Medicalizing gender: from intersex to DSD, from the laboratory to patient groups

The subject of this research, the medicalization of the gendered body, is a shifting object. It has changed its medical name from Intersex to DSD (Disorders -or Divergence- of Sex Development), since the beginning of this research project. Loosely speaking it addresses the gendered components of the body, and their subsequent consideration. Drawing closer, it addresses how modern medicine treats people who manifest variations of one of the gendered components of the body, inserting their bodies into pathological categories now called DSD. This shifting terrain of different modes of viewing the gendered body has grown to include many variations, no longer solely interested in the mythical hermaphrodite. The locus of this investigation is in the interaction between these patient groups and doctors in Italy.

Studio di marcatori immunoistochimici, analisi FISH e ruolo dei microRNA nelle neoplasie gliali di basso e di alto grado

Gliomas are the most common primary brain tumours. Despite advances in surgical techniques, postoperative supportive care, radiation and adjuvant systemic therapy, the life expectancy of patients with high grade glioma has remained essentially poor. Furthermore differential diagnosis among astrocytomas, oligodendrogliomas and oligoastrocytomas is very challenging and subject to inter-observer variability. The purpose of the research was: 1) to investigate a series of high grade and low grade gliomas at gene and protein (immunohistochemistry) levels to disclose possible genetic portraits of malignancy; 2) to verify the utility of Nogo-A, Olig-2 and synaptophysin in providing a correct histological diagnosis of oligodendroglioma and to investigate a possible complementary role in selecting the best areas suitable for detecting 1p/19q codeletion using FISH analysis; 3) to study the role of microRNA in high grade gliomas. In order to obtain these goals large series of brain tumors were studied with DNA microarrays, immunohistochemistry and RT-PCR The results demonstrated that: - Overexpression of IGFBP-2 and CDC20 is highly related to glioblastomas and their immunopositivity can be useful for the identification of glioblastoma in small biopsies. - Nogo-A is the most useful and specific marker in differentiating oigodendrogliomas from other gliomas. Furthermore, using a Nogo-A driven FISH analysis, it is possible to identify a larger number of 1p19q codeletions in gliomas. - microRNAs can be studied in paraffin embedded tissues better than in fresh tissues. A series of six microRNA, significatively deregulated in glioblastomas, may represent a genetic signature with prognostic and predictive value and could constitute candidates for novel anti-cancer therapeutics.

La musa bambina. 1911-2011: un secolo di letteratura mitologica per ragazzi in Italia tra storia, educazione e narrazione

Questa ricerca mostra l’evoluzione della letteratura mitologica per ragazzi in Italia. Il primo libro italiano di mitologia per bambini è stato pubblicato nel 1911 (lo stesso anno di un’importante e violenta guerra coloniale tra l’Italia e la Libia): la scrittrice italiana Laura Orvieto pubblicò allora “Storie della storia del mondo”, in cui riunì antichi racconti greci per giovani lettori. Queste storie erano ispirate al libro mitologico per bambini “Il libro delle meraviglie” di Hawthorne (titolo originale “A Wonder Book for Girls and Boys”). In seguito molti scrittori italiani scrissero libri mitologici per giovani lettori: serie importanti di libri di mitologia per bambini furono pubblicate durante il regime mussoliniano – talvolta per diffondere l’ideologia fascista della superiorità romana. Durante questo periodo, i libri mitologici spesso mostravano uno stile letterario solenne. Dopo la seconda guerra mondiale, la letteratura mitologica per bambini cambiò lentamente prospettiva: gli scrittori italiani cominciarono ad usare il mito per parlare di problemi sociali (p.e. Gianni Rodari descriveva re Mida come un capitalista) e per spiegare le diverse condizioni umane (p.e. Beatrice Masini fa riferimento alle dee e alle eroine greche per descrivere la condizione femminile). La ricerca analizza anche la relazione tra mito e scuola in Italia: i racconti mitologici hanno sempre fatto parte dei programmi scolastici italiani per bambini dagli 8 agli 11 anni. Le riforme scolastiche – deliberate negli anni ’20 e ’40 – fissarono pratiche didattiche sui miti ancora oggi in uso. I racconti mitologici erano soprattutto un supporto per gli studi storici e letterari. Tuttavia, negli ultimi decenni, i miti sono divenuti un importante aiuto per gli insegnamenti scientifici e artistici.

