The role of proactive coping strategies and perceived health status for Social well-being and life-project in old age.

The latter part of the 20th century was a period characterized by a fundamental demographic transition of western society. This substantial and structural demographic change proposes several challenges to contemporary society and fosters the emergence of new issues and challenges. Among these, none is more crucial than the comprehension of the mechanisms and the processes that lead people to positive aging. Rowe and Kahn’s model of successful aging highlights the interplay between social engagement with life, health, and functioning for a positive aging experience. Other systemic models of successful aging (Kahana et al., 1996; 2003; Stevernik et al., 2006) emphasize the role of internal and external resources for attaining positive aging. Among these, the proactive coping strategies are indicated as important active strategies for avoiding the depletion of resources, counterbalancing the declines and maintaining social and civic involvement. The study has analyzed the role of proactive coping strategies for two facets of positive aging, the experience of a high social well-being and the presence of personal projects in fundamental life domains. As expected, the proactive coping strategies, referred to as the active management of the environment, the accumulation of resources and the actualization of human potentials are confirmed as positive predictors of high level of social well-being and of many personal projects focused on family, culture, leisure time, civic and social participation. Perceived health status give a significant contribution only to the possession of many personal projects. Gender and level of school education give also a significant contribution to these two dimensions of positive aging, highlighting how positive aging is rooted not only in the possession of personal resources, but also in historical models of education and in positive longitudinal chains related to early development.

Cognition in context: Evidence on affordances and verbal language

This thesis investigated affordances and verbal language to demonstrate the flexibility of embodied simulation processes. Starting from the assumption that both object/action understanding and language comprehension are tied to the context in which they take place, six studies clarified the factors that modulate simulation. The studies in chapter 4 and 5 investigated affordance activation in complex scenes, revealing the strong influence of the visual context, which included either objects and actions, on compatibility effects. The study in chapter 6 compared the simulation triggered by visual objects and objects names, showing differences depending on the kind of materials processed. The study in chapter 7 tested the predictions of the WAT theory, confirming that the different contexts in which words are acquired lead to the difference typically observed in the literature between concrete and abstract words. The study in chapter 8 on the grounding of abstract concepts tested the mapping of temporal contents on the spatial frame of reference of the mental timeline, showing that metaphoric congruency effects are not automatic, but flexibly mediated by the context determined by the goals of different tasks. The study in chapter 9 investigated the role of iconicity in verbal language, showing sound-to-shape correspondences when every-day object figures, result that validated the reality of sound-symbolism in ecological contexts. On the whole, this evidence favors embodied views of cognition, and supports the hypothesis of a high flexibility of simulation processes. The reported conceptual effects confirm that the context plays a crucial role in affordances emergence, metaphoric mappings activation and language grounding. In conclusion, this thesis highlights that in an embodied perspective cognition is necessarily situated and anchored to a specific context, as it is sustained by the existence of a specific body immersed in a specific environment.

Epigenetics of nutrition in aging

There is a need to identify factors that are able to influence health in old age and to develop interventions that could slow down the process of aging and its associated pathologies. Lifestyle modifications, and especially nutrition, appear to be promising strategies to promote healthy aging. Their impact on aging biomarkers has been poorly investigated. In the first part of this work, we evaluated the impact of a one-year Mediterranean-like diet, delivered within the framework of the NU-AGE project in 120 elderly subjects, on epigenetic age acceleration measures assessed with Horvath’s clock. We observed a rejuvenation of participants after nutritional intervention. The effect was more marked in the group of Polish females and in subjects who were epigenetically older at baseline. In the second part of this work, we developed a new model of epigenetic biomarker, based on a gene-targeted approach with the EpiTYPER® system. We selected six regions of interest (associated with ELOVL2, NHLRC1, SIRT7/MAFG, AIM2, EDARADD and TFAP2E genes) and constructed our model through a ridge regression analysis. In controls, estimation of chronological age was accurate, with a correlation coefficient between predicted and chronological age of 0.92 and a mean absolute deviation of 4.70 years. Our model was able to capture phenomena of accelerated or decelerated aging, in Down syndrome subjects and centenarians and offspring respectively. Applying our model to samples of the NU-AGE project, we observed similar results to the ones obtained with the canonical epigenetic clock, with a rejuvenation of the individuals after one-year of nutritional intervention. Together, our findings indicate that nutrition can promote epigenetic rejuvenation and that epigenetic age acceleration measures could be suitable biomarkers to evaluate their impact. We demonstrated that the effect of the dietary intervention is country-, sex- and individual-specific, thus suggesting the need for a personalized approach to nutritional interventions.

