Search results for: trauma team activations

Authors: Ravid Yinon

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Introduction: Pelvic trauma causes high mortality, particularly among the elderly population. Pelvic injury ranges from low-energy incidents such as falls to high-energy trauma like motor vehicle accidents. The mortality rate among high-energy trauma patients is higher, as can be expected. The elderly population is more vulnerable to pelvic trauma even at low energy mechanisms due to the fragility and diminished physiological reserve of these patients. The aim of this study is to examine whether there is a higher long-term mortality in pelvic injuries in the elderly from the low-energy mechanism than those injured in high energy. Methods: A retrospective cohort study was conducted in a level 1 trauma center with injured patients aged 65 years and over with pelvic trauma. The patients were divided into two groups of low and high-energy mechanisms of injury. Multivariate analysis was conducted to characterize the differences between the groups. Results: There were 585 consecutive injured patients over the age of 65 with a documented pelvic injury who were treated at the primary trauma center between 2008-2020. The injured in the high energy group were younger (mean HE- 75.18, LE-80.73), with fewer comorbidities (mean 0.78 comorbidities at HE and 1.28 at LE), more men (52.6% at HE and 27.4% at LE), were consumed more treatments facilities such as angioembolization, ICU admission, emergency surgeries and blood products transfusion and higher mortality rate at admission (HE- 19/133, 14.28%, LE- 10/452, 2.21%) compared to the low energy group. However, in a long-term follow-up of one year after the injury, mortality in the low-energy group was significantly higher (HE- 14/114, 12.28%, LE- 155/442, 35.06%). Discussion: Although it can be expected that in the mechanism of high energy, the mortality rate in the long term would be higher, it was found that mortality at the low energy patient was higher. Apparently, low-energy pelvic injury in geriatric patients is a measure of frailty in these patients, causes injury to more frail and morbid patients, and is a predictor of mortality in this population in the long term. Conclusion: The long-term follow-up of injured elderly with pelvic trauma should be more intense, and the healthcare provider should put more emphasis on the rehabilitation of these special patient populations in an attempt to prevent long-term mortality.

Keywords: pelvic trauma, elderly trauma, high energy trauma, low energy trauma

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Authors: Kirsten B. Hillman

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There is a growing body of qualitative research in adult mental health and music therapy contexts which highlights user perspectives; however, only a very small sub-section of this literature pertains to people with lived experiences of psychological trauma. This paper will provide a meta-synthesis of this existing body of research, with the intention to present a cohesive overview of salient themes in this research and a platform for the under-represented voices of those with lived experience. This synthesis will be contextualised within a broader discussion of ‘Voice’ in trauma and music therapy research, considering its layered meanings: including literal expressive vocalising and musical expression, voicing after experiences of silencing, and the possibilities of experiencing self-determination and agency in therapy after trauma.

Keywords: lived experience, music therapy, trauma, user perspectives

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Authors: Y. R. Lai, J. C. Jehng, T. T. Chang

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Team is a popular job design in the management settings. Because people on a team need to work together to complete a lot of tasks, the interaction between team members strongly influences team effectiveness. The study examines the effect of social capital and empowering leadership on team cohesion. There are three facets of social capital: structural facet, relational facet, and cognitive facet. Empowering leadership includes enhancing the meaningfulness of work, fostering participation in decision making, expressing confidence in high performance, and providing autonomy from bureaucratic constraints. Data were collected from 181 team members of 47 teams in the real estate agency industry. The results show that the relational social capital, enhancing the meaningfulness of work, and providing autonomy from bureaucratic constraints are positively related to two dimensions of team cohesion: sense of belonging and feelings of moral. Additionally, expressing confidence in high performance is negatively related to sense of belonging.

Keywords: social capital, empowering leadership, team cohesion, team effectiveness

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Authors: Fang Tang, Jacob Longazo

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This paper describes a sliding autonomy approach for coordinating a team of robots to assist the human operator to accomplish tasks while adapting to new or unexpected situations by requesting help from the human operator. While sliding autonomy has been well studied in the context of controlling a single robot. Much work needs to be done to apply sliding autonomy to a multi-robot team, especially human-robot team. Our approach aims at a hierarchical sliding control structure, with components that support human-robot collaboration. We validated our approach in the USARSim simulation and demonstrated that the human-robot team's overall performance can be improved under the sliding autonomy control.