Neocostituzionalismo e positivizzazione dei valori

This doctoral thesis seeks to make a comprehensive analysis of neoconstitutionalism, studying their manifestations in constitutional law and doctrine. Neoconstitutionalism, as a new manifestation of constitutional phenomenon that emerged after World War II, is characterized by the need to take any legal possession of certain premises, materials of an immovable, coinciding with the fundamental human rights, which will fall outside the potential political majorities, and become its cornerstone. These assumptions are intended as safeguards needed to protect human dignity and the democratic system itself against anyone, even taking advantage of a power obtained democratically which intends to demolish the pillars of democracy and to establish tyranny. The Constitution is enshrined as a basic rule of real system, a repository of these fundamental rights, the observance by public authorities becomes inexcusable. This will involve a role for judicial review in its protection. Thus, supremacy of the constitution, deepening respect for and promotion of fundamental rights and role of constitutional judge as the guarantor of its validity are the bases of neoconstitutionalism, a legal phenomenon not only current, but evolving.

Modellizzazione bioeconomica per la gestione dei piccoli pelagici nel Mar Adriatico

Stocks’ overexploitation and socio-economic sustainability are two major issues currently at stake in European fisheries. In this view the European Commission is considering the implementation of management plans as a means to move towards a longer-term perspective on fisheries management, to consider regional differences and to increase stakeholder involvement. Adriatic small pelagic species (anchovies and sardines) are some of the most studied species in the world from a biologic perspective; several economic analysis have also been realised on Italian pelagic fishery; despite that, no complete bioeconomic modelization has been carried out yet considering all biologic, technical and economic issues. Bioeconomic models cannot be considered foolproof tools but are important implements to help decision makers and can supply a fundamental scientific basis for management plans. This research gathers all available information (from biologic, technologic and economic perspectives) in order to carry out a bioeconomic model of the Adriatic pelagic fishery. Different approaches are analyzed and some of them developed to highlight potential divergences in results, characteristics and implications. Growth, production and demand functions are estimated. A formal analysis about interaction and competition between Italian and Croatian fleet is examined proposing different equilibriums for open access, duopoly and a form of cooperative solution. Anyway normative judgments are limited because of poor knowledge of population dynamics and data related to the Croatian fleet.

Simulazione CAD dell'impingement articolare con protesi d'anca convenzionale e a conservazione di collo in funzione dei principali parametri chirurgici e anatomici

Lo scopo del lavoro è quello di verificare tramite software CAD l’influenza dei principali parametri chirurgici e anatomici sul Range Of Motion (ROM). Sono stati costruiti 5 modelli, uno di articolazione sana(Senza Protesi), uno di protesi Convenzionale e tre di protesi Conservative o a Conservazione (Totale, Media e Bassa Conservazione). Per tutti i modelli sono state simulate le rotazioni di base e i cosiddetti movimenti critici, ovvero quei movimenti a rischio di lussazione. Le prove sono state eseguite per teste da 28-,32-,36-,40mm di diametro, e con la coppa orientata di 45° in abduzione e 15° gradi in antiversione prima e successivamente di 45° e 0°. Inoltre, per verificare l’influenza dell’offset sul ROM, sono stati costruiti e simulati i movimenti per altri 5 modelli che non conservassero il vincolo del mantenere l’offset anatomico. Variando il diametro della testa si registrano differenze apprezzabili in termini di ROM solo per i movimenti di Estensione e Abduzione per il modello di Protesi Convenzionale e di Abduzione per il modello a Bassa Conservazione. Variando il livello di resezione del collo si è visto come per i modelli di protesi a Media Conservazione, Bassa Conservazione e Convenzionale si misurano angoli superiori a quello del riferimento tratto dalla Letteratura. Diversamente per il modello di Protesi a Totale Conservazione i valori ottenuti per alcuni movimenti sono inferiori, poiché limitati da un contatto di tipo c-b. Le simulazioni dei movimenti critici confermano la tendenza di un ROM accettabile per i modelli di protesi a Bassa Conservazione e di protesi Convenzionale, i quali forniscono escursioni angolari sempre superiori a quelle prese come riferimento dalla Letteratura. Invece, le protesi a Totale e Media Conservazione forniscono valori inferiori al riferimento per i movimenti di Pivot e Roll, essendo limitati dall’antiversione della coppa (movimenti di ExtraRotazione e contatto c-b). Variando la posizione della coppa a 45°/0° i due movimenti Critici Pivot e Roll migliorano per i modelli a Totale e Media Conservazione, tornando in linea con il riferimento. Riguardo l’offset si nota come più si avvicina a quello anatomico che misura 46,2mm (da 37 a 44mm), più si riscontra un aumento in termini di ROM.

