La sinistra:italiana una commedia in tre atti.

L’entrata nella seconda Repubblica è stata scandita dalla marcia trionfale della sinistra in predicato di vincere le elezioni politiche. I risultati elettorali più gratificanti della sinistra sono stati la traballante vittoria del 1996 e le non vittorie (sostanziali pareggi) del 2006 e del 2013, al contrario erano certe nelle previsioni e nei fatti le vittorie berlusconiane del 2001 e del 2008

Electoral Systems, Forms of Government and the Local Political Class in Italy

The local level of government in Italy represents the principal area in which the profound transformations that have taken place in the political system have been accompanied by a series of radical institutional reforms. These reforms have subverted a form of government and an organizational structure that until then had remained unchanged since the end of the Second World War. These include the direct election of the mayor; the newly conferred power of the mayor to nominate and dismiss commissioners; the separation of roles between those of government (mayor and administration) and those of normative direction and control (council). These are only the most visible and important innovations of the vast institutional transformation that accompanied the transmutation of the political system on both a local and national level in Italy. This inclination towards personalization, towards both a prominence and a managerialism of the executive level would seem to converge with similar processes (as observed by some scholars) in the local governmental systems of the principal European countries. This paper proposes, for this reason, to describe and analyze the reform of the electoral systems and forms of local government, and attempts to verify the measure in which these institutional innovations have modified the identity, role and the functions of the local political class in Italy. The empirical verification is based on analysis and comparison of the results of a qualitative research study conducted in 1993 (just before the parliamentary approval of the reform calling for the direct election of mayor) and repeated in 1999. This study was based on a questionnaire given to 160 local politicians \u2013 mayors, councilmen and commissioners \u2013 of 16 municipalities (ten questionnaires per municipality) of medium size and located in geographical areas representative of diverse social, economic and cultural contexts: Piedmont, Veneto, Tuscany and Sicily. In particular, following an analysis of the principal contents of the approved reforms in the course of the 1990s, the study moves on to a description of the principal characteristics of the municipal political class up until the end of the 1980s. In fact, the empirical research studies regarding this sector have all highlighted how, independently of the differences in social, economic and cultural contexts of the municipalities in question, the municipal councilman belonged to a well-defined category within the Italian political system. Given this reality, it was possible to draw a fairly clear profile of this political figure. The municipal administrator was prevalently male, 40 something, with a background in civil service, and a long history of membership in a political party. In other words, a sort of \u201cself-referential class\u201d associated with a single model of political engagement. Successively, these characteristics are examined in light of the empirical evidence that emerged from the 1993 and 1999 studies, thus tracing the evolution of the local political class in socio-graphic terms, and in those of a political career in parties and in public institutions. In this sense, particular attention is paid to the emergence of a process within which there is a distinct divergence between the characteristics defining the members of representative assemblies and those defining the members of the executive branch (commissioners, mayors). If one of the objectives of the reforms was to separate and distinguish the executive branch from the municipal council, and in so doing to sacrifice (according to a widely-held opinion) the role of the latter \u2013 and consequently of political parties \u2013 in the name of a greater administrative efficacy, then the most immediate consequence is that of a thorough declassification of municipal councilmen. Moreover, as far as political careers are concerned, the most significant data concerns the profound renovation of the local political class, as well as the substantial modification of the traditional structures of political opportunity, which have become (above all, among the executive branch) less strictly reliant on political parties

Elezioni 2013: la crisi del "bipolarismo imperfetto" (ed. ampliata e aggiornata)

Questo articolo analizza l'interazione tra sistema elettorale e sistema partitico nel caso italiano confrontando i risultati delle elezioni politiche nel 2006, 2008 e 2013. A partire dall'osservazione dei diversi risultati delle elezioni politiche del 2006 e del 2008, da un lato, e del 2013, dall'altro, l\u2019articolo dedica attenzione a come tra i sistemi elettorali e di partito non vi sia un nesso causale sistematico, ma una "interazione di reciproca indipendenza". Le prime due elezioni politiche, svoltesi in base alla legge elettorale del 2005, hanno portato a un mantenimento del sistema bipolare. Il terzo, al contrario, ha portato a un ripristino del sistema multipolare. Tali risultati divergenti mostrano come gli effetti incentivanti o disincentivanti per una competizione bipolare o multipolare siano anche legati alla strutturazione dei sistemi di partito e alle sue trasformazioni endogene. In questa edizione, ampliata e aggiornata rispetto alla precedente, viene analizzato anche l'esito delle elezioni europee del maggio 2014. Questo risultato - sebbene metodologicamente non confrontabile con il risultato delle precedenti elezioni politiche - sembra confermare la tendenza al multipolarismo emersa nel 2013.This article analyzes the interaction between electoral system and party system in the Italian case by comparing general elections results in 2006, 2008 and 2013. Starting from the observation of the different outcomes of 2006 and 2008 general elections, on the one hand, and 2013, on the other, the article devotes attention on how between electoral and party systems there is not a systematic causal link, but a \u201cinteraction of mutual independence\u201d. The first two general elections, which took place under the 2005 electoral law, resulted in a bipolar system retention. The third one, conversely, resulted in a multipolar system restoration. Such divergent outcomes shows how incentive or disincentive effects for a bipolar or multipolar competition are even related to party systems structuring and its endogenous transformations. In this edition, expanded and updated with respect to the previous one, the outcome of the European elections of May 2014 is also analyzed. This outcome - although methodologically not comparable with the result of the previous general elections - seems to confirm the tendency towards multipolarism that emerged in 2013

