Migration in southern Europe: The peripheral incorporation in crisis

En este trabajo se analizan los resultados principales de una investigación comparativa sobre la migración, la integración social de los migrantes y las políticas públicas hacia los inmigrantes en Campania (Italia) y Extremadura (España). Nuestra perspectiva se basa en el concepto de incorporación periférica de los inmigrantes en la sociedad local. Nuestro punto de partida, por lo tanto, fue la idea de que, en estas regiones poco desarrolladas del sur de Europa, la sociedad local incluye a los inmigrantes en la medida en que ayudan en hacer frente a la globalización económica y la reducción de las políticas sociales. La investigación, realizada en 2014 principalmente a través de una encuesta con informantes clave, destacó el inicio de una crisis en este tipo de integración social de los inmigrantes, debido a los recientes cambios. Al mismo tiempo, nuestros resultados destacan también algunas diferencias entre las dos regiones.In this paper, we discuss the main results of a comparative research on migration, the social integration of migrants, and the public policies toward immigrants in Campania (Italy) and Extremadura (Spain). Our perspective is based on the concept of peripheral incorporation of immigrants in the local society. Our starting point, therefore, was the idea that, in these low-developed regions of southern Europe, the local society includes immigrants to the extent that they support the local resilience to economic globalization and the retrenchment of social policies. The survey, conducted in 2014 mainly through interviews with key informants, highlighted the beginning of a crisis in this kind of social integration of immigrants, because of recent changes in migratory flows, the labor market, and immigrant policies. At the same time, our results highlight also some differences between these regions

New Italian Migration in the People’s Republic of China

In the panorama of international migration statistics, there is a progressive growth of registrations of Italian citizens residing abroad. In particular, the steady increase in consular registrations based in the People’s Republic of China is striking. The expression “new emigrations” is an increasingly recurrent among scholars to highlight the quantitative and qualitative changes that have characterised Italian emigration abroad in recent years. The choice to emigrate depends on many factors, the very definition of new emigration calls into question aspects of the debate that imply a careful evaluation of the different components that characterize its profile. Which dimensions, above others, act on the choice to emigrate? Which aspects characterize the profile of Italians who decide to undertake an emigration experience in the People’s Republic of China, albeit temporary? New Italian migration in Shanghai is a Skilled Migration? In this article, we will focus on some results of a qualitative research conducted on the new Italian emigration to China. More precisely, in the following pages we try to bring out which dimensions act in the choice to emigrate and which aspects characterize the profile of Italians who decide to emigrate to Shanghai

La violenza di genere confinata tra le pareti domestiche durante il lockdown

The Covid -19 pandemic has had a profound impact on our living systems and, more generally, on the economic and political organization of our country. The significant loss of human lives, the inte rruption of economic activities, the lockdown , to give just a few references, are an undoubted threat to our well -being . Rather important was the impact of the confinement on families and markedly on women , favoring the most disparate forms of abuse . In this scenario, gender -based violence is not added to the list of effects on life, but rather expresses that dimension of life – often left in the shadows – that reflects pathways of suffocated equality and rights often denied to women . Indeed, gender -based v iolence is an expression of inequality between women and men made clear by the COVID -19 outbreak. Therefore, the fight against gender -based violence remains a challenge for the 21st century. This paper aims to explore two key issues: gender inequality and interlinkage between reproduction and production sphere , focusing on pre -existing inequalities and vulnerabilities in women's life experiences

Refinement of the diagnostic approach for the identification of children and adolescents affected by familial hypercholesterolemia: Evidence from the LIPIGEN study

Background and aims: We aimed to describe the limitations of familiar hypercholesterolemia (FH) diagnosis in childhood based on the presence of the typical features of FH, such as physical sings of cholesterol accumulation and personal or family history of premature cardiovascular disease or hypercholesterolemia, comparing their prevalence in the adult and paediatric FH population, and to illustrate how additional information can lead to a more effective diagnosis of FH at a younger age.Methods: From the Italian LIPIGEN cohort, we selected 1188 (>= 18 years) and 708 (<18 years) genetically-confirmed heterozygous FH, with no missing personal FH features. The prevalence of personal and familial FH features was compared between the two groups. For a sub-group of the paediatric cohort (N = 374), data about premature coronary heart disease (CHD) in second-degree family members were also included in the evaluation.Results: The lower prevalence of typical FH features in children/adolescents vs adults was confirmed: the prevalence of tendon xanthoma was 2.1% vs 13.1%, and arcus cornealis was present in 1.6% vs 11.2% of the cohorts, respectively. No children presented clinical history of premature CHD or cerebral/peripheral vascular disease compared to 8.8% and 5.6% of adults, respectively. The prevalence of premature CHD in first-degree relatives was significantly higher in adults compared to children/adolescents (38.9% vs 19.7%). In the sub-cohort analysis, a premature CHD event in parents was reported in 63 out of 374 subjects (16.8%), but the percentage increased to 54.0% extending the evaluation also to second-degree relatives.Conclusions: In children, the typical FH features are clearly less informative than in adults. A more thorough data collection, adding information about second-degree relatives, could improve the diagnosis of FH at younger age

