct the evolutionary history, we estimated recurrent migration, migration across the history of the sample, and estimated the mutation and approximate age of mutations in each tree using SNAP Workbench. The combined phylogenetic tree using Bayesian estimation suggests that there are two main haplotypes that are difficult to be differentiated on the basis of morphology, of ecological parameters and symbiontic tree. Between these two lineages, that occur in sympatry within T. borchii populations, there is no evidence of recurrent migration. However, migration over the history of the sample was asymmetrical suggesting that isolation was a result of interrupted gene flow followed by range expansion. Low levels of divergence between the haplotypes indicate that there are likely to be two cryptic species within the T. borchii population sampled. Our results suggest that isolation between populations of T. borchii could have led to reproductive isolation between two lineages. This isolation is likely due to sympatric speciation caused by a multiple colonization from different refugia or a recent isolation. In attempting to determinate whether these haplotypes represent separate species or a partition of the same species we applied Biological and Mechanistic species Concepts. Notwithstanding, further analyses are necessary to evaluate if selection favoured premating or post-mating isolation.

Indagine sull’influenza di differenti sistemi d’allevamento sui connotati nutrizionali, tecnologici, sensoriali e di freschezza dell’orata (Sparus aurata) allevata in Italia

On account of the commercial importance of gilthead sea bream (Sparus aurata) in Italy the aim of the present study is the evaluation of the quality of nutritional, technological, sensory and freshness aspects. Sea bream production is growing in the Mediterranean and the evaluation of its quality concerns both producers and consumers alike. The culture system greatly influences final product quality. In Italy most of sea bream culture is carried out in cages but there is also a production in land based facilities and in lagoons. In this study external appeareance differentiations are pronounced. Different results were found for nutritional aspects, for fatty acids and for mineral content. Some differences in the freshness indices are also found. Furthermore, organoleptic differences have been described between culture system.

Caratteristiche merceologiche, nutrizionali, sensoriali e di freschezza di Nasello (Merluccius merluccius), Lanzardo (Scomber japonicus) e Suro (Trachurus trachurus)

Three finfish species frequently caught in the waters of the Gulf of Manfredonia (Apulia, Italy) were studied in order to know how the flesh composition (proximate, fatty acid, macro- and micro- element contents) could be affected by the season effect. The species we examined were European hake (Merluccius merluccius), chub mackerel (Scomber japonicus) and horse mackerel (Trachurus trachurus), which were analysed at the raw state in three catch season and after cooking in two catch season. More precisely, European hake and chub mackerel caught during winter, summer and fall were analysed at the raw state. The composition of the flesh of grilled European hake and chub mackerel was study on fish caught in winter and fall. Horse mackerel of summer and winter catches were analysed both at the raw and grilled state. Furthermore, an overall sensory profile was outlined for each species in two catch season and the relevant spider web diagrams compared. On the whole, two hundred and eighty fish were analysed during this research project in order to obtain a nutritional profile of the three species. One hundred and fifty was the overall number of specimens used to create complete sensory profiles and compare them among the species. The three finfish species proved to be quite interesting for their proximate, fatty acids, macro- and micro-element contents. Nutritional and sensory changes occurred as seasons elapsed for chub and horse mackerel only. A high variability of flesh composition seemed to characterise these two species. European hake confirmed its mild sensory profile and good nutritional characteristics, which were not affected by any season effect.

Liver transplantation for transthyretin amyloidosis: experience of a single center in Italy

Liver transplantation is the only definitive treatment for transthyretin amyloidosis, with an excellent 5-year survival in endemic countries where the Met30 mutation is predominant. We report our experience of liver transplantation for transthyretin amyloidosis. We reviewed the clinical records of 17 transplanted patients (11 males, 6 females; age at liver transplant: 45.7±11.7 years). We had a wide spectrum of non-Met30 mutations (52.9%), with a predominance of Gln89 (23.5%). Five-year survival after transplantation was 43.8%; at multivariate analysis, both non-Met30 mutations (HR 17.3, 95% CI 1.03-291.7) and modified BMI (HR 0.50, 95% CI 0.29-0.87) showed significant and independent prognostic roles (P=0.048 and P=0.015, respectively). Five out of the 9 non-Met30 carriers received combined heart transplantation because of severe cardiomyopathy; they showed a trend towards a better prognosis vs. the 4 patients who did not receive combined heart transplantation (although not statistically significant; P=0.095). At follow-up, no significant improvement of transthyretin amyloidosis manifestations was observed. The results of liver transplantation for transthyretin amyloidosis in our population are poorer than those reported in the literature probably because of the high prevalence of non-Met30 mutations.

