Dallo Stirone al Tigri, dal Tevere all'Eufrate: studi in onore di Claudio Saporetti
In: A 10, Scienze dell'antichità, filologico-letterarie e storico-artistiche 477
7 Ergebnisse
Sortierung:
In: A 10, Scienze dell'antichità, filologico-letterarie e storico-artistiche 477
Post-traumatic stress disorder (PTSD) may arise after events involving a risk to physical integrity or to life, one's own or that of others. It is characterized by intrusive symptoms, avoidance behaviors, and hyper-excitability. Outside certain categories (e.g., military and police), the syndrome is rarely described in the occupational setting. We report here five unusual cases of work-related PTSD, diagnosed with an interdisciplinary protocol (occupational health visit, psychiatric interview, psychological counselling and testing): (1) a 51-yr-old woman who had undergone three armed robbery attempts while working in a peripheral post office; (2) a 53-yr-old maintenance workman who had suffered serious burns on the job; (3) a 33-yr-old beauty center receptionist after sexual harassment and stalking by her male employer; (4) a 57-yr-old male psychiatrist assaulted by a psychotic outpatient; (5) a 40-yr-old woman, sales manager in a shoe store, after physical aggression by a thief. All patients required psychiatric help and pharmacological treatment, with difficulty of varying degrees in resuming work. We conclude that PTSD can develop even in professional categories generally considered to be at low risk. In such cases, a correct interdisciplinary diagnostic approach is fundamental for addressing therapy and for medico-legal actions.
BASE
[Italiano]: Una delle sfide che ha maggiormente segnato il dibattito pubblico degli ultimi anni ha riguardato lo sforzo di salvaguardare la sostenibilità dell'assistenza sanitaria in relazione al cambiamento demografico. Il progressivo invecchiamento della popolazione, nonché la tendenziale cronicizzazione delle malattie, richiede l'impiego di metodiche di cura con requisiti tecnologici-assistenziali sempre più avanzati e costosi, che in Italia gravano e mettono in difficoltà, sia da un punto di vista sanitario sia economico, il Sistema Sanitario Nazionale. Tale criticità è emersa anche durante la pandemia da COVID-19, comprovando la necessità di ripensare al modello di gestione della cronicità, ancora troppo centrato su una prospettiva specialistica e/o ospedaliera, per renderlo più idoneo a rispondere alle problematiche assistenziali dei pazienti nel rispetto delle risorse economiche disponibili. A questo proposito, può risultare di grande interesse l'Outcome Research, intesa come area di ricerca che si avvale della Real World Evidence (RWE), poiché dalle analisi delle evidenze prodotte nel mondo reale è possibile confermare o meno la validità delle decisioni politiche attuate al fine di migliorare la governance e la qualità dei servizi erogati. Questo lavoro intende proporre una fotografia dettagliata della prevalenza delle patologie croniche, e delle relative comorbidità, in Regione Campania ma, nel contempo, vuole anche essere un efficace strumento di conoscenze a disposizione di quei decisori impegnati nella programmazione delle politiche e delle strategie sanitarie. /[English]: One of the main challenges in the healthcare sector in recent years has concerned the effort to ensure the healthcare sustainability in view of demographic change. Due to the progressive increasing of aging and chronic conditions, it is necessary to employ treatment methods with increasingly advanced and costly technological and care requirements that the Italian Health System has to deal with both from a health and economic ...
BASE
In: Rencontre Assyriologique Internationale 59
Frontmatter -- Contents -- Preface: Law and (Dis)Order in Ghent (and the Ancient Near East) -- Abbreviations -- Program -- Chapter 1. Foreseeing the Future, Classifying the Present: On the Concepts of Law and Order in the Omen Literature -- Chapter 2. Le vol à l'époque paléo- babylonienne : L'application de la loi à travers la jurisprudence -- Chapter 3. "Let the Sleeping Dogs Lie" or the Taboo (NÍG.GIG=ikkibu) of the Sacredness of Sleep as Order and Noise at Night ("tapage nocturne") as Disorder in Some Ancient Near Eastern Texts -- Chapter 4. Lorsque les généraux prêtent serment ... : Quelques remarques sur l'usage du serment de loyauté (depuis la documentation d'Ur III jusqu'à l'époque néo- assyrienne) -- Chapter 5. Unjust Law: Royal Rhetoric or Social Reality? -- Chapter 6. The Vocabulary of Rebellion in Neo-Assyrian Documents -- Chapter 7. Legal Fiction in Emar and Ekalte: A Source of Order or Disorder in the Legal System? -- Chapter 8. What the "Man of One Mina" Wanted: Law and Commerce in the Ur III Period -- Chapter 9. How Ancient Near