Rising China and Internet governance: Multistakeholderism, fragmentation and the Liberal Order in the age of digital sovereignty

In its open and private-based dimension, the Internet is the epitome of the Liberal International Order in its global spatial dimension. Therefore, normative questions arise from the emergence of powerful non-liberal actors such as China in Internet governance. In particular, China has supported a UN-based multilateral Internet governance model based on state sovereignty aimed at replacing the existing ICANN-based multistakeholder model. While persistent, this debate has become less dualistic through time. However, fear of Internet fragmentation has increased as the US-China technological competition grew harsher. This thesis inquires “(To what extent) are Chinese stakeholders reshaping the rules of Global Internet Governance?”. This is further unpacked in three smaller questions: (i) (To what extent) are Chinese stakeholders contributing to increased state influence in multistakeholder fora?; (ii) (how) is China contributing to Internet fragmentation?; and (iii) what are the main drivers of Chinese stakeholders’ stances? To answer these questions, Chinese stakeholders’ actions are observed in the making and management of critical Internet resources at the IETF and ICANN respectively, and in mobile connectivity standard-making at 3GPP. Through the lens of norm entrepreneurship in regime complexes, this thesis interprets changes and persistence in the Internet governance normative order and Chinese attitudes towards it. Three research methods are employed: network analysis, semi-structured expert interviews, and thematic document analysis. While China has enhanced state intervention in several technological fields, fostering debates on digital sovereignty, this research finds that the Chinese government does not exert full control on its domestic private actors and concludes that Chinese stakeholders have increasingly adapted to multistakeholder Internet governance as they grew influential within it. To enhance control over Internet-based activities, the Chinese government resorted to regulatory and technical control domestically rather than establishing a splinternet. This is due to Chinese stakeholders’ interest in retaining the network benefits of global interconnectivity.

Sealing practices in the Near East during the Late Bronze II period: administration and trade in the age of internationalism

This PhD research investigates sealing practices in the Near East during the Late Bronze II period (ca. 1375-1175 BCE). Sealings from archaeological contexts in the Southern Levant, North Syria, Upper and Lower Mesopotamia and South-Western Iran are taken under consideration and analyzed on multiple aspects at local, regional, and international levels. The contextual, functional, and iconographic analysis of these materials, in fact, allows to reconstruct the nature of the transactions and the agents involved in the sealing operations within local administrative systems, highlighting at the same time aspects of inter-regional interactions during the age of internationalism. Following a survey of the available evidence, a corpus consisting of 1845 records from 28 different sites across the ANE, has been filed using MS Access and MS Excel, including 740 unpublished sealing from Karkemish. Among this large evidence, the corpus of recently discovered sealings from Karkemish and the other scattered sealings from the North Syrian provinces, for instance, provide insights on the core-periphery relationships under the Hittite Empire; while the deposit from Building P at Tell Sheikh Hamad, that of the Middle Assyrian houses at Tell Fekheriye, and of the dunnu of Tell Sabi Abyad, significantly contributes to defining the administration of provinces within the Middle Assyrian state and the regional circulation of good. The less extensive evidence from South Mesopotamia under the Kassite rule and from Middle Elamite contexts in South-Western Iran somewhat contribute as well to the understanding of sealing practices in the LB II period. The South Levantine kingdoms, on the other hand, seems participates to the Egyptian regional network of exchanges and sealing practices.

