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pair_25134504
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In recent years, in Italy, population lengthening of life leads to an higher number of individuals with chronic diseases (Osservatorio, 2010). The hospital which deals with the acute phase of diseases needs to be integrated with primary care. This connection is particularly important for the treatment, care and rehabilitation of patient, as well as a general need for more health and social care integrated tools. At the San Gerardo Hospital in Monza, in the context of the patient's post-acute rehabilitation, we analyze the phase between discharge from hospital and the expected date of hospitalization in facilities providing rehabilitation. The aim of this observational descriptive study is to determine the distribution of days of waiting. Furthermore, several different approach are analysed (i.e. Integrated Home Care) in order to reduce unnecessary days hospitalization and a more intelligent and cost effective use of resources The research question are the follow, to quantify waiting time between discharge and hospitalization in the rehabilitation facility and to ascertain if patients are sent to the correct facility. 1083 individuals were taken into account, of those 55% (N=652) were discharged from the hospital later. This leads to a 4505 days of inappropriate hospitalization. Although the use of home care could be beneficial to the hospital, this can be used only for tiny part of the patients and it is not cost effective. A possible solution can be set up a number of low cost bed entirely managed by nurses due to the low level of intensity care.
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INTRODUZIONE. In Italia negli ultimi anni l’aumento della sopravvivenza della popolazione ha comportato il cambiamento dello stato di salute, che vede l’incremento nella prevalenza delle patologie croniche (Osservatorio, 2011). L’ospedale, riservato alla fase acuta delle patologie, si integra necessariamente con le cure primarie. La continuità assume particolare rilevanza per la cura, assistenza e riabilitazione della persona assistita, così come l’appropriato utilizzo delle diverse tipologie di offerta socio sanitaria assistenziale e riabilitativa. OBIETTIVO. Al San Gerardo di Monza, nell’ambito della riabilitazione del paziente post-acuto, si analizza la fase che intercorre tra la dimissione prevista dall’ospedale e la data di accettazione presso gli istituti di riabilitazione. E’ possibile quantificare i tempi di attesa? L’ allocazione delle persone assistite è appropriata? Scopo dello studio osservazionale descrittivo è accertare la distribuzione dei giorni di attesa. Inoltre si ipotizza il ricorso all’Assistenza Domiciliare Integrata e a soluzioni innovative. Obiettivi sono la diminuzione delle giornate di degenza inappropriate e l’utilizzo delle risorse in modo congruo. RISULTATI. Delle 1083 persone in attesa di riabilitazione il 55% (652), a cui sono associate 4505 giornate “inappropriate”, è stato dimesso dall’ospedale oltre i tempi previsti. CONCLUSIONI. L’utilizzo dell’assistenza domiciliare, vantaggiosa per l’ospedale, può essere utilizzata solo per una minoranza di pazienti e in modo diseconomico. Per abbattere la totalità delle giornate, una soluzione innovativa può essere l’istituzione di posti letto a basso costo. E dato che la maggioranza dei casi sono solo ad alta complessità assistenziale ma a bassa intensità clinica potrebbero essere letti gestiti da infermieri.
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pair_25134505
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The project Mission Woman was set up to describe how the service offered by the Emergency Department of the Hospital San Camillo-Forlanini in Rome was perceived by women victims ( or supposed to be) of violence. The objective of this investigation is to frame clients' perception about the service offered by staff in terms of sensitivity, recognition and management of the issue. The access to the Emergency Room is the first contact of the client with a helping relationship which goes beyond the simple provision of medical care. A questionnaire devised for the purpose was filled in by women who have asked for help to the Service 'Door Woman' . The Service 'Door Woman', set up in 2009, aimed to welcome and listen women victims of violence with the collaboration of different operators in the emergency department: nurses, doctors, psychologists and social workers. The project developed within the Hospital S. Camillo-Forlanini is managed by both professionals of the Emergency Department together with the Charity 'Be Free'. The service is open 24/7, all year, the clients could be women or children and could receive assistance or medical, nursing, psychosocial and legal counselling. The triage nurses are those who through their expertise could first identify the victims of violence and to introduce them in the path. Despite the level of injuries, who access to the Emergency Room for single or repeated events of violence, may have decided to claim in court and not hide seeking.. The research aims to understand what are the theoretical and practical deficiencies of staff in the management of a issue which is not only medical but also social and legal, as well as structural and organizational weaknesses of the service.
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Il progetto Mission Woman nasce per descrivere la percezione del servizio offerto al Pronto Soccorso dell’Azienda Ospedaliera S.Camillo- Forlanini di Roma alle donne vittime di violenza, o presunta tale. Il Servizio “Sportello Donna”, istituito nel 2009, ha lo scopo di accogliere e ascoltare donne vittime di violenza attraverso la collaborazione di differenti operatori del Pronto Soccorso: infermieri, medici, psicologi, assistenti sociali. Gli infermieri di triage sono coloro che attraverso la loro competenza nell’indagine riescono per primi a individuare le vittime di violenza e a introdurle nel percorso. L’obiettivo della presente indagine è di fotografare la percezione che hanno le donne vittime di violenza, di aggressione, o presunta tale, del servizio offerto in termini di sensibilità, riconoscimento del fenomeno e gestione; capire quali sono le carenze organizzative e strutturali del servizio, le carenze teoriche e pratiche del personale sanitario nella gestione di un fenomeno che ha valenza, non solo medica, ma anche sociale e giuridica. MATERIALI E METODI. E’ stato condotto, da Maggio 2011 a Dicembre 2011, sul totale delle donne che accedono in Pronto Soccorso con triage per aggressione e prese in carico dallo Sportello Donna Antiviolenza. Lo strumento utilizzato per registrare e raccogliere i dati è un questionario. Gli accessi in Pronto Soccorso per aggressione o presunta tale sono stati 368, 205 di questi si sono rivolti allo sportello donna. Dei 205 casi solo 36, il 18 % degli accessi, ha accettato di compilare il questionario. Il 71% è vittima di aggressioni da parte del partner; il 60% subisce aggressioni da almeno 3 anni; il grado di soddisfazione dell’ambiente che ha accolto la paziente in Pronto Soccorso per il 96% è soddisfacente. La quasi totalità del campione (90 %) ha ottenuto risposte adeguate e chiare dal personale del Pronto Soccorso e dal personale di Sportello Donna. Le manovre assistenziali sono state effettuate rispettando riservatezza e delicatezza del caso. Secondo le pazienti intervistate una consistente percentuale degli operatori ha una buona preparazione/formazione. Le criticità riscontrate: è necessaria un’azione a breve-medio termine assegnando un codice colore riservato a questo tipo di evenienze e una sala di attesa dedicata e soprattutto ridurre i lunghi tempi di attesa per la visita (superiore alle due ore). L’accesso al Servizio di Pronto Soccorso è il primo contatto della vittima con una relazione di aiuto che va al di là della semplice prestazione medica. Per quanto gravi o lievi si presentino le lesioni, chi accede al Pronto Soccorso, per unici o reiterati episodi di violenza, può aver deciso di denunciare e non nascondere il fenomeno e cercare, quindi, nel personale sanitario una forma di aiuto che deve essere soddisfatto con competenza.
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pair_25134506
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The Service of Health Professions of this facility (TO2 of Turin) aimed during the 2010 to devise/develop a new evaluation tool for the new employees , trying to fit them with the profiles set up the previous year. The conceptual model of reference for the construction of working drafts of the grids was inspired by the special insert edition of 'L'infermiere' in 2007, a literature review was carried out and a number of internal meeting within 6 of the Service of health Professions were set up. A working group were set up - 93 people - as well as indicators were developed to monitor and implementation of the instruments. Once the drafts of the standard tools were made, working groups started to improve the tools provided under the supervision of a tutor. Finally half way through an evaluation was carried out using a questionnaire. The new template leads a number of problems which were later sorted out also with the support of tutors.
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lexi-ml/wmt_22_dataset_en_it
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Il Servizio delle Professioni Sanitarie dell’Azienda Sanitaria Locale TO2 di Torino si è posto come obiettivo per l’anno 2010 di costruire la scheda di valutazione del personale neo-assunto e il relativo piano di inserimento, integrandoli con i profili di posto già elaborati l’anno precedente. La fase di progettazione si è avvalsa dell’analisi della letteratura e del confronto tra il gruppo di progetto, costituito da sei componenti del Servizio delle Professioni Sanitarie. Il modello concettuale di riferimento per la realizzazione delle bozze delle griglie di lavoro è stato tratto dall’inserto speciale della rivista “L’infermiere” del 2007. Si sono inoltre costituiti i gruppi di lavoro, per un totale di 93 persone. Si sono inoltre predisposti gli indicatori per il monitoraggio e la valutazione dell’implementazione degli strumenti. Una volta realizzate le bozze degli strumenti standard, si è lanciato il mandato ai gruppi di lavoro di completare gli strumenti forniti, con la supervisione di un tutor utilizzando la formazione sul campo. Infine si è effettuata una valutazione intermedia attraverso la somministrazione di un questionario. L’introduzione degli strumenti sopra citati ha incontrato inizialmente qualche difficoltà, superata attraverso il supporto del tutor.
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pair_25134507
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in year 2008 the Ausl of Ravenna had a small number of patients at risk among the patients fallen, and among the patients evaluated with risk for fall. This could be due to the rating scale used (Conley) that does not recognize the risk factors 'drug therapy' and 'conditions clinical care'. to experiment a rating scale (Mosaic), to evaluate the performance indicators compared to the scales Conley, Fall Risk Assessment Scoring System (FRASS), Stratity; evaluate the effectiveness of actions taken to manage the risk; Operators remain vigilant about the risk falls. using the scale Mosaic for patients admitted in 16 Hospital Units for two-months. Performance indicators: sensitivity, specificity, positive predictive value and negative. Studies considered for comparison: Hospital (AO) Bologna for Conley, AO Bologna and AO Niguarda Cà Granda Milan for Stratify, AO Bergamo for FRASS. were analyzed 1474 tabs. Males are 848 (57.5%) and females 626 (43.5%), the average age is 70.8 years. Of these 42 patients have fallen (2.8%), including 25 males and 17 females and the average age is 72.2. Are not at risk 426 (29%) patients and at risk 1048 (71%) patients. In other assessments the patients at risk was 31% in AUSL Ravenna, 59% (Conley) and 13% (Stratify) in AO Bologna and 41.5% (FRASS) in AO Bergamo. The scale Mosaic has a sensitivity of 0.98 (Conley, Stratify and FRASS amounted to 0.69, to 0.20, to 0.50), a specificity of 0.30 (Conley, Stratify and FRASS amounted to 0.41, 0.87, 0.59.) The patients fallen are at risk in 41 cases (97%) and of these 24 low-risk. The most frequent risk factors are: 'mobility and gait' (1209 items), 'drug therapy' (850 items) , 'conditions clinical care' (841 items). Planned actions have an average of 2.2 in patients fallen, of 3.5 in low-risk patients and of 4.48 in patients at high risk. Compared with the previous year shows a decrease of 14 falls and an increase in the level of outcome 'no one' (from 61% to 73.5%). the greater number of falls occur among low-risk patients, the average number of shares increases with increasing levels of risk and decreases in the patients fallen. Patients are at increased risk and therefore, in the hospital, it is essential to evaluate the factors drug therapy and conditions clinical care. The scale Mosaic has a very good performance for the sensitivity but not the specificity. The indicators in the studies are very different. This poses a reflection: what is the sense of the indicators when the rated instrument is part of a multifactorial prevention project whose implementation, usually, improves the level of security by preventing the occurrence of the event? Analysis of the tool can not be based only on numerical data. The true value of each scale is the level of attention that triggers in Health Care Workers, which activate preventive measures that allow an efficient management of risk. the card Mosaic has been adopted in Ausl because it improved the level of security of patients with risk of fall.
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nel 2008 l’Ausl di Ravenna ha riscontrato uno scarso numero di degenti a rischio fra i degenti caduti e fra i degenti valutati. Una causa potrebbe essere la scala di valutazione utilizzata (Conley) che non mappa i fattori di rischio “terapia farmacologica” e “condizioni cliniche”. definire e sperimentare una nuova scala di valutazione (Mosaico), valutare gli indicatori di performance rispetto alle scale Conley, Fall Risk Assessment Scoring System (FRASS), Stratity; valutare l’efficacia delle azioni adottate per la gestione del rischio; mantenere alta l’attenzione degli Operatori sul rischio cadute. valutare con la scala Mosaico i degenti ricoverati in 16 Unità Operative per un bimestre. Indicatori di performance: sensibilità, specificità, valore predittivo positivo e negativo. Studi considerati per la comparazione: Azienda Ospedaliera (AO) Bologna per la Conley, AO Bologna e AO Niguarda Cà Granda Milano per la Stratify, AO Bergamo per la FRASS. sono state analizzate 1474 schede. I maschi sono 848 (57.5%) e le femmine 626 (43.5%), l’età media è 70.8 anni. Di questi sono caduti 42 degenti (2.8%), di cui 25 maschi e 17 femmine; l’età media è 72.2. I degenti risultati non a rischio sono 426 (29%)e quelli a rischio 1048 (71%) In altri studi i degenti a rischio erano il 31% nell’AUSL Ravenna, il 59% (Conley) ed il 13% (Stratify) nell’AO di Bologna e il 41,5% (FRASS) nell’AO Bergamo. La scala Mosaico presenta una sensibilità di 0.98 (Conley, Stratify e FRASS si attestano a 0.69, a 0.20, a 0.50), una specificità di 0.30 (Conley, Stratify e FRASS si attestano a 0.41, a 0.87, a 0.59). I degenti caduti risultano a rischio in 41 casi (97%) e di questi 24 a basso rischio. I fattori di rischio più frequenti in ingresso sono: “mobilità ed andatura” (1209 items), “terapia farmacologica” (850 items), “condizioni clinico assistenziali” (841 items). Le azioni pianificate sono mediamente 2,2 nei degenti caduti, 3,5 nei degenti a basso rischio e 4,48 nei degenti ad alto rischio. Rispetto all’anno precedente risulta un calo di 14 cadute ed un aumento del livello di esito “nessuno” (dal 61% al 73,5%). il maggior numero di cadute avviene fra i degenti a basso rischio. Il numero medio di azioni aumenta al crescere dei livelli di rischio e cala nei degenti caduti. Sono aumentati i degenti a rischio e quindi, in ospedale, è indispensabile valutare i fattori terapia e condizione cliniche. La scala Mosaico ha un’ottima performance per la sensibilità ma non per la specificità. Gli indicatori sono molto differenti e questo pone una riflessione: che senso dare agli indicatori quando lo strumento valutato è parte di un progetto di prevenzione multifattoriale la cui realizzazione di solito migliora i livelli di sicurezza impedendo il verificarsi dell’evento? L’analisi della validità di uno strumento non può basarsi solo su dati numerici. Il valore vero di ogni scala è il livello di attenzione che fa scattare negli Operatori Sanitari, i quali attivano misure preventive che permettono un’efficace gestione del rischio. In considerazione del miglioramento del livello di sicurezza, la scheda è stata adottata in Ausl.
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pair_25134508
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The increasing use of digital technologies and e-learning in nursing education and the health professions was also reflected in the time to many studies and reviews. The aim of this overview was to analyze education through e-learning technologies for nursing and health professional students. A comprehensive search of literature was conducted using database PubMed/MEDLINE, Ebsco/CINAHL, 2003-2013. The search strategy resulted in the inclusion, in first instance, of 9732 items. After the reduction of duplicates, applying limits and other parameters of inclusion/exclusion and, at the end, evaluation of quality through AMSTARD check list, we included in this overview, 22 reviews. The analized reviews were allowed to spread in different topic areas: study population (students and faculty), e-learning methods (blended learning Game/3D/situated learning) and evaluation (information technology, learning satisfaction comparison of e-learning with the traditional teaching methods) This overview demonstrates that e-learning in nursing academic education is a valid alternative to traditional learning. If e-learning activities are well structured and modulated, some advantages and economies are clear possible. Regard effects of e-learning on the improvement of ability, data are at the momenti limited when compared to traditional learning. Often e-learning appear as an adjunct respect traditional learning, but is necessary consider e-learning and digital tecnology as priority for the future of education of nursing students.
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L’obiettivo di questa overview delle revisioni è quella di fornire un quadro dei vantaggi e degli svantaggi sull’utilizzo dell’e-learning in ambito accademico per la professione infermieristica. Per e-learning (letteralmente “apprendimento elettronico”) si intende l’insieme di tutte quelle metodologie e strategie didattiche finalizzate alla distribuzione di attività formative, informative e di aggiornamento tramite l'uso delle tecnologie multimediali e della rete internet. E’ stata effettuata una ricerca bibliografica delle revisioni sistematiche e integrative sulle banche dati PubMed/MEDLINE, Ebsco-CINAHL nel periodo 2003-2013 relativa all’e-learning per la formazione accademica nel settore infermieristico RISULTATI: L’interrogazione delle banche dati selezionate per le revisioni pubblicate nel periodo 2003-2013 ha riportato 9732 articoli. Dopo la riduzione dei duplicati, applicando limiti temporali e parametri di inclusione/esclusione e a seguito della valutazione delle revisioni attraverso la check-list AMSTAR, sono stati incluse 22 revisioni. I lavori esaminati hanno consentito di ripartire in diverse aree le tematiche trattate: la popolazione di studio (studenti e docenti) le metodologie (blended learning, Game/3D/situated learning) e le valutazioni (tecnologie informatiche, apprendimento/gradimento, confronto dell’e-learning con il metodo tradizionale) CONCLUSIONI: Questa overview dimostra che l’e-learning per la formazione accademica nel settore infermieristico rappresenta un’alternativa valida se ben strutturata e modulata, per parte delle attività didattiche in presenza, con conseguenti economie di scala. E’ richiesta tuttavia una concordanza tra metodo e percorso formativo ed è necessario un adeguato training per i formatori.
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pair_25134509
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Clinical placements provide opportunities for student nurses to learn experientially, thanks to clinical - practical teaching models. For this purpose this review wanted to better investigate the latest methods developed in nursing education to ameliorate the theory practice model in nursing education teaching model. The review of the literature was performed through a search of nursing specific data bases, including Cinahl, Capsur, Ovid, Cockrane Library, PubMed from January 2010 to September 2012. It included key words, such as: Clinical Model; Nursing Education Model; Nursing Practical Teaching Model; Theory-Practice Model. A total of 8 articles were found. Of these, only 4 articles were considered for this review because they better analyzed one clinical teaching model in nursing practice. Each article was structured analyzed, by considering the 'PICOS' method, with reference to participants, interventions, comparisons, outcomes, and study design. Four innovative clinical teaching models for nursing practice were considered: the first one was the Problem-Based Leaning method in nursing education; the second one was the Self-Regulated Learning strategy; the third one was the developing nursing students' reflective skills associated as a key component in the perceived coherence between theory and practice; the fourth one was the computer-based clinical simulation. Each work performed an innovative clinical teaching model for nursing student. Some limitations were highlight, but all the literature revised emphasized the evaluation and feedback from students and the perceptions of their clinical activities is essential.