Twelve Variants Polygenic Score for Low-Density Lipoprotein Cholesterol Distribution in a Large Cohort of Patients With Clinically Diagnosed Familial Hypercholesterolemia With or Without Causative Mutations

: Background A significant proportion of individuals clinically diagnosed with familial hypercholesterolemia (FH), but without any disease-causing mutation, are likely to have polygenic hypercholesterolemia. We evaluated the distribution of a polygenic risk score, consisting of 12 low-density lipoprotein cholesterol (LDL-C)-raising variants (polygenic LDL-C risk score), in subjects with a clinical diagnosis of FH. Methods and Results Within the Lipid Transport Disorders Italian Genetic Network (LIPIGEN) study, 875 patients who were FH-mutation positive (women, 54.75%; mean age, 42.47±15.00 years) and 644 patients who were FH-mutation negative (women, 54.21%; mean age, 49.73±13.54 years) were evaluated. Patients who were FH-mutation negative had lower mean levels of pretreatment LDL-C than patients who were FH-mutation positive (217.14±55.49 versus 270.52±68.59 mg/dL, P<0.0001). The mean value (±SD) of the polygenic LDL-C risk score was 1.00 (±0.18) in patients who were FH-mutation negative and 0.94 (±0.20) in patients who were FH-mutation positive (P<0.0001). In the receiver operating characteristic analysis, the area under the curve for recognizing subjects characterized by polygenic hypercholesterolemia was 0.59 (95% CI, 0.56-0.62), with sensitivity and specificity being 78% and 36%, respectively, at 0.905 as a cutoff value. Higher mean polygenic LDL-C risk score levels were observed among patients who were FH-mutation negative having pretreatment LDL-C levels in the range of 150 to 350 mg/dL (150-249 mg/dL: 1.01 versus 0.91, P<0.0001; 250-349 mg/dL: 1.02 versus 0.95, P=0.0001). A positive correlation between polygenic LDL-C risk score and pretreatment LDL-C levels was observed among patients with FH independently of the presence of causative mutations. Conclusions This analysis confirms the role of polymorphisms in modulating LDL-C levels, even in patients with genetically confirmed FH. More data are needed to support the use of the polygenic score in routine clinical practice

Lipoprotein(a) Genotype Influences the Clinical Diagnosis of Familial Hypercholesterolemia

: Background Evidence suggests that LPA risk genotypes are a possible contributor to the clinical diagnosis of familial hypercholesterolemia (FH). This study aimed at determining the prevalence of LPA risk variants in adult individuals with FH enrolled in the Italian LIPIGEN (Lipid Transport Disorders Italian Genetic Network) study, with (FH/M+) or without (FH/M-) a causative genetic variant. Methods and Results An lp(a) [lipoprotein(a)] genetic score was calculated by summing the number risk-increasing alleles inherited at rs3798220 and rs10455872 variants. Overall, in the 4.6% of 1695 patients with clinically diagnosed FH, the phenotype was not explained by a monogenic or polygenic cause but by genotype associated with high lp(a) levels. Among 765 subjects with FH/M- and 930 subjects with FH/M+, 133 (17.4%) and 95 (10.2%) were characterized by 1 copy of either rs10455872 or rs3798220 or 2 copies of either rs10455872 or rs3798220 (lp(a) score ≥1). Subjects with FH/M- also had lower mean levels of pretreatment low-density lipoprotein cholesterol than individuals with FH/M+ (t test for difference in means between FH/M- and FH/M+ groups &lt;0.0001); however, subjects with FH/M- and lp(a) score ≥1 had higher mean (SD) pretreatment low-density lipoprotein cholesterol levels (223.47 [50.40] mg/dL) compared with subjects with FH/M- and lp(a) score=0 (219.38 [54.54] mg/dL for), although not statistically significant. The adjustment of low-density lipoprotein cholesterol levels based on lp(a) concentration reduced from 68% to 42% the proportion of subjects with low-density lipoprotein cholesterol level ≥190 mg/dL (or from 68% to 50%, considering a more conservative formula). Conclusions Our study supports the importance of measuring lp(a) to perform the diagnosis of FH appropriately and to exclude that the observed phenotype is driven by elevated levels of lp(a) before performing the genetic test for FH