Artisanal food productions of animal origin: exploring food safety in the age of Whole Genome Sequencing

The artisanal food chain is enriched by a wide diversity of local food productions with delightful organoleptic characteristics and valuable nutritional properties. Despite their increasing worldwide popularity and appeal, several food safety challenges are addressed in artisanal facilities context suffering from less standardized processing conditions. In such scenario, recent advances in molecular typing and genomic surveillance (e.g., Whole Genome Sequencing [WGS]) represent an unprecedent solution capable of inferring sources of contamination as well as contributing to food safety along the artisanal food continuum. The overall objective of this PhD thesis was to explore potential microbial hazards among different artisanal food productions of animal origins (dairy and meat-derived) typical of the food culture and heritage landscape belonging to Mediterranean countries. Three different studies were then carried out, specifically focussing on: 1) compare the seasonal variability of microbiological quality and potential occurrence of microbial hazards in two batches of Italian artisanal fermented dairy and meat productions; 2) Investigate genetic relationships as well as virulome and resistome of foodborne pathogens isolated within dairy and meat-derived productions located in Italy, Spain, Portugal and Morocco; 3) investigate the population structure, virulome, resistome and mobilome of Klebsiella spp. isolates collected from study 1, including an extended range of public sequences.

Morphological and functional study of cerebral aging in rat

Aging is a physiological process characterized by a progressive decline of the “cellular homeostatic reserve”, refereed as the capability to respond suitably to exogenous and endogenous stressful stimuli. Due to their high energetic requests and post-mitotic nature, neurons are peculiarly susceptible to this phenomenon. However, the aged brain maintains a certain level of adaptive capacities and if properly stimulated may warrant a considerable functional recovery. Aim of the present research was to verify the plastic potentialities of the aging brain of rats subjected to two kind of exogenous stimuli: A) the replacement of the standard diet with a ketogenic regimen (the change forces the brain to use ketone bodies (KB) in alternative to glucose to satisfy the energetic needs) and B) a behavioural task able to induce the formation of inhibitory avoidance memory. A) Fifteen male Wistar rats of 19 months of age were divided into three groups (average body weight pair-matched), and fed for 8 weeks with different dietary regimens: i) diet containing 10% medium chain triglycerides (MCT); ii) diet containing 20% MCT; iii) standard commercial chow. Five young (5 months of age) and five old (26-27 months of age) animals fed with the standard diet were used as further controls. The following morphological parameters reflecting synaptic plasticity were evaluated in the stratum moleculare of the hippocampal CA1 region (SM CA1), in the outer molecular layer of the hippocampal dentate gyrus (OML DG), and in the granule cell layer of the cerebellar cortex (GCL-CCx): average area (S), numeric density (Nvs), and surface density (Sv) of synapses, and average volume (V), numeric density (Nvm), and volume density (Vv) of synaptic mitochondria. Moreover, succinic dehydrogenase (SDH) activity was cytochemically determined in Purkinje cells (PC) and V, Nvm, Vv, and cytochemical precipitate area/mitochondrial area (R) of SDH-positive mitochondria were evaluated. In SM CA1, MCT-KDs induced the early appearance of the morphological patterns typical of old animals: higher S and V, and lower Nvs and Nvm. On the contrary, in OML DG, Sv and Vv of MCT-KDs-fed rats were higher (as a result of higher Nvs and Nvm) vs. controls; these modifications are known to improve synaptic function and metabolic supply. The opposite effects of MCT-KDs might reflect the different susceptibility of these brain regions to the aging processes: OML DG is less vulnerable than SM CA1, and the reactivation of ketone bodies uptake and catabolism might occur more efficiently in this region, allowing the exploitation of their peculiar metabolic properties. In GCL-CCx, the results described a new scenario in comparison to that found in the hippocampal formation: 10%MCT-KD induced the early appearance of senescent patterns (decreased Nvs and Nvm; increased V), whereas 20%MCT-KD caused no changes. Since GCL-CCx is more vulnerable to age than DG, and less than CA1, these data further support the hypothesis that MCT-KDs effects in the aging brain critically depend on neuronal vulnerability to age, besides MCT percentage. Regarding PC, it was decided to evaluate only the metabolic effect of the dietetic regimen (20%MCT-KD) characterized by less side effects. KD counteracted age-related decrease in numeric density of SDH-positive mitochondria, and enhanced their energetic efficiency (R was significantly higher in MCT-KD-fed rats vs. all the controls). Since it is well known that Purkinje and dentate gyrus cells are less vulnerable to aging than CA1 neurons, these results corroborate our previous hypothesis. In conclusion, the A) experimental line provides the first evidence that morphological and functional parameters reflecting synaptic plasticity and mitochondrial metabolic competence may be modulated by MCT-KDs in the pre-senescent central nervous system, and that the effects may be heterogeneous in different brain regions. MCT-KDs seem to supply high energy metabolic intermediates and to be beneficial (“anti-aging”) for those neurons that maintain the capability to exploit them. This implies risks but also promising potentialities for the therapeutic use of these diets during aging B) Morphological parameters of synapses and synaptic mitochondria in SM CA1 were investigated in old (26-27 month-old) female Wistar rats following a single trial inhibitory avoidance task. In this memory protocol animals learn to avoid a dark compartment in which they received a mild, inescapable foot-shock. Rats were tested 3 and 6 or 9 hours after the training, divided into good and bad responders according to their performance (retention times above or below 100 s, respectively) and immediately sacrificed. Nvs, S, Sv, Nvm, V, and Vv were evaluated. In the good responder group, the numeric density of synapses and mitochondria was significantly higher and the average mitochondrial volume was significantly smaller 9 hours vs. 6 hours after the training. No significant differences were observed among bad responders. Thus, better performances in passive avoidance memory task are correlated with more efficient plastic remodeling of synaptic contacts and mitochondria in hippocampal CA1. These findings indicate that maintenance of synaptic plastic reactivity during aging is a critical requirement for preserving long-term memory consolidation.

