Search results for: trauma informed pedagogy

Authors: Rebecca K. Blais, Lindsey Monteith, Hallie Tannahill

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Military sexual trauma (MST) includes sexual harassment or assault that occurred during military service. Studies conducted to date on the association of MST with mental health and suicide outcomes are generally circumscribed to either active duty or veteran samples, precluding a thorough analysis of developmental trajectories of distress following MST within the context of ongoing (vs. discharged from) military service. The Military Social Science Laboratory has collected data on mixed service samples of men and women service members, addressing this important literature gap. The purpose of this study was to examine the association of MST, suicide risk, PTSD, depression, alcohol use, and posttraumatic cognitions using two separate samples, which collectively allow for a comprehensive examination of the development of distress following MST. The first sample consisted of 1389 men and women service members and veterans with varying levels of MST severity, including no MST, harassment-only MST, and assault MST. The second sample consisted of 400 men and women service members, all reporting the highest severity of MST, assault MST. In both samples, roughly half reported being discharged from service. Participants completed self-report measures of MST exposure severity, suicide ideation, suicide risk, PTSD, depression, alcohol misuse, and posttraumatic cognitions, as well as perceptions of how the military responded to their MST. Relative to those still serving in the US military, veterans were more likely to endorse suicidal ideation, higher PTSD symptoms, and higher depression symptoms if they felt the military mishandled their experience of MST (referred to as perceived institutional betrayal). However, among those reporting the most severe MST, veterans reported lower alcohol misuse and more adaptive posttraumatic cognitions. These findings suggest that those separated from the military experience different posttraumatic aftermath following MST relative to those who are currently serving in the military. Such findings suggest critical differences in the developmental trajectory of distress, necessitating different interventions to successfully reduce distress and dysfunction. Additional analyses will explore the impact of gender on these associations and explore full mechanistic models of distress grouped by discharged status.

Keywords: military sexual trauma, PTSD, suicide, developmental trajectories, depression

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Authors: Smita Nepal

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Despite being on the global education reform agenda for over two decades, interpretations and practices of inclusive education vary widely across the world. In Nepal, similar to many other developing countries, inclusive education is still an emerging concept and limited research is available to date in relation to how inclusive education is conceptualized and implemented here. Moreover, very little is known about how teachers who are at the frontline of providing inclusive education understand this concept and how well they are prepared to teach inclusively. This study addresses this research gap by investigating an overarching research question, ‘How prepared are Nepalese teachers to practice inclusive pedagogy?’ Different societies and cultures may have different interpretations of the concepts of diversity and inclusion. Acknowledging that such contextual differences influence how these issues are addressed, such as preparing teachers for providing inclusive education, this study has investigated the research questions using a sociocultural conceptual framework. A sequential mixed-method research design involved quantitative data from 203 survey responses collected in the first phase, followed by qualitative data in the second phase collected through semi-structured interviews with teachers. Descriptive analysis of the quantitative data and reflexive thematic analysis of the qualitative data revealed a narrow understanding of inclusive education in the participating Nepalese teachers with limited preparedness for implementing inclusive pedagogy. Their interpretation of inclusion substantially included the need for non-discrimination and the provision of equal opportunities. This interpretation was found to be influenced by the social context where a lack of a deep understanding of human diversity was reported, leading to discriminatory attitudes and practices. In addition, common norms established in society that experiencing privileges or disadvantages was normal for diverse groups of people appeared to have led to limited efforts to enhance teachers’ understanding of and preparedness for inclusive education. This study has significant implications, not only in the Nepalese context but globally, for reform in policies and practices and for strengthening the teacher education and professional development system to promote inclusion in education. In addition, the significance of this research lies in highlighting the importance of further context-specific research in this area to ensure inclusive education in a real sense by valuing socio-cultural differences.

Keywords: inclusive education, inclusive pedagogy, sociocultural context, teacher preparation

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Authors: Rika Uchida

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In teaching sophomore level aural skills, I have dealt with students with absolute pitch do poorly in my courses, particularly in harmonic dictation. They can identify triads; however, identifying quality of seventh chords or chromatic chords poses serious challenges. Most often, they need to spell all the pitches before identifying the chord qualities and Roman Numerals. Growing up in a country where acquiring absolute pitch is considered essential, I started my early music training with fixed do system at age three and learned all my music with solfege. When I was assigned as a TA in aural skills courses at graduate school in US, I had to learn relative pitch quickly. My survival method was listening to music with absolute pitch first, then quickly "translate" to relative pitch. In teaching my courses, I have been using chord progressions (5-8 chords total), in which students are asked to sing chord arpeggiation with movable do solfege. I use same progressions for harmonic dictation; I hoped that students learn to incorporate singing and listening skills by overlapping same materials. This method has proven to be successful for most students; in particular, it has helped students with absolute pitch to hear chord quality and function. Although original progressions are written in C as a tonic, they can identify chords in harmonic dictation in other keys as well. In short, I believe singing chord progression with movable do arpeggiation helps students with absolute pitch to improve hearing function and quality of chords in harmonic dictation.

Keywords: aural skills pedagogy, music theory, absolute pitch, harmonic dictation

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Authors: Neda Valizadeh, Mani Mofidi, Sama Haghighi, Ali Hashemaghaee, Soudabeh Shafiee Ardestani

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Background: There are many systems and parameters to evaluate trauma patients in the emergency department. Most of these evaluations are to distinguish patients with worse conditions so that the care systems have a better prediction of condition for a better care-giving. The purpose of this study is to determine the relationship between axillary body temperature and mortality in patients hospitalized in the intensive care unit (ICU) with multiple traumas and with other clinical and para-clinical factors. Methods: All patients between 16 and 75 years old with multiple traumas who were admitted into Emergency Department then hospitalized in the ICU were included in our study. An axillary temperature in the first and the second day of admission, Glasgow cola scale (GCS), systolic blood pressure, Serum glucose levels, and white blood cell counts of all patients at the admission day were recorded and their relationship with mortality were analyzed by SPSS software with suitable statistical tests. Results: Axillary body temperatures in the first and second day were statistically lower in expired traumatic patients (p=0.001 and p<0,001 respectively). Patients with lower GCS had a significantly lower first-day temperature and a significantly higher mortality. (p=0.006 and p=0.006 respectively). Furthermore, the first-day axillary temperature was significantly lower in patients with a lower first-day systolic blood pressure (p=0.014). Conclusion: Our results showed that lower axillary body temperature in the first day is associated with higher mortality, lower GCS, and lower systolic blood pressure. Thus, this could be used as a predictor of mortality in evaluation of traumatic patients in emergency settings.