Eastern Societies Regulated Life in the Community: Crucial Clues from Archaeology -- Chapter 10. A Variationist Approach to Orthographic and Phonological Peculiarities of the Language in the Laws of Hammurabi -- Chapter 11. "For Each Runaway Assyrian Fugitive, Let Me Replace Him One Hundred- Fold": Fugitives/ Runaways in the Neo-Assyrian Empire -- Chapter 12. Perfections of Justice? Measure for Measure Aspirations in Biblical and Cuneiform Sources -- Chapter 13. Putting Some Order in Ur III Letter- Orders -- Chapter 14. Luminous Oils and Waters of Wisdom: Shedding New Light on Oil Divination -- Chapter 15. (Mis)Translating Gender: The Scribes Couldn't Have Been Competent, They Didn't Go to Yale -- Chapter 16. Rétablir l'ordre par la mort dans les textes législatifs du début du IIe millénaire av. J.-C. -- Chapter 17. To Be Guilty at Nuzi -- Chapter 18. Fremde Götter—eigene Götter: Zu den neuassyrischen Götterbeschreibungen -- Chapter 19. "Not Even Her Own Jewelry": Marital Property in the Middle Assyrian Laws -- Chapter 20. Disorder and Its Agents: The Akkadian Epic of Anzû Revisited -- Chapter 21. When the Trial Does Not Work: Pathological Elements in the Judicial Procedure in the Old Babylonian Period -- Chapter 22. The Ashurbanipal Library Project at the British Museum -- Chapter 23. The Sea and Monarchic Legitimation in the Ancient Near East -- Chapter 24. Putting Life in Order: The Architecture of the New Excavations in Kamid el-Loz, Lebanon -- Chapter 25. Enmity Against Samsu-ditāna -- Contributors
Background Surgery is the main modality of cure for solid cancers and was prioritised to continue during COVID-19 outbreaks. This study aimed to identify immediate areas for system strengthening by comparing the delivery of elective cancer surgery during the COVID-19 pandemic in periods of lockdown versus light restriction. Methods This international, prospective, cohort study enrolled 20 006 adult (≥18 years) patients from 466 hospitals in 61 countries with 15 cancer types, who had a decision for curative surgery during the COVID-19 pandemic and were followed up until the point of surgery or cessation of follow-up (Aug 31, 2020). Average national Oxford COVID-19 Stringency Index scores were calculated to define the government response to COVID-19 for each patient for the period they awaited surgery, and classified into light restrictions (index 60). The primary outcome was the non-operation rate (defined as the proportion of patients who did not undergo planned surgery). Cox proportional-hazards regression models were used to explore the associations between lockdowns and non-operation. Intervals from diagnosis to surgery were compared across COVID-19 government response index groups. This study was registered at ClinicalTrials.gov, NCT04384926. Findings Of eligible patients awaiting surgery, 2003 (10·0%) of 20 006 did not receive surgery after a median follow-up of 23 weeks (IQR 16–30), all of whom had a COVID-19-related reason given for non-operation. Light restrictions were associated with a 0·6% non-operation rate (26 of 4521), moderate lockdowns with a 5·5% rate (201 of 3646; adjusted hazard ratio [HR] 0·81, 95% CI 0·77–0·84; p<0·0001), and full lockdowns with a 15·0% rate (1775 of 11 827; HR 0·51, 0·50–0·53; p<0·0001). In sensitivity analyses, including adjustment for SARS-CoV-2 case notification rates, moderate lockdowns (HR 0·84, 95% CI 0·80–0·88; p<0·001), and full lockdowns (0·57, 0·54–0·60; p<0·001), remained independently associated with non-operation. Surgery beyond 12 weeks from diagnosis in patients without neoadjuvant therapy increased during lockdowns (374 [9·1%] of 4521 in light restrictions, 317 [10·4%] of 3646 in moderate lockdowns, 2001 [23·8%] of 11 827 in full lockdowns), although there were no differences in resectability rates observed with longer delays. Interpretation Cancer surgery systems worldwide were fragile to lockdowns, with one in seven patients who were in regions with full lockdowns not undergoing planned surgery and experiencing longer preoperative delays. Although short-term oncological outcomes were not compromised in those selected for surgery, delays and non-operations might lead to long-term reductions in survival. During current and future periods of societal restriction, the resilience of elective surgery systems requires strengthening, which might include protected elective surgical pathways and long-term investment in surge capacity for acute care during public health emergencies to protect elective staff and services. Funding National Institute for Health Research Global Health Research Unit, Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, Medtronic, Sarcoma UK, The Urology Foundation, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research.
