9 research outputs found

    Social Dreaming Workshop

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    Social Dreaming is an innovative method, discovered during the 1980s by Dr. Gordon Lawrence, former Director of the Tavistock Institute’s Department of Human Relations. Social Dreaming proposes that dreams be shared in a social assembly, fostering new thinking through free association and amplification of shared dream narratives (Lawrence 1998, 2003, 2005, 2007, 2011). Ancient societies valued dreams as ordinary sources of information as do some currently existing cultures such as the Australian Aborigines. Conversely, psychoanalysis has understood dreams to be conduits for, and to, unconscious material. Straddling the two positions, Gordon Lawrence developed the collective exchange of dreams into a tool to maximise creative thinking, to research the condition of systems and gain access to organizations’ unconscious reservoirs of resources when applied to organizational consultancy

    Art Therapy Large Group

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    We, the conference organisers, hoped the provision of an Art Therapy Large Group (ATLG) for the conference on each of the three days, would give delegates the opportunity to explore, through the use of art, performance and dialogue, their experiences of the conference and the dynamics that arise in a large group. We had run an ATLG at our first art therapy conference (Finding a voice, making your mark: defining art therapy for the 21st century) in 2013, and hoped there might be some continuity between the first and second ATLG, a development of the dialogue of word, performance and image through time

    Una guerra mediterranea. Grande guerra, imperi e nazioni nel Mediterraneo

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    Con la dissoluzione dell' Impero ottomano, la Grande Guerra nel Mediterraneo produsse quello spazio vuoto destinato ad essere terreno di scontro di nuove visioni nazionaliste e di diverse prospettive egemoniche che risultò ben presto essere la prova schiacciante dell'inefficienza dei trattai di pace a partire dal 1919. Nazioni sconfitte che videro trionfare il loro nazionalismo trasformandosi in Stati- nazione moderni, nazioni che non nacquero, nazioni che non si sentono comunità e così via. E poi la fragilità della pace e la ripresa quasi immediata dei conflitti areali, il primo tentativo di revisionismo che trionfa, la nascita di nuovi spazi geopolitici. Ma anche il grande sogno mediterraneo di un equilibrio mondiale profondamente riformato. Adottando tre diversi tempi storici, il volume si propone di indagare le trasformazioni che la grande guerra produsse nel Mediterraneo che, accanto a quelle che sconvolsero l'Europa, rappresentano con tutta evidenza la radice del nostro presente

    L'Italia, il Mediterraneo e la guerra

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    Con la dissoluzione dell’Impero ottomano, la Grande Guerra nel Mediterraneo produsse uno “spazio vuoto” destinato ad essere terreno di scontro di nuove visioni nazionaliste e di diverse prospettive egemoniche, che risultò ben presto essere la prova schiacciante dell’inefficienza delle strategie e dei principi guida decisi alla Conferenza di Pace inauguratasi a Versailles il 18 gennaio 1919. Nazioni sconfitte che vedono trionfare il loro nazionalismo e che si costituiscono in nazioni moderne,nazioni che non nascono, nazioni che non si sentono comunità e comunità che si sentono nazioni. E poi la fragilità della pace e la ripresa quasi immediata dei conflitti areali, il primo tentativo di revisionismo che trionfa, la nascita di nuovi spazi geopolitici. In questo contesto, il saggio analizza la dimensione mediterranea del primo conflitto mondiale per l'Italia; una dimensione dimenticata e sopraffatta dagli obiettivi nazionalistici della " vittoria mutilata".With the dissolution of the Ottoman Empire, the Great War in the Mediterranean it produced an "empty space" destined to be a battleground for new nationalist visions and different hegemonic perspectives, which soon proved to be the overwhelming proof of the inefficiency of the strategies and guiding principles decided to Peace Conference inaugurated in Versailles on January 18, 1919. Defeated nations that see their nationalism triumph and that are constituted in modern nations, nations that are not born, nations that do not feel like communities and communities that they feel like nations. And then the fragility of peace and the almost immediate recovery of area conflicts, the first attempt at revisionism that triumphs, the birth of new geopolitical spaces. In this context, the essay analyzes the Mediterranean dimension of the First World War for Italy; a dimension forgotten and overwhelmed by the nationalistic goals of "mutilated victory"

