EXTRA-HYPOTHALAMIC CRF-1 RECEPTOR MECHANISMS IN A MODEL OF BINGE-LIKE PALATABLE FOOD CONSUMPTION IN FEMALE RATS

Purpose: The present study evaluated the effect of the corticotrophin releasing factor (CRF)1 receptor antagonist R121919 and the corticosterone synthesis inhibitor metyrapone in female rats, in which binge eating for highly palatable food was evoked by frustration stress and cycles of food restrictions. Methods: We used 4 groups of rats that were first exposed or not exposed to repeated intermittent cycles of regular chow food restriction during which they were also given intermittent access to high-caloric palatable food. On the test day, we either exposed or did not expose the rats to the sight of the palatable food for 15 min, without allowing access to it (frustration stress) before assessing food consumption for 2 h. Results: We found that systemic injections of the CRF1 receptor antagonist R121919 but not of the metyrapone blocked binge-like eating behavior. Moreover, corticosterone injection did not induce binge eating in non-stressed rats. Restricted and stressed rats showed up regulation of CRH1 receptor mRNA signal in dorsal BNST and in CeA but not in PVN. Injection of CRF receptor antagonist D-Phe-CRF(12– 41) in CeA blocked binge-like eating behavior. Conclusions: These findings demonstrate that extra-hypothalamic CRF1 receptors, rather than those involved in endocrine functions, are involved in binge eating. Selective antagonism at CRF1 receptor may represent a novel pharmacological treatment for bingeing-related eating disorders

The economic impact of moderate stage Alzheimer's disease in Italy: Evidence from the UP-TECH randomized trial

Background: There is consensus that dementia is the most burdensome disease for modern societies. Few cost-of-illness studies examined the complexity of Alzheimer's disease (AD) burden, considering at the same time health and social care, cash allowances, informal care, and out-of-pocket expenditure by families. Methods: This is a comprehensive cost-of-illness study based on the baseline data from a randomized controlled trial (UP-TECH) enrolling 438 patients with moderate AD and their primary caregiver living in the community. Results: The societal burden of AD, composed of public, patient, and informal care costs, was about �20,000/yr. Out of this, the cost borne by the public sector was �4,534/yr. The main driver of public cost was the national cash-for-care allowance (�2,324/yr), followed by drug prescriptions (�1,402/yr). Out-of-pocket expenditure predominantly concerned the cost of private care workers. The value of informal care peaked at �13,590/yr. Socioeconomic factors do not influence AD public cost, but do affect the level of out-of-pocket expenditure. Conclusion: The burden of AD reflects the structure of Italian welfare. The families predominantly manage AD patients. The public expenditure is mostly for drugs and cash-for-care benefits. From a State perspective in the short term, the advantage of these care arrangements is clear, compared to the cost of residential care. However, if caregivers are not adequately supported, savings may be soon offset by higher risk of caregiver morbidity and mortality produced by high burden and stress. The study has been registered on the website www.clinicaltrials.org (Trial Registration number: NCT01700556). Copyright � International Psychogeriatric Association 2015

Socioeconomic Predictors of the Employment of Migrant Care Workers by Italian Families Assisting Older Alzheimer's Disease Patients: Evidence from the Up-Tech Study

Background: The availability of family caregivers of older people is decreasing in Italy as the number of migrant care workers (MCWs) hired by families increases. There is little evidence on the influence of socioeconomic factors in the employment of MCWs. Method: We analyzed baseline data from 438 older people with moderate Alzheimer's disease (AD), and their family caregivers enrolled in the Up-Tech trial. We used bivariate analysis and multilevel regressions to investigate the association between independent variables - education, social class, and the availability of a care allowance - and three outcomes - employment of a MCW, hours of care provided by the primary family caregiver, and by the family network (primary and other family caregivers). Results: The availability of a care allowance and the educational level were independently associated with employing MCWs. A significant interaction between education and care allowance was found, suggesting that more educated families are more likely to spend the care allowance to hire a MCW. Discussion: Socioeconomic inequalities negatively influenced access both to private care and to care allowance, leading disadvantaged families to directly provide more assistance to AD patients. Care allowance entitlement needs to be reformed in Italy and in countries with similar long-term care and migration systems. � 2015 The Author 2015. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved

Coinvolgimento, valutazione e credibilit\ue0

Come indicato nel capitolo stesso, si tratta di una focalizzazione "sull\u2019importanza che il coinvolgimento degli interlocutori nel processo di reporting e la riflessione sulle loro valutazioni, da un lato, le approvazioni da parte degli organi aziendali e i giudizi professionali, dall\u2019altro, hanno ai fini della credibilit\ue0 del bilancio sociale e dello sviluppo di consenso e fiducia rispetto all\u2019operato della banca"

Nell'ambito di: "Bilancio sociale dell\u2019esercizio 2007 \u2013 Sperimentazione relativa alla ricerca scientifica, Universit\ue0 di Macerata, 2009", indirizzo scientifico e coordinamento dei lavori

Indirizzo report social

Relazione sulla gestione: articolazione e collegamento con il controllo

Nell'ambito dell'analisi di bilanci sociali di BCC, focalizzazione sulle modalit\ue0 di articolazione della relazione sulla gestione e sul collegamento dei contenuti della stessa con i sistemi di programmazione e controllo

Diversità, opportunità, inclusione

«La spontanea diversità di modi di essere ed esperienze, lasciata libera di fluire attraverso il netto rifiuto di ogni etichetta o stigma, costituirebbe valore per tutti gli individui, non soltanto per le persone che esprimono profili diversi da quelli prevalenti. Infatti, il poter constatare l’esistenza di molteplici differenze non stigmatizzate – nel rispetto dei diritti altrui – consentirebbe libera espressione e benessere a livello generale. Ne trarrebbero beneficio le persone che presentano approcci non tipici e, insieme, anche le altre, perché tutte potrebbero valutare le dimensioni della loro natura senza il timore di mostrare divergenza e perdere potere e accettazione; tutte potrebbero quindi valutare con maggiore consapevolezza, superando schemi che sono più o meno esplicitamente, più o meno direttamente proposti/imposti nei diversi contesti socio-culturali e organizzativi» (Katia Giusepponi e Alessandra Fermani, p. 7