Keywords: fever, trauma, mortality, emergency

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Authors: Jennifer K. Bowerman, Rhonda L. Reich

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The purpose of this paper is to explore the concepts ACDC (Amore, Consciousness, Discipline, and Commitment) which the authors first discovered as a philosophy and framework for recruitment and organizational development in a successful start-up tech company in Brazil. This paper represents an exploration of these concepts as a potential pedagogical foundation for undergraduate business education in the classroom. It explores whether their application has potential to build emotional and practical resilience in the face of constant organizational and societal change. Derived from Holonomy this paper explains the concepts and develops a narrative around how change influences the operation of organizations. Using examples from leading edge organizational theorists, it explains why a different educational approach grounded in ACDC concepts may not only have relevance for the working world, but also for undergraduates about to enter that world. The authors propose that in the global context of constant change, it makes sense to develop an approach to education, particularly business education, beyond cognitive knowledge, models and tools, in such a way that emotional and practical resilience and creative thinking may be developed. Using the classroom as an opportunity to explore these concepts, and aligning personal passion with the necessary discipline and commitment, may provide students with a greater sense of their own worth and potential as they venture into their ever-changing futures.

Keywords: ACDC, holonomic thinking, organizational learning, organizational change, business pedagogy

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Authors: Randy S. Magdaluyo, Lea M. Cabar, Jefferson Q. Correa

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One recurring issue in ESL writing is the confusing differences in the writing conventions of the first language and the target language. Culture may play an intriguing role in specifying writing features and structures that ESL writers have to follow. Although writing is typically organized in a three-part structure with introduction, body, and conclusion, it is important to analyze the complex nature of ESL writing. This study investigated the organizational features and structures of argumentative essays written in English by thirty college ESL students from three linguistic backgrounds (Cebuano, Chavacao, and Tausug) in a Philippine university. The nature of word order and sentence construction in the students’ essays and the specific components of the introduction, body, and conclusion were quantitatively and qualitatively analyzed based on ESL writing models. Focus group discussions were also conducted to help clarify the possible influence of students’ first language on the ways their essays were conceptualized and organized. Results indicate that while there was no significant difference in the overall introduction, body, and conclusion in all essays, the sentence length was interestingly different for each linguistic group of ESL students, and the word order was notably inconsistent with the S-V-O pattern of the target language. The first language was also revealed to have a facilitative role in the cognitive translation process of these ESL students. As such, implications for a multicultural writing pedagogy was discussed and recommended considering both the students’ native resources in their first language and the ESL writing models in their target language.

Keywords: community funds of knowledge, contrastive rhetoric, ESL writing, multicultural writing pedagogy

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Authors: Yi Meng, Yun Gao

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Having spent significant periods studying and working in North America and Europe, we, as two Chinese art educators, have been profoundly shaped by both Eastern and Western cultures. Consequently, our ambition is to enrich students' learning experiences by delving into and merging both cultural perspectives for innovative, creative expressions. This exposition draws on our action research study on students' visual literacy practices in a visual literacy course at a prominent Chinese university. The central premise was to explore innovative art forms by cross-utilizing various aspects of diverse cultures. By examining distinct cultural elements, we encouraged students to break away from familiar approaches and forge new paths in their creative endeavors. In implementing our curriculum, we utilized a multimodal pedagogy that deviated from the predominant print-based presentations typically employed in our classroom settings. This pedagogical approach effectively encouraged students to critically analyze the artifact, imbue it with their understanding and perspectives, and then produce an original piece. This approach also motivated students to leverage the semiotic potential of various communicative modes to address diverse cultural issues through their multimodal designs. To demonstrate the potential for cultural amalgamation, we utilized the artwork of Hong Kong-based artist Tik Ka. His works epitomize the fusion of Chinese traditions with Western pop culture, which served as a visual and conceptual reference point for students. Seeing how these distinct cultural elements could coexist and enrich each other in Tik Ka's work was inspiring and motivating for the students. Taken together, these pedagogical strategies helped create a dialogical space where students could actively experience, analyze, and negotiate complex modes of expression. This environment fostered active learning, encouraging students to apply their knowledge, question their assumptions, and reconsider their perspectives. Overall, such a unique approach to visual literacy education has the potential to reshape students' understanding of both cultures. By encouraging them to critically engage with their multimodal designs, we promoted an in-depth, nuanced appreciation of these diverse cultural heritages. The students no longer just interpreted and replicated images—they actively contributed to a dynamic and ongoing conversation between cultures.

Keywords: multimodal pedagogy, creative expressions, visual literacy education, multimodal designs

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Authors: G. A. Khalid, M. D. Jones, R. Prabhu, A. Mason-Jones, W. Whittington, H. Bakhtiarydavijani, P. S. Theobald

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Head injury in childhood is a common cause of death or permanent disability from injury. However, despite its frequency and significance, there is little understanding of how a child’s head responds during injurious loading. Whilst Infant Post Mortem Human Subject (PMHS) experimentation is a logical approach to understand injury biomechanics, it is the authors’ opinion that a lack of subject availability is hindering potential progress. Computer modelling adds great value when considering adult populations; however, its potential remains largely untapped for infant surrogates. The complexities of child growth and development, which result in age dependent changes in anatomy, geometry and physical response characteristics, present new challenges for computational simulation. Further geometric challenges are presented by the intricate infant cranial bones, which are separated by sutures and fontanelles and demonstrate a visible fibre orientation. This study presents an FE model of a newborn infant’s head, developed from high-resolution computer tomography scans, informed by published tissue material properties. To mimic the fibre orientation of immature cranial bone, anisotropic properties were applied to the FE cranial bone model, with elastic moduli representing the bone response both parallel and perpendicular to the fibre orientation. Biofiedility of the computational model was confirmed by global validation against published PMHS data, by replicating experimental impact tests with a series of computational simulations, in terms of head kinematic responses. Numerical results confirm that the FE head model’s mechanical response is in favourable agreement with the PMHS drop test results.

Keywords: finite element analysis, impact simulation, infant head trauma, material properties, post mortem human subjects

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Authors: Bharti Bhandari, Bharati Mehta, Sabyasachi Sircar

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Medical education is advancing in India, with its advancement newer innovations are being incorporated in teaching and assessment methodology. Our study focusses on a teaching innovation that is more student-centric than teacher-centric and is the need of the day. The teaching innovation was carried out in 1st year MBBS students of our institute. Students were assigned control and test groups. Priming was done for the students in the test group with an open-book MCQ based test in a particular topic before delivering formal didactic lecture on that topic. The control group was not assigned any such exercise. This was followed by formal didactic lecture on the same topic. Thereafter, both groups were assessed on the same topic. The marks were compiled and analysed using appropriate statistical tests. Students were also given questionnaire to elicit their views on the benefits of “self-priming”. The mean marks scored in theory assessment by the test group were statistically higher than the marks scored by the controls. According to students’ feedback, the ‘self-priming “process was interesting, helped in better orientation during class-room lectures and better understanding of the topic. They want it to be repeated for other topics with moderate difficulty level. Better performance of the students in the primed group validates the combination of student-centric priming model and didactic lecture as superior to the conventional, teacher-centric methods alone. If this system is successfully followed, the present teacher-centric pedagogy should increasingly give way to student-centric activities where the teacher is only a facilitator.