Enzimi, acidi organici ed altri metaboliti coinvolti nella patogenesi di Penicillium spp

Blue mould caused by Penicillium expansum Link is one of the most destructive rot of pome fruit in all growing areas (Snowdon, 1990; Jones and Aldwinckle, 1991; Tonini,1996) In the past, Penicillium rot has been controlled by fungicide postharvest treatment mainly by thiabendazole (TBZ) and benomyl (Hardenburg and Spalding, 1972), but their intense use produced the appearance of resistant strains with a great reduction of their activity The aims of the present study were to characterize the isolates of Pencillium sp causing blue mold on pear in Italy by physiological and biochemical parameters. In particular differencing also the behavior of isolates to relationship with sensitivity or resistance to TBZ treatments. We have examined the early stage of infection in relation to enzyme activity, local modulation of pH, production of organic acids, and to secondary metabolism of pathogen. The results described here confirm that the majority of P. expansum isolates from pears packing houses are resistant to TBZ, Among the TBZ-resistant isolates scored in this work, different isolates (RR) showed higher percentage of conidial germination on TBZ-amended medium compared to non amended medium. This may indicate a stimulatory effect of TBZ on conidial germination. Therefore TBZ treatments are not only ineffective for controlling P. expansum, but they may also increase the severity of blue mould on fruits. In the absence of fungicide, isolates showed a significant difference for infection severity, R and RR isolates are characterized by higher pathogenic fitness on fruits, producing larger lesions than S isolates. These data are supported by the study with laboratory-induced resistant isolates, which shows the lack of correlation between TBZ resistance and osmotic sensitivity, and highlights the association between TBZ resistance and infection severity (Baraldi et al 2003). Enzymatic screening gave a positive reaction to esterase, urease, pectinase activity, in addition, the pathogen is able to synthesize a complex enzyme act to degrade the main components of the cell wall especially pectin and cellulose. Isolated sensitive and resistant are characterized by a good activity of pectinase, especially from poligactoronase, which, as already reported by several studies (D'hallewin et al, 2004; Prusky et al, 2004), are the basis of degradative process of cell wall. Also, although the measure was minor also highlighted some activities of cellulase, but even note in the production of this kind of cellulase and hemicellulase P. Expansum were not targeted, studies have found no other source of information in this regard. Twenty isolates of Penicillium expansum, were tested in vitro ad in vivo for acid production ability and pH drop. We have found that modulation of pH and the organic acids extrusion were influence to various parameter:  Initial pH: in general, the greatest reduction of pH was observed in isolates grown at pH 7, except for four isolates that maintained the pH of the medium close to 7, the others significantly decreased the pH, ranging from 5.5 to 4.1.. In extreme acid condition (pH 3,0) growth and modulation of pH is most lower respect optimal condition (pH 5,0). Also isolates R and RR have showed a greater adaptation to environmental condition more than isolates S.  Time: although the acidification continues for some days, PH modulation is strongest in early hours (48-72 hours)of inoculation process. Time also affects the quality of organic acids, for example in vitro results showed an initial abundant production of succinc acid, followed to important production of galacturoinc acid.  Substrates: there are many differences for the type of acids produced in vitro and in vivo. Results showed in vivo an abundant production of galacturonic, malic, and citric acids and some unknown organic acids in smaller concentrations. Secondary metabolite analysis revealed intra-specific differences, and patulin was found in all isolates, but most significant reduction was observed between in vitro and in vivo samples. There was no correlation between the concentration of patulin, and the percentage of infected fruits, but sample with a lower infection severity of rotten area than the others, showed a significantly lower mycotoxin concentration than samples with a higher lesion diameter of rotten area. Beyond of patulin was detected the presence of another secondary metabolite, penitrem A.