Keywords: sliding autonomy, multi-robot team, human-robot collaboration, USARSim

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Authors: Chan Yan Nok

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The present study is a qualitative study based on the coping experiences of six Hong Kong Chinese mothers who had childhood trauma from their first-person perspective. Expanding the perspective beyond the dominant discourse of “inter-generation transmission of trauma”, this study explores the experiences and meanings of child trauma embedded in their narratives through the process of thematic analysis and narrative analysis. The interviewees painted a nuanced picture of their process of coping and trauma resolution. First, acknowledgement; second, feel safe and start to tell the story of trauma; third, feel the feelings and expression of emotions; fourth, clarifying and coping with the impacts of trauma; fifth, integration and transformation; and sixth, using their new understanding of experience to have a better life. It was seen that there was no “end” within the process of trauma resolution. Instead, this is an ongoing process with positive healing trajectory. Analysis of the stories of the mothers revealed recurrent themes around continuous self-reflective awareness in the process of trauma coping. Rather than being necessarily negative and detrimental, childhood trauma could highlight the meanings of being a mother and reveal opportunities for continuous personal growth and self-enhancement. Utilizing the sense of inadequacy as a core driver in the trauma recovery process while developing a heightened awareness of the unfinished business embedded in their “automatic pattern” of behaviors, emotions, and thoughts can help these mothers become more flexible to formulate new methods in facing future predicaments. Future social work and parent education practices should help mothers deal with unresolved trauma, make sense of their impacts of childhood trauma and discover the growth embedded in the past traumatic experience. They should be facilitated in “acknowledging the reality of the trauma”, including understanding their complicated emotions arising from the traumatic experiences and voicing their struggles. In addition, helping these mothers to be aware of short-term and long-term trauma impacts (i.e., secondary responses to the trauma) and explore their effective coping strategies in “overcoming secondary responses to the trauma” are crucial for their future positive adjustment and transformation. Through affirming their coping abilities and lessons learnt from past experiences, mothers can reduce feelings of shame and powerlessness and enhance their parental capacity.

Keywords: childhood trauma, coping, mothers, self-awareness, self-reflection, trauma resolution

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Authors: Rizwan Sultan, Hasnain Zafar

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Trauma is the leading cause of death among young population not only in USA but Pakistan as well. The high prevalence of disease should result in larger amount of data and larger number of publications resulting in exploring room for improvement in the field. We aimed to review trauma literature generated from Pakistan in journals indexed with PubMed from January 2010 to December 2014. Search using term “Trauma AND Pakistan” filtering for relevant dates and species human was done on Pubmed. The abstracts and articles were reviewed by the authors to collect data on a preformed performa. 114 articles were published from Pakistan during these 5 years. 64% articles were published in international journals. 63% articles were published in journals with impact factor less than 1. 54% articles were published from one of the four provinces of Pakistan. 64% of articles provided level 4 while 14% articles provided level 5 evidence on the topic. 55% articles discussed epidemiology in non-representative populations. Trauma literature from Pakistan is not only lacking significantly but is also of poor quality and is unable to offer conclusions on this particular subject. There is a lot of space for improvement in the upcoming years.

Keywords: trauma, literature, Pakistan, level of evidence

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Authors: Athena Johnson

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Special education is an important field but often under-researched, particularly for the cause of learning deficiencies. Often times special education looks at the symptoms rather than the cause, and this can lead to many misdiagnoses. Student trauma, as measured by the Adverse Childhood Experiences (ACE) test, is extremely common, often resulting in Post Traumatic Stress Disorder (PTSD). PTSD affects the brain's ability to learn properly, making students have a much more difficult time with auditory learning and memory due to always being in flight or fight mode, and due to this, students with PTSD are often misdiagnosed with Attention Deficit and Hyperactivity Disorder (ADHD). This can lead to them getting the wrong support, with PTSD students needing more counseling than anything else. Through these research papers' methodologies, a literature review on article research from the perspectives of students who were misdiagnosed, and imperial research, the major findings of this study were the importance of trauma-informed care in schools. Trauma-informed care in the school system is crucial for helping the many students who experience traumatic life events and struggle in school due to it. It is important to support students with PTSD so that they are able to integrate and learn better in society and school with trauma-informed school care.

Keywords: ACE test, ADHD, misdiagnoses, special education, trauma, trauma-informed care, PTSD

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Authors: Satoshi Furukawa, Satomu Morita, Katsuji Nishi, Masahito Hitosugi

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We experience the autopsy cases that the deceased was alive in emergency room on arrival. Bleeding is the leading cause of preventable death after injury. This retrospective study aimed to characterize opportunities for performance improvement identified in patients who died from traffic trauma and were considered by the quality improvement of education system. The Japan Advanced Trauma Evaluation and Care (JATEC) education program was introduced in 2002. We focused the abdominal traffic trauma injury. An autopsy-based cross-sectional study conducted. A purposive sampling technique was applied to select the study sample of 41 post-mortems of road traffic accident between April 1999 and March 2014 subjected to medico-legal autopsy at the department of Forensic Medicine, Shiga University of Medical Science. 16 patients (39.0%) were abdominal trauma injury. The mean period of survival after meet with accident was 13.5 hours, compared abdominal trauma death was 27.4 hours longer. In road traffic accidents, the most injured abdominal organs were liver followed by mesentery. We thought delayed treatment was associated with immediate diagnostic imaging, and so expected to expand trauma management examination.

