Il senso del lavoro e il suo contesto. Una rilettura di Bartleby lo scrivano di Hermann Melville.

Attraverso una rilettura critica del noto racconto di Herman Melville Bartleby lo scrivano, viene proposta una chiave di comprensione psico-antropologica delle condotte lavorative, delle relazioni nei contesti lavorativi e delle loro ricadute psicopatologi che. In particolare viene avanzata una lettura che connette i comportamenti e le relazioni lavorative quali esiti della difficoltà dei singoli nella mentalizzazione dei modelli ideologico-culturali che li determinano in un dato momento storico. Viene criticata una lettura, tendenzialmente presente in psicologia clinica e in psicologia del lavoro, in chiave riduttivamente individualistica, la quale attribuisce al singolo presunti deficit psichici ricercando le cause, e gli antecedenti delle condotte disadattive delle formazioni psicopatologiche, nella sola storia personale e individuale dei soggetti

L’analisi delle simbolizzazioni affettive delle Aree Naturali Protette per un turismo responsabile. Il caso studio delle Riserva Naturale Orientata dello Zingaro.

ABSTRACT This paper presents a research on responsible tourism in protected areas, through the case study of Zingaro Nature Reserve (Sicily). The main objectives of this study were to examine the so-called collusive processes elaborated by different stakeholder of natural protected area and to propose strategies and guidelines for intervention in the perspective of sustainable development and responsible use of the local tourist activities, based on the results. The methodology applied was Emotional Analysis of the Text (EAT) that allowed to investigate the emotional representations and the expectations of stakeholders, through the study of co-occurrances of the so-called dense words, using the statistical software for textual analysis T-LAB

Dove è finito il gruppo?

Gli autori affrontano la questione della “sparizione” nella contemporaneità dei gruppi e della gruppalità in differenti contesti dove tradizionalmente il “fare gruppi” era diventato una consuetudine: ambito clinico, terapeutico, istituzionale. Ci si interroga se la difficoltà riscontrata dai professionisti della salute mentale e del benessere psicosociale, esperti in gruppi, di avviare e mantenere setting collettivi, sia una delle numerose manifestazioni della deriva neoliberista che investe le vite di tutti, le relazioni, la concezione del mondo e della vita.The authors deal with the question of the "disappearance" of groups and of groupality in the contemporary world in different contexts where traditionally "making groups" had become a habit: clinical, therapeutic, institutional sphere. The question arises whether the difficulty encountered by professionals in mental health and psychosocial well-being, experts in groups, to initiate and maintain collective settings, is one of the numerous manifestations of the neoliberal drift that affects everyone's lives, relationships, the conception of the world and life

La trasmissione tra le generazioni

La trasmissione psichica e culturale tra generazioni è un processo essenziale che presenta sfide specifiche nel tempo attuale. Mentre la trasmissione tradizionale avveniva attraverso la parola e la presenza fisica, in spazi e tempi definiti, oggi essa si realizza attraverso sistemi digitali che annullano lo spazio pubblico e offrono un'infinita fonte virtuale di informazioni, ma priva di connessione generazionale. La memoria e il calcolo vengono sostituiti dall'informazione immediatamente disponibile, facendo sì che la formazione si riduca a un accumulo di notizie e tecniche, privo di approfondimento e personalizzazione. Questo processo sembra interrompere la trasmissione autentica, sostituendola con un enorme manuale d'uso virtuale. Le istituzioni accademiche tendono a privilegiare saperi oggettivi e impersonali, escludendo l'aspetto relazionale delle esperienze. La razionalità attuale si concentra sull'efficienza immediata a scapito dell'autonomia e dell'identità dell'operatore. La trasmissione richiede cura e fiducia, e, per essere efficace e autentica, richiede tempo, fiducia e relazioni profonde.The psychic and cultural transmission between generations is an essential process that faces specific challenges in the present time. While traditional transmission occurred through spoken word and physical presence, in defined spaces and times, today it takes place through digital systems that eliminate public space and offer an infinite virtual source of information, but lack generational connection. Memory and calculation are replaced by immediately available information, reducing education to a mere accumulation of facts and techniques, devoid of depth and personalization. This process seems to interrupt authentic transmission, replacing it with a massive virtual user manual. Academic institutions tend to prioritize objective and impersonal knowledge, excluding the relational aspect of experiences. Current rationality focuses on immediate efficiency at the expense of the autonomy and identity of the operator. Transmission requires care and trust, and to be effective and authentic, it necessitates time, trust, and deep relationships