Keywords: medical education, open-book test, pedagogy, priming

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Authors: Muhandiram Rallage Ruvini Nisansala Yatigammana, Anuruddhika Kumudu Kumari Rajakaruna Jayathilaka

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Sports injuries are common among teenagers and children engaged in organized sports. While most sports injuries are typical, some rare occurrences involve conditions such as eye, dental, cervical, and rare internal organ injuries, such as pancreatic injuries. These injuries, especially traumatic pancreatitis, require prompt attention due to their potential for severe and sometimes fatal complications. This case revolves around a real accident involving a 12-year-old girl, Piyumi, who suffered a face-to-face collision during netball practice, resulting in severe abdominal pain. After a medical examination, she was diagnosed with a rare pancreatic injury, uncommon in children compared to adults. In Piyumi’s case, she had a grade 3 pancreatic injury and underwent non-surgical management, successfully healing her wound without surgery. The study attempts to fill empirical and population gaps, addressing a rarely discussed injury experienced by a 12-year-old female netball player. The paper will also provide an in-depth understanding of pancreatic injury, which is a rare sports injury. The study’s main objective was to investigate the incidence and characteristics of pancreatic injury, particularly focusing on pancreatic trauma, among children and adolescents engaged in high-impact sports, such as netball. This research adopted a case study strategy, employing interviews as the primary data collection method. Interviews were conducted with Piyumi, her parents, and the two specialist doctors directly involved in her treatment, providing firsthand accounts and insights. By examining the case, the paper arrives at three main conclusions. Firstly, pancreatic damage is uncommon, especially in the sports world, and proper diagnosis is essential to avoiding health concerns, particularly for minors. Secondly, CT (Computed Tomography) was useful in locating the injury, as injuries can be diagnosed very well with Computed Tomography (CT) images. Finally, and most importantly, pancreatic injuries are infrequent, but trauma can still occur, particularly in high-impact sports or accidents involving extreme force or falls. These injuries should be accurately diagnosed and treated promptly.

Keywords: child athlete, pancreatic injury, rare sports injuries, sportswoman

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Authors: Lynn Brunet

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In 2019 the author published a book-length study examining Jung’s Red Book. This study consisted of a close reading of each of the chapters in Liber Novus, focussing on the fantasies themselves and Jung’s accompanying paintings. It found that the plots, settings, characters and symbolism in each of these fantasies are not entirely original but remarkably similar to those found in some of the higher degrees of Continental Freemasonry. Jung was the grandson of his namesake, C.G. Jung (1794–1864), who was a Freemason and one-time Grand Master of the Swiss Masonic Lodge. The study found that the majority of Jung’s fantasies are very similar to those of the Ancient and Accepted Scottish Rite, practiced in Switzerland during the time of Jung’s childhood. It argues that the fantasies appear to be memories of a series of terrifying initiatory ordeals conducted using spurious versions of the Masonic rites. Spurious Freemasonry is a term that Masons use for the ‘irregular’ or illegitimate use of the rituals and are not sanctioned by the Order. Since the 1980s there have been multiple reports of ritual trauma amongst a wide variety of organizations, cults and religious groups that psychologists, counsellors, social workers, and forensic scientists have confirmed. The abusive use of Masonic rites features frequently in these reports. This initial study allows a reading of The Red Book that makes sense of the obscure references, bizarre scenarios and intense emotional trauma described by Jung throughout Liber Novus. It suggests that Jung appears to have undergone a cruel initiatory process as a child. The author is currently examining the extra material found in Jung’s Black Books and the results are confirming the original discoveries and demonstrating a number of aspects not covered in the first publication. These include the complex layering of ancient gods and belief systems in answer to Jung’s question, ‘In which underworld am I?’ It demonstrates that the majority of these ancient systems and their gods are discussed in a handbook for the Scottish Rite, Morals and Dogma by Albert Pike, but that the way they are presented by Philemon and his soul is intended to confuse him rather than clarify their purpose. This new study also examines Jung’s soul’s question ‘I am not a human being. What am I then?’ While further themes that emerge from the Black Books include his struggle with vanity and whether he should continue creating his ‘holy book’; and a comparison between Jung’s ‘mystery plays’ and examples from the Theatre of the Absurd. Overall, it demonstrates that Jung’s experience, while inexplicable in his own time, is now known to be the secret and abusive practice of initiation of the young found in a range of cults and religious groups in many first world countries. This paper will present a brief outline of the original study and then examine the themes that have emerged from the extra material found in the Black Books.

Keywords: C. G. Jung, the red book, the black books, masonic themes, trauma and dissociation, initiation rites, secret societies

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Authors: Richa Jaiswal, Vidisha Sharma, Amulya Rattan, Sushma Sagar, Subodh Kumar, Amit Gupta, Biplab Mishra, Maneesh Singhal

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Background: Adequate nutritional support and daily patient monitoring have an independent therapeutic role in the successful management of high output fistulae and early recovery after abdominal trauma. Case presentation: An 18-year-old girl was brought to AIIMS emergency with alleged history of fall of a heavy weight (electric motor) over abdomen. She was evaluated as per Advanced Trauma Life Support(ATLS) protocols and diagnosed to have significant abdominal trauma. After stabilization, she was referred to Trauma center. Abdomen was guarded and focused assessment with sonography for trauma(FAST) was found positive. Complete duodenojejunal(DJ) junction transection was found at laparotomy, and end-to-end repair was done. However, patient was re-explored in view of biliary peritonitis on post-operative day3, and anastomotic leak was found with sloughing of duodenal end. Resection of non-viable segments was done followed by side-to-side anastomosis. Unfortunately, the anastomosis leaked again, this time due to a post-anastomotic kink, diagnosed on dye study. Due to hostile abdomen, the patient was planned for supportive care, with plan of build-up and delayed definitive surgery. Percutaneous transheptic biliary drainage (PTBD) and STSG were required in the course as well. Nutrition: In intensive care unit (ICU), major goals of nutritional therapy were to improve wound healing, optimize nutrition, minimize enteral feed associated complications, reduce biliary fistula output, and prepare the patient for definitive surgeries. Feeding jejunostomy (FJ) was started from day 4 at the rate of 30ml/h along with total parenteral nutrition (TPN) and intra-venous (IV) micronutrients support. Due to high bile output, bile refeed started from day 13.After 23 days of ICU stay, patient was transferred to general ward with body mass index (BMI)<11kg/m2 and serum albumin –1.5gm%. Patient was received in the ward in catabolic phase with high risk of refeeding syndrome. Patient was kept on FJ bolus feed at the rate of 30–50 ml/h. After 3–4 days, while maintaining patient diet book log it was observed that patient use to refuse feed at night and started becoming less responsive with every passing day. After few minutes of conversation with the patient for a couple of days, she complained about enteral feed discharge in urine, mild pain and sign of dumping syndrome. Dye study was done, which ruled out any enterovesical fistula and conservative management were planned. At this time, decision was taken for continuous slow rate feeding through commercial feeding pump at the rate of 2–3ml/min. Drastic improvement was observed from the second day in gastro-intestinal symptoms and general condition of the patient. Nutritional composition of feed, TPN and diet ranged between 800 and 2100 kcal and 50–95 g protein. After STSG, TPN was stopped. Periodic diet counselling was given to improve oral intake. At the time of discharge, serum albumin level was 2.1g%, weight – 38.6, BMI – 15.19 kg/m2. Patient got discharge on an oral diet. Conclusion: Successful management of post-traumatic proximal high output fistulae is a challenging task, due to impaired nutrient absorption and enteral feed associated complications. Strategic- and goal-based nutrition support can salvage such critically ill patients, as demonstrated in the present case.