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lexi-ml/wmt_22_dataset_en_it
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Gli ambienti di apprendimento clinico sono definiti come una rete di fattori interagenti nel contesto, in grado di influenzare gli esiti dell’apprendimento degli studenti. La soddisfazione degli studenti è considerata un indicatore del raggiungimento degli esiti dell’apprendimento ed è determinante a partire dalla prima esperienza di tirocinio. Analizzare l’esperienza di apprendimento clinico degli studenti infermieri del primo anno di corso dopo il primo tirocinio clinico ed identificare i principali determinanti della soddisfazione degli studenti. Lo studio osservazionale è stato realizzato in cinque sedi universitarie italiane del Corso di Laurea in Infermieristica. 420 studenti hanno compilato la versione italiana della “Clinical Learning Environment, Supervision and plus Nurse Teacher (CLES+T) scale” al termine del primo tirocinio clinico. Risultati. I punteggi medi assegnati alle dimensioni della scala variano da 4.02 (clima di apprendimento) a 3.30 (relazione di tutorato). La maggior parte degli studenti è soddisfatto della propria esperienza di tirocinio (75.6%), ma sono emerse differenze in relazione alle diverse sedi di tirocinio clinico. Discussione. I principali determinanti della soddisfazione sono lo stile di leadership del coordinatore infermieristico e l’integrazione teoria-pratica nella relazione fra tutor clinico, universitario e studente. I risultati dello studio contribuiscono alla comprensione della prima esperienza di tirocinio degli studenti. Tuttavia, sono necessarie ulteriori ricerche per determinare le variabili organizzative specifiche e i modelli tutoriali in grado di aumentare la soddisfazione degli studenti, per sviluppare strategie formative basate sull’integrazione tra tutor universitari e guide di tirocinio.
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pair_34060518
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The endoscopic endonasal transsphenoidal approach to the sella and parasellar regions is now increasingly used for removal of a variety of lesions localized in the ventral skull base. The advantage of the endoscope is enhanced visualization and improved panoramic view that can result in more complete removal of the tumor. An extensive knowledge of the anatomy is mandatory to approach this region. From February 2009 to March 2020, the endoscopic endonasal approach was used in 153 patients with sellar and parasellar lesions, at our Institution: 136 pituitary adenomas, 7 craniopharyngiomas, 3 Rathke's cysts, a tuberculum sellae meningioma, an aneurysm of the internal carotid artery (ICA), a clivus chordoma, a papillary glioneuronal tumor, an histiocytosis, a pituitary metastasis from breast cancer and a chondrosarcoma. The most common surgical complications were cerebral spinal fluid leak (9), bleeding (2), pituitary abscess (2). Among endocrinological complications, the most important were diabete insipidus (23) and panhypopituitarism (3). Two patients complicated with meningitis. There were no visual worsening and no operative mortality. We had persistence of disease in 20 cases. Twelve patients underwent surgical revision for recurrence of the disease. Pre-operative planning and collaboration with several specialists are necessary in order to offer the patient the best treatment, minimizing complications.
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Lesioni della regione sellare e parasellare: gestione multidisciplinare. Introduzione: L’approccio endoscopico endonasale trans-naso-sfenoidale alla sella e alla regione parasellare è a oggi l’approccio più utilizzato per lesioni localizzate nella parte ventrale della base cranica. Il vantaggio di questa tecnica consiste in una miglior visualizzazione panoramica del sito chirurgico che consente una rimozione quanto più completa del tumore. Un’approfondita conoscenza dell’anatomia è d’obbligo per iniziare ad approcciare questa regione. Da febbraio 2009 a marzo 2020, abbiamo trattato nel nostro Istituto 153 pazienti con lesioni sellari e parassellari mediante approccio endoscopico endonasale; di questi 136 erano adenomi dell’ipofisi, 7 craniofaringiomi, 3 cisti di Rathke, un meningioma del tubercolo sellae, un aneurisma dell’arteria carotide interna, un cordoma del clivus, un tumore glioneuronale papillare, un’istiocitosi, una metastasi pituitaria da cancro al seno e un condrosarcoma. Le complicanze chirurgiche più comuni sono state la rinoliquorrea (9), il sanguinamento (2), l’ascesso pituitarico (2). Tra le complicanze endocrinologiche, le più importanti sono state il diabete insipido (23) e il panipopituitarismo (3). Due pazienti si sono complicati con meningite. Non ci sono stati deficit visivi né mortalità intraoperatoria. Abbiamo avuto persistenza di malattia in 20 casi. Dodici pazienti sono stati sottoposti a reintervento per recidiva. Un’adeguata pianificazione preoperatoria e la collaborazione tra diversi specialisti sono necessarie per offrire al paziente il miglior trattamento possibile, riducendo al minimo le complicanze.
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pair_34085987
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Presenting an extraordinary cause of intestinal obtuction, leading to incarcerated obturator hernia. We present a rare case of obturator hernia in a 90-year-old female, who presented with a three-day history of inability to defecate and abdominal pain, distension, and vomiting on the day of presentation. Hours later, a computed tomography scan revealed a bowel obstruction secondary to a right-sided obturator hernia. She underwent an emergency exploratory laparotomy and the incarcerated bowel was reduced with a repairment of the hernial defect. The patient demonstrated an uneventful postoperative period and was discharged on hospital day four. Obturator hernia, a rare anterior abdominal wall hernia, in which abdominal contents protrude through the obturator canal, is an unusual cause of intestinal obstruction. It has one of the highest mortality rates of all abdominal wall hernias with a challenging diagnosis that can still be misleading even to the most experienced surgeons. Providers should be aware of inability to defecate, abdominal pain, distension, and vomiting that may be due to an existence of incarcerated/strangulated obturator hernia, thus the further evaluation should be considered as the elements of the clinical picture are incongruent. Emergencies, Hernia, Intestines, Intestinal obstruction, Obturator.
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Si presenta il caso di un’occlusione intestinale per una eccezionale incarcerazione di un’ernia otturatoria. Si trattava di una donna di 90 anni con crisi di stipsi da tre giorni accompagnata da dolori addominali, addome disteso e vomito fin dal ricovero. Una tomografia computerizzata di ore dopo ha dimostrato trattarsi di un’occlusione intestinale a livello della porta erniaria otturatoria di destra. Alla laparotomia esplorativa d’urgenza si è provveduto a ridurre in addome l’intestino incarcerato e alla riparazione della porta erniaria. Il decorso postoperatorio è stato privo di complicazioni, e la paziente è stata dimessa dall’ospedale in quarta giornata postoperatoria. L’ernia otturatoria è una di quelle rare della parete addominale anteriore, con protrusione del contenuto addominale nel canale otturatorio, e causa insolita di occlusione intestinale. È caratterizzata da uno dei più alti tassi di mortalità tra tutte le ernie della parete addominale, di diagnosi impegnativa e fuorviante anche per i chirurghi più esperti. In conclusione gli operatori sanitari dovrebbero essere avvertiti che la stipsi prolungata, insieme a dolore e distensione addominale e vomito possono essere dovuti ad un’ernia otturatorio incarcerata o strangolata, e procedere ad una ulteriore fase diagnostica nel caso di incongruenza degli elementi del quadro clinico.
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pair_34089636
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Patients' needs and the change of health professionals' roles have led researchers to reflect about the involvement of nurses in care processes development, as well as health policies. Studies confirm how advanced nursing training promotes quality of care and reduces the costs of healthcare. The introduction of the Advanced Practice Nurses (APNs) could potentially be an added value also in the Swiss healthcare context, where this figure is positioning. The study aims to investigate how APNs can participate in building health policy projects. This is a qualitative study. Four focus groups were conducted on nurses with managerial and clinical roles. A content analysis approach with three review phases was applied. The identified macro-themes are: APN: Advanced training provides the skills needed to exercise the role. However, it emerges that the recognition of nurses in the field of health policies originates from a cultural change. Interprofessional collaboration: Multidisciplinary work allows overall patient care. However, requests for advice from the APN is still marginal. Health policy: The emerged needs are: defining a target population, educating the population and encouraging organizations to obtain quality certifications. Proposals for improvement: adequate training and the involvement of specialized figures are required for suitable care. APNs have potential impact upon health policy discussions. The authors recommend investing on education and cultural change, in order to maximize the active involvement in discussions supporting progress in nursing practice.
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I bisogni dei pazienti e i cambiamenti dei ruoli dei professionisti sanitari, hanno portato i ricercatori a riflettere sul coinvolgimento degli infermieri nello sviluppo di processi assistenziali, nonché delle politiche sanitarie. Il Consiglio Nazionale degli Infermieri, l’OMS ed esperti confermano quanto la formazione infermieristica avanzata favorisca cure di qualità e riduca i costi sanitari. L’introduzione di infermieri di pratica clinica avanzata (APN) potrebbe essere un valore aggiunto nel contesto sanitario svizzero. Lo studio ha lo scopo d’indagare come gli APN possono partecipare allo sviluppo di progetti di politica sanitaria. Si tratta di uno studio qualitativo. Sono stati condotti quattro focus group a infermieri attivi nella pratica con ruoli gestionali e clinici. È stato applicato un approccio di analisi dei contenuti induttivo, tramite software NVivo12. Sono stati identificati tre macro temi: APN: la formazione avanzata fornisce le competenze per esercitare il ruolo. Il riconoscimento dell’infermiere nelle politiche sanitarie deriva da un cambiamento culturale. Collaborazione interprofessionale: il lavoro multidisciplinare consente una presa in carico globale. La richiesta di consulenza dell’infermiere APN risulta ancora marginale. Politica sanitaria: emerge la necessità di definire una popolazione target e relativi interventi, coinvolgere e alfabetizzare la popolazione e incentivare le organizzazioni all’ottenimento delle certificazioni di qualità. Proposte di miglioramento: sono necessari un’adeguata formazione e il coinvolgimento di figure specialistiche per una presa a carico confacente. Gli APN presentano potenzialità nell’impatto delle discussioni in politica sanitaria. Gli autori raccomandano che occorre investire a livello formativo e di popolazione, per massimizzare il coinvolgimento attivo nelle discussioni a sostegno del progresso infermieristico.
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pair_34089637
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Music listening represents a gold standard in the evidence-based holistic nursing practice. However, music listening is seldom involved in orthopedic postoperative settings, and only a few related studies can be retrieved in literature. The aim was to assess the effects of music during the orthopedic postoperative period, when patients frequently report pain and anxiety. A randomized controlled trial on 56 patients, equally divided in an experimental group treated with music and a control group in standard care, was conducted during their first-day of recovery from orthopedic surgery. The primary outcome was the pain level assessed with the VAS scale and the Short Form-McGill Pain Questionnaire. Secondary outcomes assessed were anxiety level, blood pressure, heart and respiratory rates and oxygen saturation. Following surgery, when clinically stabilized and soon after their return to their ward room, patients listened to music from a personal programmed playlist using their smartphones for 30 minutes. In music group, the Short Form-McGill Pain Questionnaire score significantly improved in the sensorial dimension (p=0.006) and in the affective dimension (p=0.02). Patients showed a pleasant experience in listening to music (90%), found it useful in coping with pain (64%) and improving mood (86%). Music in the orthopedic post-surgical period induced significant improvement in pain relief, representing a useful complementary intervention to drug treatment. Music listening could be a safe treatment, inexpensive and simple to manage by nurses in orthopedic postoperative settings.
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lexi-ml/wmt_22_dataset_en_it
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L'ascolto della musica rappresenta un punto di riferimento nella pratica infermieristica olistica basata sull'evidenza. Tuttavia l'ascolto di musica a scopi terapeutici è raramente utilizzato nei settings assistenziali postoperatori ortopedici. Scopo. Valutare gli effetti della musica durante il periodo post-operatorio ortopedico, fase in cui i pazienti manifestano frequentemente dolore e ansia. Studio randomizzato controllato, su 56 pazienti durante il il primo giorno post operatorio, allocati in maniera bilanciata in un gruppo sperimentale trattato con la musica e un gruppo di controllo in assistenza standard. L'outcome primario era il livello di dolore valutato con la scala VAS e il Short Form-McGill Pain Questionnaire. Gli outcomes secondari sono stati il livello di ansia, pressione arteriosa, frequenza cardiaca, frequenza respiratoria e la saturazione dell'ossigeno. Al rientro nella camera di degenza dopo l'intervento chirurgico in condizioni cliniche stabilizzate, i pazienti hanno ascoltato musica da una playlist personalizzata usando il proprio smartphone per 30 minuti. Nel gruppo musica, il punteggio dello Short Form-McGill Pain Questionnaire è significativamente migliorato nella dimensione sensoriale (p = 0,006) e nella dimensione affettiva (p = 0,02). I pazienti hanno riportato una piacevole esperienza nell'ascolto della musica (90%), trovandola utile per la gestione del dolore (64%) e nel migliorare l'umore (86%). La musica nel periodo post-chirurgico ortopedico ha mostrato un significativo miglioramento nel livello del dolore, rappresentando un'utile intervento complementare al trattamento farmacologico. L'ascolto della musica potrebbe essere un trattamento sicuro, economico e semplice da gestire da parte degli infermieri in ambito postoperatorio.
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pair_34089638
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In the Italian and European literature there are still few studies describing the impact of the COVID-19 pandemic on the organization of nursing care in hospitals, on the actions taken by nursing leaders to contain it, and on the outcomes of these interventions. To describe nursing leaders' experiences with reorganizing healthcare pathways, through management data and personal accounts. A retrospective quali-quantitative observational study was conducted at the Mauriziano Hospital in Turin, with 484 beds and over 1,700 workers. Quantitative data were analyzed through descriptive statistical indices and integrated with qualitative data collected through semi-structured telephone interviews. The analysis of the quantitative and qualitative data provided an objective and experiential representation of the implemented interventions. We described the impact of interventions introduced by the nursing leadership during the pandemic on hospital services. In particular, the reorganization of the emergency department and of the prevention and psychological support services for the hospital's health workers. In addition, specific initiatives to support the discharge of COVID-19 positive patients, and to support and manage contacts with family members both during the hospitalization of their loved ones and following death are described. This study contributes to the discussion on some crucial issues: the increasingly clear relationship between adequate staffing and safety of patients and professionals, the importance of a good working environment and a solid leadership, the importance of continuing education for professionals and adequate skill mixes; all highlighted by the pandemic.
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Nella letteratura italiana ed europea sono ancora pochi gli studi che descrivono l'impatto della pandemia COVID-19 sull'organizzazione dell'assistenza infermieristica negli ospedali, sulle azioni attuate dai leader infermieristici per contenerla e sui risultati di tali interventi. Descrivere le esperienze di riorganizzazione dei percorsi assistenziali da parte dei leader infermieristici, attraverso i dati di gestione e le testimonianze. Studio osservazionale retrospettivo quali-quantitativo, svolto presso l’Ospedale Mauriziano di Torino, 484 posti letto e oltre 1700 operatori. I dati quantitativi sono stati analizzati con indici di statistica descrittiva e sono stati integrati con i dati qualitativi raccolti mediante interviste telefoniche semi strutturate. L’analisi dei dati quanti-qualitativi ha fornito una rappresentazione oggettiva ed esperienziale degli interventi implementati. I dati raccolti descrivono la ricaduta sui servizi degli interventi introdotti dalla leadership infermieristica durante la pandemia; in particolare la riorganizzazione del pronto soccorso e dei servizi di prevenzione e supporto psicologico per sostenere i dipendenti dell’Azienda. Inoltre, sono state descritte alcune iniziative particolari a sostegno delle dimissioni dei pazienti COVID-19 positivi e del sostegno e contatto con i familiari durante la degenza dei propri cari e in seguito al decesso. I risultati di questo studio sono un contributo alla discussione su alcuni temi cruciali: il rapporto sempre pi˘ chiaro tra staffing adeguato e sicurezza dei pazienti e dei professionisti, l’importanza delle caratteristiche dell’ambiente di lavoro e di una leadership consolidata, l’importanza della formazione dei professionisti e di skill mix adeguati. Resi più evidenti dal contesto di emergenza pandemica.
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pair_34089639
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Media play a key part in shaping nurses' social perception. Newspapers were chosen as the subject of this content analysis, as they are the main resource that Italians use to inform themselves. For this reason, ne wspapers are an appropriate resource to analyse the image of the nurse that, as found in literature, is seen as a dynamic phenomenon that changes according to different scenarios. Given the media focus on nurses during COVID- 19 it seems reasonable to analyse what nurse image was emerged. A Content Analysis with an inductive process was conducted. The analysis' objective was to evaluate the image of the nurse in national and local newspapers, published between the 30th of January and the 18th of May 2020. A triangulation methodology was used between the two researchers to ensure data quality. Five themes were identified. The risks for the nurse's psycho-physic wellbeing. Taking responsibility and human relations despite barriers. The acknowledgment of professional attributes. Uncertainty on the continuity of the nurses' social role emerged from the media. Nurses only wish to be appreciated for what they do. The agreement between the researchers on the themes has a Krippendor ff 's alpha between =0.713 and =0.985. The media's interest highlighted the nurses' competence in assisting patients with COVID-19. However, there isn't in-depth analysis, of the contemporar y image of the nurse, specifically in relation to leadership. Positive and negative tropes are recalled. The superficiality and fragility of the mediatic phenomena emerged, as opposed to a real positive strengthening of the nurse's social perception.
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La strutturazione dell’immagine sociale dell’infermiere è soggetta ad articolati processi di influenza in cui i media sono fondamentali. Poiché gli italiani per informarsi utilizzano i quotidiani, questi rappresentano una fonte appropriata per analizzare l’immagine dell’infermiere che la letteratura delinea come un fenomeno dinamico che può cambiare in situazioni diverse. L’attenzione mediatica verso l’infermiere durante l’emergenza COVID 19 rappresenta, quindi, una situazione significativa in cui analizzare quale immagine dell’infermiere sia emersa. Content Analysis con approccio induttivo, con l’obiettivo di analizzare l’immagine dell’infermiere negli articoli di quotidiani nazionali e locali pubblicati dal 30 gennaio al 18 maggio 2020. Una triangolazione tra i due ricercatori ha garantito la qualità dell’analisi dei dati. Sono stati individuati cinque temi. Rischio per il benessere psico-fisico dell’infermiere. Il farsi carico e la relazione umana nonostante le barriere. Riconoscimento degli attributi di professionalità. Incertezza sulla continuità dell’importanza del ruolo sociale emerso. Lodi agli infermieri che vogliono essere solo sé stessi. L’accordo tra i ricercatori nei temi presenta un’alpha di Krippendorff tra =0.713 =0.985. L’interesse mediatico ha fatto emergere la competenza dell’infermiere nell’assistere le persone con COVID 19, ma ha delineato solo tracce e non un’analisi approfondita di un’immagine contemporanea dell’infermiere, particolarmente in relazione a ruoli di leadership. L’apprezzamento manifestato ha richiamato stereotipi positivi e non, questi fanno emergere la superficialità e fragilità del fenomeno mediatico rispetto ad un consolidamento positivo della percezione sociale dell’infermiere.
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pair_34089640
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The Coronavirus (Covid-19) pandemic caused a severe health crisis that has affected millions of people and quarantined half of the world's population. The health emergency from Covid-19 has seen health workers on the front line face all the difficulties related to the burden of care and the reorganization of procedures, roles, and tools at the hospital level. One of the most significant and probably underestimated aspects is the psychological stress of frontline nurses. The article aims to analyze the literature relating to the impact on the mental health of nurses engaged in the management and care of Covid-19 patients. A systematic review of the published articles on the subject was conducted from January 2020 to November 2020. The search for papers was conducted on scientific databases like PubMed, Scopus and Embase. The results show the onset of anxiety, depression and stress and insomnia in healthcare workers. These aspects are closely related to numerous factors, including the fear of contracting the disease and infecting family members, stressful shifts and little rest, leading to a state of psychological and physical tension capable of activating pathological behaviours. The literature highlights the importance of support interventions for frontline personnel to avoid the onset of psycho-pathophysical severe problems. The review suggests that frontline nurses during the emergency phase of Covid- 19 may be prone to psychological disorders that can compromise mental health. Therefore, the surveillance and monitoring of symptoms, together with targeted support interventions, should be guaranteed daily to all professionals involved to prevent the onset of psychological disorders.
