La performance rituale delle Nava Durgā: musica e danza tra i Banmālā di Bhaktapur, Nepal

Il presente lavoro è il risultato di cinque anni di ricerca sulla performance rituale delle Nava Durgā del popolo newar a Bhaktapur (Nepal). Dal 1512, per circa nove mesi all'anno, gli uomini della casta inferiore Banmālā reincarnano le nove manifestazioni femminili della dea Durgā ed eseguono le danze in maschera. La performance della Nava Durgā è una pratica culturale molto complessa, composta da suoni, danze, processioni, momenti di venerazione (pūjā), rituali tantrici e momenti sacrificali. Gli aspetti musicali e teatrali della performance costituiscono il focus dell’indagine di questo studio. Dopo una descrizione analitica degli strumenti musicali utilizzati nella performance, alcuni elementi sonori vengono trascritti e analizzati mettendo in luce le caratteristiche tipiche della musica newar. I contenuti narrativi delle danze e il ciclo vitale delle Nava Durgā rispecchiano la vita hindu. La loro interpretazione viene realizzata in base alle osservazioni etnografiche; alcuni temi che costituiscono gli obiettivi dei devoti hindu (puruṣārtha) vengono esaminati attraverso l’approccio storico e quello etnografico, anche al fine di sottolineare il ruolo didascalico e formativo della performance. Un altro argomento discusso in questo lavoro consiste nell'identità dei danzatori Banmālā e quella del popolo newar in generale; questo aspetto è emerso in modo rilevante anche durante le fasi di mediatizzazione della performance delle Nava Durgā avvenute nel periodo del COVID-19. Da questo punto di vista, il presente lavoro costituisce un contributo alla diffusione della conoscenza della tradizione delle Nava Durgā; questo converge con l'obiettivo dei Banmālā di aumentare la visibilità della performance al fine di affermare la propria identità sia nel contesto nazionale che in quello internazionale.

Drive up electrochemical and electrochemiluminescence signal through biosensing mechanism optimization

Biomarkers are biological indicators of human health conditions. Their ultra-sensitive quantification is of cardinal importance in clinical monitoring and early disease diagnosis. Biosensors are some worldwide simple and easy-to-use analytical devices as a matter of fact, biosensors using electrochemiluminescence (ECL) are one of the most promising biosensors that needs an ever-increasing sensitivity for improving its clinical effectiveness. The principal aspiration of this project is the investigation of the ECL generation mechanisms for enhancing the ECL intensity and the development of an ultrasensitive sensor, the use of metal-oxide materials (Mox) and the substitution of metal-free dyes. Novel dyes such as BODIPY, TADF are used to improve the sensitivity of ECL techniques thanks to their advantageous and tunable properties, enhancing the signal and also the ECL efficiency. Additionally, the use of Mox could be beneficial for the investigation of two different ECL mechanisms, which occur simultaneously. In this thesis, the investigation of size and distance effects on electrochemical (EC) mechanisms was carried out through the innovative combination of a standard detection system using different size of micromagnetic beads (MBs). That allowed the discovery of an unexpected and highly efficient mechanistic path for electrochemical generation at small distances from the electrode’s surface. The smallest MBs (0.1μm) demostrate an enhancement of electrochemical signal than the bigger one (2.8μm) until 4 times of magnitude. Finally, a novel ultrasensitive sensor, based on the coreactant-luminophores mechanism, was developed for the determination of whole viral genome specific for cardiac HBV and COVID-19 virus. In conclusion, the ECL and the use of EC techniques (such as amperometry), improved the understanding of mechanisms responsible for the ECL/EC signal led to a great enhancement in the signal.