    La Grande Guerra e il Mediterraneo

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    Adottando tre diversi tempi storici - l’analisi dei fenomeni di lungo periodo, il racconto da diverse prospettive nazionali dell’esperienza di guerra e l’analisi dei suoi effetti nella prospettiva del Novecento - il lavoro si propone di indagare le trasformazioni che la Grande Guerra produsse nel Mediterraneo che, accanto a quelle che sconvolsero l’Europa, rappresentano con tutta evidenza la radice del nostro presente. in questo senso, molteplici e diverse sono le esperienze che concorrono a caratterizzare la Grande Guerra nel Mediterraneo: la mancata formazione dello Stato arabo, la questione ebraica, il nazionalismo balcanico, il ruolo delle principali potenze nella guerra e lo strano caso dell'Italia, potenza mediterranea che rinuncia a qualsiasi progetto egemonico. So queste anche le radici di una pace che rivelerà presto i suoi piedi d'argilla

    Suez dopo Suez. Un grande gioco mediterraneo

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    Gli Stretti del Mediterraneo, da quello di Messina a quello di Suez, passando per il Bosforo e per Gibilterra sono da sempre spazi di attrazione e nodi di circolazioen. Agli esordi dell'età contemporanea, ridisegnando completamente la geografia del Mare Nostrum, il Canale di Suez, con alle spalle già una lunga storia, quella della sua stessa realizzazione e delle vicende legate alla Compagnie Universelle du Canal Maritime de Suez, divenne protagonista indiscusso della storia mediterranea e del grande gioco delle rivalità tra le potenze europee nel Mediterraneo orientale. Elemento determinante anche della crisi ottomana e dell'emergere di nuovi protagonismi arabi, il canale cambiò per sempre la storia del Mediterraneo conferendogli una nuova dimensione globale.The Straits of the Mediterranean, from Messina to Suez, passing through the Bosphorus and Gibraltar have always been spaces of attraction and traffic junctions. At the beginning of the contemporary age, completely redesigning the geography of the Mare Nostrum, the Suez Canal, with a long history behind it, that of its own construction and the events related to the Compagnie Universelle du Canal Maritime de Suez, became the undisputed protagonist of the Mediterranean history and the great game of rivalries between European powers in the eastern Mediterranean. Also a determining element of the Ottoman crisis and the emergence of new Arab protagonists, the channel changed the history of the Mediterranean forever, giving it a new global dimension

    Functional Outcome of Intravenous Thrombolysis in Patients With Lacunar Infarcts in the WAKE-UP Trial

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    Importance: The rationale for intravenous thrombolysis in patients with lacunar infarcts is debated, since it is hypothesized that the microvascular occlusion underlying lacunar infarcts might not be susceptible to pharmacological reperfusion treatment. Objective: To study the efficacy and safety of intravenous thrombolysis among patients with lacunar infarcts. Design, Setting, and Participants: This exploratory secondary post hoc analysis of the WAKE-UP trial included patients who were screened and enrolled between September 2012 and June 2017 (with final follow-up in September 2017). The WAKE-UP trial was a multicenter, double-blind, placebo-controlled randomized clinical trial to study the efficacy and safety of intravenous thrombolysis with alteplase in patients with an acute stroke of unknown onset time, guided by magnetic resonance imaging. All 503 patients randomized in the WAKE-UP trial were reviewed for lacunar infarcts. Diagnosis of lacunar infarcts was based on magnetic resonance imaging and made by consensus of 2 independent investigators blinded to clinical information. Main Outcomes and Measures: The primary efficacy variable was favorable outcome defined by a score of 0 to 1 on the modified Rankin Scale at 90 days after stroke, adjusted for age and severity of symptoms. Results: Of the 503 patients randomized in the WAKE-UP trial, 108 patients (including 74 men [68.5%]) had imaging-defined lacunar infarcts, whereas 395 patients (including 251 men [63.5%]) had nonlacunar infarcts. Patients with lacunar infarcts were younger than patients with nonlacunar infarcts (mean age [SD], 63 [12] years vs 66 [12] years; P = .003). Of patients with lacunar infarcts, 55 (50.9%) were assigned to treatment with alteplase and 53 (49.1%) to receive placebo. Treatment with alteplase was associated with higher odds of favorable outcome, with no heterogeneity of treatment outcome between lacunar and nonlacunar stroke subtypes. In patients with lacunar strokes, a favorable outcome was observed in 31 of 53 patients (59%) in the alteplase group compared with 24 of 52 patients (46%) in the placebo group (adjusted odds ratio [aOR], 1.67 [95% CI, 0.77-3.64]). There was 1 death and 1 symptomatic intracranial hemorrhage according to Safe Implementation of Thrombolysis in Stroke-Monitoring Study criteria in the alteplase group, while no death and no symptomatic intracranial hemorrhage occurred in the placebo group. The distribution of the modified Rankin Scale scores 90 days after stroke also showed a nonsignificant shift toward better outcomes in patients with lacunar infarcts treated with alteplase, with an adjusted common odds ratio of 1.94 (95% CI, 0.95-3.93). Conclusions and Relevance: While the WAKE-UP trial was not powered to demonstrate the efficacy of treatment in subgroups of patients, the results indicate that the association of intravenous alteplase with functional outcome does not differ in patients with imaging-defined lacunar infarcts compared with those experiencing other stroke subtypes.status: publishe