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La pandemia da Coronavirus (Covid-19) ha causato una grave crisi sanitaria che ha coinvolto milioni di persone e messo in quarantena metà della popolazione mondiale. L'emergenza sanitaria da Covid-19 ha visto gli operatori sanitari in prima linea affrontare tutte le difficoltà legate all'onere della cura e alla riorganizzazione delle procedure, ruoli, e strumenti a livello ospedaliero. Uno degli aspetti più significativi e probabilmente sottovalutati è lo stress psicologico del personale infermieristico in prima linea. L'obiettivo dell’articolo è quello di analizzare la letteratura relativa all’impatto sulla salute mentale del personale infermieristico impegnato nella gestione e cura di pazienti affetti da Covid-19. È stata condotta una revisione sistematica degli articoli pubblicati sull'argomento da gennaio 2020 a novembre 2020. La ricerca degli articoli è stata condotta sui database scientifici Pub Med, Scopus e Embase. I risultati mostrano l’insorgenza nel personale sanitario di ansia, depressione e stress e insonnia. Tali aspetti risultano strettamente correlati a numerosi fattori, tra cui la paura di contrarre la malattia e di trasmetterla alle famiglie, turni stressanti e poco riposo, portando ad uno stato di tensione psicologica e fisica in grado di attivare comportamenti patologici. La letteratura evidenzia l’importanza di interventi di sostegno al personale in prima linea al fine di evitare l'insorgere di gravi problemi di natura psico-patofisica. La revisione condotta suggerisce come gli infermieri in prima linea durante la fase di emergenza di Covid-19 possano essere soggetti a disturbi psicologici in grado di compromettere la salute mentale. Pertanto, la sorveglianza e il monitoraggio dei sintomi, congiuntamente a mirati interventi di sostegno, dovrebbero essere garantiti quotidianamente a tutti i professionisti coinvolti ai fine di prevenire l'insorgenza di disturbi psicologici.
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pair_34089641
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Nursing students represent an important resource both for the patients and for the company organization; however, the impact of their presence on the quality of care is still underestimated. To provide an objective assessment of the quality of care perceived by the patient admitted to hospital departments where internships are held for nursing students. A descriptive observational study was conducted, recruiting a convenience sample made up of patients hospitalized in clinical departments where internships for nursing students of La Fe Hospital in Valencia (ES) are located. 75 patients out of 160 hospitalized partecipated to the survey, with a response rate equal to 46.87%. Most patients believe that nurses have careless attitudes towards them (42.9%) even though there is a noticeable emotional support from nurses perceived by patients (90.1%). The degree of relationship and information perceived by patients (96%) suggests that nurses in most cases guaranteed confidentiality and the assistance time employed (70.5%) was perceived as longer than usual, defining a high opinion of patients about the treatment received. The data showed that patients were very keen to be taken into consideration from a social and human point of view and not only from a clinical point of view, so much so that they claimed to perceive a careless attitude from nurses. Despite this, however, the perceived quality of nursing care by the patient was not affected. Regarding the presence of the trainee student, being the latter in the Spanish reality totally flanked by that of the nurse, almost in symbiosis, the degree of attention perceived by the patient in relation to the assistance provided does not vary.
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Introduzione: Gli studenti infermieri rappresentano una risorsa importante sia per gli assistiti che per l’organizzazione aziendale; tuttavia l’impatto della loro presenza sulla qualità assistenziale è ancora sottostimata. Obiettivo: Fornire una valutazione oggettiva della qualità assistenziale percepita dal paziente ricoverato nei reparti ospedalieri sedi di tirocinio per gli studenti infermieri. Metodo: E' stato condotto uno studio osservazionale descrittivo, arruolando un campione di convenienza composto da pazienti ricoverati nei reparti clinici sede di tirocinio per studenti infermieri dell’Ospedale La Fe di Valencia (ES). Risultati: Hanno partecipato all’indagine n. 75 pazienti sui 160 ricoverati tasso di risposta pari al 46,87%. La maggior parte dei pazienti crede che gli infermieri hanno atteggiamenti poco curanti nei loro confronti (42,9 %) anche se si nota un notevole supporto affettivo da parte degli infermieri percepito dai pazienti (90,1%). Il grado di relazione e informazione percepito dai pazienti (96%) fa intendere che gli infermieri nella maggior parte dei casi garantivano la riservatezza ed il tempo di assistenza impiegato (70,5% ) sia stato percepito come più lungo del solito definendo un’alta opinione dei pazienti circa le cure ricevute. Conclusioni: I dati hanno evidenziato che i pazienti ci tenessero molto a essere presi in considerazione dal punto di vista sociale e umano e non solo da quello clinico, tanto da affermare di percepire un atteggiamento poco curante da parte degli infermieri. Malgrado questo tuttavia la qualità percepita dal paziente dell’assistenza infermieristica non ne ha risentito. Relativamente alla presenza dello studente tirocinante, essendo quest’ultima nella realtà spagnola totalmente affiancata a quella dell’infermiere , quasi in simbiosi, non varia il grado di attenzione percepito dal paziente relativamente all’assistenza erogata.
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pair_34089642
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Palliative rehabilitation is defined as the process of helping a person with a progressive, commonly advanced, and/or incurable disease reach their physical, psychological, and social potential consistent with physiological and environmental limitations and life preferences. However, the evidence on this subject is dispersed in the literature. To examine and map interventions of palliative rehabilitation, implemented and evaluated in palliative care. A scoping review, using the Joanna Briggs Institute's guideline, was conducted. Multiple databases were searched: CINAHL Complete; PubMed; Scopus; SciELO; Cochrane Central Register of Controlled Trials; PEDro, as well as grey literature for studies that focus on qualified healthcare professionals caring for patients 18 years of age or older, working in palliative care, that focus on the concepts of palliative rehabilitation interventions. Of the 314 studies retrieved, two were included in this review. Both were conducted with physiotherapists, and none mentioned nursing rehabilitation. One of the studies implemented and evaluated an intervention of exclusively physical domain and another of physical and emotional domain. The interventions still differ in the number of treatments which ranged from 4 to 7 sessions. Both studies were implemented in oncological and non-oncological patients. Further research is needed to explore the rehabilitation strategies used by healthcare professionals working in palliative care that help patients. Moreover, since nurses are often the healthcare professionals who are in closest proximity to, and who spend the most time with, the patient, which rehabilitation interventions do these professionals should be focus of intervention.
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lexi-ml/wmt_22_dataset_en_it
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La riabilitazione palliativa è definita come il processo di aiutare una persona con una malattia progressiva, comunemente avanzata e / o incurabile a raggiungere il proprio potenziale fisico, psicologico e sociale coerente con i limiti fisiologici e ambientali e le preferenze di vita. Tuttavia, le prove su questo argomento sono disperse in letteratura OBIETTIVO: Esaminare e mappare gli interventi di riabilitazione palliativa, implementati e valutati nelle cure palliative. È stata condotta una scoping review, usando le linee guida del Joanna Briggs Institute. Sono stati cercati più database: CINAHL completo; PubMed; Scopus; SciELO; Cochrane Central Register of Controlled Trials; PEDro e letteratura grigia per studi incentrati su professionisti sanitari qualificati che si occupano di pazienti di età pari o superiore a 18 anni, che lavorano in cure palliative, che si concentrano sui concetti di interventi di riabilitazione palliativa. Dei 314 studi recuperati, due sono stati inclusi in questa revisione. Entrambi sono stati condotti con fisioterapisti e nessuno ha menzionato la riabilitazione infermieristica. Uno degli studi ha implementato e valutato un intervento dal punto di vista esclusivamente fisico e un altro dal punto di vista fisico ed emotivo. Gli interventi differiscono ancora nel numero di trattamenti che variavano da 4 a 7 sessioni. Entrambi gli studi sono stati condotti su pazienti oncologici e non oncologici. Sono necessarie ulteriori ricerche per esplorare le strategie di riabilitazione adottate dai professionisti sanitari che ricorrono a cure palliative per aiutare i pazienti. Inoltre, poiché gli infermieri sono spesso i professionisti sanitari che si trovano a più stretto contatto e trascorrono più tempo con il paziente, quali attività riabilitative facciano questi professionisti dovrebbe essere al centro dell'intervento.
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pair_30049907
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The aim of the present study was to compare the surgical results with contrast-enhanced [99mTc]methoxyisobutylisonitrile ([99mTc]MIBI) single-photon emission computed tomography (SPECT)/computed tomography (CT) results by adding the simultaneous single phase contrast to the [99mTc]MIBI SPECT/CT examination. Between November 2016 and January 2018, 24 (21 female, 3 male) patients who underwent an operation after preoperative contrast-enhanced [99mTc]MIBI SPECT/CT, and 49 asymptomatic patients (42 female, 7 male), who did not undergo surgery, were included in the study. Sensitivity and specificity rates of contrast enhanced [99mTc]MIBI SPECT/CT were 100% and 100% when evaluated together with surgical results. The rate of detection in asymptomatic patients was found to be 93.8%. With the contrast-enhanced [99mTc]MIBI SPECT/CT imaging, both high sensitivity and specificity values were achieved in the preoperative localization of parathyroid adenomas (PTAs) and high detection rates were obtained in the asymptomatic group. The use of contrast IV during the [99mTc]MIBI SPECT/CT in patients without contraindications increased both preoperative localization rates of adenomas and detection rates of asymptomatic hyperparathyroidism cases. Parathyroid adenoma, Primary Hyperparathyroidism, [99mTc]MIBI, SPECT/CT.
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Scopo di questo studio è quello di confrontare i risultati in camera operatoria con quelli di localizzazione preoperatoria ottenuti con l’impiego della MIBI SPECT / CT con miglioramento del contrasto [99mTc], aggiungendo il contrasto simultaneo a fase singola all’esame MIBI SPECT/CT [99mTc]. Lo studio è stato condotto tra novembre 2016 e gennaio 2018 su 24 pazienti (21 femmine, 3 maschi) sottoposti a intervento chirurgico dopo localizzazione preoperatoria con MIBI SPECT/CT potenziato con 99MTc, e 49 pazienti asintomatici (42 donne, 7 maschi), non sottoposti a intervento chirurgico. Come risultato le percentuali di sensibilità e specificità del potenziamento con [99mTc] della MIBI SPECT/CT sono state del 100% e ancora del 100% quando valutate insieme ai risultati chirurgici. Il tasso di rilevazione in pazienti asintomatici è risultato pari al 93,8%. Si conclude che con l’imaging MIBI SPECT/CT con contrasto aumentato mediante [99mTc], sono stati raggiunti valori di alta sensibilità e specificità nella localizzazione preoperatoria degli adenomi paratiroidali e sono stati ottenuti elevati tassi di rilevamento nel gruppo asintomatico. L’uso del contrasto IV durante il [99mTc]MIBI SPECT/CT in pazienti senza controindicazioni ha aumentato sia i tassi di localizzazione preoperatoria degli adenomi che i tassi di rilevamento dei casi di iperparatiroidismo asintomatico.
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pair_30049908
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Splenic cysts are rare benign lesions of the spleen, usually asymptomatic and incidentally discovered at imaging. A case of huge epidermoid cyst of the spleen on a 16 years old female patient is presented. This case was symptomatic with fullness and palpable mass in the entire abdomen. Initial evaluation with ultrasound and computed tomography established the diagnosis with the greater dimension of the cyst about 25cm. Because of the size and the relation with the hilum of the spleen, splenectomy was performed and any effort to rescue splenic parenchyma was impossible. Many techniques are reported as treatment options, but the standard of care for nonparasitic splenic cysts is splenectomy. Benign, Cyst, Epidermoid, Splenic.
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Le cisti spleniche sono lesioni benigne rare della milza, generalmente asintomatiche e di scoperta casuale con l’imaging. Viene qui presentato il caso di una vistosa cisti epidermoidale della milza scoperta in una ragazza di 16 anni per il senso di ripienezza addominale con massa palpabile. Le indagini iniziali con ecografia e TC hanno consentito la diagnosi e la precisazione delle dimensioni della cisti, con diametro maggiore di 25 cm. In considerazione delle sue dimensioni e la situazione dell’ilo è stata eseguita una splenectomia senza la possibilità di preservare del parenchima splenico. Vengono discusse le varie opzioni tecniche del trattamento, ma lo standard di cura per le cisti non parassitarie resta la splenectomia.
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pair_30049909
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Inguinal hernia is one of the most common surgical entities and often poses technical dilemmas, even for the experienced surgeon. Amyand's hernia is an inguinal hernia; a protrusion of abdominal cavity content through the inguinal canal, with a vermiform appendix. A 77 years old Caucasian male was referred to our institution for the evaluation of a recurrent right inguinal hernia. During the surgery, we discovered a rare type I Amyand hernia. Following the guidelines we performed, a prosthetic tension-free inguinal ernioplasty without appendectomy.The patient was discharged on the first post-operative day. The follow-up at 7 days was uneventful. First described by Claudius Amyand (1660-1740), a French born English surgeon, who successfully performed the first reported appendectomy for inflamed appendix encountered during herniotomy on an 11 year-old boy in 1735 at St George's hospital.The incidence of Amyand's hernia is between 1%. The association of appendicitis is even rarer and reported to be around of 0.1%. Losanoff and Basson proposed a classification scheme to determine the surgical management of Amyand's hernia, depending on the status of the appendix KEY WORD: Amyand Hernia, Appendix, Elderly.
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INTRODUZIONE: l’ernia inguinale è uno dei piu’ comuni problemi chirurgici e spesso pone difficoltà tecniche, anche per il chirurgo esperto. L’ernia di Amyand è un’ernia inguinale all’interno del cui sacco è contenuta l’appendice vermiforme. CASO CLINICO: un uomo di 77 anni giunge alla nostra osservazione per la valutazione di un’ernia inguinale destra ricorrente. Durante l’intervento abbiamo scoperto un raro tipo di ernia di Amyand. Seguendo le linee guida abbiamo eseguito un’ernioplastica inguinale ‘tension-free’ con utilizzo di protesi evitando l’appendicectomia. Il paziente è stato dimesso il primo giorno post-operatorio e ricontrollato dopo 7 giorni in regime ambulatoriale. DISCUSSIONE: descritta per la prima volta da Claudius Amyand (1660-1740), un chirurgo emigrato in Inghilterra ma di origine francese, che eseguì con successo la prima appendicectomia durante un intervento di ernioplastica su un piccolo paziente di 11 anni nel 1735 all’ospedale di St George. L’incidenza dell’ernia di Amyand è dell’1%. L’associazione con un quadro di appendicite è ancora più rara, intorno alla 0,1%. Losanoff e Basson hanno proposto uno schema di classificazione per determinare la gestione chirurgica dell’ernia di Amyand, a seconda che ci si trovi di fronte ad un quadro di appendicite o meno. Nel primo caso è indicata l’appendicectomia evitando l’utilizzo di materiale protesico per la cura dell’ernia.
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Acute appendicitis is the most common abdominal emergency. Its etiopathogenesis appears to be multifactorial. Several studies suggested a relationship between the development of acute appendicitis and some environmental factors. Air pollution predisposes some people to develop perforated appendicitis. However, data are relatively scarce and the results still controversial. Determine the seasonal variation of acute appendicitis and study the association between perforated appendicitis and short-term exposure to climatic factors and to air pollutants. A cross-sectional study was conducted including patients hospitalized in the general surgery department of Farhat Hached University Hospital in Sousse for acute appendicitis between January 1st and December 31st, 2014. Climatic conditions were collected from the National Institute of Meteorology. Data on air pollution were given by the National Agency for the Protection of the Environment and obtained by the modeling of the atmospheric pollution. For statistical analysis, we used mean concentrations of each environmental factor corresponding to the day of hospital admission and lagged by the 7 previous days. These factors were compared between the group of patients with perforated appendicitis and patients with nonperforated appendicitis. We collected 246 cases of acute appendicitis. Perforated appendicitis was reported in 15.2% of the cases. The incidence of acute appendicitis was higher during summer. Compared to nonperforated appendicitis, perforated appendicitis was significantly associated with the mean relative humidity of the 5 day lag (p = 0.046), rainfall of the 7 day lag (p = 0.043), and consultation delay (p <10-3). Furthermore, perforated appendicitis was significantly associated with the daily mean concentration of carbon dioxide (p = 0.042), the 2- day lag mean concentration of particulate matter less than 10 μ (PM10 ) (p = 0.016), and the 2-day lag mean concentration of ozone (p = 0.048). After multivariate statistical analysis, predictive factors for perforated appendicitis were the consultation delay (OR: 1.621, 95% CI [1.288 - 2.039]; p<10-3) and the 2 day lag mean concentration of PM10 (OR: 1.066, 95% CI [1.007- 1.130]; p = 0.029). Short-term exposure to particulate matter was associated with perforated appendicitis. Further large-scale studies are needed to support this conclusion. Air pollution, Appendicitis, perforated appendicitis, Climateparticulate matter.
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L’appendicite acuta è il più comune tipo di emergenza addominale. La sua patogenesi appare multifattoriale, e molti studi suggeriscono una relazione tra la sua insorgenza ed alcuni fattori ambientali. L’inquinamento atmosferico predispone alcuni individui allo sviluppo dell’appendicite perforata, ma i dati sono relativamente scarsi e i risultati ancora controversi. Questo studio si è proposto di determinare la variazione stagionale dell’appendicite acuta e l’associazione della perforazione appendicolare con l’esposizione di breve durata ai fattori climatici e all’inquinamento atmosferico. Lo studio trasversale è stato fatto includendo pazienti ricoverati nel dipartimento di chirurgia generale dell’Ospedale Universitario Farhat Hached di Sousse per appendicite acuta tra il 1° gennaio ed il 31 dicembre 2014. Le condizioni climatiche di questo periodo sono state quelle raccolte dall’Istituto Nazionale di Meteorologia, i dati sull’inquinamento atmosferico dall’Agenzia Nazionale per la protezione dell’ambiente ottenuti dal modello di polluzione armosferica. Per l’analisi statistica è stata utilizzata la concentrazione media di ciascun fattore ambientale corrispondente al giorno del ricovero ospedaliero esteso ai 7 giorni precedenti. Questi fattori sono stati confrontati tra il gruppo di pazienti con appendicite perforata e quello delle appendiciti senza perforazione. Dei 246 casi di appendicite acuta raccolti, i casi di appendicite perforate riguardava il 15,2% del totale. L’incidenza della appendicite acuta è risultata più elevata durante l’estate. Al confronto con l’appendicite senza perforazione, la perforazione appendicolare è risultata significativamente associata con l’umidità media relativa del 5 giorni precedenti il ricovero (p=0.046), con la pioggia dei 7 giorni precedenti (p = 0.043), e con il ritardo di ricorso al medico (p <10-3). Inoltre l’appendicite perforata è risultata significativamente associate con la concentrazione media giornaliera dell’anidride carbonica (p = 0.042), la concentrazione media nei due giorni precedenti il ricovero del microparticolato inferiore ai 10 μ (PM10) (p = 0.016), e la concentrazione di ozono dei due giorni precedenti (p = 0.048). Dopo analisi statistica multivariate I fattori predittivi dell’appendicite perforate sono risultati il ritardo di consultazione del medico, (OR: 1.621, 95% CI [1.288 - 2.039]; p<10-3) e la concentrazione nei due giorni precedenti il ricovero del PM10 (OR: 1.066, 95% CI [1.007- 1.130]; p = 0.029). In conclusione l’esposizione per breve tempo al microparticolato è risultato associato con l’appendicite perforata. Ulteriori studi a larga scala sono necessari per confermare questo risultato.
