5 research outputs found
The weekend effect on the provision of Emergency Surgery before and during the COVID-19 pandemic: caseâcontrol analysis of a retrospective multicentre database
Introduction: The concept of âweekend effectâ, 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 âweekend effectâ. 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 MarchâApril 2019 and MarchâApril 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 dâascolto 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 nellâuniversitaÌ 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 «Appressâun 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 HaÌndel al "Trovatore" di Giuseppe Verdi e alle "Chansons madeÌcasses" di Maurice Ravel; dal jazz ("Fables of Faubus" di Charles Mingus) a una canzone di Fabrizio De AndreÌ ("Non al denaro non allâamore neÌ al cielo").
Delineato lâargomento, dichiarati gli obiettivi, ogni percorso si dipana in varie proposte di attivitaÌ 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 piuÌ 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 eÌ scaturito il volume si eÌ orientata nellâindagine dei processi di apprendimento-insegnamento nellâaÌmbito della didattica dellâascolto, attraverso il perseguimento dei seguenti obiettivi: 1) un obiettivo epistemologico generale, ossia ricondurre la Didattica della musica nellâalveo generale della Musicologia, intesa come la scienza che indaga la totalitaÌ dei fenomeni musicali in chiave storica e sistematica; 2) un obiettivo metodologico, ossia accertare la funzionalitaÌ e lâefficacia della pratica traspositiva della didattica dellâascolto; 3) un obiettivo politico: perfezionare un modello di didattica dellâascolto di qualitaÌ che punti a far conoscere, comprendere e apprezzare il patrimonio musicale come parte del patrimonio artistico europeo (European Heritage).
Gli aspetti piuÌ 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 eÌ unâentitaÌ avulsa dalla musicologia, bensiÌ una ramificazione importante e vitale, in un disegno organico complessivo; b) diffondere nel mondo della scuola la percezione di quanto giovi allâinnalzamento del senso di âcittadinanzaâ in una realtaÌ composita come lâUE la conoscenza e lâapprezzamento del patrimonio musicale storico e delle culture musicali locali (europee ed extraeuropee)
Impact of the SARS-CoV-2 pandemic on emergency surgery servicesâa multi-national survey among WSES members
Background: The SARS-CoV-2 pandemic is a major challenge for health care services worldwide. Itâs 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