The blue side of diabetes: assessing the impact of depression in people with type 2 diabetes using real-world data

The aim of the thesis is to assess the impact of depression in people with type 2 diabetes. Using Healthcare Utilization Databases, I estimated in a large population-based cohort with type 2 diabetes the incidence of depression over 10 year-period, identified the demographic and clinical predictors of depression, and determined the extent to which depression is a risk factor for acute and long-term complications and mortality. In the context of COVID-19 pandemic, I evaluated whether the presence of a history of depression in type 2 diabetes increased the Emergency Department (ED) access rate for diabetes-related complications, and I investigated changes in the incidence of depression during the first year of the pandemic. Findings from the first study indicated that developing depression was associated with being a woman, being over 65 years, living in rural areas, having insulin as initial diabetes medication and having comorbid conditions; the study also confirmed that depression was associated with an increased risk for acute and long-term diabetes complications and all-cause mortality. The second observational study showed a higher rate of ED access for diabetes-related complications during the pandemic in people with type 2 diabetes and a history of depression than in those without a history of depression, similar to what was observed in a pre-pandemic period. As shown in the third population-based study, the incidence of depression decreased in 2020 compared to 2019, mainly during the first and the second waves of the COVID-19 pandemic, when people probably had difficulty reaching healthcare services. This new real-world evidence will help healthcare professionals identify timely patients at high risk of developing depression. Lastly, policymakers and physicians will benefit from new evidence of the effects of the COVID-19 pandemic on depression in people with type 2 diabetes to ensure a high level of care during crisis periods.

Analytics and optimization for emergency healthcare processes

This thesis deals with the analysis and management of emergency healthcare processes through the use of advanced analytics and optimization approaches. Emergency processes are among the most complex within healthcare. This is due to their non-elective nature and their high variability. This thesis is divided into two topics. The first one concerns the core of emergency healthcare processes, the emergency department (ED). In the second chapter, we describe the ED that is the case study. This is a real case study with data derived from a large ED located in northern Italy. In the next two chapters, we introduce two tools for supporting ED activities. The first one is a new type of analytics model. Its aim is to overcome the traditional methods of analyzing the activities provided in the ED by means of an algorithm that analyses the ED pathway (organized as event log) as a whole. The second tool is a decision-support system, which integrates a deep neural network for the prediction of patient pathways, and an online simulator to evaluate the evolution of the ED over time. Its purpose is to provide a set of solutions to prevent and solve the problem of the ED overcrowding. The second part of the thesis focuses on the COVID-19 pandemic emergency. In the fifth chapter, we describe a tool that was used by the Bologna local health authority in the first part of the pandemic. Its purpose is to analyze the clinical pathway of a patient and from this automatically assign them a state. Physicians used the state for routing the patients to the correct clinical pathways. The last chapter is dedicated to the description of a MIP model, which was used for the organization of the COVID-19 vaccination campaign in the city of Bologna, Italy.

Precarious employment and social reproduction: the impact on health and well-being

This dissertation aims to make a theoretical and empirical contribution to the debate on precarious employment, social reproduction and the impact on health and well-being. In recent years, numerous studies have examined the effect of precarious employment as a social determinant on health and well-being, focusing on gender differences in this phenomenon. Within this framework, the research design is to investigate this topic quantitatively in the United Kingdom using longitudinal data to assess the long-term effects of precarious employment and informal care work on health. More specifically, the aim of this thesis is to investigate the impact of precarious employment on health and to analyze gender differences within this phenomenon, particularly in relation to the role of informal care work. The analysis shows that precarious employment is indeed associated to a detrimental effect on health and that this effect is stronger for women’s mental health. Additionally, the analysis shows that time spent on informal care work explains part of the gender gap in mental health, and that informal care and the number of hours spent on it are associated with worse mental health for women. Finally, during the first few months of Covid-19, for both men and women, performing more hours of care work on average is associated with worse mental health, showing that it is not so much the change from fewer to more hours that affects health, but rather those who do more hours on average, hence the long-term effect of being an intensive informal carer.