Risk factors associated with postpartum impaired glucose regulation in women with previous gestational diabetes

Aims: For women with previous gestational diabetes (GDM), international guidelines recommend 75 g oral glucose tolerance test (OGTT) at 4–12 weeks after delivery to assess glucose tolerance, considering their increased risk of type 2 diabetes. We evaluated prevalence of postpartum impaired glucose regulation (IGR) and identified associated risk factors. Methods: We retrospectively collected data from 749 women with previous GDM (IADPSG criteria) who underwent postpartum OGTT for type 2 diabetes screening between 2011 and 2019. IGR was identified according to ADA criteria. Results: Prevalence of IGR was 12.7%, lower in women with pre-pregnancy normal weight, higher in women with family history of type 2 diabetes and in those treated with insulin during pregnancy. Prevalence of IGR raised with increasing number of altered glucose values at OGTT performed during pregnancy for GDM screening. HbA1c and triglycerides measured during the third trimester of pregnancy were higher in women with postpartum IGR. At postpartum screening, women with IGR had higher BMI, waist, blood pressure. At multivariate logistic regression analysis, family history of diabetes (OR 2.21; 95% CI: 1.33–3.69; p < 0.01) and presence of all three glucose values exceeding threshold at OGTT during pregnancy (OR 2.89; 95% CI: 1.42–5.86; p < 0.01) were independently associated with IGR. Conclusions: In women with GDM, persistence of IGR in the immediate postpartum period is associated with family history of diabetes and the presence of all three glucose values exceeding diagnostic threshold for GDM at OGTT in pregnancy, suggesting that these women should undergo specific diabetes monitoring and prevention programs

FDG-PET/CT Correlates with the Response of Radiorefractory Thyroid Cancer to Lenvatinib and Patient Survival

Context: 18F-fluoro-2-deoxy-D-glucose positron emission tomography-computed tomography ([18F]-FDG-PET/CT)-positive metastatic lesions in radioiodine-refractory differentiated thyroid cancer (RAI-R DTC) have a poor prognosis and lenvatinib represents the best therapy. Objective: We investigated the role of [18F]-FDG-PET/CT in the evaluation of metabolic response and prediction of the outcome of RAI-R DTC patients treated with lenvatinib. Methods: Patients (n = 33) with progressive metastatic RAI-R DTC who were treated with lenvatinib were investigated at baseline and during follow-up with biochemical (thyroglobulin and thyroglobulin antibodies), morphological (whole-body CT scan) and metabolic ([18F]-FDG-PET/CT) evaluation. Results: Nineteen (57.6%) patients showed the greatest metabolic response at the first [18F]-FDG-PET/CT scan, performed after 4 weeks of lenvatinib, while 5/33 (15.1%) patients had this response later. Moreover, 66.7% of patients had both a metabolic response at the first [18F]-FDG-PET/CT scan and a morphological response at the first CT scan. We observed a correlation between the metabolic response at [18F]-FDG-PET/CT scan performed after 4 weeks of treatment and the biochemical response at the same time in 60.6% of patients. The median overall survival (OS) was significantly longer in patients with either a metabolic response at last [18F]-FDG-PET/CT (40.00 vs 8.98 months) or a morphological response at last CT scan (37.22 vs 9.53 months) than in those without response. Moreover, the OS was longer in patients with a metabolic response at [18F]-FDG-PET/CT performed after 4 weeks of treatment (36.53 vs 11.28 months). Conclusions: Our data show that [18F]-FDG-PET/CT can early predict the response to lenvatinib and correlates with the OS of RAI-R DTC patients treated with this drug

Thyroid cancer and COVID-19: experience at one single thyroid disease referral center

Purpose: Severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2) is challenging health systems all over the world. Cancer patients have a higher risk of being infected by SARS-Cov-2 and higher coronavirus disease 2019 (COVID-19) severity and mortality. Up to date, there were no data about COVID-19 in patients with thyroid cancer (TCs). The aim of the study was to describe the prevalence of COVID-19 in a well-characterized series of TC patients evaluated for the persistence of the neoplastic disease from March to September 2020; as secondary objective, we looked for the COVID-19 disease severity in a subgroup of multimetastatic TC patients. Methods: We evaluated 1464 patients affected by persistent TC: 67 patients who were taking multikinase inhibitors (MKIs) and 1397 under active surveillance for a persistent but stable disease. During the clinical evaluation, all patients were specifically investigated about a positive history of Sars-Cov-2 infection. Results: SARS-Cov-2 infection was identified in 4/1464 (0.3%) cases of patients affected by TC. We identified three cases among patients under active surveillance (0.2%), and one case among patients treated with MKI systemic therapy (1/67, 1.5%). This patient was taking vandetanib for metastatic medullary thyroid cancer (MTC), when he came to our attention referring severe fatigue, dyspnea for light physical activities. He presented a mild COVID-19 and he received exclusively supportive care. After a multidisciplinary consultation, we decided against the discontinuation of vandetanib. After 2 months from the infection, he did not present any signs of active infection, and the MTC metastatic disease was stable. Conclusions: We showed that COVID-19 is not more frequent in TC patients than in general population, although a relatively higher prevalence in the group of TC patients treated with MKIs. A single patient with advanced TC and SARS-Cov-2 infection during MKIs treatment had a mild COVID-19 and did not require the discontinuation of MKI therapy. In cases of more severe COVID-19, an accurate evaluation from a multidisciplinary team would consider risks and benefits in taking the decision to continue or stop MKI treatment