Essays in Applied Health Economics: Evidence on Health and Health Care in Italy and UK

This thesis is the result of my experience as a PhD student taking part in the Joint Doctoral Programme at the University of York and the University of Bologna. In my thesis I deal with topics that are of particular interest in Italy and in Great Britain. Chapter 2 focuses on the empirical test of the existence of the relationship between technological profiles and market structure claimed by Sutton’s theory (1991, 1998) in the specific economic framework of hospital care services provided by the Italian National Health Service (NHS). In order to test the empirical predictions by Sutton, we identify the relevant markets for hospital care services in Italy in terms of both product and geographic dimensions. In particular, the Elzinga and Hogarty (1978) approach has been applied to data on patients’ flows across Italian Provinces in order to derive the geographic dimension of each market. Our results provide evidence in favour of the empirical predictions of Sutton. Chapter 3 deals with the patient mobility in the Italian NHS. To analyse the determinants of patient mobility across Local Health Authorities, we estimate gravity equations in multiplicative form using a Poisson pseudo maximum likelihood method, as proposed by Santos-Silva and Tenreyro (2006). In particular, we focus on the scale effect played by the size of the pool of enrolees. In most of the cases our results are consistent with the predictions of the gravity model. Chapter 4 considers the effects of contractual and working conditions on selfassessed health and psychological well-being (derived from the General Health Questionnaire) using the British Household Panel Survey (BHPS). We consider two branches of the literature. One suggests that “atypical” contractual conditions have a significant impact on health while the other suggests that health is damaged by adverse working conditions. The main objective of our paper is to combine the two branches of the literature to assess the distinct effects of contractual and working conditions on health. The results suggest that both sets of conditions have some influence on health and psychological well-being of employees.

Teorie e immagini del governo "misto" nel Cinquecento: i casi di Gasparo Contarini, Donato Giannotti, Paolo Paruta e Traiano Boccalini

This doctoral dissertation faces the debated topic of the traditions of Republicanism in the Modern Age assuming, as a point of view, the problem of the "mixed" government. The research therefore dwells upon the use of this model in Sixteenth-Century Italy, also in connection with the historical events of two standard Republics such as Florence and Venice. The work focuses on Donato Giannotti (1492-1573), Gasparo Contarini (1483-1542) and Paolo Paruta (1540-1598), as the main figures in order to reconstruct the debate on "mixed" constitution: in them, decisive in the attention paid to the peculiar structure of the Venetian Republic, the only of a certain dimension and power to survive after 1530. The research takes into account also the writings of Traiano Boccalini (1556-1613): he himself, though being involved in the same topics of debate, sets for some aspects his considerations in the framework of a new theme, that of Reason of State.

Innovazione organizzativa e istituzionale della pubblica amministrazione. Un approccio interpretativo e l'analisi di un dispositivo partecipativo nel settore della cultura

The thesis aims at inquiring into the issue of innovation and organizational and institutional change in the public administration with regard to the increasingly massive adoption of participatory devices and practices in various arenas of public policies. The field of reference regards transformations of the types of public actions and regulation systems, concerning governance. Together with the crisis of the public function and of the role played by the insitutions what is emerging are different levels of governement, both towards an over national and a local direction, and a plurality of social interlocutors, followed by a post-bureaucratic pattern of the public administration that is opening itself in the direction of environment and citizens. The public adminstration is no longer considered an inert object within the bureaucratic paradigm but as a series of communicative processes, choices, cultures and practices that actively builds itself and the environment it interacts with. Therefore, the output of the public administration isn’t the simple service being supplied but the relationship enacted with the citizen, relationship that becomes the constituent basis of adminstrative processes. The intention of thesis is to take into consideration the relation between innovation of the public administration and participatory experimentations and implementations regarded as exchanges in which citizens and the public administration hold talks and debates. The issue of the organizational change of the public administration as output and effect of inclusive deliberative practices has been analysed starting from an institutionalist approach, in other words examining the constituent features of institutions, “rediscovering” them with regard to their public nature, their ability to elaborate collective values and meanings, the social definition of problems and solutions. The participatory device employed by the Forlì city council that involved enterprises and cultural associations of the area in order to build a participatory Table, has been studied through a qualitative methodology (participant observation and semi-strutctured interviews). The analysis inquired into the public nature both of the participatory device and the administrative action itself as well as into elements pertaining the deliberative setting, the regulative reference framework and the actors which took part in the process.