Keywords: abdominal traffic trauma, preventable death, autopsy, emergency medicine

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Authors: Sabiha Sahin, Kursad Bora Carman, Coskun Yarar

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Introduction: Measuring the diameter of the optic nerve sheath is a noninvasive and easy to use imaging technique to predict intracranial pressure in children and adults. The aim was to measure the diameter of the optic nerve sheath in pediatric head trauma. Methods: The study group consisted of 40 children with healthy and 40 patients with head trauma. Transorbital sonographic measurement of the optic nerve sheath diameter was performed. Conclusion: The mean diameters of the optic nerve sheath of right and left eyes were 0.408 ± 0.064 mm and 0.417 ± 0.065 mm, respectively, in the trauma group. These results were higher in patients than in control group. There was a negative correlation between optic nerve sheath diameters and Glasgow Coma Scales in patients with head trauma (p < 0.05). There was a positive correlation between optic nerve sheath diameters and positive CT findings, systolic blood pressure in patients with head trauma. The clinical status of the patients at admission, blood pH and lactate level were related to the optic nerve sheath diameter. Conclusion: Measuring the diameter of the optic nerve sheath is not an invasive technique and can be easily used to predict increased intracranial pressure and to prevent secondary brain injury.

Keywords: head trauma, intracranial pressure, optic nerve, sonography

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Authors: Zena Ebrahim, Susan Woodhouse

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Previous research shows that mothers’ experiences of trauma are linked to their child’s later socioemotional functioning. However, the mechanisms involved are not well understood. One potential mediator is maternal insensitive responses to child distress. This study examined the link between maternal trauma, mothers’ responses to toddler distress, and toddlers’ socioemotional outcomes among a socioeconomically diverse sample of 110 mothers and their 12- to 35-month-old toddlers. It was hypothesized that a mother’s difficulty in responding sensitively to her child’s distress would mediate the relations between maternal trauma and child internalizing and externalizing behaviors. Two mediational models were tested to examine non-supportive responses to distress as a potential mediator of the relation between maternal trauma and toddler mental health outcomes; one model focused on predicting child internalizing symptoms and the other focused on predicting child externalizing symptoms. Measures included assessment of maternal trauma (Life Stressor Checklist-Revised), mothers’ responses to child distress (Coping with Toddlers’ Negative Emotions Scale), and toddler socioemotional functioning (Infant-Toddler Social and Emotional Assessment). Results revealed that the relations between maternal trauma and toddler symptoms (internalizing and externalizing symptoms) were mediated by maternal non-supportive response to child distress for both internalizing and externalizing domains of child mental health. Findings suggest the importance of early intervention for trauma-exposed mothers and target areas for parenting interventions.

Keywords: trauma, parenting, child mental health, transgenerational effects of trauma

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Authors: Gizem Akcan, Erdinc Ozturk

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The purpose of the study was to determine some psychosocial variables that predict dissociation in university students. These psychosocial variables were perceived childhood trauma, alexithymia, and gender. 150 (75 males, 75 females) university students (bachelor, master and postgraduate) were enrolled in this study. They were chosen from universities in Istanbul at the education year of 2016-2017. Dissociative Experiences Scale (DES), Childhood Trauma Questionnaire (CTQ) and Toronto Alexithymia Scale were used to assess related variables. Demographic Information Form was given to students in order to have their demographic information. Frequency Distribution, Linear Regression Analysis, and t-test analysis were used for statistical analysis. Childhood trauma and alexithymia were found to have predictive value on dissociation among university students. However, physical abuse, physical neglect and emotional neglect sub dimensions of childhood trauma and externally-oriented thinking sub dimension of alexithymia did not have predictive value on dissociation. Moreover, there was no significant difference between males and females in terms of dissociation scores of participants.

Keywords: childhood trauma, dissociation, alexithymia, gender

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Authors: Wahyu Purnama Putra, Artono Isharanto

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Thoracic trauma is trauma that hits the thoracic wall or intrathoracic organs, either due to blunt trauma or sharp trauma. Thoracic trauma often causes impaired ventilation-perfusion due to damage to the lung parenchyma. This results in impaired tissue oxygenation, which is one of the causes of acute respiratory distress syndrome (ARDS). These changes are caused by the release of pro-inflammatory mediators, plasmatic proteins, and proteases into the alveolar space associated with ongoing edema, as well as oxidative products that ultimately result in severe inhibition of the surfactant system. This study aims to predict the incidence of acute respiratory distress syndrome (ARDS) through human neutrophil elastase levels. This study examines the relationship between plasma elastase levels as a predictor of the incidence of ARDS in thoracic trauma patients in Malang. This study is an observational cohort study. Data analysis uses the Pearson correlation test and ROC curve (receiver operating characteristic curve). It can be concluded that there is a significant (p= 0.000, r= -0.988) relationship between elastase levels and BGA-3. If the value of elastase levels is limited to 23.79 ± 3.95, the patient will experience mild ARDS. While if the value of elastase levels is limited to 57.68 ± 18.55, in the future, the patient will experience moderate ARDS. Meanwhile, if the elastase level is between 107.85 ± 5.04, the patient will likely experience severe ARDS. Neutrophil elastase levels correlate with the degree of severity of ARDS incidence.

