Compare outcome in patients of ileostomy and colostomy closure with surgical stapler versus ileostomy and colostomy closure with hand sewn anastomosis: a prospective study

Background: Diverting temporary stoma is created to protect the primary bowel pathology and distal anastomosis. Once that primary pathology has been overcome or distal anastomosis gets healed, closure of temporary stomas can be carried out. Invention of stapling devices for intestinal anastomosis provided another dimension than hand sewn method to the stoma closure techniques. In this study, we have compared two methods of loop stoma closure-hand sewn method versus stapler method.Methods: This is prospective comparative study in which 50 cases of loop ileostomy/colostomy were taken. 25 patients underwent ileostomy/colostomy closure by hand sewn anastomosis (group A). Another 25 patients underwent ileostomy/colostomy closure by stapler anastomosis (group B). Time taken for operation, initiation of oral intake, anastomotic leak, post-operative wound infection and total hospital stay duration were compared between these two groups to conclude about which method is superior and in the best interest of patient and surgeon.Results: Mean operation time 105.96 minutes (group A) and 72.84 minutes (group B). Mean time to start oral intake 5.36 days (group A), 3.6 days (group B). 16% patients (4/25) group A and 4% patients (1/25) group B developed anastomotic leak. 28% patients (7/25) group A and 8% patients (2/25) group B had post-operative wound infection. Mean hospital stay 10.4 days in group A and 7.84 days in group B.Conclusions: Stapler method provides significant benefits in terms of less operative time, early oral intake and less hospital stay. Overall stapler method for stoma closure is more efficient and cost effective.

A moral e a morte como defesas perante a culpa e a insatisfação libidinal em uma tragédia de Nelson Rodrigues / Morality and death as defenses against guilt and libidinal dissatisfaction in a tragedy of Nelson Rodrigues / La moral y la muerte como defensas ante la culpa y la insatisfacción libidinal en una tragedia de Nelson Rodrigues

As afinidades da psicanálise com a literatura são inequívocas e estão presentes desde as primeiras formulações freudianas. Édipo Rei, de Sófocles, e as tragédias de Shakespeare são manifestações dessa relação. Neste trabalho, elegemos como objeto de análise da tragédia rodrigueana "A falecida", que estreou em maio de 1953. A hipótese proposta sobre os percalços de Zulmira, a protagonista, postula que seu contexto de pobreza cultural e material, a falta de afeto demonstrada pelo marido e o sentimento de culpa por tê-lo traído desencadeiam sua busca de elevação moral. Para ela o sexo, e todas as suas manifestações libidinais, passa a ser abominável e sua grande obsessão torna-se a cerimônia do seu enterro. As acusações do Supereu a atormentam a ponto de ela acreditar que apenas a morte, seguida por um enterro luxuoso, poderá redimi-la. Isso parece indicar que essa personagem intenciona buscar na morte e no ritual de purificação que a envolve, uma redenção para sua vida medíocre e neurótica. Zulmira torna-se uma vítima inerte do Supereu que, como veículo da pulsão de morte, acabará por levá-la ao padecimento. A ciência, representada pelo médico Dr. Borborena, não consegue escutar a queixa de desamor de Zulmira e sua estruturação histérica. Procede-se também a uma análise da narrativa por meio do modelo actancial proposto por Greimas.

The affinities of psychoanalysis with the literature are unmistakable and have been present since the earliest Freudian formulations. Oedipus the King, by Sophocles, and the tragedies of Shakespeare are manifestations of this relationship. In this work, we chose as an object of analysis of the Rodriguean tragedy "The deceased" that premiered in May 1953. The proposed hypothesis about Zulmira's mishaps, the protagonist, postulates that its context of cultural and material poverty, lack of affection demonstrated by husband and the sense of guilt for having betrayed him, unleash his quest for moral elevation. For her, sex and all her libidinal manifestations become abominable and her great obsession becomes the ceremony of her burial. The accusations of the Superego torment her to the point where she believes that only death, followed by a luxurious burial, you can redeem it. This seems to indicate that this character intends to seek in death and the purification ritual that surrounds her, a redemption for her mediocre and neurotic life. Zulmira becomes an inert victim of the Superego, who, as a vehicle for the death drive, will eventually lead her to suffering. Science, represented by Dr. Borborena, cannot hear Zulmira's complaint of dismay and her hysterical structure. An analysis of the narrative is also done through the actantial model proposed by Greimas.