The role of technology at school: new perspectives on distance education and cyberbullying

The integration of digital technology in school is a complex phenomenon that affects both teaching and peer relationships. Accordingly, the main aim of this dissertation was to investigate the implementation of distance education among Italian teachers during the COVID-19 pandemic and analyze peer relationships concerning cyberbullying and bullying. While the theoretical section provided an overview of the phenomena, four empirical studies were presented. The first one tested a moderated moderation model among 178 secondary teachers on the interactions among perceived usefulness, perceived ease of use of technology and online teaching self-efficacy. Findings showed that each variable significantly predicted the intention to use technology. In addition, a moderation effect of online teaching self-efficacy on perceived usefulness was found. The second study analyzed the differences in factors promoting the integration of digital technology among 357 teachers of different levels and subjects and their positive and negative experiences with distance education. Results revealed several differences in the function of the grade and subjects taught. Moreover, four main themes emerged from the content analysis. The third study investigated the dyadic perception of bullying and cyberbullying among 50 students using the eye-tracker. Findings showed that, despite differences among different kinds of bullying and cyberbullying, the victim and bully were the most observed roles. Finally, the last study tested two multiple mediation models among 563 students on the association between bullying, cyberbullying, and well-being, considering three different variables related to the school context (peer network, teacher support and school connectedness). The results highlighted the importance of peer networks and school connectedness in mediating the association between victimization, cybervictimzation and well-being. Taken together, the findings provided a rich overview of digital technology integration in schools, highlighting positive and negative aspects and its implications for future research and school policies.

Essays in development and political economy

This thesis includes three papers studying diverse questions in development, economic history and political economy. The first two chapters, that fall under development and economic history, use novel forms of text data and analysis to answer the questions at hand. The first chapter studies the possible impact of a historically matrilineal and matrilocal caste group on present day outcomes of gender equality. It introduces a novel surname strategy using electoral data to deduce caste from the surnames of electors and overcomes the unavailability of caste data. It shows proof of persistence of caste in space. And finally, following a matching exercise it concludes that the effect of the matrilineal and matrilocal caste on present day gender outcomes might not be as strong as previously believed. The second paper studies how discriminatory fake news arises and spatially diffuses. It focuses on India at the onset of the COVID-19 pandemic: on March 30, a Muslim convention (the Tablighi Jamaat) in New Delhi became publicly recognized as a COVID hotspot, and the next day, fake news on Muslims intentionally spreading the virus spiked. Using Twitter data, it finds, in cross-sectional and difference-in-difference settings, that discriminatory fake news became much more widespread after March 30 (1) in New Delhi, (2) in districts closer to New Delhi, and (3) in districts with higher social media interactions with New Delhi. Further, it shows that, after March 30, discriminatory fake news was more common in districts historically exposed to attacks by Muslim groups. The final paper is a political economy paper that studies the short term and long term effect of earlier eligibility on voting in the context of a large North Italian municipality setting with little institutional barriers to voting. It also studies the differing mobilisation of members in the same household by newly eligible voters.

Teaching informatics to novices: big ideas and the necessity of optimal guidance

This thesis reports on the two main areas of our research: introductory programming as the traditional way of accessing informatics and cultural teaching informatics through unconventional pathways. The research on introductory programming aims to overcome challenges in traditional programming education, thus increasing participation in informatics. Improving access to informatics enables individuals to pursue more and better professional opportunities and contribute to informatics advancements. We aimed to balance active, student-centered activities and provide optimal support to novices at their level. Inspired by Productive Failure and exploring the concept of notional machine, our work focused on developing Necessity Learning Design, a design to help novices tackle new programming concepts. Using this design, we implemented a learning sequence to introduce arrays and evaluated it in a real high-school context. The subsequent chapters discuss our experiences teaching CS1 in a remote-only scenario during the COVID-19 pandemic and our collaborative effort with primary school teachers to develop a learning module for teaching iteration using a visual programming environment. The research on teaching informatics principles through unconventional pathways, such as cryptography, aims to introduce informatics to a broader audience, particularly younger individuals that are less technical and professional-oriented. It emphasizes the importance of understanding informatics's cultural and scientific aspects to focus on the informatics societal value and its principles for active citizenship. After reflecting on computational thinking and inspired by the big ideas of science and informatics, we describe our hands-on approach to teaching cryptography in high school, which leverages its key scientific elements to emphasize its social aspects. Additionally, we present an activity for teaching public-key cryptography using graphs to explore fundamental concepts and methods in informatics and mathematics and their interdisciplinarity. In broadening the understanding of informatics, these research initiatives also aim to foster motivation and prime for more professional learning of informatics.

