Archivio Istituzionale della Ricerca - Università degli Studi di Pavia
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Functional hypothalamic amenorrhea and dietary intervention: A systematic review to guide further research in amenorrheic women without overt eating disorder
No full textFunctional hypothalamic amenorrhea (FHA) is a multifactorial condition caused by psychological stress, energy deficit, weight loss, and excessive physical activity in the absence of adequate energy intake. Nutrition plays a key role in FHA treatment, with the primary intervention focused on correcting energy imbalance. Evidence regarding the exact amount of energy required to restore menses, the timeframe for recovery, and the optimal nutritional practices to support long-term recovery and optimize reproductive outcomes, remain limited. In this review, we aimed to assess if dietary intervention affects the nutritional status, food intake, nutrition knowledge, and hormonal milieu in women with FHA. We performed this review in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses method, using the Population, Intervention, Control, Outcome, Study design criteria. A quality appraisal checklist for case series was used. The search included 4 databases and was restricted to English and Italian languages. Eleven articles were included. Five of these referred to the same population analyzed in 2 randomized controlled trials (RCTs); 3 nonrandomized controlled trials (NRCTs); and 1 nonrandomized uncontrolled trial, and 2 case series. Overall, the risk of bias was low for RCTs and moderate-to-high for NRCTs. Menstrual cycle can be restored in 1 to 12 months. One article indicated an additional 350 kcal/d energy intake to achieve this. However, the long-term impact of nutritional intervention alone remains unclear. Further research with a comprehensive, patient-centered approach is needed to confirm these findings and to clarify the possible role of nutritional counseling in FHA treatment
Local boundedness and higher integrability for the sub-critical singular porous medium system
No full textThe gradient of weak solutions to porous medium-type equations or systems possesses a higher integrability than the one assumed in the pure notion of a solution. We settle the critical and sub-critical, singular case and complete the program
Exploring the intersection of sustainability performance and M&A activity: A review of the literature
No full textThis study adopts a bibliometric and content analysis to investigate extant literature on the link between sustainability and M&A. Findings from the analysis of 96 papers show that the extant literature is fragmented and interdisciplinary, with many authors from Chinese and Australian institutions analyzing primarily Chinese and US firms. Preferred outlets either are in the field of general management or specialized in finance. From a methodological perspective, quantitative studies represent by far the majority of the analyzed sample. Several avenues for further research are addressed
Altobello Melone, Adorazione del Bambino con i santi Paolo e Caterina d’Alessandria, 1512-1513 circa
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Il rapporto di lavoro dirigenziale nel settore privato
No full textL’elaborato si propone di analizzare la figura del dirigente nel settore privato, evidenziandone l’evoluzione normativa e giurisprudenziale, la natura del rapporto di lavoro e le tutele applicabili. Particolare attenzione è dedicata alla definizione delle categorie dei prestatori di lavoro e alla loro collocazione nel Codice Civile, con un focus specifico sulla categoria dirigenziale. Si esamina come, nel tempo, dottrina e giurisprudenza abbiano ricondotto i dirigenti a un’unica categoria, con piena coincidenza tra quella contrattuale e quella legale. Parte dell’analisi è dedicata alla disciplina del licenziamento dei dirigenti, in cui si evidenzia come la mancata inclusione di questi nell’ambito di applicazione della L. n. 604/1966 li abbia relegati nell’ambito di applicazione del libero recesso ad nutum, adducendo a giustificazione ragionevole dell’intervento normativo la peculiare combinazione tra subordinazione attenuata e il forte elemento fiduciario della figura dell’alter ego. L’introduzione di tutele da parte della contrattazione collettiva e l’estensione di altre di matrice legale ai dirigenti, fa emergere chiaramente una certa erosione del perimetro della libera recedibilità. La nozione di giustificatezza, quale causale al licenziamento del dirigente di matrice contrattual-collettiva, viene ricostruita attraverso i principi interpretativi della giurisprudenza, rivelando una qualche sovrapposizione tra le causali legali e contrattuali dei giustificati motivi. L’intento complessivo dello scritto è quello di mettere in evidenza le tensioni interpretative tra la volontà di differenziare il dirigente dagli altri lavoratori subordinati e la necessità di garantirgli alcune tutele tipiche di questi ultimi.The dissertation aims to analyze the role of managers in the private sector, highlighting their regulatory and judicial evolution, the nature of the employment relationship, and the applicable protections. Particular attention is given to the definition of worker categories and their classification within the Civil Code, with a specific focus on the managerial category. The study examines how, over time, legal scholarship and case law have consolidated managers into a single category, aligning their contractual and legal status.
A portion of the analysis is dedicated to the legal framework for executive dismissals, emphasizing how their exclusion from the scope of Law No. 604/1966 has subjected them to the regime of free termination ad nutum. This legislative choice has been justified by the unique combination of attenuated subordination and the strong fiduciary element inherent in the alter ego role. However, the introduction of protections through collective bargaining agreements and the extension of certain statutory safeguards to managers clearly indicate a progressive erosion of the employer’s unfettered right to dismiss them.