Keywords: nutritional monitoring, nutritional support, duodenal fistula, abdominal trauma

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Authors: Maryam Risla Shahul Hameed, Tharsiga Yogarajah, Fritzy Mathew, Tayyaba Syed, Shalin Shaunak

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Aim: Auditing the adherence of Trauma and Orthopaedics Operative notes to the RCS Good Surgical Practice Guidelines. Method: Clinical audit conducted on 150 operative notes over a period of 2 months April- May 2023, including emergency and elective surgeries performed in Ashford and St. Peter’s Hospital. The RCS Good Practice Surgical Guidelines for an ideal operative note were used to compare.Results: Date of the procedure and signature of the surgeon were mentioned in all the notes by default in the electronic template being used. Title of the operation performed and whether elective or emergency were mentioned by 92% and 45%, respectively. Name of theatre anaesthetist and operating surgeons were mentioned by 73% and 93% respectively. Time of surgery mentioned by 26%. Operative findings and operative diagnosis mentioned by 83% and 53% respectively. Incision and complications of surgery mentioned in 80% and 53%, respectively. Details of tissue added/ altered/ removed mentioned by 46%. Information on prosthesis or implant used is mentioned by 54%. Details of closure and anticipated blood loss mentioned in 91% and 45% respectively. Antibiotic prophylaxis was mentioned by 63%, out of which only 23% mentioned the name and duration of the antibiotic. VTE prophylaxis was mentioned by 84%, out of which only 23% and 29% mentioned the name and duration of the prophylaxis, respectively. Conclusion: There is more for improvement in the operative notes for better continuity of care between the operating surgeons and other doctors in the wards taking care of the patients post operatively. We recommend to follow a standardized guidelines by all the nationwide and a standard template to be followed by all.

Keywords: surgery, notes, RCS, guidelines

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Authors: Jia Liu

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This article explores the shifting nature of physician-patient relationship in mainland China. Specifically, it takes the physician-patient relationship during the barefoot doctor program in 1968-1978, the marketization of healthcare services in 1978-2002, and the healthcare reform in 2003-2020 as three typical historical periods, illustrating how the nature of the physician-patient relationship has changed over time in mainland China. Drawing on recent jurisprudential literature that emphasizes the roles and functions done by and through obligation rather than right, it explores how the obligations of physicians and patients along with the implementation of informed consent, marketization of the healthcare system, and the basic healthcare reform have affected their relationship. One key feature of this article is that it analyzes the ways in which commodification and decommodification of healthcare have defined and in many different ways have determined the expectations and practices of physicians and patients, which illustrates how the trust between physicians and patients threatens to collapse and the bond between the citizen and the state fails to be firmly established in the mainland Chinese healthcare context. It also pays special attention to the role played by law and legal institutions—for instance, the implementation of informed consent and the liability law—in being complicit in facilitating the decoupling of the practices of physicians and patients from their ethical senses of obligation and undermining the bond (the trust relationship) between them.

Keywords: healthcare, marketization, physician-patient relationship, sense of obligation

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Authors: Maelle Noir

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International Human rights norms prescribe the obligation to protect refugee women against violence which requires, inter alia, state provision of justiciable, accessible, affordable and non-discriminatory access to justice. However, the interpretation and application of the law still lack gender sensitivity, intersectionality and a trauma-informed approach. Consequently, many refugee survivors face important structural obstacles preventing access to justice and often experience secondary traumatisation when navigating the legal system. This paper argues that the unique nature of the experiences of refugees with gender-based violence against women exacerbated throughout the migration journey calls for a tailored practice of the law to ensure adequate access to justice. The argument developed here is that the obligation to provide survivors with justiciable, accessible, affordable and non-discriminatory access to justice implies radically transforming the practice of the law altogether. This paper, therefore, proposes feminist lawyering as an alternative approach to the practice of the law when addressing gender-based violence against women refugees. First, this paper discusses the specific nature of gender-based violence against refugees with a particular focus on two aspects of the power-violence nexus: the analysis of the shift in gender roles and expectations following displacement as one of the causes of gender-based violence against women refugees and the argument that the asylum situation itself constitutes a form of state-sponsored and institutional violence. Second, the re-traumatising and re-victimising nature of the legal system is explored with the objective to demonstrate States’ failure to comply with their legal obligation to provide refugee women with effective access to justice. Third, this paper discusses some key practical strategies that have been proposed and implemented to transform the practice of the law when dealing with gender-based violence outside of the refugee context. Lastly, this analysis is applied to the specificities of the experiences of refugee survivors of gender-based violence.

Keywords: feminist lawyering, feminist legal theory, gender-based violence, human rights law, intersectionality, refugee protection

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Authors: Mohammed E. Ibrahim, Baraa A. Taha, Kamil M. A. Shabban

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Background: Epilepsy is a common but widely misunderstood illness. Consequently, patients with epilepsy suffer from considerable stigmatization in society. This social stigma and discrimination often cause more suffering for the patients than the disease itself. Since very few studies have explored the misperceptions about epilepsy among university students in Sudan, it is not possible to provide focused intervention aimed at eliminating this discrimination. Methods: A cross-sectional study was applied among the first-year medical students at the University of Khartoum between December (2020) and February (2021). A 29-item standardized questionnaire was self-administered by 198 students (out of 320) who agreed to participate in this study. Google form was the tool used to collect the data. The data were analyzed using the Statistical Package for Social Science software version 26. Result: Overall, the results indicate a negative trend in knowledge and attitude toward epilepsy. The vast majority of the respondents (84.8%) have read or heard about epilepsy, while 43.9% had seen someone with epilepsy. Only 7.5% of the participants reported that epilepsy is contagious, whereas 43.4% of them think that epilepsy is a psychological disorder. About 62.2% of students think head/birth trauma is a cause of epilepsy. On the other side, about 15.7% and 5.1% believed that evil spirits and punishment from god can also be a possible cause of epilepsy; we found these false beliefs are more common in participants from rural areas (p-value < 0.05). In regard to attitude, 19.7% of students thought that it is inappropriate for a patient with epilepsy to have a child. This attitude correlates with the mother’s education as the percentage is higher for those who have lower mother’s education (through secondary school education and below) (p < 0.05). The majority of Our participant knew that some people with epilepsy need life-long drug treatment; this belief was found to be more common in females than their counterparts(p < 0.05). . Finally, most of the respondents (93.9%) thought that a child with epilepsy Can be successful in a normal class. This belief is four-time as common in participants whose mothers have higher education (through university education and above) compared with corresponding respondents (p < 0.05). Conclusion: This study concludes that students' knowledge about epilepsy is limited and requires immediate intervention through educational campaigns to develop a well-informed and tolerant community.