Evidence-based polytherapies and long-term mortality after acute myocardial infarction in very old subjects compared with elderly and adults: a nested case-control study

Background: Clinical trials have demonstrated that selected secondary prevention medications for patients after acute myocardial infarction (AMI) reduce mortality. Yet, these medications are generally underprescribed in daily practice, and older people are often absent from drug trials. Objectives: To examine the relationship between adherence to evidence-based (EB) drugs and post-AMI mortality, focusing on the effects of single therapy and polytherapy in very old patients (≥80 years) compared with elderly and adults (<80 years). Methods: Patients hospitalised for AMI between 01/01/2008 and 30/06/2011 and resident in the Local Health Authority of Bologna were followed up until 31/12/2011. Medication adherence was calculated as the proportion of days covered for filled prescriptions of angiotensin-converting enzyme inhibitors (ACEIs)/angiotensin receptor blockers (ARBs), β-blockers, antiplatelet drugs, and statins. We adopted a risk set sampling method, and the adjusted relationship between medication adherence (PDC≥75%) and mortality was investigated using conditional multiple logistic regression. Results: The study population comprised 4861 patients. During a median follow-up of 2.8 years, 1116 deaths (23.0%) were observed. Adherence to the 4 EB drugs was 7.1%, while nonadherence to any of the drugs was 19.7%. For both patients aged ≥80 years and those aged <80 years, rate ratios of death linearly decreased as the number of EB drugs taken increased. There was a significant inverse relationship between adherence to each of 4 medications and mortality, although its magnitude was higher for ACEIs/ARBs (adj. rate ratio=0.60, 95%CI=0.52–0.69) and statins (0.60, 0.50–0.72), and lower for β-blockers (0.75, 0.61–0.92) and antiplatelet drugs (0.73, 0.63–0.84). Conclusions: The beneficial effect of EB polytherapy on long-term mortality following AMI is evident also in nontrial older populations. Given that adherence to combination therapies is largely suboptimal, the implementation of strategies and initiatives to increase the use of post-AMI secondary preventive medications in old patients is crucial.