Keywords: ARDS, human neutrophil elastase, severity, thoracic trauma

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Authors: Divya Pathak, James Sloane

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Surgical treatment of midface fractures should ideally occur within two weeks of injury, after which bony healing and consolidation make the repair more difficult for the operating surgeon. The oral and maxillofacial unit at the Royal Surrey Hospital is the tertiary referral center for maxillofacial trauma from five regional hospitals. This is a complete audit cycle of midface trauma referrals managed over a one year period. The standard set was that clinical assessment of the midface fracture would take place in a consultant led outpatient clinic within 7 days, and when indicated, surgical fixation would occur within 10 days of referral. Retrospective data was collected over one year (01/11/2018 - 31/12/2019). Three key changes were implemented: an IT referral mailbox, standardization of an on-call trauma table, and creation of a trauma theatre list. Re-audit was carried out over six months completing the cycle. 283 midface fracture referrals were received, of which 22 patients needed surgical fixation. The average time from referral to outpatient follow-up improved from 14.5 days to 8.3 days, and time from referral to surgery improved from 21.5 days to 11.6 days. Changes implemented in this audit significantly improved patient prioritization to appropriate outpatient clinics and shortened time to surgical intervention.

Keywords: maxillofacial trauma, midface trauma, oral and maxillofacial surgery, surgery fixation

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Authors: Yang Liu

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The work team has been being adopted by the CCP for special missions in a limited time. Since the 18th National Congress of CCP, the unprecedented practice of the work team has had impacts beyond the original goal of poverty alleviation, their functions in village governance have still not been well studied. As the state agents that come from the outside of the village community, this article argues that the work team is a group that represents the coexistence of political, economic, and cultural capital, which contributes to effectively empower the state, and the village cadres and the peasants. For the state, more accurate bottom-up information could be collected by the work team, and policies could be made scientifically and implemented without distortion. For the village cadres, they can learn leadership skills and share more resources owned or mobilized by the work team. For the peasants, they have more access to participate the public affairs of their village and express their claims. The multiple empowerments have greatly improved the relationship among the state, the peasants, and the village cadres since a series of reforms from 1980s to 2000s that alienated the relationship among them.

Keywords: state, village cadre, empowerment, work team, peasants

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Authors: Grace Baptie, Jackie Andrade, Alison Bacon, Alyson Norman

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Background: Many women experience their childbirth as traumatic, and 4-6% of mothers present with postnatal posttraumatic stress disorder (PTSD) as a result of their birth. Aims: To measure the relationship between obstetric and subjective experience of childbirth on mothers’ experience of postnatal trauma and identify salient aspects of the birth experience considered traumatic. Methods: Women who had given birth within the last year completed an online mixed-methods survey reporting on their subjective and obstetric birth experience as well as symptoms of postnatal trauma, depression and anxiety. Findings: 29% of mothers experienced their labour as traumatic and 15% met full or partial criteria for PTSD. Feeling supported and in control mediated the relationship between obstetric intervention and postnatal trauma symptoms. Five key themes were identified from the qualitative data regarding aspects of the birth considered traumatic including: obstetric complications; lack of control; concern for baby; psychological trauma and lack of support. Conclusion: Subjective birth experience is a significantly stronger predictor of postnatal trauma than level of medical intervention, the psychological consequences of which can be buffered by an increased level of support and control.

Keywords: birth trauma, perinatal mental health, postnatal PTSD, subjective experience

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Authors: G. Scremin, I. Y. Suh, S. Doukas