Meccanismi di formazione dei tubi di lava

Two analytical models are proposed to describe two different mechanisms of lava tubes formation. A first model is introduced to describe the development of a solid crust in the central region of the channel, and the formation of a tube when crust widens until it reaches the leve\'es. The Newtonian assumption is considered and the steady state Navier- Stokes equation in a rectangular conduit is solved. A constant heat flux density assigned at the upper flow surface resumes the combined effects of two thermal processes: radiation and convection into the atmosphere. Advective terms are also included, by the introduction of velocity into the expression of temperature. Velocity is calculated as an average value over the channel width, so that lateral variations of temperature are neglected. As long as the upper flow surface cools, a solid layer develops, described as a plastic body, having a resistance to shear deformation. If the applied shear stress exceeds this resistance, crust breaks, otherwise, solid fragments present at the flow surface can weld together forming a continuous roof, as it happens in the sidewall flow regions. Variations of channel width, ground slope and effusion rate are analyzed, as parameters that strongly affect the shear stress values. Crust growing is favored when the channel widens, and tube formation is possible when the ground slope or the effusion rate reduce. A comparison of results is successfully made with data obtained from the analysis of pictures of actual flows. The second model describes the formation of a stable, well defined crust along both channel sides, their growing towards the center and their welding to form the tube roof. The fluid motion is described as in the model above. Thermal budget takes into account conduction into the atmosphere, and advection is included considering the velocity depending both on depth and channel width. The solidified crust has a non uniform thickness along the channel width. Stresses acting on the crust are calculated using the equations of the elastic thin plate, pinned at its ends. The model allows to calculate the distance where crust thickness is able to resist the drag of the underlying fluid and to sustain its weight by itself, and the level of the fluid can lower below the tube roof. Viscosity and thermal conductivity have been experimentally investigated through the use of a rotational viscosimeter. Analyzing samples coming from Mount Etna (2002) the following results have been obtained: the fluid is Newtonian and the thermal conductivity is constant in a range of temperature above the liquidus. For lower temperature, the fluid becomes non homogeneous, and the used experimental techniques are not able to detect any properties, because measurements are not reproducible.

Aspetti di vita quotidiana, religiosa, militare e civile in Britannia e lungo il Vallo di Adriano

The dissertation aims to provide an overview of some aspects of everyday life in Roman Britain in general and in the area of Hadrian’s Wall in particular. In a preliminary description, the writer addresses the complex topic related to the genesis of borders as the fulfillment of the expansionist parable of Rome, and as the space manifestation of the sunset of the idea of an imperium sine fine. Then the thesis passes to examine, in subsequent chapters, first the religious theme in its peculiar indigenous component and in the cultural practices triggered by the process of Romanization, secondly the question whether is possible to study everyday life in the northernmost province of the Empire through a discussion of the civilian settlements in proximity to military sites. This issue is drawn especially thanks to the analysis of the so-called Vindolanda tablets, which constitute a valuable evidence of a lively environment both under human and social respect. Before giving an indication of the specific bibliography, the work offers a number of appendices which elaborate part of the information which has been supplied in the previous sections. Mention of the epigraphic repertoires and literary and antiquarian sources is finally made.

