Infantile trauma: representations of self, others and relationships and problematic behaviours in maltreated children.

Literature suggests that different types of early traumatic experiences (such as child maltreatment) have an impact on children’s psychological well-being, especially, in terms of understanding and expectations of relationships, representations of self and others and on their emotion regulation. This can influence their attachment pattern and their emotional and behavioural development. Narrative tasks, such as the Story Stem Assessment Profile, offer the children an opportunity to express their expectations about themselves, others and relationships, especially attachment relationships (Hodges & Steele, 2000; Hodges, Steele, Kaniuk, Hillman & Asquith, 2009). An area of research that needs further study is the investigation of the link, in traumatised children, between children representations and their symptomatology. The present exploratory research investigates the connection between early traumatic experiences of maltreatment, children's representations of self, others and relationships and psychological well-being in terms of behavioural problems and stress. 25 maltreated and 25 non-maltreated children, aged 4 to 8 years old, participated in this research. The measures used were the Story Stem Assessment Profile to investigate child's representations of self, others and relationships (Hodges et al., 2013), the Child Behavior Checklist to identify behavioural problems in the child (Achenbach & Rescorla, 2000) and the Parent Stress Index to evaluate the magnitude of stress in the parent–child system, as seen by the mother (Abidin,1990). Preliminary data suggest that traumatised children showed more behavioural and post-traumatic symptoms. Moreover, they represented the world as a dangerous place where adults are dangerous or unaware, protection is lacking and extreme violence often occurs

The weekend effect on the provision of Emergency Surgery before and during the COVID-19 pandemic: case–control analysis of a retrospective multicentre database

Introduction: The concept of “weekend effect”, that is, substandard healthcare during weekends, has never been fully demonstrated, and the different outcomes of emergency surgical patients admitted during weekends may be due to different conditions at admission and/or different therapeutic approaches. Aim of this international audit was to identify any change of pattern of emergency surgical admissions and treatments during weekends. Furthermore, we aimed at investigating the impact of the COVID-19 pandemic on the alleged “weekend effect”. Methods: The database of the CovidICE-International Study was interrogated, and 6263 patients were selected for analysis. Non-trauma, 18+ yo patients admitted to 45 emergency surgery units in Europe in the months of March–April 2019 and March–April 2020 were included. Demographic and clinical data were anonymised by the referring centre and centrally collected and analysed with a statistical package. This study was endorsed by the Association of Italian Hospital Surgeons (ACOI) and the World Society of Emergency Surgery (WSES). Results: Three-quarters of patients have been admitted during workdays and only 25.7% during weekends. There was no difference in the distribution of gender, age, ASA class and diagnosis during weekends with respect to workdays. The first wave of the COVID pandemic caused a one-third reduction of emergency surgical admission both during workdays and weekends but did not change the relation between workdays and weekends. The treatment was more often surgical for patients admitted during weekends, with no difference between 2019 and 2020, and procedures were more often performed by open surgery. However, patients admitted during weekends had a threefold increased risk of laparoscopy-to-laparotomy conversion (1% vs. 3.4%). Hospital stay was longer in patients admitted during weekends, but those patients had a lower risk of readmission. There was no difference of the rate of rescue surgery between weekends and workdays. Subgroup analysis revealed that interventional procedures for hot gallbladder were less frequently performed on patients admitted during weekends. Conclusions: Our analysis revealed that demographic and clinical profiles of patients admitted during weekends do not differ significantly from workdays, but the therapeutic strategy may be different probably due to lack of availability of services and skillsets during weekends. The first wave of the COVID-19 pandemic did not impact on this difference