BASE
Background Surgery is the main modality of cure for solid cancers and was prioritised to continue during COVID-19 outbreaks. This study aimed to identify immediate areas for system strengthening by comparing the delivery of elective cancer surgery during the COVID-19 pandemic in periods of lockdown versus light restriction. Methods This international, prospective, cohort study enrolled 20 006 adult (≥18 years) patients from 466 hospitals in 61 countries with 15 cancer types, who had a decision for curative surgery during the COVID-19 pandemic and were followed up until the point of surgery or cessation of follow-up (Aug 31, 2020). Average national Oxford COVID-19 Stringency Index scores were calculated to define the government response to COVID-19 for each patient for the period they awaited surgery, and classified into light restrictions (index 60). The primary outcome was the non-operation rate (defined as the proportion of patients who did not undergo planned surgery). Cox proportional-hazards regression models were used to explore the associations between lockdowns and non-operation. Intervals from diagnosis to surgery were compared across COVID-19 government response index groups. This study was registered at ClinicalTrials.gov, NCT04384926. Findings Of eligible patients awaiting surgery, 2003 (10·0%) of 20 006 did not receive surgery after a median follow-up of 23 weeks (IQR 16–30), all of whom had a COVID-19-related reason given for non-operation. Light restrictions were associated with a 0·6% non-operation rate (26 of 4521), moderate lockdowns with a 5·5% rate (201 of 3646; adjusted hazard ratio [HR] 0·81, 95% CI 0·77–0·84; p<0·0001), and full lockdowns with a 15·0% rate (1775 of 11 827; HR 0·51, 0·50–0·53; p<0·0001). In sensitivity analyses, including adjustment for SARS-CoV-2 case notification rates, moderate lockdowns (HR 0·84, 95% CI 0·80–0·88; p<0·001), and full lockdowns (0·57, 0·54–0·60; p<0·001), remained independently associated with non-operation. Surgery beyond 12 weeks from diagnosis in patients without neoadjuvant therapy increased during lockdowns (374 [9·1%] of 4521 in light restrictions, 317 [10·4%] of 3646 in moderate lockdowns, 2001 [23·8%] of 11827 in full lockdowns), although there were no differences in resectability rates observed with longer delays. Interpretation Cancer surgery systems worldwide were fragile to lockdowns, with one in seven patients who were in regions with full lockdowns not undergoing planned surgery and experiencing longer preoperative delays. Although short-term oncological outcomes were not compromised in those selected for surgery, delays and non-operations might lead to long-term reductions in survival. During current and future periods of societal restriction, the resilience of elective surgery systems requires strengthening, which might include protected elective surgical pathways and long- term investment in surge capacity for acute care during public health emergencies to protect elective staff and services. Funding National Institute for Health Research Global Health Research Unit, Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, Medtronic, Sarcoma UK, The Urology Foundation, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research.
BASE
Background: Surgery is the main modality of cure for solid cancers and was prioritised to continue during COVID-19 outbreaks. This study aimed to identify immediate areas for system strengthening by comparing the delivery of elective cancer surgery during the COVID-19 pandemic in periods of lockdown versus light restriction. Methods: This international, prospective, cohort study enrolled 20 006 adult (≥18 years) patients from 466 hospitals in 61 countries with 15 cancer types, who had a decision for curative surgery during the COVID-19 pandemic and were followed up until the point of surgery or cessation of follow-up (Aug 31, 2020). Average national Oxford COVID-19 Stringency Index scores were calculated to define the government response to COVID-19 for each patient for the period they awaited surgery, and classified into light restrictions (index 60). The primary outcome was the non-operation rate (defined as the proportion of patients who did not undergo planned surgery). Cox proportional-hazards regression models were used to explore the associations between lockdowns and non-operation. Intervals from diagnosis to surgery were compared across COVID-19 government response index groups. This study was registered at ClinicalTrials.gov, NCT04384926. Findings: Of eligible patients awaiting surgery, 2003 (10·0%) of 20 006 did not receive surgery after a median follow-up of 23 weeks (IQR 16-30), all of whom had a COVID-19-related reason given for non-operation. Light restrictions were associated with a 0·6% non-operation rate (26 of 4521), moderate lockdowns with a 5·5% rate (201 of 3646; adjusted hazard ratio [HR] 0·81, 95% CI 0·77-0·84; p<0·0001), and full lockdowns with a 15·0% rate (1775 of 11 827; HR 0·51, 0·50-0·53; p<0·0001). In sensitivity analyses, including adjustment for SARS-CoV-2 case notification rates, moderate lockdowns (HR 0·84, 95% CI 0·80-0·88; p<0·001), and full lockdowns (0·57, 0·54-0·60; p<0·001), remained independently associated with non-operation. Surgery beyond 12 weeks from diagnosis in patients without neoadjuvant therapy increased during lockdowns (374 [9·1%] of 4521 in light restrictions, 317 [10·4%] of 3646 in moderate lockdowns, 2001 [23·8%] of 11 827 in full lockdowns), although there were no differences in resectability rates observed with longer delays. Interpretation: Cancer surgery systems worldwide were fragile to lockdowns, with one in seven patients who were in regions with full lockdowns not undergoing planned surgery and experiencing longer preoperative delays. Although short-term oncological outcomes were not compromised in those selected for surgery, delays and non-operations might lead to long-term reductions in survival. During current and future periods of societal restriction, the resilience of elective surgery systems requires strengthening, which might include protected elective surgical pathways and long-term investment in surge capacity for acute care during public health emergencies to protect elective staff and services.
BASE