Interazioni tra Glicoproteine che mediano la penetrazione del Virus Herpes Simplex nella cellula e disegno razionale di Peptidi Inibitori

Herpes simplex virus entry into cells requires a multipartite fusion apparatus made of gD, gB and heterodimer gH/gL. gD serves as receptor-binding glycoprotein and trigger of fusion; its ectodomain is organized in a N-terminal domain carrying the receptor-binding sites, and a C-terminal domain carrying the profusion domain, required for fusion but not receptor-binding. gB and gH/gL execute fusion. To understand how the four glycoproteins cross-talk to each other we searched for biochemical defined complexes in infected and transfected cells, and in virions. We report that gD formed complexes with gB in absence of gH/gL, and with gH/gL in absence of gB. Complexes with similar composition were formed in infected and transfected cells. They were also present in virions prior to entry, and did not increase at virus fusion with cell. A panel of gD mutants enabled the preliminary location of part of the binding site in gD to gB to the aa 240-260 portion and downstream, with T306P307 as critical residues, and of the binding site to gH/gL at aa 260-310 portion, with P291P292 as critical residues. The results indicate that gD carries composite independent binding sites for gB and gH/gL, both of which partly located in the profusion domain. The second part of the project dealt with rational design of peptides inhibiting virus entry has been performed. Considering gB and gD, the crystal structure is known, so we designed peptides that dock in the structure or prevent the adoption of the final conformation of target molecule. Considering the other glycoproteins, of which the structure is not known, peptide libraries were analyzed. Among several peptides, some were identified as active, designed on glycoprotein B. Two of them were further analyzed. We identified peptide residues fundamental for the inhibiting activity, suggesting a possible mechanism of action. Furthermore, changing the flexibility of peptides, an increased activity was observed,with an EC50 under 10μM. New approaches will try to demonstrate the direct interaction between these peptides and the target glycoprotein B.

Identificazione di un QTL principale per resistenza a ruggine bruna sul cromosoma 7B di frumento duro

Leaf rust caused by Puccinia triticina is a serious disease of durum wheat (Triticum durum) worldwide. However, genetic and molecular mapping studies aimed at characterizing leaf rust resistance genes in durum wheat have been only recently undertaken. The Italian durum wheat cv. Creso shows a high level of resistance to P. triticina that has been considered durable and that appears to be due to a combination of a single dominant gene and one or more additional factors conferring partial resistance. In this study, the genetic basis of leaf rust resistance carried by Creso was investigated using 176 recombinant inbred lines (RILs) from the cross between the cv. Colosseo (C, leaf rust resistance donor) and Lloyd (L, susceptible parent). Colosseo is a cv. directly related to Creso with the leaf rust resistance phenotype inherited from Creso, and was considered as resistance donor because of its better adaptation to local (Emilia Romagna, Italy) cultivation environment. RILs have been artificially inoculated with a mixture of 16 Italian P. triticina isolates that were characterized for virulence to seedlings of 22 common wheat cv. Thatcher isolines each carrying a different leaf rust resistance gene, and for molecular genotypes at 15 simple sequence repeat (SSR) loci, in order to determine their specialization with regard to the host species. The characterization of