Musica e Poesia son due sorelle: percorsi d'ascolto per le Scuole

Questa raccolta di saggi si focalizza sulla trasposizione didattica del sapere musicale attraverso strategie d’ascolto mirate, con riferimento costante al contesto storico-culturale. I ventidue percorsi didattici qui offerti, tutti incentrati su brani musicali muniti di testo poetico, si devono a musicologi attivi nell’università e nelle scuole, e si rivolgono tanto agli insegnanti delle scuole quanto ai semplici appassionati. I percorsi affrontano composizioni esteticamente e culturalmente assai diverse: dal madrigale trecentesco «Appress’un fiume chiaro» di Giovanni da Cascia al "Quaderno di strada" di Salvatore Sciarrino; dalla cinquecentesca "Missa Hercules Dux Ferrariae" di Josquin des Prez ai "Canti di prigionia" di Luigi Dallapiccola; dal "Giulio Cesare in Egitto" di Georg Friedrich Händel al "Trovatore" di Giuseppe Verdi e alle "Chansons madécasses" di Maurice Ravel; dal jazz ("Fables of Faubus" di Charles Mingus) a una canzone di Fabrizio De André ("Non al denaro non all’amore né al cielo"). Delineato l’argomento, dichiarati gli obiettivi, ogni percorso si dipana in varie proposte di attività per gli studenti, in ipotesi di sviluppo che approfondiscano le conoscenze acquisite, in alcune linee guida per la verifica degli obiettivi. Il volume mette a frutto le più aggiornate ricerche in campo pedagogico-musicale, in particolare relativamente alla Didattica dell'ascolto, una pratica di trasposizione del sapere musicale sulla quale si sono confrontati, negli ultimi anni, tanto gli studiosi di Pedagogia generale e Didattiche disciplinari, quanto i musicologi esperti di Storia della musica. La ricerca da cui è scaturito il volume si è orientata nell’indagine dei processi di apprendimento-insegnamento nell’àmbito della didattica dell’ascolto, attraverso il perseguimento dei seguenti obiettivi: 1) un obiettivo epistemologico generale, ossia ricondurre la Didattica della musica nell’alveo generale della Musicologia, intesa come la scienza che indaga la totalità dei fenomeni musicali in chiave storica e sistematica; 2) un obiettivo metodologico, ossia accertare la funzionalità e l’efficacia della pratica traspositiva della didattica dell’ascolto; 3) un obiettivo politico: perfezionare un modello di didattica dell’ascolto di qualità che punti a far conoscere, comprendere e apprezzare il patrimonio musicale come parte del patrimonio artistico europeo (European Heritage). Gli aspetti più innovativi del volume risiedono principalmente nel duplice scopo di: a) rafforzare in seno alla musicologia nazionale e internazionale la consapevolezza che la Didattica della musica non è un’entità avulsa dalla musicologia, bensì una ramificazione importante e vitale, in un disegno organico complessivo; b) diffondere nel mondo della scuola la percezione di quanto giovi all’innalzamento del senso di ‘cittadinanza’ in una realtà composita come l’UE la conoscenza e l’apprezzamento del patrimonio musicale storico e delle culture musicali locali (europee ed extraeuropee)

Impact of the SARS-CoV-2 pandemic on emergency surgery services—a multi-national survey among WSES members

Background: The SARS-CoV-2 pandemic is a major challenge for health care services worldwide. It’s impact on oncologic therapies and elective surgery has been described recently, and the literature provides guidelines regarding appropriate elective patient treatment during the pandemic. However, the impact of SARS-CoV-2 pandemic on emergency surgery services has been poorly investigated up to now. Methods: A 17-item web survey had been distributed to emergency surgeons in June 2020 around the world, investigating the impact of SARS-CoV-2 pandemic on patients and septic diseases both requiring emergency surgery and the time-to-intervention in emergency surgery routine, as well as experiences with surgery in COVID-19 patients. Results: Ninety-eight collaborators from 31 countries responded to the survey. The majority (65.3%) estimated the impact of the SARS-CoV-2 pandemic on emergency surgical patient care as being strong or very strong. Due to the pandemic, 87.8% reported a decrease in the total number of patients undergoing emergency surgery and approximately 25% estimated a delay of more than 2 h in the time-to-diagnosis and another 2 h in the time-to-intervention. Fifty percent make structural problems with in-hospital logistics (e.g. transport of patients, closed normal wards etc.) mainly responsible for delayed emergency surgery and the frequent need (56.1%) for a triage of emergency surgical patients. 56.1% of the collaborators observed more severe septic abdominal diseases during the pandemic, especially for perforated appendicitis and severe septic cholecystitis (41.8% and 40.2%, respectively). 62.2% had experiences with surgery in COVID-19-infected patients. Conclusions: The results of The WSES COVID-19 emergency surgery survey are alarming. The combination of an estimated decrease in numbers of emergency surgical patients and an observed increase in more severe septic diseases may be a result of the fear of patients from infection with COVID-19 and a consecutive delayed hospital admission and diagnosis. A critical delay in time-to-diagnosis and time-to-intervention may be a result of changes in in-hospital logistics and operating room as well as intensive care capacities. Both reflect the potentially harmful impact of SARS-CoV-2 pandemic on emergency surgery services