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Psychotherapy research is a rapidly developing area of study that aims to explore the integration of inner and outer conditions of an individual's experience, the interplay between subjective and objective, as well as between individual and collective. Questions regarding a more integrative view and qualitative research in psychotherapy are discussed in the paper. The author introduces some ideas from the studies on psychotherapy effectiveness that were done at Vilnius University by a group of researchers who work in the 'Centre for research on the psychodynamics of personality'. Clinical psychologists who hold a doctorate degree or who are in doctoral studies in the Department of Psychology at Vilnius University are members of this research group. The subjective understanding about healing episodes and the development of depth premises were the main tasks of these studies. Among other methods, the researchers used the drawing a picture of a healing moment and telling a psychotherapy story recalled by the client to collect data. Two examples of drawing a picture of a healing moment and one example of telling a therapy story are analyzed in the paper. The themes of subjective experience of renewal in psychotherapy as well as the multiplicity of experience and results in psychotherapy are discussed in the paper with case illustrations. This study showed that drawing a picture opens one more dimension of reflection and that it can be an appropriate tool for developing individual narratives as well. Authoring and re-authoring one's life narrative is accepted as part of a productive therapy as well as discovering one's inner authorship. The ability to follow a succession of meanings, as well as a connection to nature and culture could be one of the ways of actualizing an integrative view in psychotherapy research.
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La ricerca in psicoterapia è un’area di studio in rapida evoluzione che tende ad esplorare l’integrazione tra le condizioni interne ed esterne dell’esperienza individuale, l’interazione tra soggettivo ed oggettivo tanto quanto tra individuale e collettivo. Nell’articolo vengono affrontate domande relative ad una visione più integrativa ed alla ricerca qualitativa in psicoterapia. L’Autrice introduce alcune idee prese dagli studi sull’efficacia della psicoterapia effettuati all’università di Vilnius da un gruppo di ricercatori, che lavorano nel ‘Center for Research on the psychodynamics of personality’. Psicologi clinici che hanno conseguito un dottorato o che lo stanno per conseguire presso il Dipartimento di Psicologia dell’Università di Vilnius fanno parte di questo gruppo di ricerca. La comprensione soggettiva degli episodi di guarigione e lo sviluppo di premesse profonde erano gli obiettivi principali di questi studi. Tra i tanti metodi utilizzati dai ricercatori per raccogliere informazioni vi è il disegno di un’immagine di un momento di guarigione e la narrazione di una storia terapeutica rammentata dal paziente. Due esempi del ‘disegno di un’immagine di un momento di guarigione’ e un esempio della ‘narrazione di una storia terapeutica’ sono analizzati nell’articolo. I temi dell’esperienza soggettiva del rinnovamento nella psicoterapia così come la molteplicità di esperienze e risultati vengono trattati nell’articolo con illustrazioni di casi. Questo studio ha mostrato che disegnare un’immagine apre un’ulteriore dimensione di riflessione e che può essere uno strumento appropriato per lo sviluppo di una narrazione individuale. Scrivere e riscrivere la narrazione della propria vita fa parte di una terapia produttiva tanto quanto la scoperta di esserne l’autore. L’abilità di seguire una successione di significati, così come una connessione con la natura e la cultura, potrebbe essere un modo per realizzare una prospettiva nella ricerca psicoterapeutica.
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Psychotherapy research is a rapidly developing area of study that aims to explore the integration of inner and outer conditions of an individual's experience, the interplay between subjective and objective, as well as between individual and collective. Questions regarding a more integrative view and qualitative research in psychotherapy are discussed in the paper. The author introduces some ideas from the studies on psychotherapy effectiveness that were done at Vilnius University by a group of researchers who work in the 'Centre for research on the psychodynamics of personality'. Clinical psychologists who hold a doctorate degree or who are in doctoral studies in the Department of Psychology at Vilnius University are members of this research group. The subjective understanding about healing episodes and the development of depth premises were the main tasks of these studies. Among other methods, the researchers used the drawing a picture of a healing moment and telling a psychotherapy story recalled by the client to collect data. Two examples of drawing a picture of a healing moment and one example of telling a therapy story are analyzed in the paper. The themes of subjective experience of renewal in psychotherapy as well as the multiplicity of experience and results in psychotherapy are discussed in the paper with case illustrations. This study showed that drawing a picture opens one more dimension of reflection and that it can be an appropriate tool for developing individual narratives as well. Authoring and re-authoring one's life narrative is accepted as part of a productive therapy as well as discovering one's inner authorship. The ability to follow a succession of meanings, as well as a connection to nature and culture could be one of the ways of actualizing an integrative view in psychotherapy research.
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心理治疗研究是一个快速发展的领域, 它的目标是探索个体经验内在和外在状况的整合、主体与客体间以及个体与集体间的相互作用。这篇文章讨论的问题涉及心理治疗中更加整合的观点及定性的研究。作者介绍了来自维尔纽斯大学“人格心理动力研究中心”的一群研究者在进行心理治疗有效性研究时所发展出来的一些概念。这一研究团队的成员为具有博士学位的临床心理学家或是在维尔纽斯大学心理系在读的博士生。对治愈情节的主观理解, 以及作为治愈前提的深度发展是这些研究的主要任务。在研究者采用的诸多方法中, 还包括画出治愈时刻的图画, 以及来访者通过回忆而讲一个心理治疗的故事, 这些都作为研究所收集的数据。文章分析了两幅关于治愈时刻的绘画的案例, 以及一个治疗故事讲述的案例。治疗中更新的主体经验主题, 以及心理治疗中多样化的经验与结局都被作者以个案的形式进行了描绘。这一研究显示, 绘画可以带来更多层面的反思, 它可以是一个合适的工具用于个体叙述的发展。编著及再编著个体的生命叙述被当作为一种有益的治疗, 与此同时, 也有益于个体发现自己内在的著作者。有能力去跟随意义的演替, 以及去联系自然与文化, 可以是一种实行心理治疗研究的整合视角的途径。.
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Psychotherapy research is a rapidly developing area of study that aims to explore the integration of inner and outer conditions of an individual's experience, the interplay between subjective and objective, as well as between individual and collective. Questions regarding a more integrative view and qualitative research in psychotherapy are discussed in the paper. The author introduces some ideas from the studies on psychotherapy effectiveness that were done at Vilnius University by a group of researchers who work in the 'Centre for research on the psychodynamics of personality'. Clinical psychologists who hold a doctorate degree or who are in doctoral studies in the Department of Psychology at Vilnius University are members of this research group. The subjective understanding about healing episodes and the development of depth premises were the main tasks of these studies. Among other methods, the researchers used the drawing a picture of a healing moment and telling a psychotherapy story recalled by the client to collect data. Two examples of drawing a picture of a healing moment and one example of telling a therapy story are analyzed in the paper. The themes of subjective experience of renewal in psychotherapy as well as the multiplicity of experience and results in psychotherapy are discussed in the paper with case illustrations. This study showed that drawing a picture opens one more dimension of reflection and that it can be an appropriate tool for developing individual narratives as well. Authoring and re-authoring one's life narrative is accepted as part of a productive therapy as well as discovering one's inner authorship. The ability to follow a succession of meanings, as well as a connection to nature and culture could be one of the ways of actualizing an integrative view in psychotherapy research.
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La recherche dans le domaine de la psychothérapie est un domaine d’étude en croissance rapide qui vise à étudier l’intégration des conditions intérieures et extérieures dans l’expérience d’une personne, l’interaction entre le subjectif et l’objectif, ainsi qu’entre l’individuel et le collectif. L’article aborde des questions concernant une perspective plus intégrative et la recherche qualitative en psychothérapie. L’auteur introduit des idées provenant d’études faites par un groupe de chercheurs à l’université de Vilnius sur l’efficacité de la psychothérapie. Ces chercheurs travaillent au « Centre for research on the psychodynamics of personality » (Centre de recherche sur les psychodynamiques de la personnalité). Ils sont docteurs en psychologie clinique ou doctorants dans le département de Psychologie à l’université de Vilnius. L’objet principal de ces recherches est la compréhension subjective d’épisodes de guérison et la construction de postulats de profondeur. Parmi différentes méthodes pour obtenir des données, les chercheurs ont utilisé celle consistant à faire un dessin d’un moment de guérison et celle consistant à raconter une histoire de psychothérapie telle que le client se la rappelle. Deux exemples de faire un dessin d’un moment de guérison ainsi qu’un exemple de raconter une histoire de psychothérapie sont analysés dans l’article. Les thèmes de l’expérience subjective du renouveau en psychothérapie, ainsi que la multiplicité d’expérience et de résultats en psychothérapie sont traités dans l’article et illustrés par des cas. Cette étude montre que de faire un dessin ouvre une dimension de plus dans la réflexion et que cela peut être un outil approprié pour le développement des récits individuels. Etre l’auteur de son récit de vie, ainsi que de sa réécriture, est considéré comme étant un aspect d’une thérapie productive. De même que découvrir sa capacité intérieure à « être auteur ». La capacité à suivre une succession de significations, ainsi qu’un lien avec la nature et la culture pourraient être une des manières d’actualiser une perspective intégrative dans la recherche en psychothérapie.
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Psychotherapy research is a rapidly developing area of study that aims to explore the integration of inner and outer conditions of an individual's experience, the interplay between subjective and objective, as well as between individual and collective. Questions regarding a more integrative view and qualitative research in psychotherapy are discussed in the paper. The author introduces some ideas from the studies on psychotherapy effectiveness that were done at Vilnius University by a group of researchers who work in the 'Centre for research on the psychodynamics of personality'. Clinical psychologists who hold a doctorate degree or who are in doctoral studies in the Department of Psychology at Vilnius University are members of this research group. The subjective understanding about healing episodes and the development of depth premises were the main tasks of these studies. Among other methods, the researchers used the drawing a picture of a healing moment and telling a psychotherapy story recalled by the client to collect data. Two examples of drawing a picture of a healing moment and one example of telling a therapy story are analyzed in the paper. The themes of subjective experience of renewal in psychotherapy as well as the multiplicity of experience and results in psychotherapy are discussed in the paper with case illustrations. This study showed that drawing a picture opens one more dimension of reflection and that it can be an appropriate tool for developing individual narratives as well. Authoring and re-authoring one's life narrative is accepted as part of a productive therapy as well as discovering one's inner authorship. The ability to follow a succession of meanings, as well as a connection to nature and culture could be one of the ways of actualizing an integrative view in psychotherapy research.
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Psychotherapieforschung ist ein sich rasant entwickelndes Forschungsgebiet, das darauf abzielt, die Integration der inneren und äußeren Bedingungen einer individuellen Erfahrung, das Zusammenspiel von Subjektivem und Objektivem sowie von Individuellem und Kollektivem zu untersuchen. In diesem Beitrag werden Fragen diskutiert, die sowohl eine integrativere Sichtweise als auch qualitative Forschung in der Psychotherapie berücksichtigen. Die Autorin stellt einige Ideen aus Studien zur Wirksamkeit von Psychotherapie vor, die an der Universität Vilnius von einer Gruppe von Forschern durchgeführt wurden, die im 'Zentrum zur Erforschung der Psychodynamik der Persönlichkeit' arbeiten. Zu dieser Forschergruppe gehören promovierte klinische Psychologen oder solche, die gegenwärtig am Institut für Psychologie der Universität Vilnius promovieren. Das subjektive Verständnis von Heilungsepisoden und die Entwicklung von Tiefenprämissen stellten die Hauptthemen dieser Studien dar. Neben anderen Methoden verwendeten die Forscher das Zeichnen eines Bildes eines Heilungsmomentes und das Erzählen einer Psychotherapiegeschichte, wie sie von Klienten erinnert wurde, um Daten zu sammeln. In der Arbeit werden zwei Beispiele für das Zeichnen eines Bildes eines Heilungsmomentes und ein Beispiel für das Erzählen einer Therapiegeschichte analysiert. Anhand von Falldarstellungen werden in dem Beitrag die Themen der subjektiven Erfahrung von Erneuerung in der Psychotherapie und die Vielzahl der Erfahrungen mit sowie die Ergebnisse von Psychotherapie diskutiert. Diese Studie hat gezeigt, daß das Zeichnen eines Bildes eine weitere Dimension der Reflexion eröffnet und ein geeignetes Werkzeug für die Entwicklung individueller Erzählungen sein kann. Das Verfassen und Neuverfassen der eigenen Lebenserzählung wird dabei als Teil einer produktiven Therapie und als Entdeckung der inneren Urheberschaft angesehen. Die Fähigkeit, einer Sukzession von Bedeutungen zu folgen sowie eine Verbindung zu Natur und Kultur herzustellen könnte eine der Möglichkeiten sein, eine integrative Sichtweise in der Psychotherapieforschung zu verwirklichen.
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Psychotherapy research is a rapidly developing area of study that aims to explore the integration of inner and outer conditions of an individual's experience, the interplay between subjective and objective, as well as between individual and collective. Questions regarding a more integrative view and qualitative research in psychotherapy are discussed in the paper. The author introduces some ideas from the studies on psychotherapy effectiveness that were done at Vilnius University by a group of researchers who work in the 'Centre for research on the psychodynamics of personality'. Clinical psychologists who hold a doctorate degree or who are in doctoral studies in the Department of Psychology at Vilnius University are members of this research group. The subjective understanding about healing episodes and the development of depth premises were the main tasks of these studies. Among other methods, the researchers used the drawing a picture of a healing moment and telling a psychotherapy story recalled by the client to collect data. Two examples of drawing a picture of a healing moment and one example of telling a therapy story are analyzed in the paper. The themes of subjective experience of renewal in psychotherapy as well as the multiplicity of experience and results in psychotherapy are discussed in the paper with case illustrations. This study showed that drawing a picture opens one more dimension of reflection and that it can be an appropriate tool for developing individual narratives as well. Authoring and re-authoring one's life narrative is accepted as part of a productive therapy as well as discovering one's inner authorship. The ability to follow a succession of meanings, as well as a connection to nature and culture could be one of the ways of actualizing an integrative view in psychotherapy research.
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La investigación en psicoterapia es un área de estudio en creciente desarrollo cuyo objetivo es explorar la integración entre las condiciones internas y externas de la experiencia de un individuo, el inter-juego entre lo subjetivo y lo objetivo, así como entre lo individual y lo colectivo. Se plantean consideraciones respecto a una perspectiva más integradora y a la investigación cualitativa. La autora introduce algunas ideas, a partir de estudios sobre la efectividad de la psicoterapia llevados a cabo en la Universidad de Vilnius, por un grupo de investigadores que trabajan en el ‘Centro de investigación en los procesos psicodinámicos de la personalidad’. Los miembros de este grupo de investigación son psicólogos clínicos que tienen un doctorado o están realizando un doctorado en el Departamento de Psicología en la Universidad de Vilnius. Las principales tareas de estos estudios fueron el desarrollo de premisas profundas y la comprensión subjetiva sobre los episodios de curación. Entre otros métodos, los investigadores para recoger data, utilizaban el dibujar un cuadro sobre un momento de curación y contar una historia de psicoterapia contada por el cliente. Dos ejemplos de dibujar un cuadro de un momento de curación y un ejemplo de contar una historia de terapia son analizados en el presente trabajo. Se da cuenta de la experiencia subjetiva de renovación en psicoterapia así como de la multiplicidad de experiencias y resultados a partir de la ilustración de casos. El estudio muestra que el dibujar un cuadro abre una nueva dimensión de reflexión y puede ser una herramienta apropiada para el desarrollo de narrativas individuales. Ser autor/a, y volver a ser autor/a de la propia narrativa de vida se acepta como parte de una terapia productiva así como del descubrimiento de la autoridad interna. La habilidad de dar cuenta de una sucesión de sentidos, así como una conexión con la naturaleza y la cultura podrían ser uno de los modos de actualizar una perspectiva integradora en la investigación en psicoterapia.
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Psychotherapy research is a rapidly developing area of study that aims to explore the integration of inner and outer conditions of an individual's experience, the interplay between subjective and objective, as well as between individual and collective. Questions regarding a more integrative view and qualitative research in psychotherapy are discussed in the paper. The author introduces some ideas from the studies on psychotherapy effectiveness that were done at Vilnius University by a group of researchers who work in the 'Centre for research on the psychodynamics of personality'. Clinical psychologists who hold a doctorate degree or who are in doctoral studies in the Department of Psychology at Vilnius University are members of this research group. The subjective understanding about healing episodes and the development of depth premises were the main tasks of these studies. Among other methods, the researchers used the drawing a picture of a healing moment and telling a psychotherapy story recalled by the client to collect data. Two examples of drawing a picture of a healing moment and one example of telling a therapy story are analyzed in the paper. The themes of subjective experience of renewal in psychotherapy as well as the multiplicity of experience and results in psychotherapy are discussed in the paper with case illustrations. This study showed that drawing a picture opens one more dimension of reflection and that it can be an appropriate tool for developing individual narratives as well. Authoring and re-authoring one's life narrative is accepted as part of a productive therapy as well as discovering one's inner authorship. The ability to follow a succession of meanings, as well as a connection to nature and culture could be one of the ways of actualizing an integrative view in psychotherapy research.
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Исследование в психотерапии - это быстро развивающая область знаний, задачи которой состоят в изучении интеграции внутренних и внешних условий индивидуального опыта, взаимодействия между субъективным и объективным, индивидуальным и коллективным. В статье обсуждаются вопросы, связанные с интегративным подходом и качественными исследованиями в психотерапии. Автор представляет читателю некоторые идеи из работ по эффективности психотерапии, которые были проведены в университете Вильнюса группой ученых, работавших в «Центре исследования по психодинамике личности». Клинические психологи, имеющие докторскую степень или пишущие докторскую диссертацию на факультете психологии в университете Вильнюса, являются членами этой группы. Субъективное понимание моментов исцеления, а также предпосылки развития глубины терапии были основными задачами исследования. Среди прочих методов докторанты использовали рисунки моментов исцеления и рассказ психотерапевтической истории клиентом, которого приглашали для сбора данных. В статье анализируется два рисунка момента исцеления и одна терапевтическая история. Темы субъективного опыта обновления в психотерапии, а также многогранность опыта и результаты в психотерапии обсуждаются в статье вместе с клиническими иллюстрациями. Исследование показало, что рисунок открывает несколько измерений рефлексии, он может быть использован как адекватное средство для развития индивидуального нарратива. Авторское творение повторное сотворение нарратива своей жизни принимает как часть продуктивной терапии, а также позволяет открыть внутреннего автора. Способность прослеживать преемственность смыслов, а также связь между природой и культурой может быть одним из способов актуализации интегративного взгляда в исследовании в психотерапии.
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This paper discusses the main features of Siberian identity formed throughout the historical development of Siberia under the influence of social, economic, geographical, climatic, and other factors. Siberian cultural identity is closely connected with the mythology and ancient religion of the indigenous peoples of Siberia - shamanism, whose rituals, images, symbols, and motifs are often manifested in the clients' dreams. Following an in-depth study of Siberian history and culture, I formulate a complex of homelessness rooted in a deep collective trauma that left its imprint on people's psyche. Three clinical cases presented in the paper reveal a deep relationship between cultural complexes and collective traumas on the one hand, and individual complexes and traumas, on the other. My psychotherapeutic practice shows that a client's awareness of their history and culture brings them closer to the meaning and source of their suffering, which, in turn, helps them find their own way of individuation, rather than relive the transgenerational trauma of their ancestors.