Acute Delta Hepatitis in Italy spanning three decades (1991–2019): Evidence for the effectiveness of the hepatitis B vaccination campaign

Updated incidence data of acute Delta virus hepatitis (HDV) are lacking worldwide. Our aim was to evaluate incidence of and risk factors for acute HDV in Italy after the introduction of the compulsory vaccination against hepatitis B virus (HBV) in 1991. Data were obtained from the National Surveillance System of acute viral hepatitis (SEIEVA). Independent predictors of HDV were assessed by logistic-regression analysis. The incidence of acute HDV per 1-million population declined from 3.2 cases in 1987 to 0.04 in 2019, parallel to that of acute HBV per 100,000 from 10.0 to 0.39 cases during the same period. The median age of cases increased from 27 years in the decade 1991-1999 to 44 years in the decade 2010-2019 (p &lt; .001). Over the same period, the male/female ratio decreased from 3.8 to 2.1, the proportion of coinfections increased from 55% to 75% (p = .003) and that of HBsAg positive acute hepatitis tested for by IgM anti-HDV linearly decreased from 50.1% to 34.1% (p &lt; .001). People born abroad accounted for 24.6% of cases in 2004-2010 and 32.1% in 2011-2019. In the period 2010-2019, risky sexual behaviour (O.R. 4.2; 95%CI: 1.4-12.8) was the sole independent predictor of acute HDV; conversely intravenous drug use was no longer associated (O.R. 1.25; 95%CI: 0.15-10.22) with this. In conclusion, HBV vaccination was an effective measure to control acute HDV. Intravenous drug use is no longer an efficient mode of HDV spread. Testing for IgM-anti HDV is a grey area requiring alert. Acute HDV in foreigners should be monitored in the years to come

Familial hypercholesterolaemia in children and adolescents from 48 countries: a cross-sectional study

Background: Approximately 450 000 children are born with familial hypercholesterolaemia worldwide every year, yet only 2·1% of adults with familial hypercholesterolaemia were diagnosed before age 18 years via current diagnostic approaches, which are derived from observations in adults. We aimed to characterise children and adolescents with heterozygous familial hypercholesterolaemia (HeFH) and understand current approaches to the identification and management of familial hypercholesterolaemia to inform future public health strategies. Methods: For this cross-sectional study, we assessed children and adolescents younger than 18 years with a clinical or genetic diagnosis of HeFH at the time of entry into the Familial Hypercholesterolaemia Studies Collaboration (FHSC) registry between Oct 1, 2015, and Jan 31, 2021. Data in the registry were collected from 55 regional or national registries in 48 countries. Diagnoses relying on self-reported history of familial hypercholesterolaemia and suspected secondary hypercholesterolaemia were excluded from the registry; people with untreated LDL cholesterol (LDL-C) of at least 13·0 mmol/L were excluded from this study. Data were assessed overall and by WHO region, World Bank country income status, age, diagnostic criteria, and index-case status. The main outcome of this study was to assess current identification and management of children and adolescents with familial hypercholesterolaemia. Findings: Of 63 093 individuals in the FHSC registry, 11 848 (18·8%) were children or adolescents younger than 18 years with HeFH and were included in this study; 5756 (50·2%) of 11 476 included individuals were female and 5720 (49·8%) were male. Sex data were missing for 372 (3·1%) of 11 848 individuals. Median age at registry entry was 9·6 years (IQR 5·8-13·2). 10 099 (89·9%) of 11 235 included individuals had a final genetically confirmed diagnosis of familial hypercholesterolaemia and 1136 (10·1%) had a clinical diagnosis. Genetically confirmed diagnosis data or clinical diagnosis data were missing for 613 (5·2%) of 11 848 individuals. Genetic diagnosis was more common in children and adolescents from high-income countries (9427 [92·4%] of 10 202) than in children and adolescents from non-high-income countries (199 [48·0%] of 415). 3414 (31·6%) of 10 804 children or adolescents were index cases. Familial-hypercholesterolaemia-related physical signs, cardiovascular risk factors, and cardiovascular disease were uncommon, but were more common in non-high-income countries. 7557 (72·4%) of 10 428 included children or adolescents were not taking lipid-lowering medication (LLM) and had a median LDL-C of 5·00 mmol/L (IQR 4·05-6·08). Compared with genetic diagnosis, the use of unadapted clinical criteria intended for use in adults and reliant on more extreme phenotypes could result in 50-75% of children and adolescents with familial hypercholesterolaemia not being identified. Interpretation: Clinical characteristics observed in adults with familial hypercholesterolaemia are uncommon in children and adolescents with familial hypercholesterolaemia, hence detection in this age group relies on measurement of LDL-C and genetic confirmation. Where genetic testing is unavailable, increased availability and use of LDL-C measurements in the first few years of life could help reduce the current gap between prevalence and detection, enabling increased use of combination LLM to reach recommended LDL-C targets early in life