Ruolo dei glicosaminoglicani su struttura e funzione dei crimps nei tendini e nei legamenti

The biomechanical roles of both tendons and ligaments are fulfilled by extracellular matrix of these tissues. In particular, tension is mainly transmitted and resisted by fibrous proteins (collagen, elastin), whereas compressive load is absorbed by water-soluble glycosaminoglycans (GAGs). GAGs spanning the interfibrillar spaces and interacting with fibrils also seem to play a part in transmitting and resisting tensile stresses. Apart from different functional roles and collagen array, tendons and ligaments share the same basic structure showing periodic undulations of collagen fibers or crimps. Each crimp is composed of many knots of each single fibril or fibrillar crimps. Fibrillar and fiber crimps act as shock absorbers during the initial elongation of both tendons and ligaments and assist the elastic recoil of fibrils and fibers when the tensile stress is removed. The aim of this thesis was to evaluate whether GAGs directly affect the 3D microstructural integrity of fibrillar crimp and fiber crimps in both tendons and ligaments. Achilles tendons and medial collateral ligaments of the knee from eight female Sprague-Dawley rats (90 days old) were digested with chondroitinase ABC to remove GAGs and observed under a scanning electron microscope (SEM). In addition, isolated fibrils from these tissues obtained by mechanical homogenization were analyzed by a transmission electron microscope (TEM). Both samples digested with chondroitinase ABC or mechanically disrupted still showed crimps and fibrillar crimps comparable to tissues with a normal GAGs content. All fibrils in the fibrillar crimp region always twisted leftwards, thus changing their running plane, and then sharply bent, changing their course on a new plane. These data suggest that GAGs do not affect structural integrity or fibrillar crimps functions that seem mainly related to the local fibril leftward twisting and the alternating handedness of collagen from a molecular to a supramolecular level.

Indicatori per la valutazione della presa in carico dei pazienti con disturbi mentali

Secondo la definizione dell’Organizzazione Mondiale della Sanità (OMS) “la salute mentale è la base per un corretto sviluppo emotivo, psicologico, intellettuale e sociale degli individui e allo stesso tempo ha effetti favorevoli sull’ambiente in cui le persone vivono e sul luogo di lavoro, generando crescita economica e sviluppo sociale”. In tutti i paesi la frequenza dei disturbi mentali è in aumento, con conseguente incremento dei costi sociali ed economici. Circa il 14 % della popolazione adulta a livello mondiale è colpita da un disturbo mentale o di comportamento, con picchi di oltre il 20% negli Stati Uniti. Negli ultimi anni le politiche sanitarie si sono orientate sempre più verso la ricerca di soluzioni per l’organizzazione dei servizi di salute mentale, favorendo un approccio territoriale piuttosto che ospedaliero, che ha portato in alcuni paesi ad una netta riduzione di posti letto riservati a malati psichiatrici. Fondamentale quindi l’istituzione di percorsi integrati che soddisfino i bisogni di salute mentale dei pazienti, garantiscano la continuità assistenziale e perseguano un miglioramento della qualità della vita dei pazienti e dei loro familiari. Obiettivo di questa tesi è la proposta di un set di indicatori per la salute mentale che avranno l’obiettivo di monitorare tutte le fasi del percorso assistenziale. A tale scopo, sarà necessario collegare i diversi flussi di informazioni: schede di dimissione ospedaliera, specialistica ambulatoriale, prestazioni farmaceutiche effettuate in distribuzione diretta o per conto, prestazioni dei dipartimenti di salute mentale, registro di mortalità, anagrafe.