La nuova eGovernance sanitaria europea: verso una piena integrazione della digitalizzazione nei sistemi sanitari degli Stati membri

L’elaborato approfondisce il diritto alla salute nell’ordinamento dell’Unione europea, con la consapevolezza che il settore della sanità, nella complessità di una tensione perdurante tra la sua matrice sociale e l’applicazione di logiche europee di mercato, rappresenta un ambito da sempre sottratto all’intervento diretto e vincolante delle istituzioni. Contemporaneamente, prende spunto dall’osservazione della transizione digitale dei sistemi sanitari nazionali per proporre una rilettura dei tradizionali equilibri istituzionali tra ordinamenti e constatare il grado di influenza dell’Unione oltre la dimensione transfrontaliera. Infatti, per le attuali esigenze di sostenibilità dei sistemi di tutela della salute e per il valore aggiunto riconosciuto alle azioni europee nel corso della gestione della pandemia da Covid-19, l’eHealth ha rappresentato l’occasione per una vigorosa intrusione delle istituzioni europee entro prerogative tipicamente statuali, fino all’emersione di una eGovernance sanitaria europea. Pertanto, la trattazione compie un percorso evolutivo che muove dalla Direttiva 2011/24 sull’assistenza transfrontaliera e l’assistenza sanitaria online, in combinato disposto con il complesso degli atti di soft law connessi, per verificarne l’esiguo impatto sui sistemi sanitari degli Stati membri e, alla luce dei recenti investimenti strategici ed interventi normativi rilevanti in tema di tecnologie applicate alla sanità, riconoscerne il sostanziale superamento. In particolare, il confronto tra l’insufficiente livello di digitalizzazione raggiunto finora nei sistemi sanitari degli Stati membri ed il tenore della Proposta di regolamento sullo European Health Data Space suggerisce l’evoluzione dell’impianto di governo dei dati sanitari stabilito nella Direttiva, a partire dalla previsione di una disciplina comune sulla cartella sanitaria. A questo proposito, l’interoperabilità tra tecnologie diviene un presupposto operativo indefettibile, che corrobora la natura ‘tecnologicamente condizionata’ del diritto alla salute e propone l’idea che la sanità digitale rappresenti un passo in avanti verso un’assistenza europea uniforme.

Obesità infantile: abitudini alimentari e stili di vita delle famiglie. Un'analisi sociologica sul territorio riminese

L'obesità infantile può essere considerata una delle maggiori sfide sanitarie del XXI secolo. In Italia, la fascia d'età più colpita è quella tra i 6 e gli 11 anni. L'infanzia e l'adolescenza non solo influenzano lo sviluppo fisico, cognitivo e sociale dell'adulto, ma anche l'aspettativa di vita. Inoltre, l'interruzione dell'insegnamento in classe e le misure di contenimento di Covid-19 hanno aumentato il comfort food, la sedentarietà e la vulnerabilità socio-economica delle famiglie. Lo scopo del lavoro di ricerca è stato quello di studiare i fattori sociali che hanno influenzato le abitudini alimentari e gli stili di vita delle famiglie con bambini di età compresa tra i 6 e gli 11 anni, all'interno dell'ambiente di socializzazione primario (famiglia) e secondario (scuola e altre istituzioni) anche durante la pandemia di COVID-19. La ricerca è stata condotta in Emilia-Romagna nella città di Rimini e poi estesa al contesto europeo contemporaneo. Per indagare questo punto, è stata utilizzata una metodologia in parte qualitativa e in parte quantitativa. L'approccio mosaico composto da 15 interviste semi-strutturate; 8 focus group e 5 etnografie ha permesso di costruire un questionario, online e cartaceo, somministrato a 361 genitori. I principali risultati rivelano che (1) i bambini sono ingrassati durante il periodo di Covid; (2) esiste una correlazione tra il peso della madre e il peso del bambino; (3) le madri sottovalutano l'obesità dei figli.