Keywords: epilepsy, awareness, attitude, university students, Sudan

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Authors: Adrian Craig, Jonathan Easaw, Rose Jordan, Ben Hall

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The prescription of intravenous fluids is a fundamental component of inpatient management, but it is one which usually lacks thought. Fluids are a drug, which like any other can cause harm when prescribed inappropriately or wrongly. However, it is well recognised that it is poorly done, especially in the acute portals. The National Institute for Health and Care Excellence (NICE) recommends 1mmol/kg of potassium, sodium, and chloride per day. With various options of fluids, clinicians tend to face difficulty in choosing the most appropriate maintenance fluid, and there is a reluctance to prescribe potassium as part of an intravenous maintenance fluid regime. The aim was to prospectively audit the prescription of the first bag of intravenous maintenance fluids, the use of urea and electrolytes results to guide the choice of fluid and the use of fluid prescription charts, in a busy emergency department of a major trauma centre in Stoke-on-Trent, United Kingdom. This was undertaken over a week in early November 2016. Of those prescribed maintenance fluid only 8.9% were prescribed a fluid which was most appropriate for their daily electrolyte requirements. This audit has helped to highlight further the issues that are faced in busy Emergency Departments within hospitals that are stretched and lack capacity for prompt transfer to a ward. It has supported the findings of NICE, that emergency admission portals such as Emergency Departments poorly prescribed intravenous fluid therapy. The findings have enabled simple steps to be taken to educate clinicians about their fluid of choice. This has included: posters to remind clinicians to consider the urea and electrolyte values before prescription, suggesting the inclusion of a suggested intravenous fluid of choice in the prescription chart of the trust and the inclusion of a session within the introduction programme revising intravenous fluid therapy and daily electrolyte requirements. Moving forward, once the interventions have been implemented then, the data will be reaudited in six months to note any improvement in maintenance fluid choice. Alongside this, an audit of the rate of intravenous maintenance fluid therapy would be proposed to further increase patient safety by avoiding unintentional fluid overload which may cause unnecessary harm to patients within the hospital. In conclusion, prescription of maintenance fluid therapy was poor within the Emergency Department, and there is a great deal of opportunity for improvement. Therefore, the measures listed above will be implemented and the data reaudited.

Keywords: chloride, electrolyte, emergency department, emergency medicine, fluid, fluid therapy, intravenous, maintenance, major trauma, potassium, sodium, trauma

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Authors: Shana Malio-Satele, Lemalu Silao Vaisola Sefo

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Introductory Statement: South Seas Healthcare is Ōtara’s largest Pacific health provider in South Auckland, New Zealand. Our vision is excellent health and well-being for Pacific people and all communities through strong Pacific values. During the DELTA and Omicron outbreak of COVID-19, our Pacific people, indigenous Māori, and the community of South Auckland were disproportionately affected and faced significant hardship with existing inequities magnified. This study highlights the community-based learnings of harnessing community-based strengths such as indigenous resilience, family-informed experiences and stories that provide critical insights that inform health reform changes that will be sustainable and equitable for all indigenous populations. This study is based on critical learnings acquired during COVID-19 that challenge the deficit narrative common in healthcare about indigenous populations. This study shares case studies of marginalised groups and religious groups and the successful application of indigenous cultural strengths, such as collectivism, positive protective factors, and using trusted relationships to create meaningful change in the way healthcare is delivered. The significance of this study highlights the critical conditions needed to adopt a community-informed way of creating integrated healthcare that works and the role that the community can play in being part of the solution. Methodologies: Key methodologies utilised are indigenous and Pacific-informed. To achieve critical learnings from the community, Pacific research methodologies, heavily informed by the Polynesian practice, were applied. Specifically, this includes; Teu Le Va (Understanding the importance of trusted relationships as a way of creating positive health solutions); The Fonofale Methodology (A way of understanding how health incorporates culture, family, the physical, spiritual, mental and other dimensions of health, as well as time, context and environment; The Fonua Methodology – Understanding the overall wellbeing and health of communities, families and individuals and their holistic needs and environmental factors and the Talanoa methodology (Researching through conversation, where understanding the individual and community is through understanding their history and future through stories). Major Findings: Key findings in the study included: 1. The collectivist approach in the community is a strengths-based response specific to populations, which highlights the importance of trusted relationships and cultural values to achieve meaningful outcomes. 2. The development of a “village model” which identified critical components to achieving health reform change; system navigation, a sense of service that was culturally responsive, critical leadership roles, culturally appropriate support, and the ability to influence the system enablers to support an alternative way of working. Concluding Statement: There is a strong connection between community-based strengths being implemented into healthcare strategies and reforms and the sustainable success of indigenous populations and marginalised communities accessing services that are cohesive, equitably resourced, accessible and meaningful for families. This study highlights the successful community-informed approaches and practices used during the COVID-19 response in New Zealand that are now being implemented in the current health reform.

Keywords: indigenous voice, community voice, health reform, New Zealand

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Authors: Kinneret Segal

Abstract:

The work of a midwife is emotionally challenging, both positively and negatively. Midwives share moments of joy when a baby is welcomed into the world, and also attend difficult events of loss and trauma. The relationship that develops with the maternity is the essence of the midwife's care, and it is a fundamental source of motivation and professional satisfaction. This close relationship with the maternity may be used as a double-edged sword in cases of exposure to traumatic events at birth. Birth problems, exposure to emergencies and traumatic events, and loss can affect the professional quality of life and the Compassion satisfaction of the midwife. It seems that the issue of traumatic experiences in the work of midwives, has not been sufficiently explored. The present study examined the associations between exposure to traumatic events, personal resilience and post-traumatic symptoms, professional quality of life and organizational commitment among midwifery nurses in Israeli hospitals. 131 midwives from three hospitals in the country's center in Israel participated in this study. The data were collected during 2021 using a self-report questionnaire that examined sociodemographic characteristics, the degree of exposure to traumatic events in the delivery room, personal resilience, post-traumatic symptoms, professional quality of life, and organizational commitment. The three most difficult traumatic events for the midwives were death or fear of death of a newborn, death or fear of the death of a mother and a quiet birth. The higher the frequency of exposure to traumatic events, the more numerous and intense the onset of post-trauma symptoms. The more numerous and powerful the post-trauma symptoms, the higher the level of professional burnout and/or compassion fatigue, and the lower the level of compassion satisfaction. High levels of compassion satisfaction and/or low professional burnout were expressed in a heightened sense of organizational commitment. Personal resilience, country of birth, traumatic symptoms and organizational commitment, predicted satisfaction from compassion. Midwives are exposed to traumatic events associated with dissatisfaction and impairment of the professional quality of life that accompanies burnout and compassion fatigue. Exposure to traumatic events leads to the appearance of traumatic symptoms, a decrease in organizational commitment, and psychological and mental well-being. The issue needs to be addressed by implementing training programs, organizational support, and policies to improving well-being and quality of care among midwives.