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Questo articolo esamina i principali aspetti dell’identità siberiana formatisi nel corso dello sviluppo della Siberia sotto l’influenza di fattori sociali, economici, geografici, climatici ed altri. L’identità culturale siberiana è strettamente correlata alla mitologia ed all’antica religione della popolazione indigena della Siberia - lo sciamanesimo, i cui rituali, immagini, simboli e temi si manifestano spesso nei sogni dei pazienti. A seguito di uno studio approfondito della storia e della cultura siberiana ho individuato un ‘complesso del senza fissa dimora’ radicato in un profondo trauma collettivo che ha lasciato la sua impronta nella psiche della popolazione. Tre casi clinici presentati nell’articolo rivelano un profondo legame tra complessi culturali e traumi collettivi da un lato, e complessi e traumi individuali dall’altro. La mia pratica psicoterapeutica mostra come la consapevolezza che i pazienti hanno della loro storia e cultura li porti più vicini al significato ed alla radice della loro sofferenza, che a sua a volta li aiuta a trovare la loro personale strada per l’individuazione, piuttosto che rivivere il trauma transgenerazionale dei loro antenati.
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This paper discusses the main features of Siberian identity formed throughout the historical development of Siberia under the influence of social, economic, geographical, climatic, and other factors. Siberian cultural identity is closely connected with the mythology and ancient religion of the indigenous peoples of Siberia - shamanism, whose rituals, images, symbols, and motifs are often manifested in the clients' dreams. Following an in-depth study of Siberian history and culture, I formulate a complex of homelessness rooted in a deep collective trauma that left its imprint on people's psyche. Three clinical cases presented in the paper reveal a deep relationship between cultural complexes and collective traumas on the one hand, and individual complexes and traumas, on the other. My psychotherapeutic practice shows that a client's awareness of their history and culture brings them closer to the meaning and source of their suffering, which, in turn, helps them find their own way of individuation, rather than relive the transgenerational trauma of their ancestors.
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这篇文章讨论了在西伯利亚在社会、经济、地域、气候和其它因素影响下的历史发展中, 所构建起来西伯利亚人身份认同的主要特征。西伯利亚人的文化身份密切联系着其神话和原著民的古老宗教--即萨满教, 其仪式、意象、象征和教义常在来访者的梦中呈现。作者对西伯利亚的历史与文化进行了深层研究之后, 阐述了一个无家可归情结, 它根植在一个深度的集体创伤中, 并在人们的心灵中留下了印记。文章呈现了三个案例, 一方面展示了文化情结和集体创伤间的关系, 另一方面展示了个体情结和个体创伤。作者的心理治疗实践显示, 来访者对其历史和文化的觉察让他们更明了他们伤痛的意义和来源, 因此帮助他们找到自己的自性化之路, 而不是活在来自他们祖先的代际创伤中。.
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This paper discusses the main features of Siberian identity formed throughout the historical development of Siberia under the influence of social, economic, geographical, climatic, and other factors. Siberian cultural identity is closely connected with the mythology and ancient religion of the indigenous peoples of Siberia - shamanism, whose rituals, images, symbols, and motifs are often manifested in the clients' dreams. Following an in-depth study of Siberian history and culture, I formulate a complex of homelessness rooted in a deep collective trauma that left its imprint on people's psyche. Three clinical cases presented in the paper reveal a deep relationship between cultural complexes and collective traumas on the one hand, and individual complexes and traumas, on the other. My psychotherapeutic practice shows that a client's awareness of their history and culture brings them closer to the meaning and source of their suffering, which, in turn, helps them find their own way of individuation, rather than relive the transgenerational trauma of their ancestors.
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Cet article étudie les caractéristiques principales de l’identité Sibérienne formée au cours du développement historique de la Sibérie sous l’influence de facteurs sociaux, économiques, géographiques, climatiques et autres. L’identité culturelle Sibérienne est intimement liée à la mythologie et la religion ancienne des peuples indigènes de Sibérie - le shamanisme, dont les rituels, les images, les symboles et les motifs apparaissent souvent dans les rêves des clients. Après une étude approfondie de l’histoire et de la culture sibérienne, j’élabore le complexe « d’être sans domicile » enraciné dans un traumatisme collectif profond qui a laissé sa marque sur la psyché des personnes. Trois cas cliniques sont présentés. Ils révèlent une relation profonde entre les complexes culturels et les traumatismes collectifs d’une part, et les complexes et traumatismes individuels d’autre part. Ma clientèle psychothérapeutique montre qu’un client qui a conscience de son histoire et de sa culture se rapproche plus de la source et du sens de sa souffrance, et que ceci l’aide à trouver son propre chemin d’individuation, plutôt que de revivre le traumatisme transgénérationnel de leurs ancêtres.
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pair_31418834
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This paper discusses the main features of Siberian identity formed throughout the historical development of Siberia under the influence of social, economic, geographical, climatic, and other factors. Siberian cultural identity is closely connected with the mythology and ancient religion of the indigenous peoples of Siberia - shamanism, whose rituals, images, symbols, and motifs are often manifested in the clients' dreams. Following an in-depth study of Siberian history and culture, I formulate a complex of homelessness rooted in a deep collective trauma that left its imprint on people's psyche. Three clinical cases presented in the paper reveal a deep relationship between cultural complexes and collective traumas on the one hand, and individual complexes and traumas, on the other. My psychotherapeutic practice shows that a client's awareness of their history and culture brings them closer to the meaning and source of their suffering, which, in turn, helps them find their own way of individuation, rather than relive the transgenerational trauma of their ancestors.
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In diesem Artikel werden die Hauptmerkmale der sibirischen Identität erörtert, wie sie sich während der historischen Entwicklung Sibiriens unter dem Einfluß sozialer, wirtschaftlicher, geographischer, klimatischer und anderer Faktoren gebildet hat. Die sibirische kulturelle Identität ist eng mit der Mythologie und der alten Religion der sibirischen Ureinwohner verbunden - dem Schamanismus, dessen Rituale, Bilder, Symbole und Motive sich häufig in den Träumen der Klienten manifestieren. Nach einer eingehenden Untersuchung der sibirischen Geschichte und Kultur skizziere ich einen Komplex von Obdachlosigkeit, der in einem tiefen kollektiven Trauma wurzelt und seine Spuren in der Psyche der Menschen hinterlassen hat. Drei in der Arbeit vorgestellte klinische Fälle enthüllen eine tiefe Beziehung zwischen kulturellen Komplexen und kollektiven Traumata einerseits und individuellen Komplexen und Traumata andererseits. Meine psychotherapeutische Praxis zeigt, daß das Bewußtsein eines Klienten für seine Geschichte und Kultur ihn näher an die Bedeutung und die Quelle seines Leidens heranbringt was ihm wiederum hilft, seinen eigenen Weg der Individuation zu finden, anstatt das generationsübergreifende Trauma seiner Vorfahren erneut zu erleben.
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This paper discusses the main features of Siberian identity formed throughout the historical development of Siberia under the influence of social, economic, geographical, climatic, and other factors. Siberian cultural identity is closely connected with the mythology and ancient religion of the indigenous peoples of Siberia - shamanism, whose rituals, images, symbols, and motifs are often manifested in the clients' dreams. Following an in-depth study of Siberian history and culture, I formulate a complex of homelessness rooted in a deep collective trauma that left its imprint on people's psyche. Three clinical cases presented in the paper reveal a deep relationship between cultural complexes and collective traumas on the one hand, and individual complexes and traumas, on the other. My psychotherapeutic practice shows that a client's awareness of their history and culture brings them closer to the meaning and source of their suffering, which, in turn, helps them find their own way of individuation, rather than relive the transgenerational trauma of their ancestors.
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El presente trabajo da cuenta de los rasgos principales de la identidad Siberiana formada a través del desarrollo histórico de Siberia bajo la influencia de factores sociales, económicos, geográficos, climáticos y otros. La identidad cultural Siberiana está conectada a la mitología y a la religión antigua de los pueblos originarios de Siberia - el chamanismo, cuyos rituales, imágenes, símbolos y motivos se manifiestan a menudo en los sueños de los clientes. A partir de un estudio profundo sobre la cultura y la historia de Siberia, he formulado un complejo de “sin hogar” enraizado en un profundo trauma colectivo que deja sus marcas en la psique de las personas. Los tres casos clínicos presentados revelan una profunda relación entre complejos culturales y traumas colectivos por un lado, y complejos individuales y traumas, por otro. Mi práctica psicoterapéutica muestra que el conocimiento por parte del cliente de su historia y su cultura, le posibilita un acercamiento al sentido y a la fuente de su sufrimiento, lo cual, a su turno, le permite encontrar su propio modo de individuación, en lugar de revivir el trauma transgeneracional de sus ancestros.
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This paper discusses the main features of Siberian identity formed throughout the historical development of Siberia under the influence of social, economic, geographical, climatic, and other factors. Siberian cultural identity is closely connected with the mythology and ancient religion of the indigenous peoples of Siberia - shamanism, whose rituals, images, symbols, and motifs are often manifested in the clients' dreams. Following an in-depth study of Siberian history and culture, I formulate a complex of homelessness rooted in a deep collective trauma that left its imprint on people's psyche. Three clinical cases presented in the paper reveal a deep relationship between cultural complexes and collective traumas on the one hand, and individual complexes and traumas, on the other. My psychotherapeutic practice shows that a client's awareness of their history and culture brings them closer to the meaning and source of their suffering, which, in turn, helps them find their own way of individuation, rather than relive the transgenerational trauma of their ancestors.
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В статье исследуются основные черты сибирской идентичности, сформировавшиеся в ходе исторического развития Сибири под влиянием социальных, экономических, географических, климатических и других факторов. Сибирская культурная идентичность тесно связана с мифологией и древними верованиями коренных жителей Сибири - шаманизмом, чьи ритуалы, образы, символы и мотивы часто проявляются в сновидениях клиентов. Глубинное изучение истории и культуры Сибири позволило мне сформулировать комплекс бездомности, укорененный в глубине коллективной травмы, которая оставила свой отпечаток в психике людей. Три клинических случая, представленные в статье, раскрывают глубокие отношения между культурными комплексами и коллективными травмами с одной стороны, и индивидуальными комплексами и травмами с другой. Моя психотерапевтическая практика показывает, что осознание клиентами их истории и культуры приближает их к смыслу и источнику страданий, что в свою очередь помогает найти путь индивидуации и избежать повторного проживания травмы их предков.
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The paper's central focus is on the usefulness or not of taking established and well-tried and tested models of training into cultures with different social, political and clinical attitudes. Beginning with the author's description of necessary changes introduced to ensure the revival of her own institute, the Society of Analytical Psychology, the author goes on to explore issues relevant to different aspects of training in countries where the IAAP runs its own training, known as the 'Router Programmes'. Here, analysts, teachers and supervisors visiting other cultures to offer their expertise may experience clashes in their views about the nature of the analytic attitude, not only with those they train but also amongst themselves.
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L’articolo si focalizza sull’utilità o meno dell’importare modelli di formazione consolidati e testati all’interno di culture con diverse attitudini sociali, politiche e cliniche. Iniziando con la descrizione dell’Autrice dei necessari cambiamenti introdotti per garantire il rilancio del proprio istituto, la Società di Psicologia Analitica (SAP), l’Autrice prosegue esplorando temi relativi a diversi aspetti della formazione in Paesi dove la IAAP svolge la propria formazione, conosciuta come il Programma dei Routers. Qui, analisti, insegnanti e supervisori in visita ad altre culture per offrire la loro competenza, potrebbero avvertire conflitti nelle loro visioni sulla natura dell’attitudine analitica, non solo nei confronti di chi educano, ma anche tra loro stessi.
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The paper's central focus is on the usefulness or not of taking established and well-tried and tested models of training into cultures with different social, political and clinical attitudes. Beginning with the author's description of necessary changes introduced to ensure the revival of her own institute, the Society of Analytical Psychology, the author goes on to explore issues relevant to different aspects of training in countries where the IAAP runs its own training, known as the 'Router Programmes'. Here, analysts, teachers and supervisors visiting other cultures to offer their expertise may experience clashes in their views about the nature of the analytic attitude, not only with those they train but also amongst themselves.
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文章的核心关注点是:对不同社会、政治、临床态度的文化中输入训练时的获益之处, 或者说关注的是如何在输入训练时不去用已经建构好的, 被反复实践试验的训练模型。作者先描述了那些为了让她的机构 (即分析心理学学会)可以保有新生力而作出的必要改变, 然后探索了IAAP在多个国家独立运行的训练, 即“行者项目”, 多方面的相关问题。这个项目中, 当分析师、教师、督导到访其它国家, 并提供他们的专业时, 可能会经历到与他们分析性态度不一致的冲突, 这些冲突不仅仅来自于他们所训练的人, 也来自他们自己内在。.
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The paper's central focus is on the usefulness or not of taking established and well-tried and tested models of training into cultures with different social, political and clinical attitudes. Beginning with the author's description of necessary changes introduced to ensure the revival of her own institute, the Society of Analytical Psychology, the author goes on to explore issues relevant to different aspects of training in countries where the IAAP runs its own training, known as the 'Router Programmes'. Here, analysts, teachers and supervisors visiting other cultures to offer their expertise may experience clashes in their views about the nature of the analytic attitude, not only with those they train but also amongst themselves.
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L’accent central de cet article est la question de savoir s’il est heureux ou non d’importer des modèles de formation établis et qui ont fait leurs preuves dans des cultures qui ont des attitudes cliniques, sociales et politiques différentes. Commençant par la description par l’auteur de changements nécessaires introduits pour assurer le renouveau de son propre institut, la Society of Analytical Psychology, l’auteur poursuit en explorant des questions concernant différents aspects de la formation dans des pays ou l’AIPA fournit sa propre formation, que l’on appelle le Programme Router. Ici, les analystes, enseignants et superviseurs qui sont en visite dans les autres cultures pour apporter leur expertise peuvent faire l’expérience de conflits dans leurs perspectives sur la nature de l’attitude analytique, non seulement avec ceux qu’ils forment mais entre formateurs.
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The paper's central focus is on the usefulness or not of taking established and well-tried and tested models of training into cultures with different social, political and clinical attitudes. Beginning with the author's description of necessary changes introduced to ensure the revival of her own institute, the Society of Analytical Psychology, the author goes on to explore issues relevant to different aspects of training in countries where the IAAP runs its own training, known as the 'Router Programmes'. Here, analysts, teachers and supervisors visiting other cultures to offer their expertise may experience clashes in their views about the nature of the analytic attitude, not only with those they train but also amongst themselves.
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Das Hauptaugenmerk des Beitrages gilt der Zweckmäßigkeit oder Nichtzweckmäßigkeit etablierter und bewährter Ausbildungsmodelle in Kulturen mit unterschiedlichen sozialen, politischen und klinischen Einstellungen. Beginnend mit den Schilderung der notwendigen Veränderungen, die getroffen wurden, um die Wiederbelebung ihres eigenen Institutes, der Society of Analytical Psychology, zu bewirken, untersucht die Autorin anschließend Fragen, die für verschiedene Aspekte der Ausbildung in Ländern relevant sind, in denen die IAAP ihre eigene Ausbildung durchführt, bekannt als das sogenannte 'Router-Programme'. Hier besuchen Analytiker, Lehrer und Supervisoren andere Kulturen, um ihr Fachwissen zur Verfügung zu stellen und erleben dabei Zusammenstöße ihrer Ansichten über die Art der analytischen Haltung nicht nur mit denen jener, die sie ausbilden, sondern auch untereinander.
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pair_31418836
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The paper's central focus is on the usefulness or not of taking established and well-tried and tested models of training into cultures with different social, political and clinical attitudes. Beginning with the author's description of necessary changes introduced to ensure the revival of her own institute, the Society of Analytical Psychology, the author goes on to explore issues relevant to different aspects of training in countries where the IAAP runs its own training, known as the 'Router Programmes'. Here, analysts, teachers and supervisors visiting other cultures to offer their expertise may experience clashes in their views about the nature of the analytic attitude, not only with those they train but also amongst themselves.
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El foco central del artículo es sobre la utilidad o no, de llevar modelos de formación establecidos, y bien probados y testeados, a culturas con diferentes actitudes sociales, políticas y clínicas. Comenzando con la descripción de los cambios necesarios introducidos para asegurar la renovación de su propio instituto, la Sociedad de Psicología Analítica, la autora continúa explorando cuestiones relevantes a aspectos diferentes de la formación en países donde la IAAP conduce su propia formación, conocida como “Programas de Routers”. Aquí, analistas, docentes y supervisores que visitan otras culturas para ofrecer su experticia pueden experimentar confrontaciones con sus perspectivas sobre la naturaleza de la actitud analítica, no solamente con aquellos a quienes forman, sino también entre sí mismos.
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The paper's central focus is on the usefulness or not of taking established and well-tried and tested models of training into cultures with different social, political and clinical attitudes. Beginning with the author's description of necessary changes introduced to ensure the revival of her own institute, the Society of Analytical Psychology, the author goes on to explore issues relevant to different aspects of training in countries where the IAAP runs its own training, known as the 'Router Programmes'. Here, analysts, teachers and supervisors visiting other cultures to offer their expertise may experience clashes in their views about the nature of the analytic attitude, not only with those they train but also amongst themselves.
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Внимание статьи обращено на полезность (или бесполезность) использования существующих хорошо апробированных тренинговых моделей в культурах с иными социальными, политическими и клиническими установками. Автор начинает с описания необходимых изменений, которые были внесены и оживили ее собственный институт the Society of Analytical Psychology. Затем она исследует вопросы, относящиеся к разным аспектам тренинга в странах, IAAP проводит свои обучающие «Рутерские Программы». Аналитики, преподаватели, супервизоры, приезжающие в другую культуру, чтобы предложить свою экспертизу, могут переживать столкновения своих взглядов на природу аналитической установки не только с убеждениями тех, кого они обучают, но и с коллегами по программе.
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pair_31418843
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In this paper, the Bluebeard story is used to highlight mechanisms underlying an individual analytic case and some cultural phenomena from a Jungian perspective. I describe a patient whose psyche was dissociated into a tormenting monstrous figure and a regressed childish self, which Kalsched explains as activation of the archetypal defence system. As her analyst, I had to survive attacks of the patient's persecuting inner object, which she related to Bluebeard as a representation of relentless murderousness. At the cultural level, Bluebeard pertains to the concept of the totalitarian object (Sebek 1996) and to the pole of grandiosity of the Russian cultural complex.
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In questo articolo, la storia di Barbablù è utilizzata per evidenziare meccanismi sottostanti un caso analitico e alcuni fenomeni culturali da una prospettiva junghiana. Descrivo una paziente la cui psiche era dissociata in una figura mostruosa e crudele ed in un sé infantile regredito, che Kalsched descrive come attivazione del sistema di difesa archetipico. Come suo analista, ho dovuto superare attacchi da parte dell’oggetto interno persecutorio della paziente, da lei collegato a Barbablù come rappresentazione di una implacabile furia omicida. A livello culturale, Barbablù riguarda il concetto dell’oggetto totalitario (Sebek 1996) ed è il polo di grandiosità del complesso culturale russo.
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In this paper, the Bluebeard story is used to highlight mechanisms underlying an individual analytic case and some cultural phenomena from a Jungian perspective. I describe a patient whose psyche was dissociated into a tormenting monstrous figure and a regressed childish self, which Kalsched explains as activation of the archetypal defence system. As her analyst, I had to survive attacks of the patient's persecuting inner object, which she related to Bluebeard as a representation of relentless murderousness. At the cultural level, Bluebeard pertains to the concept of the totalitarian object (Sebek 1996) and to the pole of grandiosity of the Russian cultural complex.
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lexi-ml/wmt_22_dataset_en_it
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文中用蓝胡子的故事来强调在一个个体分析案例中发生的基本的心理机制, 以及从荣格学派的角度强调了一些文化现象。作者描述了一个病人, 其心灵分裂为一个折磨人的可怕人物和一个退行的孩子气的自我, 即卡尔斯切德所说的被激活的原型防御系统。作为她的分析师, 我必须要受得住这位病人迫害性的内在客体的攻击, 她把这个客体与蓝胡子联系起来, 代表了残酷的谋杀性。在文化层面, 蓝胡子属于极权主义客体的概念 (Sebek 1996), 是俄罗斯文化情结中自大狂的极点。.