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Spectators follow their favorite sports teams for different reasons. While some attend a sporting event simply for its entertainment value, others do so because of the personal sense of achievement and accomplishment their connection with a sports team creates. Moreover, the level of identity spectators feel toward their favorite sports team falls in a broad continuum. Some are mere spectators. For those spectators, their association to a sports team has little impact on their self-image. Others are die-hard fans who are proud of their association with their team and whose connection with that team is an important reflection of who they are. Several motives for sports consumption can be used to explain the level of spectator support in a variety of sports. Those motives can also be used to explain the variance in the identification, attachment, and loyalty spectators feel toward their favorite sports team. Motives for sports consumption can be used to discriminate the degree of identification spectators have with their favorite sports team. In this study, motives for sports consumption was used to discriminate the level of identity spectators feel toward their sports team. It was hypothesized that spectators with a strong level of team identity would report higher rates of interest in player, interest in sports, and interest in team than spectators with a low level of team identity. And spectators with a low level of team identity would report higher rates for entertainment value, bonding with friends or family, and wholesome environment. Football spectators in the United States and England were surveyed about their motives for football consumption and their level of identification with their favorite football team. To assess if the motives of sports fans differed by level of team identity and allegiance to an American or English football team, a Multivariate Analysis of Variance (MANOVA) under the General Linear Model (GLM) procedure found in SPSS was performed. The independent variables were level of team identity and allegiance to an American or English football team, and the dependent variables were the sport fan motives. A tripartite split (low, moderate, high) was used on a composite measure for team identity. Preliminary results show that effect of team identity is statistically significant (p < .001) for at least nine of the 17 motives for sports consumption assessed in this investigation. These results indicate that the motives of spectators with a strong level of team identity differ significantly from spectators with a low level of team identity. Those differences can be used to discriminate the degree of identification spectators have with their favorite sports team. Sports marketers can use these methods and results to develop identity profiles of spectators and create marketing strategies specifically designed to attract those spectators based on their unique motives for consumption and their level of team identification.

Keywords: fan identification, market segmentation of sports fans, motives for sports consumption, team identity

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Authors: Yu-Chen Wei

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The relationship between organizational human capital and organizational effectiveness have been a common topic of interest to organization researchers. Much of this research has concluded that higher human capital can predict greater organizational outcomes. Whereas human capital research has traditionally focused on organizations, the current study turns to the team level human capital. In addition, there are no known empirical studies assessing the effect of human capital divergence on team performance. Team human capital refers to the sum of knowledge, ability, and experience embedded in team members. Team human capital divergence is defined as the variation of human capital within a team. This study is among the first to assess the role of human capital divergence as a moderator of the effect of team human capital on team performance. From the traditional perspective, team human capital represents the collective ability to solve problems and reducing operational risk of all team members. Hence, the higher team human capital, the higher the team performance. This study further employs social learning theory to explain the relationship between team human capital and team performance. According to this theory, the individuals will look for progress by way of learning from teammates in their teams. They expect to have upper human capital, in turn, to achieve high productivity, obtain great rewards and career success eventually. Therefore, the individual can have more chances to improve his or her capability by learning from peers of the team if the team members have higher average human capital. As a consequence, all team members can develop a quick and effective learning path in their work environment, and in turn enhance their knowledge, skill, and experience, leads to higher team performance. This is the first argument of this study. Furthermore, the current study argues that human capital divergence is negative to a team development. For the individuals with lower human capital in the team, they always feel the pressure from their outstanding colleagues. Under the pressure, they cannot give full play to their own jobs and lose more and more confidence. For the smart guys in the team, they are reluctant to be colleagues with the teammates who are not as intelligent as them. Besides, they may have lower motivation to move forward because they are prominent enough compared with their teammates. Therefore, human capital divergence will moderate the relationship between team human capital and team performance. These two arguments were tested in 510 team-seasons drawn from major league baseball (1998–2014). Results demonstrate that there is a positive relationship between team human capital and team performance which is consistent with previous research. In addition, the variation of human capital within a team weakens the above relationships. That is to say, an individual working with teammates who are comparable to them can produce better performance than working with people who are either too smart or too stupid to them.

Keywords: human capital divergence, team human capital, team performance, team level research

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Authors: Yoonhee Cho, Gye-Hoon Hong

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This study focuses on the roles of distributive and procedural justice on job engagement. Additionally, the study focuses on whether situational factors such as team efficacy and team leaders’ coaching moderate the relationship between distributive and procedural justice and job engagement. Ordinary linear regression was used to analyze data from seven South Korean Companies (total N=346). Results confirmed the hypothesized model indicating that both distributive and procedural justices were positively related to job engagement of employees. Team efficacy and team leaders’ coaching moderated the relationship between distributive justice and job engagement whereas it brought non-significant result found for procedural justice. The facts that two types of justice and the interactive effects of two situational variables were different implied that different managerial strategies should be used when job engagement was to be enhanced.