    Intravenous alteplase for stroke with unknown time of onset guided by advanced imaging: systematic review and meta-analysis of individual patient data

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    Background: Patients who have had a stroke with unknown time of onset have been previously excluded from thrombolysis. We aimed to establish whether intravenous alteplase is safe and effective in such patients when salvageable tissue has been identified with imaging biomarkers. Methods: We did a systematic review and meta-analysis of individual patient data for trials published before Sept 21, 2020. Randomised trials of intravenous alteplase versus standard of care or placebo in adults with stroke with unknown time of onset with perfusion-diffusion MRI, perfusion CT, or MRI with diffusion weighted imaging-fluid attenuated inversion recovery (DWI-FLAIR) mismatch were eligible. The primary outcome was favourable functional outcome (score of 0–1 on the modified Rankin Scale [mRS]) at 90 days indicating no disability using an unconditional mixed-effect logistic-regression model fitted to estimate the treatment effect. Secondary outcomes were mRS shift towards a better functional outcome and independent outcome (mRS 0–2) at 90 days. Safety outcomes included death, severe disability or death (mRS score 4–6), and symptomatic intracranial haemorrhage. This study is registered with PROSPERO, CRD42020166903. Findings: Of 249 identified abstracts, four trials met our eligibility criteria for inclusion: WAKE-UP, EXTEND, THAWS, and ECASS-4. The four trials provided individual patient data for 843 individuals, of whom 429 (51%) were assigned to alteplase and 414 (49%) to placebo or standard care. A favourable outcome occurred in 199 (47%) of 420 patients with alteplase and in 160 (39%) of 409 patients among controls (adjusted odds ratio [OR] 1·49 [95% CI 1·10–2·03]; p=0·011), with low heterogeneity across studies (I 2=27%). Alteplase was associated with a significant shift towards better functional outcome (adjusted common OR 1·38 [95% CI 1·05–1·80]; p=0·019), and a higher odds of independent outcome (adjusted OR 1·50 [1·06–2·12]; p=0·022). In the alteplase group, 90 (21%) patients were severely disabled or died (mRS score 4–6), compared with 102 (25%) patients in the control group (adjusted OR 0·76 [0·52–1·11]; p=0·15). 27 (6%) patients died in the alteplase group and 14 (3%) patients died among controls (adjusted OR 2·06 [1·03–4·09]; p=0·040). The prevalence of symptomatic intracranial haemorrhage was higher in the alteplase group than among controls (11 [3%] vs two [<1%], adjusted OR 5·58 [1·22–25·50]; p=0·024). Interpretation: In patients who have had a stroke with unknown time of onset with a DWI-FLAIR or perfusion mismatch, intravenous alteplase resulted in better functional outcome at 90 days than placebo or standard care. A net benefit was observed for all functional outcomes despite an increased risk of symptomatic intracranial haemorrhage. Although there were more deaths with alteplase than placebo, there were fewer cases of severe disability or death. Funding: None
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