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zh-cn
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pair_31418843
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In this paper, the Bluebeard story is used to highlight mechanisms underlying an individual analytic case and some cultural phenomena from a Jungian perspective. I describe a patient whose psyche was dissociated into a tormenting monstrous figure and a regressed childish self, which Kalsched explains as activation of the archetypal defence system. As her analyst, I had to survive attacks of the patient's persecuting inner object, which she related to Bluebeard as a representation of relentless murderousness. At the cultural level, Bluebeard pertains to the concept of the totalitarian object (Sebek 1996) and to the pole of grandiosity of the Russian cultural complex.
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lexi-ml/wmt_22_dataset_en_it
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Dans cet article, l’histoire de Barbe Bleue est utilisée afin de souligner les mécanismes à l’œuvre dans un cas analytique et quelques phénomènes culturels à partir d’une perspective Jungienne. Je décris un patient dont la psyché a été dissociée en un personnage monstrueux et torturant, et en un soi infantile régressé, ce que Kalsched explique en tant que l’activation du système défensif archétypal. En tant que son analyste, j’eus à survivre les attaques de l’objet intérieur persécuteur du patient, qu’elle rapprochait de Barbe Bleue en tant que représentation d’une envie de tuer irrépressible. Au niveau culturel, Barbe Bleue se rapporte au concept d’objet totalitaire (Sebek 1996) et au pôle grandiose dans le complexe culturel russe.
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fr
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pair_31418843
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In this paper, the Bluebeard story is used to highlight mechanisms underlying an individual analytic case and some cultural phenomena from a Jungian perspective. I describe a patient whose psyche was dissociated into a tormenting monstrous figure and a regressed childish self, which Kalsched explains as activation of the archetypal defence system. As her analyst, I had to survive attacks of the patient's persecuting inner object, which she related to Bluebeard as a representation of relentless murderousness. At the cultural level, Bluebeard pertains to the concept of the totalitarian object (Sebek 1996) and to the pole of grandiosity of the Russian cultural complex.
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lexi-ml/wmt_22_dataset_en_it
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In diesem Aufsatz wird aus einer Jungianischen Perspektive die Blaubartgeschichte dazu verwendet, Mechanismen aufzuzeigen, die einem individuellen analytischen Fall wie auch einigen kulturellen Phänomenen zugrunde liegen. Ich beschreibe einen Patienten, dessen Psyche in eine quälende monströse Gestalt und ein regrediertes kindliches Selbst zerlegt war, was Kalsched mit einer Aktivierung des archetypischen Abwehrsystems erklärt. Als ihr Analytiker mußte ich Angriffe des verfolgenden inneren Objektes der Patientin überleben, welches sie mit Blaubart als Repräsentanten unerbittlicher Mordlust in Verbindung brachte. Auf kultureller Ebene steht Blaubart in Verbindung mit dem Konzept des totalitären Objektes (Sebek 1996) und dem Pol der Grandiosität des russischen kulturellen Komplexes.
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de
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pair_31418843
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In this paper, the Bluebeard story is used to highlight mechanisms underlying an individual analytic case and some cultural phenomena from a Jungian perspective. I describe a patient whose psyche was dissociated into a tormenting monstrous figure and a regressed childish self, which Kalsched explains as activation of the archetypal defence system. As her analyst, I had to survive attacks of the patient's persecuting inner object, which she related to Bluebeard as a representation of relentless murderousness. At the cultural level, Bluebeard pertains to the concept of the totalitarian object (Sebek 1996) and to the pole of grandiosity of the Russian cultural complex.
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lexi-ml/wmt_22_dataset_en_it
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train
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En el presente trabajo, la historia de Barba Azul es utilizada para esclarecer los mecanismos que subyacen a un caso analítico individual, y ciertos fenómenos culturales desde una perspectiva Junguiana. Describo a un paciente cuya psique fue disociada entre una figura monstruosa y atormentadora, y un self infantil regresivo, lo cual Kalsched ha explicado como la activación del sistema arquetipal de defensa. Como su analista, he tenido que sobrevivir a los ataques de un objeto interno persecutorio de la paciente, el cual ella relacionó con Barba Azul como representación de un incesante impulso homicida. A nivel cultural, Barba Azul pertenece al concepto de objeto totalitario (Sebek 1996) y al polo de grandiosidad del complejo cultural Ruso.
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es
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pair_31418843
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In this paper, the Bluebeard story is used to highlight mechanisms underlying an individual analytic case and some cultural phenomena from a Jungian perspective. I describe a patient whose psyche was dissociated into a tormenting monstrous figure and a regressed childish self, which Kalsched explains as activation of the archetypal defence system. As her analyst, I had to survive attacks of the patient's persecuting inner object, which she related to Bluebeard as a representation of relentless murderousness. At the cultural level, Bluebeard pertains to the concept of the totalitarian object (Sebek 1996) and to the pole of grandiosity of the Russian cultural complex.
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lexi-ml/wmt_22_dataset_en_it
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В данной статье история Синей Бороды использована для того, чтобы осветить с юнгианской точки зрения механизмы, лежащие в основе индивидуального аналитического случая и некоторых культурных феноменов. Я описываю пациентку, чья психика раскололась на мучающего монстра и регрессировавшее детское я. Калшед объясняет подобный процесс как активацию архетипической системы защит. Будучи ее аналитиком, я должен был выжить под атаками преследующего внутреннего объекта пациентки, которого она называла Синей Бородой - репрезентацией неуемной жажды убивать. На культурном уровне Синюю Бороду можно соотнести с понятием тоталитарного объекта (Sebek 1996) и с полюсом грандиозности в русском культурном комплексе.
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ru
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pair_31418844
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This paper outlines the difference between healthy and unhealthy forms of dissociation following, and in response to, traumatic experience, in particular the experience of refugees, calling on 30 years' experience in working with refugees in voluntary and public sectors, including 20 years at the Refugee Therapy Centre, London. It differentiates dissociation from repression, and looks at some of the specific traumatic experiences associated with refugees' displacement and situation, particularly relating to loss. Four key characteristics of resilience are described: 'psychic space', 'sense of self', and the use of a 'listening other' and 'healthy dissociation/resiliency'. Two vignettes are given to illustrate the difference between healthy and unhealthy dissociation.
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train
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Questo articolo delinea la differenza tra forme di dissociazione sane e malate a seguito, ed in risposta, a l’esperienza traumatica, in particolare l’esperienza dei rifugiati, facendo riferimento a 30 anni di esperienza di lavoro con essi, sia nel settore pubblico che nel volontariato, compresi 20 anni presso il Refugee Therapy Centre di Londra. In questo articolo si differenzia la dissociazione dalla repressione, e si guarda ad alcune specifiche esperienze traumatiche associate al dislocamento dei rifugiati ed alla loro situazione, in particolare in relazione alla perdita. Le quattro caratteristiche chiave della resilienza sono descritte come: ‘spazio psichico’, ‘senso di sé’, l’utilizzo di un ‘altro che ascolta’ ed una ‘sana dissociazione/resilienza’. Vengono presentate due vignette per illustrare questa differenza tra dissociazione sana e dissociazione malata.
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pair_31418844
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This paper outlines the difference between healthy and unhealthy forms of dissociation following, and in response to, traumatic experience, in particular the experience of refugees, calling on 30 years' experience in working with refugees in voluntary and public sectors, including 20 years at the Refugee Therapy Centre, London. It differentiates dissociation from repression, and looks at some of the specific traumatic experiences associated with refugees' displacement and situation, particularly relating to loss. Four key characteristics of resilience are described: 'psychic space', 'sense of self', and the use of a 'listening other' and 'healthy dissociation/resiliency'. Two vignettes are given to illustrate the difference between healthy and unhealthy dissociation.
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lexi-ml/wmt_22_dataset_en_it
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这篇文章结合了作者30年间作为志愿者和公共机关工作者与难民工作的经验, 以及20年来在伦敦难民治疗中心的经验, 来概述健康与不健康的隔离间的差别, 及其与创伤的关系, 文章特别关注了难民的经验。文章把隔离与压抑做了区分, 分析了难民的移置和其特别处境相关的创伤经验, 特别是与他们的丧失有关的经验。文章描述了四种关键的弹性特征:“心理空间”, “自我感”, 对“倾听的他人”的使用, “健康的隔离/弹性”。文章插叙了两个片段用来区分健康与不健康的隔离。.
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zh-cn
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pair_31418844
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This paper outlines the difference between healthy and unhealthy forms of dissociation following, and in response to, traumatic experience, in particular the experience of refugees, calling on 30 years' experience in working with refugees in voluntary and public sectors, including 20 years at the Refugee Therapy Centre, London. It differentiates dissociation from repression, and looks at some of the specific traumatic experiences associated with refugees' displacement and situation, particularly relating to loss. Four key characteristics of resilience are described: 'psychic space', 'sense of self', and the use of a 'listening other' and 'healthy dissociation/resiliency'. Two vignettes are given to illustrate the difference between healthy and unhealthy dissociation.
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lexi-ml/wmt_22_dataset_en_it
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train
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Cet article souligne la différence entre des formes saines et des formes pathologiques de dissociation, qui surviennent à la suite d’expériences traumatiques et en réponse à ces expériences. L’article s’appuie en particulier sur l’expérience de réfugiés ainsi que l’expérience de trente années de travail de l’auteur auprès de réfugiés dans le secteur public et privé, dont vingt années au Refugee Therapy Centre à Londres. L’article fait la différence entre dissociation et refoulement, et étudie les expériences traumatiques spécifiques des réfugiés, concernant le déplacement et le statut, et particulièrement l’expérience de la perte. Quatre caractéristiques de la résilience sont décrites: « l’espace psychique », « le sentiment de soi », l’accès à « quelqu’un qui écoute » et la « dissociation saine/la résilience ». Deux vignettes cliniques sont données pour illustrer cette différence entre dissociation saine et dissociation pathologique.
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fr
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pair_31418844
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This paper outlines the difference between healthy and unhealthy forms of dissociation following, and in response to, traumatic experience, in particular the experience of refugees, calling on 30 years' experience in working with refugees in voluntary and public sectors, including 20 years at the Refugee Therapy Centre, London. It differentiates dissociation from repression, and looks at some of the specific traumatic experiences associated with refugees' displacement and situation, particularly relating to loss. Four key characteristics of resilience are described: 'psychic space', 'sense of self', and the use of a 'listening other' and 'healthy dissociation/resiliency'. Two vignettes are given to illustrate the difference between healthy and unhealthy dissociation.
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lexi-ml/wmt_22_dataset_en_it
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In diesem Beitrag wird der Unterschied zwischen gesunden und ungesunden Formen der Dissoziation nach und als Reaktion auf traumatische Erfahrungen, insbesondere die Erfahrungen von Flüchtlingen, skizziert. Dabei wird auf 30 Jahre Erfahrung in der Arbeit mit Flüchtlingen im freiwilligen und öffentlichen Sektor zurückgegriffen, darunter 20 Jahre im EU Flüchtlingstherapiezentrum London. Es wird zwischen Dissoziation und Unterdrückung unterschieden und der Blick auf einige der spezifischen traumatischen Erfahrungen gerichtet, die mit der Vertreibung und der allgemeinen Lage von Flüchtlingen verbunden sind, insbesondere hinsichtlich Verlust. Es werden vier Schlüsselmerkmale der Resilienz beschrieben: ‘psychischer Raum', ‘Selbstgefühl' und die Bedeutung eines ‘zuhörenden Anderen' sowie ‘gesunde Dissoziation/Resilienz'. Zwei Vignetten veranschaulichen den Unterschied zwischen gesunder und ungesunder Dissoziation.
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de
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pair_31418844
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This paper outlines the difference between healthy and unhealthy forms of dissociation following, and in response to, traumatic experience, in particular the experience of refugees, calling on 30 years' experience in working with refugees in voluntary and public sectors, including 20 years at the Refugee Therapy Centre, London. It differentiates dissociation from repression, and looks at some of the specific traumatic experiences associated with refugees' displacement and situation, particularly relating to loss. Four key characteristics of resilience are described: 'psychic space', 'sense of self', and the use of a 'listening other' and 'healthy dissociation/resiliency'. Two vignettes are given to illustrate the difference between healthy and unhealthy dissociation.
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lexi-ml/wmt_22_dataset_en_it
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train
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El presente trabajo da cuenta de la diferencia entre formas saludables y no saludables de disociación, en respuesta a experiencias traumáticas, en particular, la experiencia de los refugiados; a partir de 30 años de experiencia trabajando con refugiados en sectores públicos y privados, incluyendo 20 años en el Centro de Terapia para Refugiados, en Londres. Se diferencia la disociación de la represión, y se atiende a las experiencias traumáticas específicas asociadas a los desplazamientos de los refugiados, y a la situación particular relacionada con la pérdida. Se describen cuatro características de la resiliencia: ‘espacio psíquico’, ‘sentido del sí mismo’, ‘y el uso de ‘otro que escucha’ y ‘sana disociación/resiliencia’. Se presentan dos viñetas para ilustrar la diferencia entre la disociación saludable y no saludable.
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es
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pair_31418844
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This paper outlines the difference between healthy and unhealthy forms of dissociation following, and in response to, traumatic experience, in particular the experience of refugees, calling on 30 years' experience in working with refugees in voluntary and public sectors, including 20 years at the Refugee Therapy Centre, London. It differentiates dissociation from repression, and looks at some of the specific traumatic experiences associated with refugees' displacement and situation, particularly relating to loss. Four key characteristics of resilience are described: 'psychic space', 'sense of self', and the use of a 'listening other' and 'healthy dissociation/resiliency'. Two vignettes are given to illustrate the difference between healthy and unhealthy dissociation.
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lexi-ml/wmt_22_dataset_en_it
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train
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В статье описаны различия между здоровыми и нездоровыми формами диссоциации как ответной реакции на травматический опыт. Особое внимание уделено опыту беженцев, так как автор проработала 30 лет в добровольческих и общественных организациях помощи беженцам, в том числе в Терапевтическом Центре для беженцев в Лондоне. Проводится различие между диссоциацией и вытеснением, а также исследуются травматические переживания беженцев, связанные с перемещением и утратой. Описаны 4 главные характеристики устойчивости: «психическое пространство», «чувство я», использование «слушающего другого» и «здоровая диссоциация/устойчивость». Две виньетки иллюстрируют различия между здоровой и нездоровой диссоциацией.
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ru
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pair_31418846
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Beginning with the story of Bluebeard, the author considers how traumatic overwhelm can occur in everyday childhood situations of a psychically murderous quality; for example, a nanny's totalitarian regime may be invisible to parents ruled by collective social and cultural norms. A child who is remote from mother and idealises a father embodying a powerful patriarchal system may remain naïvely dependent in marriage and unable to cope with the realities of human aggression. The paper describes analytic work with a woman who had suffered repeated breakdowns and needed to relinquish a fragile, socially constructed identity in order to establish her own true orientation.
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lexi-ml/wmt_22_dataset_en_it
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Iniziando con la storia di Barbablù, l’autrice considera come una inondazione traumatica, con una qualità potenzialmente omicida, possa avvenire in situazioni quotidiane dell’infanzia; per esempio, il regime totalitario di una bambinaia può essere invisibile a genitori guidati da norme sociali e culturali. Un bambino distante dalla madre e che idealizza un padre che incarna un potente sistema patriarcale, può rimanere ingenuamente dipendente nel matrimonio e incapace di affrontare le realtà dell’aggressività umana. L’articolo descrive il lavoro analitico con una donna, che aveva sofferto ripetuti crolli ed aveva bisogno di rinunciare ad una identità fragile, costruita per la società, al fine di definire il proprio vero orientamento.
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pair_31418846
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Beginning with the story of Bluebeard, the author considers how traumatic overwhelm can occur in everyday childhood situations of a psychically murderous quality; for example, a nanny's totalitarian regime may be invisible to parents ruled by collective social and cultural norms. A child who is remote from mother and idealises a father embodying a powerful patriarchal system may remain naïvely dependent in marriage and unable to cope with the realities of human aggression. The paper describes analytic work with a woman who had suffered repeated breakdowns and needed to relinquish a fragile, socially constructed identity in order to establish her own true orientation.
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lexi-ml/wmt_22_dataset_en_it
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文章以蓝胡子的故事作为开始, 作者讨论了创伤性的压制可以出现在童年日常情境中, 表现为心理谋杀的特性。比如, 在集体社会和文化规范统治之下的父母可能看不出保姆所持有的极权主义状态。远离母亲并把父亲理想化的孩子, 体现了一个有力的父权体系, 它会维持对婚姻天真的依赖, 无法应对人类攻击性的事实。文章描述了和一位女性的分析性工作, 她重复性地经历了崩溃的状态, 她需要放弃一个脆弱的、被社会建构的身份, 以便于建构她自己的真实取向。.
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zh-cn
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pair_31418846
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Beginning with the story of Bluebeard, the author considers how traumatic overwhelm can occur in everyday childhood situations of a psychically murderous quality; for example, a nanny's totalitarian regime may be invisible to parents ruled by collective social and cultural norms. A child who is remote from mother and idealises a father embodying a powerful patriarchal system may remain naïvely dependent in marriage and unable to cope with the realities of human aggression. The paper describes analytic work with a woman who had suffered repeated breakdowns and needed to relinquish a fragile, socially constructed identity in order to establish her own true orientation.
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lexi-ml/wmt_22_dataset_en_it
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Prenant pour point de départ l’histoire de Barbe Bleue, l’auteur examine comment le débordement traumatique peut se produire dans l’enfance dans des situations de tous les jours qui ont une qualité psychique meurtrière. Par exemple, le régime totalitaire d’une assistante maternelle (nourrice) peut être invisible aux yeux de parents régis par des normes collectives sociales et culturelles. Un enfant émotionnellement à distance de sa mère et qui idéalise un père incarnant un système patriarcal puissant peut rester dépendant d’une manière naïve étant marié et incapable de se débrouiller de la réalité de l’agressivité humaine. L’article décrit le travail analytique avec une femme qui a vécu des dépressions à répétition et qui devait renoncer à une identité fragile, construite selon des normes sociales, afin d’établir son orientation personnelle authentique.
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fr
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pair_31418846
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Beginning with the story of Bluebeard, the author considers how traumatic overwhelm can occur in everyday childhood situations of a psychically murderous quality; for example, a nanny's totalitarian regime may be invisible to parents ruled by collective social and cultural norms. A child who is remote from mother and idealises a father embodying a powerful patriarchal system may remain naïvely dependent in marriage and unable to cope with the realities of human aggression. The paper describes analytic work with a woman who had suffered repeated breakdowns and needed to relinquish a fragile, socially constructed identity in order to establish her own true orientation.
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lexi-ml/wmt_22_dataset_en_it
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Ausgehend von der Geschichte von Blaubart betrachtet die Autorin, wie traumatische Überwältigungen von psychisch mörderischer Qualität in alltäglichen Situationen der Kindheit auftreten können. Zum Beispiel mag das totalitaristische Regime einer Kinderfrau für Eltern unsichtbar sein, die ihrerseits von kollektiven sozialen und kulturellen Normen bestimmt sind. Ein Kind, das fern der Mutter ist und einen Vater idealisiert, der ein mächtiges patriarchales System verkörpert, kann in der Ehe naiv abhängig bleiben und unfähig sein, mit den Realitäten menschlicher Aggression fertig zu werden. Der Aufsatz beschreibt die analytische Arbeit mit einer Frau, die wiederholt Zusammenbrüche erlitten hatte und eine fragile, sozial konstruierte Identität aufgeben mußte, um ihre eigene wahre Orientierung zu finden.