La resistibile ascesa del lavoro flessibile. Incidenti e morti sul lavoro

In Italia circa un milione di incidenti sul lavoro all'anno, tra questi 26 mila persone costrette all'invalidità e 3 morti al giorno, rappresentano le cifre di una vera e propria lotta per la sopravvivenza. Essa, a parere dell’autrice del volume,va combattuta fino in fondo, ma per farlo bisogna conoscerla fino in fondo. Questo è lo scopo dell’invito rivolto al lettore ad approfondire il nesso tra lavoro, nuove misure di flessibilità, incidenti e caduti sul lavoro. Ci si chiede inoltre:perché soltanto negli ultimissimi anni il problema è assunto alle cronache, è emerso dalla rassegnazione in cui era stato confinato? Se poi questo ritardo e questa mancata informazione non comportino precise responsabilità per le molte vittime che si sarebbero potute evitare? Infatti non possiamo non riflettere sul fatto che da almeno 30 anni i più seri studiosi del mercato del lavoro abbiano avvertito in merito alle conseguenze derivanti dalla forte crescita della fascia secondaria del mercato del lavoro, cioè di quel settore caratterizzato dal lavoro informale, sommerso, irregolare (senza regole appunto), di solito definito lavoro nero, nel quale sono occupati in gran parte i lavoratori senza diritti, i lavoratori stranieri con diritti inferiori e i giovani costretti alla ricerca di una qualsiasi forma di lavoro. Dall’esame dei dati, svolto dall’autrice del volume, si ricava come spesso si crede, gli incidenti non riguardino solo i settori delle costruzioni, dell'industria e dell'agricoltura, ma si siano particolarmente diffusi più di recente nei servizi : cioè nei lavori caratterizzati da una maggiore flessibilità. Di conseguenza soprattutto nell’attuale crisi economica non è il caso di domandarsi se le ormai decennali politiche incentrate sulla valorizzazione della flessibilità della forza lavoro, sull'incremento dei lavori atipici nelle più diverse forme, non favoriscano in modo decisivo la mancanza di sicurezza sul lavoro, non aumentino i pericoli, non riducano la forza contrattuale di quanti hanno il dovere di pensare anche alla propria salute? Non ci dice qualcosa il fatto che più del 55% degli incidenti riguardino gli immigrati? Il volume esplora queste problematiche con rigore ma senza tecnicismi. Su questa base e con questa impostazione critica vengono riportati in sintesi le valutazioni emerse dalle interviste rivolte a rappresentanti di reti istituzionali, di organizzazioni sindacali, ad attori locali e alcuni infortunati. Per giungere a parlare di “sicurezza” in concreto, infatti, si è ritenuto necessario andare oltre la dimensione numerica, normativa e tecnica; si è ritenuto fondamentale raccogliere le “storie” di vittime di incidenti, che spiegano come “si sarebbe potuto evitare …” E' innegabile che su questo drammatico problema più di recente sia cresciuta l'informazione e vi sia un maggiore impegno sul piano normativo, tuttavia, è anche indiscutibile il dato che la progressiva e continua frammentazione dei rapporti lavoro di fatto “deresponsabilizza” l’impresa