Las afinidades del psicoanálisis con la literatura son inequívocas y están presentes desde las primeras formulaciones freudianas. Edipo Rey, de Sófocles, y las tragedias de Shakespeare son manifestaciones de esa relación. En este trabajo, elegimos como objeto de análisis de la tragedia rodrigueana "La fallecida" que se estrenó en mayo de 1953. La hipótesis propuesta sobre los percances de Zulmira, la protagonista, postula que su contexto de pobreza cultural y material, la falta de afecto demostrada por el marido y el sentimiento de culpa por haberlo traicionado, desencadenan su búsqueda de elevación moral. Para ella, el sexo y todas sus manifestaciones libidinales, pasa a ser abominable y su gran obsesión se convierte en la ceremonia de su entierro. Las acusaciones de Superyó la atormentan hasta el punto de que cree que sólo la muerte, seguida por un entierro lujoso, puede redimirla. Esto parece indicar que ese personaje intenta buscar en la muerte y en el ritual de purificación que la envuelve, una redención para su vida mediocre y neurótica. Zulmira se convierte en una víctima inerte del Superyó, que, como vehículo de la pulsión de muerte, acabará por llevarla al padecimiento. La ciencia, representada por el médico Dr.Borborena, no consigue escuchar la queja de desamor de Zulmira y su estructuración histérica. Se procede también a un análisis de la narrativa a través del modelo actancial propuesto por Greimas.

Construyendo el concepto de la resiliencia: una revisión de la literatura / Building the concept of resilience: a review of the literature

Este articulo expone una revisión bibliográfica de la resiliencia como proceso transformador que se ha venido consolidando a través del tiempo y que surge a partir de la psicología positiva. Ofrece, además, algunas reflexiones finales para clarificar el concepto de resiliencia, pese a sus múltiples usos e interpretaciones, a partir del lente del sociólogo Stefan Vanistendael, quién brinda una comprensión más holística e integral de su significado.

This article exposes a bibliographic review of resilience as a transformative process that has been consolidated over time and that arises from positive psychology. It also offers some final reflections to clarify the concept of resilience, despite its multiple uses and interpretations, from the lens of sociologist Stefan Vanistendael, who provides a more holistic and comprehensive understanding of its meaning.

É possível superar ideações e tentativas de suicídio? Um estudo sobre idosos / Is it possible to overcome suicidal ideation and suicide attempts? A study of the elderly

Este estudo apresenta uma análise qualitativa sobre como idosos que tentaram suicídio passaram a superar o desejo e o impulso de tirar a própria vida. Faz parte de uma pesquisa com 87 homens e mulheres brasileiros de 60 anos ou mais, residentes em várias regiões do país e com comportamento suicida, dos quais 20 deram pistas importantes sobre suas estratégias de enfrentamento (coping). A análise aqui realizada se refere apenas a esses últimos. Todos foram ouvidos por meio de entrevistas semiestruturadas, que incluíam em seu escopo perguntas sobre o processo de superação das ideações e tentativas. O foco central da análise – superação – se apoiou nos seguintes conceitos: estratégias de enfrentamento (coping), autonomia e equilíbrio emocional. E da fala dos idosos emergiram cinco núcleos de sentido que ressaltam a efetividade dos seguintes elementos, independentemente do sexo dos entrevistados: religiosidade e práticas religiosas; apoio social e familiar; suporte dos serviços de saúde; contato com animais de estimação; e retomada da autonomia para gerir a própria vida. Este estudo pode subsidiar a prevenção primária e secundária dos comportamentos suicidas em pessoas idosas.