Early and mid-term outcome of patients with low-flow-low-gradient aortic stenosis treated with newer-generation transcatheter aortic valves

Patients with non-paradoxical low-flow-low-gradient (LFLG) aortic stenosis (AS) are at increased surgical risk, and thus, they may particularly benefit from transcatheter aortic valve replacement (TAVR). However, data on this issue are still limited and based on the results with older-generation transcatheter heart valves (THVs). The aim of this study was to investigate early and mid-term outcome of TAVR with newer-generation THVs in the setting of LFLG AS. Data for the present analysis were gathered from the OBSERVANT II dataset, a national Italian observational, prospective, multicenter cohort study that enrolled 2,989 consecutive AS patients who underwent TAVR at 30 Italian centers between December 2016 and September 2018, using newer-generation THVs. Overall, 420 patients with LVEF <= 50% and mean aortic gradient <40 mmHg were included in this analysis. The primary outcomes were 1-year all-cause mortality and a combined endpoint including all-cause mortality and hospital readmission due to congestive heart failure (CHF) at 1 year. A risk-adjusted analysis was performed to compare the outcome of LFLG AS patients treated with TAVR (n = 389) with those who underwent surgical aortic valve replacement (SAVR, n = 401) from the OBSERVANT I study. Patients with LFLG AS undergoing TAVR were old (mean age, 80.8 +/- 6.7 years) and with increased operative risk (mean EuroSCORE II, 11.5 +/- 10.2%). VARC-3 device success was 83.3% with 7.6% of moderate/severe paravalvular leak. Thirty-day mortality was 3.1%. One-year all-cause mortality was 17.4%, and the composite endpoint was 34.8%. Chronic obstructive pulmonary disease (HR 1.78) and EuroSCORE II (HR 1.02) were independent predictors of 1-year mortality, while diabetes (HR 1.53) and class NYHA IV (HR 2.38) were independent predictors of 1-year mortality or CHF. Compared with LFLG AS treated with SAVR, TAVR patients had a higher rate of major vascular complications and permanent pacemaker, while SAVR patients underwent more frequently to blood transfusion, cardiogenic shock, AKI, and MI. However, 30-day and 1-year outcomes were similar between groups. Patients with non-paradoxical LFLG AS treated by TAVR were older and with higher surgical risk compared with SAVR patients. Notwithstanding, TAVR was safe and effective with a similar outcome to SAVR at both early and mid-term

Metastasis-Directed Radiation Therapy with Consolidative Intent for Oligometastatic Urothelial Carcinoma: A Systematic Review and Meta-Analysis

The management of patients with oligometastatic urothelial carcinoma (UC) represents an evolving field in uro-oncology, and the role of metastasis-directed therapies, including metastasectomy and metastasis-directed radiation therapy (MDRT), is gaining increasing attention. Herein, we summarize available evidence about the role of MDRT with consolidative intent in oligometastatic UC patients. A systematic review was performed in December 2021. Six studies involving 158 patients were identified. Most patients (n = 120, 90.2%) had a history of bladder cancer and the most frequent sites of metastases were lymph nodes (n = 61, 52.1%) followed by the lungs (n = 34, 29%). Overall, 144 metastases were treated with MDRT. Median follow-up ranged from 17.2 to 25 months. Local control rates ranged from 57% to 100%. Median Overall Survival (OS) ranged from 14.9 to 51.0 months and median progression-free survival ranged from 2.9 to 10.1 months. Rates of OS at one and two years ranged from 78.9% to 96% and from 26% to 63%, respectively. Treatment-related toxicity was recorded in few patients and in most cases a low-grade toxicity was evident. MDRT with consolidative intent represents a potential treatment option for selected patients with oligometastatic UC

One-Year Outcomes after Surgical versus Transcatheter Aortic Valve Replacement with Newer Generation Devices