Keywords: traumatic experirnces, midwives, quality of life, burnout, organizational commitment, personal resilience

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Authors: Garry Gorman, Nigel McKelvey, James Connolly

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This study will evaluate a growth mindset intervention with Junior Cycle Coding and Senior Cycle Computer Science students in Ireland, where gamification will be used to incentivise growth mindset behaviour. An artificial intelligence (AI) driven personalised learning system will be developed to present computer programming learning tasks in a manner that is best suited to the individuals’ own learning preferences while incentivising and rewarding growth mindset behaviour of persistence, mastery response to challenge, and challenge seeking. This research endeavours to measure mindset with before and after surveys (conducted nationally) and by recording growth mindset behaviour whilst playing a digital game. This study will harness the capabilities of AI and aims to determine how a personalised learning (PL) experience can impact the mindset of a broad range of students. The focus of this study will be to determine how personalising the learning experience influences female and disadvantaged students' sense of belonging in the computer science classroom when tasks are presented in a manner that is best suited to the individual. Whole Brain Learning will underpin this research and will be used as a framework to guide the research in identifying key areas such as thinking and learning styles, cognitive potential, motivators and fears, and emotional intelligence. This research will be conducted in multiple school types over one academic year. Digital games will be played multiple times over this period, and the data gathered will be used to inform the AI algorithm. The three data sets are described as follows: (i) Before and after survey data to determine the grit scores and mindsets of the participants, (ii) The Growth Mind-Set data from the game, which will measure multiple growth mindset behaviours, such as persistence, response to challenge and use of strategy, (iii) The AI data to guide PL. This study will highlight the effectiveness of an AI-driven personalised learning experience. The data will position AI within the Irish educational landscape, with a specific focus on the teaching of CS. These findings will benefit coding and computer science teachers by providing a clear pedagogy for the effective delivery of personalised learning strategies for computer science education. This pedagogy will help prevent students from developing a fixed mindset while helping pupils to exhibit persistence of effort, use of strategy, and a mastery response to challenges.

Keywords: computer science education, artificial intelligence, growth mindset, pedagogy

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Authors: Asima Ranjan Parhi

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English language teaching-learning in higher education departments in Indian and Asian contexts needs to be one of innovation and experimentation rather than rigid prescription. The communicative language teaching has been proposing the context to be of primary importance in this process. Today, English print and electronic media have flooded the market with plenty of material suitable to the classroom context. The entries are poetic, catchy and contain a deliberate method in them which could be utilized to teach not only English language but literature, literary terms and the theory of literature. The Bollywood movies, especially through their songs have been propagating a package which may be useful to teach language and even theory in the sub-continent. While investigating, one may be fascinated to see how such material in the body of media (print and electronic), movies and popular songs generate a data for our classroom in our context, thereby developing a mass language with huge pedagogical implications. Harping on the four skills of teaching and learning of a language in general and English language in particular appears stale and mechanical in a decontextualised, matter of fact classroom. So this discussion visualizes a model beyond these skills as well as the conventional theory, literature, language classroom practices in order to build up a systematic pattern stressing the factors responsible in the particular context, that of specific language, society and culture in tune with language-literature teaching. This study intends to examine certain catchy use of the language entries in mass media which could be in the direction of inviting more such investigations in the Asian context in order to develop a common platform of decolonized pedagogy.

Keywords: pedagogy, electronic media, Bollywood, decolonized, mass media

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Authors: Asish Subedi, Krishna Pokharel, Birendra Prasad Sah, Pashupati Chaudhary

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Objectives: To evaluate an association between preoperative Nepali pain catastrophizing scale (N-PCS) scores and postoperative pain intensity and total opioid consumption. Methods: In this prospective cohort study we enrolled 135 patients with an American Society of Anaesthesiologists physical status I or II, aged between 18 and 65 years, and scheduled for surgery for lower-extremity fracture under spinal anaesthesia. Maximum postoperative pain reported during the 24 h was classified into two groups, no-mild pain group (Numeric rating scale [NRS] scores 1 to 3) and a moderate-severe pain group (NRS 4-10). The Spearman correlation coefficient was used to compare the association between the baseline N-PCS scores and outcome variables, i.e., the maximum NRS pain score and the total tramadol consumption within the first 24 h after surgery. Logistic regression models were used to identify the predictors for the intensity of postoperative pain. Results: As four patients violated the protocol, the data of 131 patients were analysed. Mean N-PCS scores reported by the moderate-severe pain group was 27.39 ±9.50 compared to 18.64 ±10 mean N-PCS scores by the no-mild pain group (p<0.001). Preoperative PCS scores correlated positively with postoperative pain intensity (r =0.39, [95% CI 0.23-0.52], p<0.001) and total tramadol consumption (r =0.32, [95% CI 0.16-0.47], p<0.001). An increase in catastrophizing scores was associated with postoperative moderate-severe pain (odds ratio, 1.08 [95% confidence interval, 1.02-1.15], p=0.006) after adjusting for gender, ethnicity and preoperative anxiety. Conclusion: Patients who reported higher pain catastrophizing preoperatively were at increased risk of experiencing moderate-severe postoperative pain.

Keywords: nepali, pain catastrophizing, postoperative pain, trauma

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Authors: Mohammad Akbar Paiman, Yasmin Nadeem Parpio, Naureen Akbarali, Khwaja Mir Islam Saeed, Murad Moosa Khan

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Background: Gender-based violence (GBV) is widely considered a significant public health problem that is associated with acute morbidity and mortality. GBV is commonly understood as a physical, sexual, and mental assault from intimate partners, sexual violence by non-partners, sexual assault of girls, and acts like trafficking women for sex. Objective: This study aimed to determine the factors associated with injuries and trauma among victims of GBV in Afghanistan. Method: We conducted a record-based analysis of the data collected by the Gender Department of the Family Protection Centre nationally between November 2013 and October 2019. Cross-tabulation between different variables such as age, sex, marital status, and type of violence and associations between different types of violence, age, gender, and geographical location was determined using the logistic regression model. Results: During the study period, there were a total of 58,160 GBV in Afghanistan. Most of the victims were women 98% with over three-quarters being adults 78%. Most of the victims were married 76%, followed by single 14%, widowed 5%, and engaged 5%. Over three-quarters of the violence, 73% was observed in the victim’s house while nearly one-quarter of the violence 24 % occurred in the perpetrator’s house. Conclusions: GBV is a significant public health problem in Afghanistan that needs to be addressed at multiple levels including policy, state, and community as well as by raising public awareness and education and a strong code of conduct against GBV by all stakeholders.