Youth psychosocial adjustment in the context of parental illness: risk and protective factors

Young carers might experience both psychological distress and positive changes from living with their chronically ill parent. However, little is known about why some young carers do well with their situation and experience positive outcomes, whereas others do not. In this regard, this dissertation aims to investigate how parental chronic illness affects young carers’ psychosocial adjustment through risk (i.e., unmet needs) and protective factors (i.e., benefit finding, emotion regulation). This main goal has been addressed by conducting three studies presented in Chapters 2–4. Chapter 2 has examined the mediating role of unmet needs on the relationship between illness unpredictability and youth psychosocial adjustment (i.e., quality of life and internalizing problems). In this regard, it has been found that levels of unmet needs significantly mediated the relationship between illness unpredictability and offspring health-related quality of life. In the systematic review with meta-analysis presented within Chapter 3, it has been sought to investigate the mediating role of the protective factors (i.e., benefit finding and emotion regulation) in the relationship between caregiving components and youth psychosocial adjustment in young carers. This study has shown the significant associations between caregiving components and psychosocial adjustment in young carers not only directly, but also indirectly through protective factors. Finally, to expand on previous findings, a qualitative study in Chapter 4 has examined the unique experiences of young carers, as well as the effects of the COVID-19 global pandemic. This study has yielded a deeper understanding of how protective factors may be operated during young carers’ lived experiences before and during the COVID-19 global pandemic. Overall, this dissertation has shed light on the pivotal role played by risk and protective factors in caregiving components that serve as key determinants that can enhance positive psychosocial outcomes as well as concurrently mitigate adverse psychosocial consequences among young carers.

Audience attitudes towards simil sync: a pilot study

This thesis is based on a pilot investigation which explores the attitudes of a sample of Italian viewers towards the simil sync technique which in Italy is used for the dub of non-fictional television contents. The thesis seeks to analyse and define the characteristics of this dubbing modality which is often considered by scholars and professionals in the dubbing industry a hybrid modality of standard synchronised dubbing and voice-over. In order to investigate viewers’ attitudes, I organised 4 focus groups sessions which, due to the impact of Covid-19 pandemic, were carried out online. The online recruitment of participants, which was a difficult task, resulted in a small sample of eighteen participants (and two interviewees). The four online focus groups revealed that participants were aware of the simil sync technique. They recognised that the clips were dubbed in a different modality from standard synchronised dubbing. The characteristic that was mostly mentioned for detecting simil sync was the original soundtrack that was audible below the dub, followed by the identification of the genre of the programme in the clip and the absence of lip sync. Moreover, while simil sync with a barely audible original soundtrack received neutral or positive attitudes, simil sync with a more audible original soundtrack, instead, was tolerated or considered annoying. Simil sync passed unnoticed in the in-depth interviews in which the discussion about dubbing was not focused on the distinction between two dubbing modalities, for instance simil sync versus standard synchronised dubbing, but rather on the distinction between programmes that originated in Italian and those that were translated into Italian from another language and then dubbed.

MR in vivo tractography for the reconstruction of cranial nerves course

Aim The aim of my Ph.D. was to implement a diffusion tensor tractography (DTT) pipeline to reconstruct cranial nerve I (olfactory) to study COVID-19 patients, and anterior optic pathway (AOP, including optic nerve, chiasm, and optic tract) to study patients with sellar/parasellar tumors, and with Leber’s Hereditary Optic Neuropathy (LHON). Methods We recruited 23 patients with olfactory dysfunction after COVID-19 infection (mean age 37±14 years, 12 females); 27 patients with sellar/parasellar tumors displacing the optic chiasm eligible for endonasal endoscopic surgery (mean age 53. ±16.4 years, 13 female) and 6 LHON patients (mutation 11778/MT-ND4, mean age 24.9±15.7 years). Sex- and age-matched healthy control were also recruited. In LHON patients, optical coherence tomography (OCT) was performed. Acquisitions were performed on a clinical high field 3-T MRI scanner, using a multi-shell HARDI (High Angular Resolution Diffusion Imaging) sequence (b-values 0-300-1000-2000 s/mm2, 64 maximum gradient directions, 2mm3 isotropic voxel). DTT was performed with a multi-tissue spherical deconvolution approach and mean diffusivity (MD) DTT metrics were compared with healthy controls using an unpaired t-test. Correlations of DTT metrics with clinical data were sought by regression analysis. Results In all 23 hypo/anosmic patients with previous COVID-19 infection the CN I was successfully reconstructed with no DTT metrics alterations, thus suggesting the pathogenetic role of central olfactory cortical system dysfunction. In all 27 patients with sellar/parasellar tumors the AOP was reconstructed, and in 11/13 (84.7%) undergoing endonasal endoscopic surgery the anatomical fidelity of the reconstruction was confirmed; a significant decrease in MD within the chiasma (p<0.0001) was also found. In LHON patients a reduction of MD in the AOP was significantly associated with OCT parameters (p=0.036). Conclusions Multi-shell HARDI diffusion-weighted MRI followed by multi-tissue spherical deconvolution for the DTT reconstruction of the CN I and AOP has been implemented, and its utility demonstrated in clinical practice.