Metodi biomolecolari per il follow up dei pazienti HIV positivi

As proviral human immunodeficiency virus type 1 (HIV-1) DNA can replenish and revive viral infection upon attivation, its analysis, in addition to RNA viral load, could be considered a useful marker during the follow-up of infected individuals, to evaluate reservoir status, especially in HAART-treated patients when RNA viral load is undetectable by current techniques and the antiretroviral efficacy of new, more potent therapeutic regimens. Standardized methods for the measurement of the two most significant forms of proviral DNA, total and non-integrated, are currently lacking, despite the widespread of molecular biology techniques. In this study, total and 2-LTR HIV-1 DNA proviral load, in addition to RNA viral load, CD4 cell count and serological parameters, were determined by quantitative analysis in peripheral blood mononuclear cells (PBMC) in naïve or subsequently HAART-treated patients with acute HIV-1 infection in order to establish the role of these two DNA proviral forms in the course of HIV infection. The study demonstrated that HAART-treated individuals show a significant decrease in both total and 2-LTR circular HIV-1 DNA proviral load compared with naïve patients: these findings confirm that HIV-1 reservoir decay correlates with therapeutic effectiveness. The persistence of small amounts of 2-LTR HIV-1 DNA form, which is considered to be a molecular determinant of infectivity, in PBMC from some patients demonstrates that a small rate of replication is retained even when HAART is substantially effective: HAART could not eradicate completely the infection because HIV is able to replicate at low levels. Plasma-based viral RNA assays may fail to demonstrate the full extent of viral activity. In conclusion, the availability of a new standardized assay to determine DNA proviral load will be important in assessing the true extent of virological suppression suggesting that its quantification may be an important parameter in monitoring HIV infection.

Studio di metodi di preparazione e caratterizzazione di nanostrutture per la funzionalizzazione di materiali ceramici

This thesis was carried out in the context of a co-tutoring program between Centro Ceramico Bologna (Italy) and Instituto di Tecnologia Ceramica, Castellón de la Plana (Spain). The subject of the thesis is the synthesis of silver nanoparticles and at their likely decorative application in the productive process of porcelain ceramic tiles. Silver nanoparticles were chosen as a case study, because metal nanoparticles are thermally stable, and they have non-linear optical properties when nano-structured, and therefore they develop saturated colours. The nanoparticles were synthesized by chemical reduction in aqueous solution, a method chosen because of its reduced working steps and energy costs. Besides such a synthesis method uses non-expensive and non-toxic raw material. By adopting this synthesis technique, it was also possible to control the dimension and the final shape of the nanoparticles. Several syntheses were carried out during the research work, modifying the molecular weight of the reducing agent and/or the firing temperature, in order to evaluate the influence such parameters have on the Ag-nanoparticles formation. The syntheses were monitored with the use of UV-Vis spectroscopy and the average dimension as well as the morphology of the nanoparticles was analysed by SEM. From the spectroscopic data obtained from each synthesis, a kinetic study was completed, relating the progress of the reaction to the two variables (ie temperature and molecular weight of the reducing agent). The aim was finding equations that allow the establishing of a relationship between the operating conditions during the synthesis and the characteristics of the final product. The next step was finding the best method of synthesis for the decorative application. For such a purpose the amount of nanoparticles, their average particle size, the shape and the agglomeration are considered. An aqueous suspension containing the nanoparticles is then sprayed over the fired ceramic tiles and they are subsequently thermally treated in conditions similar to the industrial one. The colorimetric parameters of the obtained ceramic tiles were studied and the method proved successful, giving the ceramic tiles stable and intense colours.

Salute e sicurezza sul lavoro: significati e problemi della valutazione dei rischi da stress lavoro-correlato nelle aziende sanitarie

Work environment changes bring new risks, in particular an increase in certain diseases and illnesses caused by stress. The European Agreement of October 2004 defines stress as “a state accompanied by physical, psychological or social dysfunctions, due to the fact that people do not feel able to overcome the gap in relation to requests or expectations for them”. A new strategy aims to reduce accidents and occupational illnesses through a series of actions at European level. The approaches to prevent work related stress must specifically aim to face up organizational and social aspects, to provide training to managers and employees on management of stress, to reduce the impact and to develop suitable systems for rehabilitation and return to work for those who suffered health problems. The enterprises will have to carry out the obligations laid down by legislation, adopting detection systems customised on their size and on their specific interests. Currently manifold tools and methodologies are proposed from different subjects as employer associations, advisors for safety, psychologists etc., but none of these has been identified as a model to follow. After the reconstruction of the theoretical framework where the theme is placed in, the thesis, through a background analysis done by collecting the comments of experts who are involved in the management of occupational safety and the examination of a concrete assessment of work-related stress risk, carried out at a local health authority of Emilia-Romagna region, aims to highlight the main sociological implications related to the emergence of these new risks.