Keywords: gender-based violence, physical and psychological violence, injuries, Afghanistan

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Authors: Sandhyarani Guggilla

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For several reasons no two individuals can be considered identical and hence individualization of therapy is the current trend in treating the patients. Influence of menstrual cycle on the pharmacokinetics of Doxycycline. Twelve healthy female volunteers have been included in the study after obtaining written informed consent. The age ranged from 16 to 25 years. Experimental design: The volunteer selection and recruitment will be carried out after obtaining informed consent from each volunteer. The drug administration will be done to each volunteer at 7 a.m along with a glass of water after an overnight fasting on 3rd, 13th and 23rd day of menstrual cycle. These saliva samples will be stored under frozen conditions until HPLC analysis. Results: In the present study the changes in estrogen levels during ovulatory phase have not shown any influence onAUCo-t of Doxycycline. Only AUCo-t of doxycycline showed an increasing trend with increasing levels of estrogen in ovulatory phase, but not in other phases. Even though the FSH levels differed significantly among volunteers during different phases FSH does not seem to influence the overall pharmacokinetic behavior of Doxycycline during different phases. The present study indicated only the trend that the hormone levels may influence the pharmacokinetic behavior of the Doxycycline. Conclusion: In the present study the changes in hormones have shown an increasing C-max, increasing AUCo-t of Doxycycline pharmacokinetics significantly in follicular phase than ovulatory and luteal phases among volunteers during different phases. In other pharmacokinetic properties like clearance, biological half-life, volume of distribution, mean residence time the change was not significant.

Keywords: menstrual cycle, doxycycline, estrogen, FSH, ovulatory phase

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Authors: Abhishek Sharma, Amit Gupta, Manish Singhal

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Background: The management of patients with penetrating neck injuries in the prehospital setting and in the emergency department has evolved with regard to the use of multidetector computed tomographic (MDCT) imaging. Hence, there is a shift in the management of neck injuries from mandatory exploration in certain anatomic areas to more conservative approach using imaging and so-called “no zone approach”. Objective: To study the no zone approach in the management of penetrating neck injury using routine imaging in all stable patients. Methods: 137 patients with penetrating neck injury attending emergency department of level 1 trauma centre at AIIMS between 2008–2014 were retrospectively analysed. All hemodynamically stable patients were evaluated using CT scanning. Results: Stab injury is most common (55.91%) mode of pni in civilian population followed by gunshot(18.33%). The majority of patients could be managed with imaging and close observation. 39 patients (28.46%) required operative intervention. The most common indication for operative intervention was vascular followed by airway injury manifesting as hemodynamic destabilisation.There was no statistical difference between the zonal distribution of injuries in patients managed conservatively and those taken to OR. Conclusions: Study shows that patients with penetrating neck trauma who are haemodynamically stable and exhibit no “hard signs” of vascular injury or airway injury may be evaluated initially by MDCT imaging even when platysma violation is present. “No Zone” policy may be superior to traditional zone wise management.

Keywords: penetrating neck injury, zone approach, CT scanning, multidetector computed tomographic (MDCT)

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Authors: Rebekah Volgin, Jane Shakespeare-Finch, Ian Shochet

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Commercial sexual exploitation (CSE) and sex trafficking affect between 5000-7000 girls and women in Nepal each year and can have devastating physical and psychological consequences. Much research has documented these effects, however, there is no published longitudinal research that focuses on whether healing and growth outcomes are possible for survivors of CSE and sex trafficking. The narratives of 27 girls and women (13-22 years) were taken at two-time points during participation in a six-week group psychoeducation and art therapy program which was delivered across three NGO’s in Kathmandu, Nepal. These narratives form part of a larger ethnographic project. Thematic analysis of the data was undertaken. Themes emerging from time point 1 were: psychological distress in the form of anxiety and grief over loss of family, psychosomatic symptoms, empathy and compassion, and posttraumatic growth (PTG) in the form of new possibilities, relating to others and personal strength. Posttraumatic growth refers to positive changes in the aftermath of trauma. The themes emerging from time point 2, were: empathy and compassion and PTG (cognitive restructuring, new possibilities, relating to others and personal strength). Alongside the distress that these participants experienced, they also experienced positive outcomes such as empathy and compassion and psychological growth. Future research would advance knowledge by further examining the process of PTG in this population, if the changes observed were lasting, and if so, ways in which PTG can be facilitated or promoted.

Keywords: commercial sexual exploitation, human trafficking, posttraumatic growth, sexual trauma

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Authors: Hannah M. Russell

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‘The Attach Project’ (TAP), is an educational intervention aimed at improving educational and socio-emotional outcomes for children who are looked after. TAP is underpinned by Attachment Theory and is adapted from Dyadic Developmental Psychotherapy (DDP), which is a treatment for children and young people impacted by complex trauma and disorders of attachment. TAP has been implemented in primary schools in Northern Ireland throughout the 2018/19 academic year. During this time, a design and implementation study has been conducted to assess the promise of effectiveness for the future dissemination and ‘scaling-up’ of the programme for a larger, randomised control trial. TAP has been designed specifically for implementation in a school setting and is comprised of a whole school element and a more individualised Key Adult-Key Child pairing. This design and implementation study utilises a mixed-methods research design consisting of quantitative, qualitative, and observational measures with stakeholder input and involvement being considered an integral component. The use of quantitative measures, such as self-report questionnaires prior to and eight months following the implementation of TAP, enabled the analysis of the strengths and direction of relations between the various components of the programme, as well as the influence of implementation factors. The use of qualitative measures, incorporating semi-structured interviews and focus groups, enabled the assessment of implementation factors, identification of implementation barriers, and potential methods of addressing these issues. Observational measures facilitated the continual development and improvement of ‘TAP training’ for school staff. Preliminary findings have provided evidence of promise for the effectiveness of TAP and indicate the potential benefits of introducing this type of attachment-based intervention across other educational settings. This type of intervention could benefit not only children who are looked after but all children who may be impacted by complex trauma or disorders of attachment. Furthermore, findings from this study demonstrate that it is possible for children to form a secondary attachment relationship with a significant adult in school. However, various implementation factors which should be addressed were identified throughout the study, such as the necessity of protected time being introduced to facilitate the development of a positive Key Adult- Key Child relationship. Furthermore, additional ‘re-cap’ training is required in future dissemination of the programme, to maximise ‘attachment friendly practice’ in the whole staff team. Qualitative findings have also indicated that there is a general opinion across school staff that this type of Key Adult- Key Child pairing could be more effective if it was introduced as soon as children begin primary school. This research has provided ample evidence for the need to introduce relationally based interventions in schools, to help to ensure that children who are looked after, or who are impacted by complex trauma or disorders of attachment, can thrive in the school environment. In addition, this research has facilitated the identification of important implementation factors and barriers to implementation, which can be addressed prior to the ‘scaling-up’ of TAP for a robust, randomised controlled trial.