Internet of healthcare (law): privacy and data protection aspects in an internet of everything

The purpose of this research study is to discuss privacy and data protection-related regulatory and compliance challenges posed by digital transformation in healthcare in the wake of the COVID-19 pandemic. The public health crisis accelerated the development of patient-centred remote/hybrid healthcare delivery models that make increased use of telehealth services and related digital solutions. The large-scale uptake of IoT-enabled medical devices and wellness applications, and the offering of healthcare services via healthcare platforms (online doctor marketplaces) have catalysed these developments. However, the use of new enabling technologies (IoT, AI) and the platformisation of healthcare pose complex challenges to the protection of patient’s privacy and personal data. This happens at a time when the EU is drawing up a new regulatory landscape for the use of data and digital technologies. Against this background, the study presents an interdisciplinary (normative and technology-oriented) critical assessment on how the new regulatory framework may affect privacy and data protection requirements regarding the deployment and use of Internet of Health Things (hardware) devices and interconnected software (AI systems). The study also assesses key privacy and data protection challenges that affect healthcare platforms (online doctor marketplaces) in their offering of video API-enabled teleconsultation services and their (anticipated) integration into the European Health Data Space. The overall conclusion of the study is that regulatory deficiencies may create integrity risks for the protection of privacy and personal data in telehealth due to uncertainties about the proper interplay, legal effects and effectiveness of (existing and proposed) EU legislation. The proliferation of normative measures may increase compliance costs, hinder innovation and ultimately, deprive European patients from state-of-the-art digital health technologies, which is paradoxically, the opposite of what the EU plans to achieve.

La paradoja de Maastricht. Los distintos modelos económicos y políticos para el futuro integrador de la UE

La crisis existencial del proyecto de integración europea constituye el principal reto al que debe enfrentarse la Comunidad en su futuro más inmediato puesto que se alza como toda una amenaza para la continuidad del sistema establecido desde el Tratado fundacional de Roma (1957). Las tres crisis acontecidas durante los primeros años del siglo XXI, véase la gran crisis económica del año 2008, la pandemia global de la Covid-19 y la actual intervención de la Federación Rusa en Ucrania, están poniendo constantemente a prueba la firmeza de los cimientos y valores sobre los cuales se ha construido la Comunidad durante todos estos años. Esta tesis doctoral pretende ser una contribución académica al debate abierto en las sociedades comunitarias acerca de por donde debe de transitar la evolución del proyecto de integración europea en los próximos años. Para conseguir alcanzar este objetivo, la investigación se retrotrae hasta los orígenes del proceso de integración y avanza en la línea temporal hasta nuestros días, analizando con ello las posibles causas que pudieran encontrarse detrás de la crisis existencial actual. A su vez, , la investigación estudia con detenimiento los múltiples efectos que está generando la problemática existencial en los Estados miembros en los últimos años, tales como el aumento del apoyo social a favor de actores considerados populistas o el fenómeno de la creciente desafección ciudadana. Esta investigación analiza los distintos escenarios propuestos por la Comisión Europea en su Libro Blanco sobre el futuro de Europa para determinar cuál podría ser el mejor escenario que concordara con la nueva realidad económica y sociopolítica que actualmente impera en los Estados miembro. Lo que se persigue es formular una propuesta que pueda dar por terminada la crisis existencial de la Comunidad abriendo con ello una nueva etapa en la historia de la integración europea.