Keywords: coaching, distributive justice, job engagement, procedural justice, team efficacy

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Authors: Zarabizan Zakaria, Hayati Zainal

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The construction industry is one of the most important sectors that contribute to the nation’s economy and catalyze towards the growth of other industries. However, some construction projects have not been completed on its stipulated time and duration, scope and budget due to several factors. This problem arises due to the weaknesses of human factors, especially from ineffective leadership quality practiced by project managers and contractors in managing project teams. Therefore, a construction project should impose the element of Project Team. The project team is formed in the implementation of the project which includes the project brief, project scope, customer requirements and provided designs. Many organizations in the construction sector use teams to meet today's global competition and customer expectations, however, team effectiveness evaluation is required. In insuring the construction team is successful and effectiveness, the construction department must encourage, measure, set up, and evaluate or review the effectiveness of project team that was formed. In order to produce a better outcome for a high-end project, an effective and efficient project team is required which also help in increasing overall productivity. The purpose of this study is to determine the role of team effectiveness in the construction project team based on the overall construction project performance. It examines several different factors which related to team effectiveness. It also examines the relationship between team effectiveness factor and project performance aspect. Team Effect Review and Project Performance Review are developed to be used for data collection. Data collected were analyzed using several statistical tests. Results obtained from data analysis are validated using semi-structured interviews. Besides that, a comprehensive survey were developed to assess the way construction project teams in order to maintain its effectiveness throughout the project phase. In order to determine a project successful it has been found that Project Team Leadership is the most important factor. In addition, the definition of team effectiveness in the construction project team is developed based on the perspective of project clients and project team members. The results of this study are expected to provide an idea on the factors that are needed to be focused on improving the team's effectiveness towards project performance aspects. At the same time, the definition of team effectiveness from team members and owner views has been developed in order to provide a better understanding of the word team's effectiveness in construction projects.

Keywords: project team, leadership, construction project, project successful

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Authors: Aleksandra Bogdanovic, Milicat Tošić Radev, Tatjana Stefanovic Stanojevic

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The aim behind this study was to first analyze the nature and the extent of childhood trauma and existing maladaptive outcomes (internalized and externalized problems and dissociation) among adolescents in the foster system and then analyze the possibility of using traumatic experiences to predict the aforementioned outcomes of childhood trauma. The sample consists of 121 respondents, children, and youths in the care of child protective services, without adequate parental care, residing in temporary foster care families on the territory of Serbia, aged between 11 and 18. The respondents filled out the Childhood Trauma Questionnaire – CTQ, Relationship Questionaire – Clinical version RQ-CV, the Dissociative experience scale for adolescents, A-DES and the Child behavior checklist – youth self-report. The results of the analyses have indicated that physical and emotional neglect are the most frequent forms of maltreatment in early childhood, with a relatively high prevalence of the other individual forms of trauma. Early childhood trauma statistically significantly predicted all the analyzed maladaptive outcomes, explaining approximately 20% of the variance of internalized and externalized problems and dissociation. Recommendations are given for future studies.

Keywords: trauma, maladaptive outcomes, disorganization, dissociation

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Authors: Mohamed Abo El Nasr, Mohamed Shoeib, Abdelhamid Abdelkhalik, Amro Serag

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Background: Early assessment of severity of chest trauma, either blunt or penetrating is of critical importance in prediction of patient outcome. Different trauma scoring systems are widely available and are based on anatomical or physiological parameters to expect patient morbidity or mortality. Up till now, there is no ideal, universally accepted trauma score that could be applied in all trauma centers and is suitable for assessment of severity of chest trauma patients. Aim: Our aim was to compare various trauma scoring systems regarding their predictability of morbidity and mortality in chest trauma patients. Patients and Methods: This study was a prospective study including 400 patients with chest trauma who were managed at Tanta University Emergency Hospital, Egypt during a period of 2 years (March 2014 until March 2016). The patients were divided into 2 groups according to the mode of trauma: blunt or penetrating. The collected data included age, sex, hemodynamic status on admission, intrathoracic injuries, and associated extra-thoracic injuries. The patients outcome including mortality, need of thoracotomy, need for ICU admission, need for mechanical ventilation, length of hospital stay and the development of acute respiratory distress syndrome were also recorded. The relevant data were used to calculate the following trauma scores: 1. Anatomical scores including abbreviated injury scale (AIS), Injury severity score (ISS), New injury severity score (NISS) and Chest wall injury scale (CWIS). 2. Physiological scores including revised trauma score (RTS), Acute physiology and chronic health evaluation II (APACHE II) score. 3. Combined score including Trauma and injury severity score (TRISS ) and 4. Chest-Specific score Thoracic trauma severity score (TTSS). All these scores were analyzed statistically to detect their sensitivity, specificity and compared regarding their predictive power of mortality and morbidity in blunt and penetrating chest trauma patients. Results: The incidence of mortality was 3.75% (15/400). Eleven patients (11/230) died in blunt chest trauma group, while (4/170) patients died in penetrating trauma group. The mortality rate increased more than three folds to reach 13% (13/100) in patients with severe chest trauma (ISS of >16). The physiological scores APACHE II and RTS had the highest predictive value for mortality in both blunt and penetrating chest injuries. The physiological score APACHE II followed by the combined score TRISS were more predictive for intensive care admission in penetrating injuries while RTS was more predictive in blunt trauma. Also, RTS had a higher predictive value for expectation of need for mechanical ventilation followed by the combined score TRISS. APACHE II score was more predictive for the need of thoracotomy in penetrating injuries and the Chest-Specific score TTSS was higher in blunt injuries. The anatomical score ISS and TTSS score were more predictive for prolonged hospital stay in penetrating and blunt injuries respectively. Conclusion: Trauma scores including physiological parameters have a higher predictive power for mortality in both blunt and penetrating chest trauma. They are more suitable for assessment of injury severity and prediction of patients outcome.