The superiority of transcatheter (TAVR) over surgical aortic valve replacement (SAVR) for severe aortic stenosis (AS) has not been fully demonstrated in a real-world setting. This prospective study included 5706 AS patients who underwent SAVR from 2010 to 2012 and 2989 AS patients who underwent TAVR from 2017 to 2018 from the prospective multicenter observational studies OBSERVANT I and II. Early adverse events as well as all-cause mortality, major adverse cardiac and cerebrovascular events (MACCEs), and hospital readmission due to heart failure at 1-year were investigated. Among 1008 propensity score matched pairs, TAVR was associated with significantly lower 30-day mortality (1.8 vs. 3.5%, p = 0.020), stroke (0.8 vs. 2.3%, p = 0.005), and acute kidney injury (0.6 vs. 8.2%, p < 0.001) compared to SAVR. Moderate-to-severe paravalvular regurgitation (5.9 vs. 2.0%, p < 0.001) and permanent pacemaker implantation (13.8 vs. 3.3%, p < 0.001) were more frequent after TAVR. At 1-year, TAVR was associated with lower risk of all-cause mortality (7.9 vs. 11.5%, p = 0.006), MACCE (12.0 vs. 15.8%, p = 0.011), readmission due to heart failure (10.8 vs. 15.9%, p < 0.001), and stroke (3.2 vs. 5.1%, p = 0.033) compared to SAVR. TAVR reduced 1-year mortality in the subgroups of patients aged 80 years or older (HR 0.49, 95% CI 0.33-0.71), in females (HR 0.57, 0.38-0.85), and among patients with EuroSCORE II >= 4.0% (HR 0.48, 95% CI 0.32-0.71). In a real-world setting, TAVR using new-generation devices was associated with lower rates of adverse events up to 1-year follow-up compared to SAVR

Perceptions and attitudes toward the use of telemedicine for the postoperative outpatient urological care during the COVID-19 pandemic in an Academic Hospital in Southern Italy

Introduction: Telemedicine is a most used tools in various medical and surgical scenarios. The aim of the present study was to explore attitudes and perceptions by urologic patients toward the use of telemedicine in the context of patient-physicians communication during the post-operative follow-up in a large academic tertiary urology referral department in Italy. Materials and methods: An anonymous questionnaire consisting of 15 multiple choice questions was designed including three sections: respondents' demographics, attitudes, and perceptions towards the use of telemedicine. Invitations to participate to this anonymous questionnaire was given to outpatients attended at Urology Department, University of Naples Federico II. Results: In total 697 responses were received (participation rate 73%). The frequency of telemedicine use was described as frequently, occasional, rarely, and never by 41.6%, 30.4%, 15.1%, and 12.6% of respondents, respectively. WhatsApp messenger used by 59.5% of respondents and telephone call (34.3%) were the most common type of tools. Satisfaction in using telemedicine was reported as very satisfied, satisfied, neutral, dissatisfied, and very dissatisfied by 39.6%,41.4%,10%,7% and 2% of respondents respectively. Overall, 43.7%% of participants individuated limited interaction and risk of misdiagnosis as the major limit of telemedicine. Conclusions: Telemedicine represents the future of medical practice due to several benefits as well as convenience, increased access to care and decreased healthcare costs

Telemedicine and social media: A contemporary analysis of the most shared content by internet users

Objective: To evaluate the telemedicine information published on the most popular social media platforms, during the second year of the COVID-19 pandemic. Methods: We queried the BuzzSumo tool to identify related telemedicine article links that were shared most on social media, from February 2021 to February 2022. The PEMAT-P was used for the quality assessment of the most shared links. Results: 125 links were eligible for the analysis. Facebook was the most used social media platform for sharing articles (median engagement: 1000). Most of the articles were published by magazines (n = 82, 65.6%) and the main topic addressed was general information (n = 49, 39.2%). In the subgroup analyses of the 34 most shared articles, Facebook was the most used social media platform (median engagement:1950), most of the articles were published by magazines (n = 24, 70.6%), whereas the main topic addressed was the prescription of the abortion pill (n = 9, 26.5%). According to the PEMAT-P tool, the median understandability and actionability score was 63.8 and 20%, respectively. Conclusions: The interest in telemedicine has increased all over the world, as evidenced by the high engagement in social media articles, recorded during the last year. However, the access to digital health services is still limited, the information provided is often not verified by an official entity and unable to fill the digital divide exacerbated by COVID 19 pandemic crisis. Hence, health policy should be developed or modified to ensure a more egalitarian Internet access for all citizens. Official medical institutions should standardize telemedicine regulation and online content to reduce the widespread of misleading information