This paper provides an empirical analysis of the result of the referendum on constitutional reform held in Italy on 4 December 2016. The votes against (59.1%) won by a significant margin, with an unexpectedly high turnout at the polls and more than 33 million citizens voting. Using as a point of departure the polls carried out prior to and following the referendum, in which Italians said they were essentially in favour of the reform proposed by the prime minister, the essay focuses on the mistakes made by Matteo Renzi that discouraged Italians from voting Yes. These touch on all aspects of the referendum: 1) the parliamentary process, 2) its combination with electoral law, 3) institutional communication, and 4) his political analysis and strategic approach. The final section evaluates the effects of the referendum result on the Italian political system, emphasising the setback to reformism and the strengthening of the anti-system parties that support leaving the Euro (in particular the Movimento 5 Stelle).
Background: Prolonged university closures and social distancing-imposed measures due to the COVID-19 pandemic obliged students to at-home learning with online lectures and educational programs promoting potential social isolation, loneliness, hopelessness, and episodes of clinical decompensation. Methods: A web-based cross-sectional survey was carried out in a university institute in Milan, Northern Italy, to assess the COVID-19 lockdown impact on the mental health of the undergraduate students. We estimated the odds ratios (OR) and the corresponding 95% confidence intervals (CI) using adjusted logistic regression models. Results: Of the 8,177 students, 12.8% reported depressive symptoms, 25.6% anxiety, 8.7% insomnia, and 10.6% reported impulsive tracts, with higher proportions among females than males. Mental health symptoms were positively associated with caring for a person at home, a poor housing quality, and a worsening in working performance. Among males compared with females, a poor housing quality showed a stronger positive association with depressive symptoms and impulsivity, and a worsening in the working performance was positively associated with depressive and anxiety symptoms. In addition, the absence of private space was positively associated with depression and anxiety, stronger among males than females. Conclusions: To our knowledge, this is the first multidisciplinary consortium study, involving public mental health, environmental health, and architectural design. Further studies are needed to confirm or refute our findings and consequent recommendations to implement well-being interventions in pandemic conditions.
The goal of this study was to evaluate specific characteristics associated with hopelessness, potentially correlated with coping strategies, sensory profile, and alexithymia in patients with borderline personality disorder (BPD).
Serum CA-125 was determined in 60 patients with variously extended ovarian cancer and monitored during and after chemotherapy. The study indicates that: 1) prechemotherapy CA-125 shows the presence of an active disease with an accuracy greater than 85%. The antigen is elevated in 97% of patients with greater than 2 cm disease, but sensitivity is low (67%) in patients with minimal residual disease (less than 2 cm); 2) changes in CA-125 correspond well with the response to chemotherapy. CA-125 becomes negative in every patient having clinical CR and increases in every patient with progressive disease. These changes can indicate the type of response some months ahead of time; 3) CA-125 indicates in advance the recurrence of the disease after an objective remission: 4) In the conditions studied CA-125 basal levels do not seem to have prognostic value as regarding either response or survival.
Since the World Health Organization (WHO) declared the coronavirus infectious disease 2019 (COVID-19) outbreak a pandemic on 11 March, severe lockdown measures have been adopted by the Italian Government. For over two months of stay-at-home orders, houses became the only place where people slept, ate, worked, practiced sports, and socialized. As consolidated evidence exists on housing as a determinant of health, it is of great interest to explore the impact that COVID-19 response-related lockdown measures have had on mental health and well-being. We conducted a large web-based survey on 8177 students from a university institute in Milan, Northern Italy, one of the regions most heavily hit by the pandemic in Europe. As emerged from our analysis, poor housing is associated with increased risk of depressive symptoms during lockdown. In particular, living in apartments <60 m2 with poor views and scarce indoor quality is associated with, respectively, 1.31 (95% CI: 1046–1637), 1.368 (95% CI: 1166–1605), and 2.253 (95% CI: 1918–2647) times the risk of moderate–severe and severe depressive symptoms. Subjects reporting worsened working performance from home were over four times more likely to also report depression (OR = 4.28, 95% CI: 3713–4924). Housing design strategies should focus on larger and more livable living spaces facing green areas. We argue that a strengthened multi-interdisciplinary approach, involving urban planning, public mental health, environmental health, epidemiology, and sociology, is needed to investigate the effects of the built environment on mental health, so as to inform welfare and housing policies centered on population well-being.
Objective: International and national recommendations for brain imaging in patients planned to undergo potentially curative resection of nonsmall-cell lung cancer (NSCLC) are variably implemented throughout the United Kingdom [Hudson BJ, Crawford MB, and Curtin J et al (2015) Brain imaging in lung cancer patients without symptoms of brain metastases: a national survey of current practice in England Clin Radiol https://doi.org/10.1016/j.crad.2015.02.007].However, the recommendations are not based on high-quality evidence and do not take into account cost implications and local resources.Our aim was to determine local practice based on historic outcomes in this patient cohort.Methods: This retrospective study took place in a regional thoracic surgical centre in the United Kingdom.Pathology records for all patients who had undergone lung resection with curative intent during the time period January 2012-December 2014 were analysed in October 2015.Electronic pathology and radiology reports were accessed for each patient and data collected about their histological findings, TNM stage, resection margins, and the presence of brain metastases on either pre-operative or post-operative imaging.From the dates given on imaging, we calculated the number of days post-resection that the brain metastases were detected.Results: 585 patients were identified who had undergone resection of their lung cancer.Of these, 471 had accessible electronic radiology records to assess for the radiological evidence of brain metastases.When their electronic records were evaluated, 25/471 (5.3%) patients had radiological evidence of brain metastasis.Of these, five patients had been diagnosed with a brain metastasis at initial presentation and had undergone primary resection of the brain metastasis followed by resection of the lung primary.One patient had been diagnosed with both a primary lung and a primary bowel adenocarcinoma; on review of the case, it was felt that the brain metastasis was more likely to have originated from the bowel cancer.One had been clinically diagnosed with a cerebral abscess while the radiology had been reported as showing a metastatic deposit.Of the remaining 18/471 (3.8%) patients who presented with brain metastases after their surgical resection, 12 patients had adenocarcinoma, four patients had squamous cell carcinoma, one had basaloid, and one had large-cell neuroendocrine.The mean number of days post-resection that the brain metastases were identified was 371 days, range 14-1032 days, median 295 days (date of metastases not available for two patients).
La cure thermale est une therapeutique. Comme toutes les therapeutiques, elle doit etre evaluee dans son cout et dans son efficacite. L'Angeiologie thermale et notamment la phlebologie a beneficie pour preciser ses indications des formidables progres des methodes d'exploration, et pour preciser ses resultats des formidables progres de l'informatique. La place de la cure thermale se precise quant a l'affection et quant au moment dans cette affection. Autant dire qu'il y a des indications precises, des moments precis, des stations, une maniere efficace et un cout bien definis. Ce sont ces quelques notions concretes que nous exposons dans cette communication, en precisant la facon dont le medecin traitant doit prescrire la cure et en indiquant le cout pour le curiste