Keywords: chest trauma, trauma scores, blunt injuries, penetrating injuries

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Authors: P. B. Thumar

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Today’s athletes face acute and unique challenges as the competition standards are higher and tougher. There are certain moments during a competition that appear to carry great psychological significance when the momentum starts to shift in one direction or another. These situations require athletes to remain completely focused and calm in facing the difficult circumstances. The purpose of the study was to compare the Mental Toughness level among the players of the team and individual sports. Purposive sampling was done in which subjects for the present study were the male students of The M. S. University of Baroda, Vadodara studying various courses in the academic year 2014-15. Thus, a total number of 120 boys were identified and included in the study from which 60 boys had participated in individual sports and 60 in team sports. ‘The Mental Toughness Questionnaire’ prepared by Dr. Alan Goldberg was used to determine mental toughness level of the players of the team and individual sports. The scores arrived from 60 individual players and 60 team players were compared by applying the t-test. Significant difference was found on overall Mental Toughness and in subcomponents there was significant difference in ability to handle pressure, concentration and confidence whereas there was no significant difference in reboundability and motivation among team and individual sports players. This could be largely due the nature of both sports. Team players of MSU found to be having more overall mental toughness, and team players are able to handle pressure more than individual players, can concentrate more and are also more confident while playing in the team. Team preparation and training prior to competition could have increased the level of ability to handle pressure, concentration and confidence of team players.

Keywords: mental toughness, reboundability, confidence, team sports, individual sports

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Authors: Murray Anderson, Galina Freed, Karli Jahn

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Trauma is increasingly recognized as an important construct that has health implications for those who struggle with various mental health issues. For those individuals who meet the criteria for a diagnosis of hoarding disorder (HD), many have experienced some form of trauma. Further, some of the therapeutic interventions for those with HD can further perpetuate or magnify the experience of trauma. Therefore, the aim of this scoping review is to identify and document the nature and extent of research evidence related to trauma as it connects with HD. This review was guided by the questions, ‘How can our understanding of the trauma cycle help us to better appreciate the experiences of individuals who hoard, and how will a trauma informed lens inform the interventions for hoarding disorder? A comprehensive literature search was performed to identify original studies that contained the words “hoarding” and “trauma.” PsychINFO”,''EBSCO host,” “CINAHL” and “PubMed” were searched between January 2005 and April 2021. Articles were screened by three reviewers. Data extracted included publication date, demographics, study design, type of analysis, and noted connections between hoarding and trauma. Of the 329 articles, all duplicates, articles on hoardings of animals, articles not in English, and those without full-text availability were removed. Five categories were found in the remaining 45 articles, including (a) traumatic and stressful life events; (b) the link between posttraumatic stress disorder, trauma, and hoarding; (c) the relationships between different comorbidities, trauma, and hoarding; (d) the lack of early emotional expression and other forms of parental deprivation; and (e) the role of attachment. Lastly, the literature explains how the links between hoarding and trauma are difficult to study due to the highly stigmatized identities with this population. The review provided strong support for the connections between the experience of trauma and HD. What is missing from the literature is the use of a trauma-informed lens to better account for the ways in which hoarding disorder is understood. Other missing pieces in the literature are the potential uses of a trauma-informed lens to enhance the therapeutic process, to understand and reduce treatment attrition, and to improve treatment outcomes. The application of a trauma informed lens could improve our understanding of effective interactions among clients, families, and communities and improve the education around hoarding-related matters. Exploring the connections between trauma and HD can improve therapeutic delivery and destigmatize the experience of dealing with clutter and hoarding concerns. This awareness can also provide health care professionals with both the language and skills to liberate them from a reductionist view on HD.