Keywords: attachment, complex trauma, educational interventions, implementation

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Authors: Sandra K. Enriquez, Claudia Camargo, Jesús E. Olguín, Juan A. López, German Galindo

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Currently companies have increased the number of disorders of cumulative trauma (CTDs), these are increasing significantly due to the Highly Repetitive Movements (HRM) performed in workstations, which causes economic losses to businesses, due to temporary and permanent disabilities of workers. This analysis focuses on the prevention of disorders caused by: repeatability, duration and effort; And focuses on reducing cumulative trauma disorders such as occupational diseases using sensory thermography as a noninvasive method, the above is to evaluate the injuries could have workers to perform repetitive motions. Objectives: The aim is to define rest periods or job rotation before they generate a CTD, this sensory thermography by analyzing changes in temperature patterns on wrists and elbows when the worker is performing HRM over a period of time 2 hours and 30 minutes. Information on non-work variables such as wrist and elbow injuries, weight, gender, age, among others, and work variables such as temperature workspace, repetitiveness and duration also met. Methodology: The analysis to 4 industrial designers, 2 men and 2 women to be specific was conducted in a business in normal health for a period of 12 days, using the following time ranges: the first day for every 90 minutes continuous work were asked to rest 5 minutes, the second day for every 90 minutes of continuous work were asked to rest 10 minutes, the same to work 60 and 30 minutes straight. Each worker was tested with 6 different ranges at least twice. This analysis was performed in a controlled room temperature between 20 and 25 ° C, and a time to stabilize the temperature of the wrists and elbows than 20 minutes at the beginning and end of the analysis. Results: The range time of 90 minutes working continuous and a rest of 5 minutes of activity is where the maximum temperature (Tmax) was registered in the wrists and elbows in the office, we found the Tmax was 35.79 ° C with a difference of 2.79 ° C between the initial and final temperature of the left elbow presented at the individual 4 during the 86 minutes, in of range in 90 minutes continuously working and rested for 5 minutes of your activity. Conclusions: It is possible with this alternative technology is sensory thermography predict ranges of rotation or rest for the prevention of CTD to perform HRM work activities, obtaining with this reduce occupational disease, quotas by health agencies and increasing the quality of life of workers, taking this technology a cost-benefit acceptable in the future.

Keywords: sensory thermography, temperature, cumulative trauma disorder (CTD), highly repetitive movement (HRM)

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Authors: Kinneret Segal

Abstract:

Background: The work of a midwife is emotionally challenging, both positively and negatively. Midwives share moments of joy when a baby is welcomed into the world and also attend difficult events of loss and trauma. The relationship that develops with the maternity is the essence of the midwife's care, and it is a fundamental source of motivation and professional satisfaction. This close relationship with the maternity may be used as a double-edged sword in cases of exposure to traumatic events at birth. Birth problems, exposure to emergencies and traumatic events, and loss can affect the professional quality of life and the Compassion satisfaction of the midwife. It seems that the issue of traumatic experiences in the work of midwives has not been sufficiently explored. Aim: The present study examined the associations between exposure to traumatic events, personal resilience and post-traumatic symptoms, professional quality of life, and organizational commitment among midwifery nurses in Israeli hospitals. Methods: 131 midwives from three hospitals in the country's center in Israel participated in this study. The data were collected during 2021 using a self-report questionnaire that examined sociodemographic characteristics, the degree of exposure to traumatic events in the delivery room, personal resilience, post-traumatic symptoms, professional quality of life, and organizational commitment. Results: The three most difficult traumatic events for the midwives were death or fear of death of a newborn, death or fear of the death of a mother, and a quiet birth. The higher the frequency of exposure to traumatic events, the more numerous and intense the onset of post-trauma symptoms. The more numerous and powerful the post-trauma symptoms, the higher the level of professional burnout and/or compassion fatigue, and the lower the level of compassion satisfaction. High levels of compassion satisfaction and/or low professional burnout were expressed in a heightened sense of organizational commitment. Personal resilience, country of birth, traumatic symptoms, and organizational commitment predicted satisfaction from compassion. Conclusions: Midwives are exposed to traumatic events associated with dissatisfaction and impairment of the professional quality of life that accompanies burnout and compassion fatigue. Exposure to traumatic events leads to the appearance of traumatic symptoms, a decrease in organizational commitment, and psychological and mental well-being. The issue needs to be addressed by implementing training programs, organizational support, and policies to improving well-being and quality of care among midwives.

Keywords: organizational commitment, traumatic experiences, personal resilience, quality of life

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Authors: Dawn Tsang

Abstract:

This paper aims at synthesizing the difficulties in cognitive processes faced by translation majors in mainland China. The purpose is to develop possible solutions and innovation in terms of translation pedagogy, curriculum reform, and syllabus design. This research will base its analysis on students’ instant feedback and interview after training in translation and interpreting courses, and translation faculty’s teaching experiences. This research will take our translation majors as the starting point, who will be one of the focus groups. At present, our Applied Translation Studies Programme is offering translation courses in the following areas: practical translation and interpreting, translation theories, culture and translation, and internship. It is a four-year translation programme, and our students would start their introductory courses since Semester 1 of Year 1. The medium of instruction of our College is solely in English. In general, our students’ competency in English is strong. Yet in translation and especially interpreting classes, no matter it is students’ first attempt or students who have taken university English courses, students find class practices very challenging, if not mission impossible. Their biggest learning problem seems to be weakening cognitive processes in terms of lack of intercultural competence, incomprehension of English language and foreign cultures, inadequate aptitude and slow reaction, and inapt to utilize one’s vocabulary bank etc. This being so, the research questions include: (1) What specific and common cognitive difficulties are students facing while learning translation and interpreting? (2) How to deal with such difficulties, and what implications can be drawn on curriculum reform and syllabus design in translation? (3) How significant should cognitive study be placed on translation curriculum, i.e., the proportion of cognitive study in translation/interpreting courses and in translation major curriculum? and (4) What can we as translation educators do to maximize teaching and learning effectiveness by incorporating the latest development of cognitive study?. We have collected translation students’ instant feedback and conduct interviews with both students and teaching staff, in order to draw parallels as well as distinguishing from our own current teaching practices at United International College (UIC). We have collected 500 questionnaires for now. The main learning difficulties include: poor vocabulary bank, lack of listening and reading comprehension skills in terms of not fully understanding the subtext, aptitude in translation and interpreting etc. This being so, we propose to reform and revitalize translation curriculum and syllabi to address to these difficulties. The aim is to maximize teaching effectiveness in translation by addressing the above-mentioned questions with a special focus on cognitive difficulties faced by translation majors.

Keywords: cognitive difficulties, teaching and learning effectiveness, translation curriculum reform, translation pedagogy

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