the leaf rust isolates was conducted at the Cereal Disease Laboratory of the University of Minnesota (St. Paul, USA) (Chapter 2). A genetic linkage map was constructed using segregation data from the population of 176 RILs from the cross CL. A total of 662 loci, including 162 simple sequence repeats (SSRs) and 500 Diversity Arrays Technology markers (DArTs), were analyzed by means of the package EasyMap 0.1. The integrated SSR-DArT linkage map consisted of 554 loci (162 SSR and 392 DArT markers) grouped into 19 linkage blocks with an average marker density of 5.7 cM/marker. The final map spanned a total of 2022 cM, which correspond to a tetraploid genome (AABB) coverage of ca. 77% (Chapter 3). The RIL population was phenotyped for their resistance to leaf rust under artificial inoculation in 2006; the percentage of infected leaf area (LRS, leaf rust susceptibility) was evaluated at three stages through the disease developmental cycle and the area under disease progress curve (AUDPC) was then calculated. The response at the seedling stage (infection type, IT) was also investigated. QTL analysis was carried out by means of the Composite Interval Mapping method based on a selection of markers from the CL map. A major QTL (QLr.ubo-7B.2) for leaf rust resistance controlling both the seedling and the adult plant response, was mapped on the distal region of chromosome arm 7BL (deletion bin 7BL10-0.78-1.00), in a gene-dense region known to carry several genes/QTLs for resistance to rusts and other major cereal fungal diseases in wheat and barley. QLr.ubo-7B.2 was identified within a supporting interval of ca. 5 cM tightly associated with three SSR markers (Xbarc340.2, Xgwm146 e Xgwm344.2), and showed an R2 and an LOD peak value for the AUDPC equal to 72.9% an 44.5, respectively. Three additional minor QTLs were also detected (QLr.ubo-7B.1 on chr. 7BS; QLr.ubo-2A on chr. 2AL and QLr.ubo-3A on chr. 3AS) (Chapter 4). The presence of the major QTL (QLr.ubo-7B.2) was validated by a linkage disequilibrium (LD)-based test using field data from two different plant materials: i) a set of 62 advanced lines from multiple crosses involving Creso and his directly related resistance derivates Colosseo and Plinio, and ii) a panel of 164 elite durum wheat accessions representative of the major durum breeding program of the Mediterranean basin. Lines and accessions were phenotyped for leaf rust resistance under artificial inoculation in two different field trials carried out at Argelato (BO, Italy) in 2006 and 2007; the durum elite accessions were also evaluated in two additional field experiments in Obregon (Messico; 2007 and 2008) and in a green-house experiment (seedling resistance) at the Cereal Disease Laboratory (St. Paul, USA, 2008). The molecular characterization involved 14 SSR markers mapping on the 7BL chromosome region found to harbour the major QTL. Association analysis was then performed with a mixed-linear-model approach. Results confirmed the presence of a major QTL for leaf rust resistance, both at adult plant and at seedling stage, located between markers Xbarc340.2, Xgwm146 and Xgwm344.2, in an interval that coincides with the supporting interval (LOD-2) of QLr.ubo-7B.2 as resulted from the RIL QTL analysis. (Chapter 5). The identification and mapping of the major QTL associated to the durable leaf rust resistance carried by Creso, together with the identification of the associated SSR markers, will enhance the selection efficiency in durum wheat breeding programs (MAS, Marker Assisted Selection) and will accelerate the release of cvs. with durable resistance through marker-assisted pyramiding of the tagged resistance genes/QTLs most effective against wheat fungal pathogens.

