L'esecutivo e la Rai: riforma di una governance anomala

Le caratteristiche dello statuto Rai: le anomalie e le peculiarità; la riforma del 2015 e i principali nodi in discussione; l’imminente scadenza della convenzione e la necessaria ridefinizione dei fini e delle caratteristiche del servizio pubblico radiotelevisivo; il rapporto tra la struttura della governance e la ragion d’essere dell’azienda.The characteristics of the RAI bylaws: anomalies and peculiarities; the 2015 reform and the primary issues of contention; the upcoming deadline for the current agreement and the need to redefine the objectives and style of public radio and television; the relationship between the governance structure and the broadcaster’s raison d’être

Presidenziali USA: l’alternanza di governo nell’ultimo sistema bipartitico al mondo

In una delle posizioni più note e controverse nella metodologia delle scienze sociali, Friedrich von Hayek affermò che le scienze sociali si distinguono dalle scienze naturali perché mentre queste ultime hanno ad oggetto di studio i fatti (od i fenomeni) oggettivi, le scienze sociali hanno come oggetto le idee che gli individui hanno sui fatti, e le idee che essi hanno sulle idee proprie e su quelle degli altri individui. Questa posizione metodologica mostra tutta la sua rilevanza nel considerare le elezioni presidenziali, legislative e statali americane svoltesi lo scorso 8 novembre. Vi è un primo senso in cui essa si esplicita, e riguarda cosa si ritiene che di queste elezioni si debba spiegare. Per dirla con Karl Popper, aperti alla spiegazione sono quei fenomeni che contrastano con le aspettative, oppure quei fenomeni che sono effetti inattesi di azioni razionali. In termini più generali, le elezioni presidenziali del 2016 non sono aperte ad una spiegazione in senso popperiano. Il risultato finale, che è poi il solo rilevante, è infatti che dopo due mandati presidenziali Democratici gli elettori hanno scelto un presidente Repubblicano. Questa alternanza è pressoché la regola nella storia elettorale americana. Una alternanza che non è una descrizione di casualità statistica, ma corrisponde ad una determinante fondamentale del corpo elettorale americano, rimasta stabile nei secoli, che è quella di vedere il cambiamento di per sé (“change”) come un valore positivo

Macron e l'eccezionalismo francese

Commento all'elezione 2017 di Emmanuel Macron all'Eliseo sottolineano come il voto delle presidenziali francesi dia una boccata d'ossigeno all'Unione europea

Psychological Distress in Morbid Obesity in Relation to Weight History

Background: Very few data are available on psychological distress in morbidly obese subjects in relation to the history of their weight. In subjects with childhood obesity, psychological distress might be better than in adult-onset obesity, because of progressive adaptation to the social stigma. Methods: Psychological distress was tested in relation to BMI at age 20 years (BMI-20), weight history and somatic co-morbidities in 632 treatment-seeking, morbidly obese participants from the QUOVADIS cohort (130 men, 502 women; mean age 45.5 years). The number of dieting attempts/year, BMI increase and cumulative BMI loss since age 20 were calculated as weight cycling parameters.The Symptom Check List-90 (SCL-90), the Psychological General Well- Being (PGWB), the Binge-Eating Scale, and the ORWELL-97 questionnaire were used to score psychometry and health-related quality of life (HRQL). Complications were quantitatively assessed by a modified Charlson\u2019s score. Results: BMI-20 was normal in 35% of cases and >35 kg/m2 in only 14%. Psychometric scores were not different in relation to BMI-20, when corrected for age, with the exception of the General Health scale of PGWB, showing a greater distress in subjects with normal BMI-20. In most cases, the prevalence of pathological results of questionnaires showed a Jshaped curve, with participants with normal BMI-20 or those with Class II-III obesity in early adulthood having the highest prevalence of psychological/psychiatric distress and poor HRQL.Weight cycling was a risk factor for binge-eating, depression and interpersonal sensitivity in SCL-90, whereas somatic co-morbidities adversely affected most SCL-90 and all PGWB scales. Conclusion: Weight cycling and somatic co-morbidities, but not age of onset of obesity, are the main factors negatively influencing psychological health in treatment-seeking, morbidly obese subjects

Weight Loss Expectations and Attrition in Treatment-Seeking Obese Women

Objective: The analysis of the relation between weight loss goals and attrition in the treatment of obesity has produced conflicting results. The aim of the present study was to investigate the role of weight loss goals on attrition in a cohort of obese women seeking treatment at 8 Italian medical centres. Methods: 634 women with obesity, consecutively enrolled in weight loss programmes, were included in the study. Weight loss goals were evaluated with the Goals and Relative Weights Questionnaire (GRWQ), reporting a sequence of unrealistic (\u2018dream\u2019 and \u2018happy\u2019) and more realistic (\u2018acceptable\u2019 and \u2018disappointing\u2019) weight loss goals. Attrition was assessed at 12 months on the basis of patients\u2019 medical records. Results: At 12 months, 205/634 patients (32.3%) had interrupted their programme and were lost to followup. After adjustment for age, baseline weight, education and employment status, attrition was significantly associated with higher percent acceptable and disappointing weight loss targets, not with dream and happy weight loss. Conclusion: In \u2018real world\u2019 clinical settings, only realistic expectations might favour attrition whenever too challenging, whereas unrealistic weight loss goals have no effect. Future studies should assess the effect of interventions aimed at coping with too challenging weight goals on attrition