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de
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pair_31418846
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Beginning with the story of Bluebeard, the author considers how traumatic overwhelm can occur in everyday childhood situations of a psychically murderous quality; for example, a nanny's totalitarian regime may be invisible to parents ruled by collective social and cultural norms. A child who is remote from mother and idealises a father embodying a powerful patriarchal system may remain naïvely dependent in marriage and unable to cope with the realities of human aggression. The paper describes analytic work with a woman who had suffered repeated breakdowns and needed to relinquish a fragile, socially constructed identity in order to establish her own true orientation.
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en
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lexi-ml/wmt_22_dataset_en_it
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train
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text
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Comenzando con la historia de Barba Azul, la autora considera cómo una devastación traumática puede ocurrir en situaciones cotidianas de infancias con cualidades de asesinato psíquico; por ejemplo, el régimen totalitario de una abuelita puede resultar invisible a los padres regulados por normas colectivas sociales y culturales. Un niño controlado por la madre y que idealiza a un padre que representa un sistema profundamente patriarcal, puede permanecer ingenuamente dependiente del matrimonio e incapaz de hacerle frente a las realidades de la agresión humana. El artículo describe el trabajo analítico con una mujer que sufrió repetidas crisis y necesitó renunciar a una frágil identidad, socialmente construida para poder establecer su propia y verdadera orientación.
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es
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pair_31418846
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Beginning with the story of Bluebeard, the author considers how traumatic overwhelm can occur in everyday childhood situations of a psychically murderous quality; for example, a nanny's totalitarian regime may be invisible to parents ruled by collective social and cultural norms. A child who is remote from mother and idealises a father embodying a powerful patriarchal system may remain naïvely dependent in marriage and unable to cope with the realities of human aggression. The paper describes analytic work with a woman who had suffered repeated breakdowns and needed to relinquish a fragile, socially constructed identity in order to establish her own true orientation.
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en
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lexi-ml/wmt_22_dataset_en_it
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Начиная со сказки про Синюю Бороду, автор рассматривает, как травматическая охваченность убийственного для психики качества может случиться в повседневной жизни ребенка. Например, тоталитарный режим, введенный няней и невидимый для родителей. Ребенок, который удален от матери и идеализирует отца - носителя мощной патриархальной системы, может оставаться наивно зависимым в браке и не уметь справляться с человеческой агрессией. В статье описана аналитическая работа с женщиной, которая страдала от повторяющихся эмоциональных срывов. Ей было необходимо отказаться от хрупкой, социально сконструированной идентичности, чтобы установить свои подлинные ориентиры.
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ru
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pair_31418848
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The research into the phenomenon of cultural trauma is growing as the effects of historical transformations are recognized and analysed. The concept of cultural trauma and the analytic concept of the cultural complex is a suitable theoretical approach for this research. The Lithuanian experience of cultural trauma after the historical shifts indicates the importance of the interplay between societal and individual factors in coping with trauma. Academic psychotraumatological studies carried out at Vilnius University indicate a stronger traumatic experience by people who are survivors of direct political repression and even intergenerational transmission of trauma, but this group also seems to demonstrate an intergenerational transmission of resilience. Paradoxically, from a long-term perspective, the victims of direct repression seem to have suffered less than the people who accommodated to the regime, and this applies also to their offspring. Analysis in terms of overcoming cultural trauma indicates that society is gradually integrating historic traumatic experiences, although a healthy cultural identity has not yet been restored.
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en
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lexi-ml/wmt_22_dataset_en_it
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train
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text
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La ricerca sul fenomeno del trauma culturale cresce man mano che gli effetti delle trasformazioni storiche vengono riconosciuti ed analizzati. Il concetto di trauma culturale ed il concetto analitico del complesso culturale sono degli adeguati approcci teorici per questa ricerca. L’esperienza lituana del trauma culturale dopo i cambiamenti storici indica l’importanza dell’interazione tra fattori sociali ed individuali nell’affrontare il trauma. Studi accademici di psicotraumatologia condotti all’Università di Vilnius indicano un’esperienza traumatica maggiore nelle persone che sono sopravvissute a dirette repressioni politiche ed addirittura trasmissioni intergenerazionali del trauma, ma questo gruppo sembra dimostrare anche trasmissioni intergenerazionali della resilienza. Paradossalmente, da una prospettiva a lungo termine, le vittime di repressioni dirette sembrano aver sofferto meno delle persone che si sono adattate al regime, e questo vale anche per i loro discendenti. L’analisi in termini di superamento del trauma culturale indica che la società sta gradualmente integrando esperienze traumatiche della storia, nonostante non sia stata ancora ripristinata una sana identità culturale.
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it
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pair_31418848
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The research into the phenomenon of cultural trauma is growing as the effects of historical transformations are recognized and analysed. The concept of cultural trauma and the analytic concept of the cultural complex is a suitable theoretical approach for this research. The Lithuanian experience of cultural trauma after the historical shifts indicates the importance of the interplay between societal and individual factors in coping with trauma. Academic psychotraumatological studies carried out at Vilnius University indicate a stronger traumatic experience by people who are survivors of direct political repression and even intergenerational transmission of trauma, but this group also seems to demonstrate an intergenerational transmission of resilience. Paradoxically, from a long-term perspective, the victims of direct repression seem to have suffered less than the people who accommodated to the regime, and this applies also to their offspring. Analysis in terms of overcoming cultural trauma indicates that society is gradually integrating historic traumatic experiences, although a healthy cultural identity has not yet been restored.
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en
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lexi-ml/wmt_22_dataset_en_it
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train
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text
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随着人们越多地对历史性转变效应的觉察和分析, 关于文化创伤现象的研究也越发增多。文化创伤的概念 和分析心理学关于文化情结的概念 是适合于这类研究的理论取向。立陶宛在历史性转变之后所经历的文化创伤, 呈现了在应付创伤时, 社会与个体因素相互作用的重要性。在维尔纽斯大学进行的关于心理创伤的学术研究显示, 经历过直接的政治性压迫的幸存者, 具有更强的创伤经验, 甚至会把创伤进行隔代的传递, 但这个群体似乎也在隔代之间传递了弹性。矛盾的是, 从长期的角度看, 受到直接压迫的受害者似乎比那些适应了这个制度的人更少地感受到痛苦, 对于他们的后代来说也是如此。关于文化创伤的克服的分析显示, 社会在逐步整合历史性的创伤经验, 尽管一个健康的文化身份尚未恢复。.
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zh-cn
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pair_31418848
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The research into the phenomenon of cultural trauma is growing as the effects of historical transformations are recognized and analysed. The concept of cultural trauma and the analytic concept of the cultural complex is a suitable theoretical approach for this research. The Lithuanian experience of cultural trauma after the historical shifts indicates the importance of the interplay between societal and individual factors in coping with trauma. Academic psychotraumatological studies carried out at Vilnius University indicate a stronger traumatic experience by people who are survivors of direct political repression and even intergenerational transmission of trauma, but this group also seems to demonstrate an intergenerational transmission of resilience. Paradoxically, from a long-term perspective, the victims of direct repression seem to have suffered less than the people who accommodated to the regime, and this applies also to their offspring. Analysis in terms of overcoming cultural trauma indicates that society is gradually integrating historic traumatic experiences, although a healthy cultural identity has not yet been restored.
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en
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lexi-ml/wmt_22_dataset_en_it
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train
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text
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La recherche sur le phénomène du traumatisme culturel se développe alors que les effets des transformations historiques sont reconnues et analysées. Le concept de traumatisme culturel et le concept analytique du complexe culturel donnent un cadre théorique utile pour ce domaine d’études. L’expérience lithuanienne de traumatisme culturel après les changements historiques montre l’importance de l’interaction entre les facteurs sociétaux et individuels pour se débrouiller du traumatisme. Des études en psychotraumatologie faites à l’université de Vilnius montrent une expérience traumatique plus forte chez les personnes qui ont survécu à une répression politique directe, et même une transmission intergénérationnelle du traumatisme. Mais ces chercheurs semblent aussi pouvoir montrer une transmission intergénérationnelle de la résilience. De manière paradoxale, sur le long terme, les victimes d’une répression directe semblent avoir moins souffert que les personnes qui se sont adaptées au régime, et ceci s’applique également à leurs descendants. L’analyse s’occupant de surmonter le traumatisme culturel montre que la société procède peu à peu à l’intégration des expériences historiques traumatiques, bien qu’une identité culturelle saine n’ait pas encore été restaurée.
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fr
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pair_31418848
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The research into the phenomenon of cultural trauma is growing as the effects of historical transformations are recognized and analysed. The concept of cultural trauma and the analytic concept of the cultural complex is a suitable theoretical approach for this research. The Lithuanian experience of cultural trauma after the historical shifts indicates the importance of the interplay between societal and individual factors in coping with trauma. Academic psychotraumatological studies carried out at Vilnius University indicate a stronger traumatic experience by people who are survivors of direct political repression and even intergenerational transmission of trauma, but this group also seems to demonstrate an intergenerational transmission of resilience. Paradoxically, from a long-term perspective, the victims of direct repression seem to have suffered less than the people who accommodated to the regime, and this applies also to their offspring. Analysis in terms of overcoming cultural trauma indicates that society is gradually integrating historic traumatic experiences, although a healthy cultural identity has not yet been restored.
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en
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lexi-ml/wmt_22_dataset_en_it
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train
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text
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Die Erforschung des Phänomens des kulturellen Traumas nimmt zu, je mehr die Auswirkungen historischer Veränderungen sichtbar und analysiert werden. Das Konzept des Kulturtraumas und das analytische Konzept des Kulturellen Komplexes bilden geeignete theoretische Ansätze für diese Forschung. Die litauische Erfahrung des kulturellen Traumas nach den historischen Verschiebungen zeigt, wie wichtig das Zusammenspiel von gesellschaftlichen und individuellen Faktoren bei der Bewältigung von Traumata ist. Akademische psychotraumatologische Studien der Universität Vilnius weisen auf eine stärkere traumatische Erfahrung von Menschen hin, die Überlebende direkter politischer Unterdrückung sind und sehen bei diesen gleichzeitig eine intergenerationale Weitergabe von Traumata. Diese Gruppe scheint jedoch auch eine Weitergabe von Resilienz zwischen den Generationen aufzuweisen. Paradoxerweise scheinen die Opfer der direkten Repression auf lange Sicht weniger gelitten zu haben als die Menschen, die sich mit dem Regime arrangiert hatten und dies gilt auch für ihre Nachkommen. Analysen mit dem Ziel der Überwindung kultureller Traumata zeigen, daß die Gesellschaft nach und nach historische traumatische Erlebnisse integriert, wenngleich eine gesunde kulturelle Identität noch nicht wiederhergestellt ist.
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de
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pair_31418848
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The research into the phenomenon of cultural trauma is growing as the effects of historical transformations are recognized and analysed. The concept of cultural trauma and the analytic concept of the cultural complex is a suitable theoretical approach for this research. The Lithuanian experience of cultural trauma after the historical shifts indicates the importance of the interplay between societal and individual factors in coping with trauma. Academic psychotraumatological studies carried out at Vilnius University indicate a stronger traumatic experience by people who are survivors of direct political repression and even intergenerational transmission of trauma, but this group also seems to demonstrate an intergenerational transmission of resilience. Paradoxically, from a long-term perspective, the victims of direct repression seem to have suffered less than the people who accommodated to the regime, and this applies also to their offspring. Analysis in terms of overcoming cultural trauma indicates that society is gradually integrating historic traumatic experiences, although a healthy cultural identity has not yet been restored.
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en
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lexi-ml/wmt_22_dataset_en_it
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train
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text
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Mientras los efectos sobre las transformaciones históricas y sociales están siendo reconocidas y analizadas, la investigación sobre el fenómeno del trauma cultural está creciendo. El concepto de trauma cultural y el concepto analítico de complejo cultural es un abordaje teórico apropiado para dicha investigación. La experiencia Lituana de trauma cultural luego de los cambios históricos da cuenta de la importancia del inter-juego entre factores individuales y sociales para hacer frente al trauma. Estudios académicos psico-traumatológicos llevados a cabo e la Universidad de Vilnius indican la presencia de experiencias traumáticas más intensas en las personas sobrevivientes de una represión política directa, y también de la transmisión intergeneracional del trauma, pero este grupo, también pareciera demostrar la transmisión intergeneracional de resiliencia. Paradójicamente, desde una perspectiva a largo plazo, las víctimas de represión directa parecieran haber sufrido menos que quienes se acomodaron al régimen, y esto aplica también a los descendientes. El análisis, en términos de sobreponerse al trauma cultural indica que la sociedad está gradualmente integrando las experiencias traumáticas de la historia, aunque una identidad cultural saludable todavía no ha podido ser restaurada.
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es
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pair_31418848
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The research into the phenomenon of cultural trauma is growing as the effects of historical transformations are recognized and analysed. The concept of cultural trauma and the analytic concept of the cultural complex is a suitable theoretical approach for this research. The Lithuanian experience of cultural trauma after the historical shifts indicates the importance of the interplay between societal and individual factors in coping with trauma. Academic psychotraumatological studies carried out at Vilnius University indicate a stronger traumatic experience by people who are survivors of direct political repression and even intergenerational transmission of trauma, but this group also seems to demonstrate an intergenerational transmission of resilience. Paradoxically, from a long-term perspective, the victims of direct repression seem to have suffered less than the people who accommodated to the regime, and this applies also to their offspring. Analysis in terms of overcoming cultural trauma indicates that society is gradually integrating historic traumatic experiences, although a healthy cultural identity has not yet been restored.
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en
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lexi-ml/wmt_22_dataset_en_it
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train
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text
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Область исследований феномена культурной травмы растет по мере того, как распознаются и анализируются эффекты исторических перемен. Понятие культурной травмы и аналитическое понятие культурного комплекса - подходящие для этого исследования теоретические концепции. Литовский опыт культурной травмы исторических перемен показывает важность взаимодействия между общественными и индивидуальными копинговыми стратегиями. Академические психотравматологические исследования, проведенный в Университете Вильнюса, свидетельствуют о более сильном травматическом опыте у людей, переживших политические репрессии и межпоколенческую травму. Однако у этой же группы наблюдается межпоколонеческая передача устойчивости. Парадоксально, что с точки зрения долгосрочной перспективы жертвы репрессий пострадали меньше, чем люди, которые приспособились к режиму. Это верно и для их потомков. В терминах преодоления культурной травмы анализ показывает, что общество постепенно интегрирует исторический травматический опыт, однако здоровая культурная идентичность еще не восстановлена.
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ru
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pair_33746117
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This study is aimed at verifying the effect of specific management modalities aimed at reducing or preventing the incidence of infections in the blood flow in relation to the use of the central venous catheter (CRBSI = catheterrelated bloodstream infection) in patients undergoing chemotherapy. 36 patients (n = 36) with a peripherally inserted venous catheter (PICC) were enrolled in the integrated medical treatment group, while 128 patients with an internal central venous catheter were enrolled in the control group. The patients in the control group underwent routine nursing, while the patients in the treatment group underwent integrated surveillance control infection treatment by doctors and were compared between these two groups l incidence of complications, CRBSI. The incidence of complications of the CRBSI type was significantly lower in the whole treatment group than in the control group and the difference was statistically significant (p <0.05). It is concluded that the implementation of the infection control management modality within the integration of medical care for PICC chemotherapy patients in the Oncology Department can effectively reduce the incidence of infectious complications in the bloodstream, and improve the level of nursing care in peripheral venous catheterization (PICC) with improved patient satisfaction. Chemotherapy, Individualized management, Infection control management mode under medical care integration/Nursing, Peripherally inserted central catheter (PICC).
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en
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lexi-ml/wmt_22_dataset_en_it
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train
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text
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Questo studio è finalizzato a verificare l’effetto di specifiche modalità di gestione intese a ridurre o prevenire l’incidenza delle infezioni nel flusso ematico in relazione all’impiego del catetere venoso centrale (CRBSI = catheter-related bloodstream infection) nei pazienti sottoposti a chemioterapia. Sono stati arruolati nel gruppo di trattamento medico integrato 36 pazienti (n = 36) con un catetere venoso inserito perifericamente (PICC), mentre 128 pazienti con un catetere venoso centrale interno sono stati arruolati nel gruppo di controllo. I pazienti del gruppo di controllo sono stati sottoposti ad un intervento infermieristico di routine, mentre i pazienti nel gruppo di trattamento sono stati sottoposti ad un trattamento di controllo dell’infezione integrato da sorveglianza da parte dei medici ed è stata confrontata tra questi due gruppi l’incidenza di complicanze, CRBSI. Risultati: l’incidenza di complicanze del tipo CRBSI, è stata significativamente inferiore nel gruppo di trattamento integrao rispetto al gruppo di controllo e la differenza era statisticamente significativa (p <0,05). Si conclude che l’implementazione della modalità di gestione del controllo delle infezioni nell’ambito dell’integrazione delle cure mediche per i pazienti chemioterapici con PICC nel Dipartimento di Oncologia può ridurre efficacemente l’incidenza di complicanze infettive nel torrente ematico, e migliorare il livello di assistenza infermieristica nel cateterismo venoso periferico (PICC) con miglioramento della soddisfazione del paziente.
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it
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pair_33746119
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We aim to evaluate the prognostic significance of tumor volume in esophageal cancer. Patients who underwent curative resection due to esophageal cancer between the years 2015 and 2019 were included in the study. The Tumor Depth Parameter (TDP) was defined as mucosa and submucosa =1, muscularis propria =2, adventitia =3, and invasion into adjacent organs=4. The Tumor Volume Index (TVI) was defined as the major axis X the minor axis X TDP. Two groups were formed based on TVI: Group 1 (low TVI) and Group 2 (high TVI). In the groups; patients were compared in terms of demographic and clinical features, intraoperative and postoperative outcomes, characteristics of the tumor and average survival. The patients were divided into two groups based on the cut-off value of 4,000. Group 1 (low TVI) consisted of 16 patients and Group 2 (high TVI) consisted of 28 patients. Male sex ratio was higher in Group 2 (50% vs 85%, p:0.011) Tumor diameter was observed to be larger in Group 2 (3.06 vs 5.54, p:0.000). Adenocarcinoma histologic type was more common in Group 2 (25% vs 64.3%, p:0.012). Incidence of respiratory complications was higher in Group 2 (0% vs 35.7%, p:0.024),Survival time (months) was shorter in Group 2 (36 vs 11, p:0.005). TVI's being over 4000 (HR)(95%-Confidence Interval ((Cl) 0.057 (0.011-0.311),p:0.001) was an independent risk factor to determine the rate of survival. TVI can be used as a prognostic factor in patients with esophageal cancer who underwent surgical therapy. TVI is closely associated with tumor histology and postoperative outcomes. Esophageal cancer, Prognosis, Postoperative complication, Surgical manangment, Survey, Tumor volume.