L'Azienda USL di Bologna: analisi dell'impatto della fusione delle tre precedenti Aziende sugli assetti organizzativi

L’Azienda USL di Bologna è la più grande della regione ed è una delle più grandi in Italia: serve una popolazione di 836.697 abitanti ed è distribuita su 50 comuni. E’ stata istituita il 1° gennaio 2004 con la Legge della Regione Emilia Romagna n. 21 del 20/10/2003 che ha unificato i Comuni di tre Aziende USL: “Città di Bologna”, “Bologna Sud” e “Bologna Nord” (ad eccezione del Comune di Medicina che dall’Area Nord è entrato a far parte dell’Azienda USL di Imola che ha mantenuto un’autonoma configurazione giuridica). Il territorio dell’Azienda USL di Bologna si estende per 2915,4 Kmq ed è caratterizzato dalla particolare ubicazione geografica dei suoi distretti. Al Distretto prettamente urbano, quale quello di Bologna Città si affiancano nell’Area Nord i Distretti di pianura quali Pianura Est e Pianura Ovest, mentre nell’Area Sud si collocano i Distretti con territorio più collinare, quali quelli di Casalecchio di Reno e San Lazzaro di Savena ed il Distretto di Porretta Terme che si caratterizza per l’alta percentuale di territorio montuoso. L’unificazione di territori diversi per caratteristiche orografiche, demografiche e socioeconomiche, ha comportato una maggiore complessità rispetto al passato in termini di governo delle condizioni di equità. La rimodulazione istituzionale ed organizzativa dell’offerta dei sevizi sanitari ha comportato il gravoso compito di razionalizzarne la distribuzione, tenendo conto delle peculiarità del contesto. Alcuni studi di fattibilità precedenti l’unificazione, avevano rilevato come attraverso la costituzione di un’Azienda USL unica si sarebbero potuti più agevolmente perseguire gli obiettivi collegati alle prospettive di sviluppo e di ulteriore qualificazione del sistema dei servizi delle Aziende USL dell’area bolognese, con benefici per il complessivo servizio sanitario regionale. Le tre Aziende precedentemente operanti nell’area bolognese erano percepite come inadeguate, per dimensioni, a supportare uno sviluppo dei servizi ritenuto indispensabile per la popolazione ma, che, se singolarmente realizzato, avrebbe condotto ad una inutile duplicazione di servizi già presenti. Attraverso l’integrazione delle attività di acquisizione dei fattori produttivi e di gestione dei servizi delle tre Aziende, si sarebbero potute ragionevolmente conseguire economie più consistenti rispetto a quanto in precedenza ottenuto attraverso il coordinamento volontario di tali processi da parte delle tre Direzioni. L’istituzione della nuova Azienda unica, conformemente al Piano sanitario regionale si proponeva di: o accelerare i processi di integrazione e di redistribuzione dell’offerta dei servizi territoriali, tenendo conto della progressiva divaricazione fra i cambiamenti demografici, che segnavano un crescente deflusso dal centro storico verso le periferie, ed i flussi legati alle attività lavorative, che si muovevano in senso contrario; o riorganizzare i servizi sanitari in una logica di rete e di sistema, condizione necessaria per assicurare l’equità di accesso ai servizi e alle cure, in stretta interlocuzione con gli Enti Locali titolari dei servizi sociali; o favorire il raggiungimento dell’equilibrio finanziario dell’Azienda e contribuire in modo significativo alla sostenibilità finanziaria dell’intero sistema sanitario regionale. L’entità delle risorse impegnate nell’Area bolognese e le dimensioni del bilancio della nuova Azienda unificata offrivano la possibilità di realizzare economie di scala e di scopo, attraverso la concentrazione e/o la creazione di sinergie fra funzioni e attività, sia in ambito ospedaliero, sia territoriale, con un chiaro effetto sull’equilibrio del bilancio dell’intero Servizio sanitario regionale. A cinque anni dalla sua costituzione, l’Azienda USL di Bologna, ha completato una significativa fase del complessivo processo riorganizzativo superando le principali difficoltà dovute alla fusione di tre Aziende diverse, non solo per collocazione geografica e sistemi di gestione, ma anche per la cultura dei propri componenti. La tesi affronta il tema dell’analisi dell’impatto della fusione sugli assetti organizzativi aziendali attraverso uno sviluppo così articolato: o la sistematizzazione delle principali teorie e modelli organizzativi con particolare attenzione alla loro contestualizzazione nella realtà delle organizzazioni professionali di tipo sanitario; o l’analisi principali aspetti della complessità del sistema tecnico, sociale, culturale e valoriale delle organizzazioni sanitarie; o l’esame dello sviluppo organizzativo dell’Azienda USL di Bologna attraverso la lettura combinata dell’Atto e del Regolamento Organizzativo Aziendali esaminati alla luce della normativa vigente, con particolare attenzione all’articolazione distrettuale e all’organizzazione Dipartimentale per cogliere gli aspetti di specificità che hanno caratterizzano il disegno organizzativo globalmente declinato. o l’esposizione degli esiti di un questionario progettato, in accordo con la Direzione Sanitaria Aziendale, allo scopo di raccogliere significativi elementi per valutare l’impatto della riorganizzazione dipartimentale rispetto ai tre ruoli designati in “staff “alle Direzioni degli otto Dipartimenti Ospedalieri dell’AUSL di Bologna, a tre anni dalla loro formale istituzione. La raccolta dei dati è stata attuata tramite la somministrazione diretta, ai soggetti indagati, di un questionario costituito da numerosi quesiti a risposta chiusa, integrati da domande aperte finalizzate all’approfondimento delle dimensioni di ruolo che più frequentemente possono presentare aspetti di criticità. Il progetto ha previsto la rielaborazione aggregata dei dati e la diffusione degli esiti della ricerca: alla Direzione Sanitaria Aziendale, alle Direzioni Dipartimentali ospedaliere ed a tutti i soggetti coinvolti nell’indagine stessa per poi riesaminare in una discussione allargata i temi di maggiore interesse e le criticità emersi. Gli esiti sono esposti in una serie di tabelle con i principali indicatori e vengono adeguatamente illustrati.