This study presents a qualitative analysis of how older people who had attempted suicide began to overcome the desire and the urge to take their own life. This article is based on a survey of 87 Brazilian men and women aged 60 and over, living in different regions of Brazil, who have demonstrated suicidal behaviour; twenty of whom gave important information about their coping strategies. The analysis in this article only refers to the aforementioned twenty participants. All the participants were heard through semi-structured interviews, which included questions about the process of overcoming suicidal ideation and suicide attempts. The central focus of the analysis - overcoming suicidal ideation and suicide attempts - was based on the following concepts: coping strategies, autonomy, and emotional balance. Irrespective of the gender of the respondents, five centers of meaning emerged from the discourses of the elderly, which highlighted the effectiveness of the following factors: religiosity and religious practices; social and family support; the support of health services; contact with pets; and the recovery of the autonomy to manage their own lives. This study can help to support the primary and secondary prevention of suicidal behavior in older people.

A Study on the Patients with Hansen's Disease who Experienced Suicidal Urge and Overcame Suicide / 나학회지

This research analyzed the structural dynamics about neglected and isolated patients with Hansen's disease who experienced suicidal urge and overcame suicide. The research found the way to prevent them from killing themselves by searching what triggered the suicidal urge and how they got over the temptation. The participants were 6 members who lived in the group home. They had been excluded from the community and their family. They were trafficked for forced labor from their group home. This experience had caused suicidal urge before they came to the group home. To know how they overcame suicidal urge, they were interviewed by using semi-structured opened ended questions. According to the interview, there are four reasons that stopped the suicidal urge. The participants said that the first reason to stop thinking about death is the belief. This is a reliance on almighty God. Because the place where they live together is run by the Catholic Foundation, the community spirit and their belief are thought as the particular reason. Second, they got an economical and emotional support from their group home. Their group home provided food, clothing, and shelter, which were never provided from their family and society. By living together with other patients, they strengthened their emotional relationship and made a new social community. Next, they were getting generous when they belonged here. They accepted social prejudice without confronting unreasonable issues. Last, they changed their aim of life. They decided to live happily for good. They thought it could be the only way to take revenge to people who ignored and excluded them from the society. That is, they found the certain goal of their life by making new social relationship from the group home which could be called their real home. Also, they were helping one another in their community in various ways. As a result, this facility provided emotional and financial support and cooperating systems to people who were living together. From the investigation going along, social relationship is thought as the main factor of overcoming suicide. So, it is necessary to build social relationship to interact with other people who are in the same oven. It is also important to make well established motional and financial support from the society. On the basis of data furnished by this research, it is essential to develop infrastructure for overcoming suicide of the neglected people beside patients with Hansen's disease.

The Process of Overcoming the Professional Burnout of Clinical Nurses / 간호행정학회지

PURPOSE: The purpose of this study was to identify the process of overcoming professional burnout among clinical nurses. METHODS: Data were collected from 12 clinical nurses through in-depth interviews about their actual experiences. The main question was "How do you describe your experience of the process of overcoming professional burnout?" Qualitative data from the field notes and transcribed notes were analyzed using the grounded theory methodology developed by Strauss & Corbin. RESULTS: The core category of experience of the process of professional burnout among clinical nurses was identified as "Keeping a balance by awakening-relaxing-coexisting". The participants used six interactional strategies such as 'Confronting problems', 'Exposing problems', 'Laying the mind's burdens down', 'Taking a breather', 'Seeing from a different perspective', 'Accepting realities'. The results of overcoming process of professional burnout were 'Coexisting' and 'Revitalizing'. CONCLUSION: The results of this study provide useful information for designing supportive programs and policies to solve professional burnout in clinical nurses.