Weight Loss Expectations in Obese Patients and Treatment Attrition: An Observational Multicenter Study

Objective: To investigate the influence of weight loss expectations (expected 1-year BMI loss, dream and maximum acceptable BMI) on attrition in obese patients seeking treatment. Research Methods and Procedures: Obese subjects (1785; 1393 women; median age, 46 years; median BMI, 36.7 kg/m2) seeking treatment in 23 medical Italian centers were evaluated. Baseline diet and weight history, weight loss expectations, and primary motivation for seeking treatment (health or improving appearance) were systematically recorded. Psychiatric distress, binge eating, and body image dissatisfaction were tested at baseline by self-administered questionnaires (Symptom Check List-90, Binge Eating Scale, and Body Uneasiness Test). Attrition and BMI change at 12 months were prospectively recorded. Results: At 12 months, 923 of 1785 patients (51.7%) had discontinued treatment. Compared with continuers, dropouts had a significantly lower age, a lower age at first dieting, lower dream BMI, a higher expected 1-year BMI loss, and a higher weight phobia. At logistic regression analysis, the strongest predictors of attrition at 12 months were lower age and higher expected 1-year BMI loss. The risk of drop-out increased systematically for unit increase in expected BMI loss at 12 months (hazard ratio, 1.12; 95% confidence interval, 1.04 to 1.20; p 0.0018). The risk was particularly elevated in the first 6 months. Discussion: Baseline weight loss expectations are independent cognitive predictors of attrition in obese patients entering a weight-losing program; the higher the expectations, the higher attrition at 12 months. Unrealistic weight goals should be tackled at the very beginning of treatment

Weight Loss Expectations and Attrition in Treatment-Seeking Obese Women

Objective: The analysis of the relation between weight loss goals and attrition in the treatment of obesity has produced conflicting results. The aim of the present study was to investigate the role of weight loss goals on attrition in a cohort of obese women seeking treatment at 8 Italian medical centres. Methods: 634 women with obesity, consecutively enrolled in weight loss programmes, were included in the study. Weight loss goals were evaluated with the Goals and Relative Weights Questionnaire (GRWQ), reporting a sequence of unrealistic (‘dream' and ‘happy') and more realistic (‘acceptable' and ‘disappointing') weight loss goals. Attrition was assessed at 12 months on the basis of patients' medical records. Results: At 12 months, 205/634 patients (32.3%) had interrupted their programme and were lost to follow-up. After adjustment for age, baseline weight, education and employment status, attrition was significantly associated with higher percent acceptable and disappointing weight loss targets, not with dream and happy weight loss. Conclusion: In ‘real world' clinical settings, only realistic expectations might favour attrition whenever too challenging, whereas unrealistic weight loss goals have no effect. Future studies should assess the effect of interventions aimed at coping with too challenging weight goals on attrition

Nutritional Regimes Enriched with Antioxidants as an Efficient Adjuvant for IBD Patients under Infliximab Administration, a Pilot Study

Antioxidants are privileged candidates for the development of adjuvants able to improve the efficiency of pharmacological therapies, particularly for chronic inflammatory syndromes. During the last 20 years, anti-TNFα (tumor necrosis factor alpha) monoclonal antibodies infusion has been the biological therapy most frequently administered but there is still large space for improvement in disease remission rates and maintenance. In this context, nutritional bioactive compounds contained in dietary patterns or included as supplements, may act as adjuvants for the induction and maintenance of IBD (inflammatory bowel diseases) remission. To verify this possibility, a single-center preliminary study (SI-CURA, Soluzioni Innovative per la gestione del paziente e il follow up terapeutico della Colite UlceRosA) was designed and carried out to evaluate whether a daily administration of purple corn supplement could improve the response to Infliximab (IFX) infusion of IBD patients with both Crohn’s disease (CD) and ulcerative colitis (UC). A cohort of 47 patients was enrolled in the study. Biological samples were collected before the first and the third IFX infusion. All patients received nutritional guidelines, 27 of them received commercial red fruit tea with low anthocyanins content, while 20 received a purple corn supplement with a high anthocyanin content. Results show that the administration of an antioxidant-enriched purple corn supplement could improve IFX-mediated disease remission in terms of circulating inflammatory markers. Comparison between CD and UC patients revealed that, at this anthocyanin dosage, the purple corn extract administration improved the IFX response in CD but not in UC patients. Our results may pave the way for a new metacentric study of CD patients, recruiting a wider cohort and followed-up over a longer observational time

L'idea di progresso scientifico

Vi sono due ordini di ragioni per le quali è possibile affermare che il concetto di progresso scientifico deve essere considerato come categoria fondamentale della cultura e della storia dei nostri tempi. Come proverò a mostrare, vi sono delle ragioni teoretiche, e vi sono delle ragioni pratiche. Il concetto di progresso scientifico sembra essere particolarmente bisognoso di una sua giustificazione, di una apologia pro vita sua, nell’era della post-modernità, la quale appare aver dissolto ogni universalità nella frammentazione delle categorie del pensiero e della storia, in un particolarismo relativistico di tempo e di spazio nel quale il solo discorso epistemologicamente – ed anche moralmente – possibile sarebbe quello di una sua descrizione contestualistica, senza che si possano affermare rapporti causali universali o comunque universalizzabili in linea di principio