The concept of “giustificatezza” (justifiability), the contractual-collective cause for managerial dismissal, is reconstructed through judicial interpretative principles, revealing a certain degree of overlap between statutory and contractual grounds for termination. The overall aim of this work is to highlight the interpretative tensions between the intention to distinguish managers from other subordinate workers and the need to extend to them certain protections typically granted to the latter
The Many Faces of REM Sleep Behavior Disorder. Providing Evidence for a New Lexicon
No full textBackground: People with idiopathic/isolated REM sleep behavior disorder (iRBD) are highly heterogeneous, showing mild motor, cognitive, and dysautonomia symptoms. The aim of this study is to unveil the clinical heterogeneity of iRBD with a specific reference to overlapping features with prodromal Parkinson's disease (pPD) and prodromal dementia with Lewy bodies (pDLB) labels. Methods: People with a polysomnography-confirmed diagnosis of iRBD were enrolled and followed over time. At baseline, pPD and pDLB criteria were assessed. Results: Among the 285 iRBD people (68.2 ± 7.6 years, 81% males), due to additional signs or symptoms, 49.8% fulfilled pPD criteria only, 5.6% pDLB criteria only, and 14.4% subjects fulfilled both pPD and pDLB criteria. Conversely, about one third of iRBD people (30.2%) did not meet either pPD or pDLB criteria. At follow-up (40.6 ± 43.6 months), 28.8% subjects phenoconverted, developing PD (56.1%), DLB (39%), or multiple system atrophy (4.9%). Subjects with iRBD fulfilling either pPD or pDLB criteria, or both, have an increased risk of phenoconversion (adjusted hazard ratio, aHR 2.34, 95% confidence interval, CI 1.24–4.41). On the opposite, subjects not fulfilling prodromal criteria have a significantly reduced short-term phenoconversion likelihood (aHR 0.43, 95% CI 0.23–0.81). Notably, pPD and pDLB criteria did not predict PD and DLB diagnoses, respectively. Conclusions: People with iRBD are highly heterogeneous, and the presence of other concomitant signs and symptoms is frequent, leading to faster phenoconversion. Thus, the terms idiopathic and isolated may be poorly appropriate and possibly even confounding. These results pave the way to a more appropriate new lexicon for people with RBD
Applicazioni del Connect Parent Group nel contesto adottivo. Uno studio di fattibilità
No full textAdopted adolescents are a vulnerable population, but specific interventions for adoptive parents of adolescents are scarce. Connect Parent Group (CPG) is a 10-session, attachment-based group intervention for parents of adolescents, delivered both in-person and online. This pilot study implemented both the traditional in-person and trauma-informed online versions of CPG with two groups of adoptive parents. Post-intervention results show a decrease in adolescent emotional-behavioural problems and parenting stress, stability in the quality of the dyadic relationship, and positive parental feedback, prompting further studies on larger and more homogeneous sample
The semi-structured interview for bipolar at-risk states (SIBARS): psychometric properties and validation
No full textBackground: Established psychometric instruments to detect individuals at high-risk of bipolar disorders (BD) are essential to advance preventive approaches. Methods: The Semi-structured Interview for Bipolar At-Risk States (SIBARS)’s psychometric properties were evaluated through: (i) dimensionality (confirmatory factor analysis, CFA); (ii) reliability (internal/inter-rater reliability); and (iii) validity in terms of convergent validity (Hamilton Depression Rating Scale, HAM-D, Mini-International Neuropsychiatric Interview, MINI; Temperament Evaluation of Memphis, Pisa, and San Diego Autoquestionnaire, TEMPS-A; Young Mania Rating Scale, YMRS), divergent validity (Comprehensive Assessment of At-Risk Mental States, CAARMS; Hamilton Anxiety Rating Scale, HAM-A), concurrent criterion validity (Bipolar Prodrome Symptom Interview and Scale–Abbreviated Screen for Patients, BPSS-AS-P). Results: A total of 193 participants were included. The CFA for depression plus mania showed excellent data fit (Root Mean Square Error Approximation = 0.02). Internal (Cronbach's α = 0.90; McDonald's ω = 0.96) and inter-rater (Intra-class Correlation Coefficient = 0.97) reliability were excellent. Convergent validity was confirmed by moderate-to-strong associations between the SIBARS mania scale and the YMRS (β = 0.49, p < 0.001), the SIBARS depression scale and the HAM-D (β = 0.54, p < 0.001), and the SIBARS cyclothymic temperament scale and the TEMPS-A (β = 0.69 p < 0.001). Divergent validity was evidenced by very weak associations between SIBARS and CAARMS' outcomes (χ2 = 4.14, p = 0.042, phi = 0.15) or the HAM-A (r = 0.16, p = 0.025). Concurrent validity was indexed by a significant association of SIBARS' researcher-based ratings and BPSS-AS-P participant-based ratings (r = 0.23, p = 0.001). Conclusions: There is convincing psychometric evidence supporting the SIBARS as a reliable and valid instrument for detecting individuals at clinical high-risk of BD. The cross-sectional design of the study, however, did not allow to test the SIBARS' predictive validity
Abdominal lymphatic malformations in children: case series
No full text: Lymphatic Malformations (LMs) are benign congenital malformations of the lymphatic system that commonly involve the abdomen in children (mesentery of the small intestine and omentum). The management of these malformations is not unique. 7 children with different ages (range: newborn to 14 years), diagnosis was incidental in some cases, while in others for abdominal pain. All patients underwent abdominal ultrasound and Magnetic Resonance Imaging (MRI). Laparoscopy for diagnosis was useful in 4 cases. Treatment was: conservative in 1 child, laparoscopic excision in 3 patients, laparotomic excision in 3 cases. At follow up we observed recurrence in a case that required integrated treatment and bowel occlusion after excision in 1 case. This benign malformations may not cause any symptoms to patient. The goal of treatment is to maintain organ function, preserve aesthetic integrity and complications control. Management of these patients could be varied: the best approach should be evaluated on the basis of the patient