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en
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lexi-ml/wmt_22_dataset_en_it
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train
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text
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Si è voluto valutare il significato prognostico del volume del tumore nel cancro esofageo. Per questo sono stati inclusi nello studio i pazienti sottoposti a resezione curativa di cancro esofageo nell’intervallo tra il 2015 e il 2019. Il Tumor Depth Parameter (TDP) è stato definito come mucosa e sottomucosa = 1, muscolare propria = 2, avventizia = 3 e invasione negli organi adiacenti = 4. Il Tumor Volume Index (TVI) è stato definito come l’asse maggiore X l’asse minore X TDP. Sono stati formati due gruppi sulla base del TVI: Gruppo 1 (TVI basso) e Gruppo 2 (TVI alto). Nei gruppi; i pazienti sono stati confrontati in termini di caratteristiche demografiche e cliniche, esiti intraoperatori e postoperatori, caratteristiche del tumore e sopravvivenza media. RISULTATI: I pazienti sono stati divisi in due gruppi in base al valore di cut-off di 4.000. Il gruppo 1 (TVI basso) era composto da 16 pazienti e il gruppo 2 (TVI alto) era composto da 28 pazienti. Il rapporto tra i sessi maschili era più alto nel gruppo 2 (50% vs 85%, p: 0,011) Il diametro del tumore è stato osservato essere maggiore nel gruppo 2 (3,06 vs 5,54, p: 0,000). Il tipo istologico di adenocarcinoma era più comune nel gruppo 2 (25% vs 64,3%, p: 0,012). L’incidenza delle complicanze respiratorie è stata maggiore nel Gruppo 2 (0% vs 35,7%, p: 0,024), il tempo di sopravvivenza (mesi) è stato più breve nel Gruppo 2 (36 vs 11, p: 0,005) .TVI è superiore a 4000 (HR) (95 L’intervallo di confidenza% ((CI) 0,057 (0,011-0,311), p: 0,001) è stato un fattore di rischio indipendente per determinare il tasso di sopravvivenza. CONCLUSIONE: TVI può essere utilizzato come fattore prognostico nei pazienti con cancro esofageo sottoposti a terapia chirurgica. La TVI è strettamente associata all’istologia del tumore e agli esiti postoperatori.
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it
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pair_33746120
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This study aimed to explore the role of the PI3K/AKT signaling pathway in bFGF/PDGF composite hydrogel promoting the repair of spinal cord injuries. In this study, the spinal cord injury rat model was established using Allen's punch method. Healthy male Sprague Dawley rats of the clean grade were randomly divided into four groups (n=18, each): sham operation group (group S), bFGF/PDGF composite hydrogel group (group A), bFGF/PDGF composite hydrogel + LY294002 (PI3K/AKT signaling pathway inhibitor) group (group B) and bFGF/PDGF composite hydrogel + IGF-1 (PI3K/AKT signaling pathway agonist) group (group C). After the operation, the motor function of the posterior limbs, the apoptosis of the spinal cord cells and the expression of PI3K, Akt and phosphorylated Akt (p-Akt) in the spinal cord tissues of the rats in each group were detected. BBB joint score were significantly higher (P<0.05). BFGF/PDGF composite hydrogel can significantly promote the repair of spinal cord injuries and the mechanism is closely correlated to the activation of the PI3K/AKT signaling pathway. BFGF, Cell apoptosis, PDGF, PI3K/Akt signaling pathway, Spinal cord injury.
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en
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lexi-ml/wmt_22_dataset_en_it
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train
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text
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Questo studio è finalizzato all’esplorazione del ruolo della via di segnalazione PI3K / AKT nell’idrogel composito bFGF / PDGF che promuove la riparazione delle lesioni del midollo spinale. Per questo studio è stato utilizzato il modello di lesione del midollo spinale sul ratto utilizzando il metodo del punzone di Allen. Sono stati utilizzati ratti maschi sani Sprague Dawley, “clean grade” suddivisi casualmente in quattro gruppi di 18 esemplari ciascuno: gruppo di intervento simulato (gruppo S): gruppo trattato con idrogel composito bFGF / PDGF (gruppo A); gruppo trattato con idrogel composito bFGF / PDGF + LY294002 (PI3K / AKT signaling athway inibitor) (gruppo B); e gruppo trattato con bFGF / PDGF idrogel composito + IGF-1 (PI3K / AKT signaling pathway agonist) (group C). Dopo l’operazione sono state rilevate la funzione motoria degli arti posteriori, l’apoptosi delle cellule del midollo spinale e l’espressione di PI3K, Akt e Akt fosforilato (p-Akt) nei tessuti del midollo spinale dei ratti di ciascun gruppo. RISULTATI: rispetto al gruppo S, i livelli di espressione di PI3K e p-Akt nei gruppi A, B e C erano significativamente più bassi, l’indice di apoptosi (AI) era significativamente più alto e il punteggio del test della piastra inclinata e il punteggio dell’articolazione BBB erano significativamente più bassi (P <0,05). Rispetto al gruppo A, i livelli di espressione di PI3K e p-Akt nel gruppo B erano significativamente inferiori, AI era significativamente più alto e il punteggio del test della piastra inclinata e il punteggio del giunto BBB erano significativamente inferiori. I livelli di espressione di PI3K e p-Akt gruppo C erano significativamente più alti, AI era significativamente più basso e il punteggio del test della piastra inclinata e il punteggio del giunto BBB erano significativamente più alti (P <0,05). CONCLUSIONE: l’idrogel composito BFGF / PDGF può promuovere in modo significativo la riparazione delle lesioni del midollo spinale e il meccanismo è strettamente correlato all’attivazione della via di segnalazione PI3K / AKT.
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it
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pair_33746121
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Whether or not the laparoscopic technique has substantial advantages over the mini-laparotomy one for ventriculoperitoneal shunt is still controversial. The present study is a literature review and a meta-analysis about this topic, focused on the duration of surgery, length of stay (LOS), infection rate and rate of distal catheter failure. An extensive online literature search was performed, followed by a meta-analysis implemented with RevMan 5.0 Cochrane software. For laparoscopy and mini-laparotomy group, odds ratio (OR) and 95% confidence interval (CI) was calculated for distal catheter malposition/obstruction and infection rate. Mean difference was considered for duration of surgery and LOS. Fixed-effect model with a significance < 0.05 was employed. A t-test (p< 0.05) between the groups, also including the non-comparative cohort studies, was performed for each primary endpoint. 18 studies, involving 3361 patients, were selected. Average level of evidence was 3.2 ± 0.7. Primary shunts were 93 % in laparoscopy group and 87 % in mini-laparotomy one (p=0.626). A previous abdominal surgery was present in 37.5 % and 33.7% of laparoscopy and laparotomy group, respectively (p=0.449). Laparoscopy had a lower incidence of distal catheter failure (OR 0.52, 95% CI 0.38-0.72; p<0.001). No differences were revealed about the duration of surgery, LOS and infection rate. Laparoscopic technique has a lower risk of distal catheter failure in ventriculoperitoneal shunt for the treatment of hydrocephalus. Duration of surgery, LOS and infection rate are independent by the surgical technique. The overall level of evidence is low, and no absolute conclusions can be drawn. Hand-Assisted Laparoscopy, Hydrocephalus, Meta-Analysis, Mini-Laparotomy, Shunt Failure, Shunt Malfunction, Ventriculoperitoneal Shunt.
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en
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lexi-ml/wmt_22_dataset_en_it
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train
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text
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È ancora controverso se la tecnica laparoscopica abbia sostanziali vantaggi rispetto a quella mini-laparotomica nello shunt ventricolo-peritoneale. Il presente studio consiste in una revisione della letteratura e una meta-analisi su questo argomento, fondamentalmente incentrata sulla durata dell’intervento chirurgico, durata della degenza, tasso di infezioni e tasso di malfunzionamento/ostruzione del catetere distale. È stata eseguita un’ampia ricerca online della letteratura, seguita da una meta-analisi mediante l’ausilio del software Cochrane RevMan 5.0. Per il gruppo di laparoscopia e mini-laparotomia è stato calcolato l’odds ratio (OR) e l’intervallo di confidenza al 95% (CI) relativi a tasso di malfunzionamento/ostruzione del catetere distale, e tasso di infezione. La differenza media è stata invece analizzata relativamente alla durata dell’intervento chirurgico e al tempo di degenza. È stato impiegato un modello a effetto fisso con un livello di significatività p<0.05. Per ciascun endpoint primario è stato inoltre eseguito un test t (p <0,05) tra i gruppi, inclusi anche gli studi di coorte non comparativi. Sono stati selezionati 18 studi, che hanno coinvolto in totale 3361 pazienti. Il livello medio di evidenza è stato 3,2 ± 0,7. Gli shunt primari erano 93% nel gruppo laparoscopico e 87% in quello mini-laparotomico (p = 0,626). Un precedente intervento chirurgico addominale era presente nel 37,5% e 33,7% del gruppo laparoscopico e laparotomico, rispettivamente (p = 0,449). La laparoscopia ha avuto una minore incidenza di fallimento (malfunzionamento/ ostruzione) del catetere distale (OR 0,52, IC 95% 0.38-0.72; p <0,001). Non sono state rilevate differenze relative alla durata dell’intervento chirurgico, tempo di degenza e tasso di infezioni. La tecnica laparoscopica presenta un minor rischio di fallimento del catetere derivativo distale nello shunt ventricolo- peritoneale eseguito per il trattamento dell’idrocefalo. La durata dell’intervento chirurgico, il tempo di degenza e il tasso di infezioni sono indipendenti dalla tecnica chirurgica. Il livello complessivo di evidenza degli studi è basso, non essendo possibile al momento trarre conclusioni assolute.
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it
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pair_33746122
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In this study, we aimed to evaluate patients who underwent curative surgical treatment for primary duodenal adenocarcinoma and to present our experience. Patients diagnosed with primary duodenal adenocarcinoma between 2006 and 2018 participated in the study. The demographic and clinical characteristics of the patients, details of the operation, pathological features of the tumors, short- and long-term follow-up results, and mean survival were evaluated retrospectively. Nine patients with a mean age of 54.7 participated in the study. 55% of the patients were male. The most common presenting symptom was abdominal pain (n: 6; 67%). The most common tumor localization was D2-3 (n: 7; 78%), and the most common surgical operation was pancreaticoduodenectomy (n: 7; 78%). There were no intraoperative complications in any patient. The mean tumor diameter was 3.5 cm. The mean number of lymph nodes dissected was 8.3 and the mean number of metastatic lymph nodes was 2. The most common postoperative complication was pancreatic fistula (n: 3; 33%). The mean length of stay was 21.8 days. One patient developed septic shock and mortality happened within the 30-day period. The most common cause of unplanned admission to the hospital within 90 days was wound infection (n: 2; 22%). One patient developed local recurrence and two patients had systemic metastasis. We found an average survival of 40 months. Pancreaticoduodenectomy is the most common approach in its curative surgery and it has a long survival despite the high postoperative complication rate. We recommend radical resection in the surgical treatment of primary duodenal adenocarcinoma. Adenocarcinoma, Duodenum, Pancreaticoduodenectomy.
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lexi-ml/wmt_22_dataset_en_it
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train
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Questo studio è finalizzato a presentare la nostra esperienza su pazienti sottoposti a trattamento chirurgico curativo per l’adenocarcinoma duodenale primario. Lo studio è stato effettuato sui pazienti con diagnosi di adenocarcinoma duodenale primario trattati tra il 2006 e il 2018. Sono stati valutati retrospettivamente le caratteristiche demografiche e cliniche dei pazienti, i dettagli dell’operazione, le caratteristiche patologiche dei tumori, i risultati di follow-up a breve e lungo termine e la sopravvivenza media. Sono stati inclusi nello studio nove pazienti con un’età media di 54.7 anni: 55% dei pazienti era di sesso maschile. Il sintomo più comune al ricovero era il dolore addominale (n. 6; 67%). La localizzazione del tumore più comune è stata la D2-3 (n. 7; 78%) e l’operazione chirurgica più frequentemente eseguita è stata la pancreaticoduodenectomia (n. 7; 78%). Non ci sono state complicanze intraoperatorie in nessun paziente. Il diametro medio del tumore era di 3,5 cm. Il numero medio di linfonodi dissezionati era 8,3 e il numero medio di linfonodi metastatici era 2. La complicazione postoperatoria più comune era la fistola pancreatica (n. 3; 33%). La durata media della degenza è stata di 21,8 giorni. Un paziente è andato incontro a shock settico e mortalità seguita entro 30 giorni. La causa più comune di ricovero non programmato in ospedale entro 90 giorni è stata l’infezione della ferita (n. 2; 22%). Un paziente ha presentato recidiva locale e due pazienti hanno presentato metastasi sistemiche. Abbiamo registrato una sopravvivenza media di 40 mesi. La pancreaticoduodenectomia è l’approccio più comune quale chirurgia curativa con lunga sopravvivenza nonostante l’alto tasso di complicanze postoperatorie. Raccomandiamo dunque la resezione radicale nel trattamento chirurgico dell’adenocarcinoma duodenale primario.
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pair_33746123
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Traumatic and ischemic injuries of the spinal cord are effective in the development of neurological dysfunction of tissue damage caused by primary and secondary mechanisms. Free radical changes are effective in the development of early ischemia and progressive tissue ischemia is the main cause of secondary damage. Delaying ischemia is the basis of treatment. In this study, we aimed to demonstrate the presence of neuroprotective effects of alpha-lipoic acid in comparison with methylprednisolone. 50 Sprague Dawley rats were divided into 5 groups (n = 10) and spinal cord trauma was created by the method, described by Rivlin and Tator. Group 1: Laminectomy group, Group 2: Laminectomy + spinal cord injury (SCI), Group 3: Laminectomy + SCI + alpha-lipoic acid (ALA) (100 mg / kg), Group 4: Laminectomy + SCl + Methyl-prednisolone (30 mg / kg), Group 5: Laminectomy + SCl + ALA + Methyl-prednisolone. Rats with spinal cord injury were found to be paraplegic. There was no significant change in motor function between the groups. When the antioxidant values were compared in the groups, there was a statistically significant difference between Group 2 and Group 3. Oxygen radicals decreased significantly between ALA and Methylprednisolone. The most striking difference was between the monotherapy group and the combined treatment group. Our results showed that alpha lipoic acid given after spinal cord trauma in rats decreases anti-oxidant formation. Alpha-lipoic acid, Methyl-prednisolone, Oxygen radicals, Spinal cord injury.
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lexi-ml/wmt_22_dataset_en_it
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train
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Le lesioni traumatiche e ischemiche del midollo spinale sono causa di disfunzione neurologica da danno tissutale per meccanismi primari e secondari. I cambiamenti dei radicali liberi sono dannosi per lo sviluppo dell’ischemia precoce e l’ischemia progressiva dei tessuti è la principale causa di danno secondario. Ritardare l’ischemia è la base del trattamento. In questo studio, abbiamo mirato a dimostrare la presenza di effetti neuroprotettivi dell’acido alfa-lipoico rispetto al metilprednisolone. Sono stati impiegati sperimentalmente 50 ratti Sprague Dawley, divisi in 5 gruppi (ciascuno di 10 unità) e il trauma del midollo spinale è stato creato con il metodo, descritto da Rivlin e Tator. Gruppo 1: gruppo Laminectomia, Gruppo 2: Laminectomia + lesione del midollo spinale (SCI), Gruppo 3: Laminectomia + SCI + acido alfa-lipoico (ALA) (100 mg / kg), Gruppo 4: Laminectomia + SCl + Metil-prednisolone ( 30 mg / kg), Gruppo 5: Laminectomia + SCl + ALA + Metilprednisolone. RISULTATI E DISCUSSIONE: I ratti con lesione del midollo spinale sono risultati paraplegici. Non vi è stato alcun cambiamento significativo nella funzione motoria tra i gruppi. Quando i valori di antiossidanti sono stati confrontati nei gruppi, c’era una differenza statisticamente significativa tra il gruppo 2 e il gruppo 3. I radicali dell’ossigeno sono diminuiti significativamente tra ALA e metilprednisolone. La differenza più evidente era tra il gruppo di monoterapia e il gruppo di trattamento combinato. In conclusione questi risultati hanno indicato che l’acido alfa lipoico somministrato dopo un trauma del midollo spinale nei ratti diminuisce la formazione di antiossidanti.
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pair_33746124
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Laparoscopy appendectomy (LA) is the most widely used method for the treatment of acute appendicitis (AA). The interest has shifted towards the mini-incision open method (MOA). A retrospective study was conducted considering all patients who underwent surgery due to suspected appendicitis from December 2014 to January 2019. The final analysis included 234 patients. The following data were collected: patient age, sex, surgery duration, hospitalization time, wound infections, and mortality. The average time of surgery was 69.89 minutes in the LA group and 62.17 minutes in the MOA group, while the average time of postoperative hospitalization was respectively 5.579 days and 5.143 days. Wound infections occurred in 2 patients in the LA group and in 3 patients in the MOA group. Laparoscopic appendectomy has a similar operating time, hospitalization time and wound infections as Mini-incision open appendectomy. Therefore,both techniques are to be considered valid. Appendicitis, Laparoscopic appendectomy, Appendectomy, Instrumentation, Open approach.
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lexi-ml/wmt_22_dataset_en_it
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L’appendicectomia laparoscopica (LA) è il metodo più ampiamente usato per il trattamento dell’appendicite acuta (AA). Nonostante ciò, l’interesse si è spostato verso il metodo “open” mini-incisionale (MOA). Lo studio retrospettivo è stato condotto prendendo in considerazione tutti i pazienti sottoposti ad intervento chirurgico, per sospetta appendicite, da Dicembre 2014 a Gennaio 2019. L’analisi finale ha incluso 234 pazienti. Sono stati raccolti i seguenti dati: età del paziente, sesso, durata dell’intervento, durata della degenza, infezioni della ferita e mortalità. Il tempo medio dell’intervento chirurgico è stato di 69,89 minuti nel gruppo LA e di 62,17 minuti nel gruppo MOA, mentre il tempo medio di degenza post-operatoria è stato rispettivamente di 5,579 giorni nel gruppo LA e di 5,143 giorni nel gruppo MOA. Infezioni della ferita si sono verificate in 2 pazienti nel gruppo LA e in 3 pazienti nel gruppo MOA. L’appendicectomia laparoscopica ha una durata dell’intervento chirurgico, un tempo di degenza e infezioni della ferita simili all’appendicectomia “open” mini-incisionale. Pertanto, entrambe le tecniche devono essere considerate valide.
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pair_33746219
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This prospective, non-randomised study documents our initial experience using the Flex<sup>®</sup> Surgical System for transoral surgery in Italy. All patients who underwent transoral robotic surgery using the Medrobotics<sup>®</sup> Flex<sup>®</sup> Robotic System (Raynham, MA, USA) between March 2018 and April 2019 were reviewed. Rates of successful surgery, surgical time and complications were evaluated. 43 surgical procedures were performed in the study. The average age was 62.56 years (range 36-90 years). The Flex<sup>®</sup> system was used successfully in surgery of the base of the tongue, palatine tonsils, supraglottis, hypopharynx and glottis, which was the most frequent target. All procedures were successfully completed. There were no intraoperative or serious postoperative complications, with no cases of intraoperative haemorrhage. This is the first study in Italy evaluating the use of the Flex<sup>®</sup> system to safely resect lesions in the oral cavity, larynx and pharynx.
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lexi-ml/wmt_22_dataset_en_it
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train
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text
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Chirurgia robotica transorale flessibile: l’esperienza italiana. Questo studio prospettico, non randomizzato, documenta l’esperienza iniziale con il sistema chirurgico Flex® nella chirurgia transorale in Italia tra Marzo 2018 ed Aprile 2019. Sono state eseguite 43 procedure chirurgiche su 41 pazienti con età media di 62,56 anni (intervallo 36-90 anni). Sono stati valutati i tassi di successo dell’intervento chirurgico, il tempo chirurgico e le complicanze. Il sistema Flex<sup>®</sup> è stato utilizzato nella chirurgia della base della lingua, delle tonsille palatine, della regione sovraglottica, dell’ipofaringe e della glottide: quest’ultimo è stato il target chirurgico più frequente. Tutte le procedure sono state completate con successo. Non ci sono state complicanze intraoperatorie e postoperatorie gravi, nè casi di emorragia. Questo è il primo studio in Italia in cui viene utilizzato il sistema Flex<sup>®</sup> per la resezione di lesioni faringee e laringee e ne documenta l’affidabilità e la sicurezza.
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