Keywords: hoarding, attachment, parental deprivation, trauma

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Authors: Sarah Snyder

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Historians use the term ‘post-Holocaust’ to indicate the period from 1945 onward; however, for survivors of the Holocaust and their families, the Holocaust did not end in 1945. In fact, for some, it was just the beginning of their struggles. There are those who could not return to their homes, find loved ones, or fight off night terrors. Additionally, they continue to suffer from mental illness or physical disease stemming from the Holocaust. In order for historians to have a clearer understanding of the trauma survivors have endured, it is must to approach time differently. Trauma does not operate on a timeline and thereby, our understanding of ‘before,’ ‘during’ and ‘after’ are flawed. In order to convey this flaw, this study will examine memoirs of second and third-generation survivors and of child survivors. Within the second and third generation group, there are two types of generational memoirs that are scrutinized for this case study. The first being when a child or grandchild records the stories of their parent(s) or grandparent(s) without any of the second or third generation’s stories implicitly written. ‘Implicitly’ is used in the context that it is impossible for any writer to not impose at least some stylistic portion of themselves into writing, but the intent was to focus on the parent or grandparent. The other type of memoir is when they write their parent(s) or grandparent(s) story intertwined with their own story. Additionally, the child survivor has a unique role in memory and trauma studies. Much like later generations who write about the Holocaust but have not experienced the trauma firsthand, the child survivor must write about what they lived through and experienced but cannot remember without the assistance of research or other survivors. This study shows that survivors continue to demonstrate trauma-related paranoia. They fear experiencing another Holocaust. In their minds, they replay the horrors that they had experienced. A pilgrimage to a 20th century Europe, unlike one of the 1940s, causes uncertainty, confusion, and additional paranoia. It is through these findings that it becomes evident that historians must learn to study trauma without placing strict timelines that prevent understanding of how trauma impacts those who have experienced complex trauma.

Keywords: holocaust, generational, memoirs, trauma

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Authors: Siqi Fang, Jingxi Hou

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Positive psychology and coaching psychology share a number of fundamental assumptions and common themes. Blending positive psychology, mindfulness, and coaching psychology, our work in team coaching with leaders enhances both leadership and team effectiveness. Although individual coaching has proven to be effective, this article advocates the benefits of leadership coaching in team settings, because durable changes in leadership behaviors are more likely to occur. Does leadership team coaching really work? Does it help improve senior leadership team effectiveness and productivity? This action research study answers these questions by tracking the progress of three typical senior leadership teams consisting of 31 executives participating in a six-month team coaching program. Assessments (pre- and post), workshops, and feedback based on ego development theories and mindfulness were applied to upgrade the senior leadership teams’ transformational stages and reframe their organizational leadership cultures. Results suggest that the team effectiveness of the three leadership teams increased up to 43 percent according to post-survey feedback from superior, direct report, and peers. Discussion is offered to show that senior leadership team coaching help teams to achieve a consensus on common purposes, establish a foundation of trust, improve collective skills, and promote efficient operation. All factors translate into better team performance. Implications of the results for future executive development programs are discussed and specific recommendations are provided.

Keywords: action research, ego development, mindfulness, senior leadership team coaching, team effectiveness, transformational stages

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Authors: Samar Mousa, Rebecca Shirley

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Injuries to the hand account for 20% of all emergency department attendances, with an estimated annual treatment cost of over £100 million in the UK. Functional impairments as a result of hand injuries often necessitate absence from employment, resulting in reduced productivity estimated to incur an additional £600m loss to the UK economy. Appropriate and early management is vital to preserve anatomy, prevent stiffness and allow function. The initial assessment and management of hand injuries are usually undertaken by junior staff, many of whom have little or no training or experience in splinting hand fractures. In our plastic surgery department at Stoke Mandeville hospital Buckinghamshire trust, we carried out an audit project to detect errors in hand splinting in the period between April 2022 and July 2022 and find out measures to support junior doctors, nurses and hand therapists in providing the best possible care for hand trauma patients. Our standards were The British Society for Surgery of the Hand (BSSH) standard of care in hand trauma, AO surgery reference and Stoke Mandeville hospital hand therapy mini protocol Feb 2022 During the period of 4 months, 5 cases were identified. Two cases of wrong splint choice, two cases of early removal of the splint and one tight splint that required change. In order to avoid those mistakes, a training program was given to junior doctors and nurses in collaboration with the hand therapy team regarding ways of splinting the hand in different injuries like fractures, tendons injuries, muscle injuries and ligamentous injuries. In addition to, a poster hung in the examination rooms and theatres to help junior doctors reach the correct decision.

Keywords: splinting, hand trauma, plastic surgery, tendon injury, hand fracrture

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Authors: Erdinc Ozturk, Gizem Akcan

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The aim of this study was to determine some psychosocial variables that predict childhood trauma and dissociation in university students. These psychosocial variables were perceived social support, relationship status, gender and life satisfaction. 250 (125 males, 125 females) university students (bachelor, master and postgraduate degree) were enrolled in this study. They were chosen from universities in Istanbul at the education year of 2016-2017. Dissociative Experiences Scale (DES), Childhood Trauma Questionnaire (CTQ), Multidimensional Perceived Social Support Scale, Life Satisfaction Scale and Relationship Scales Questionnaire were used to assess related variables. Demographic information form was given to students in order to have their demographic information. Frequency distribution, multiple linear regression, and t-test analysis were used for statistical analysis. As together, perceived social support, relationship status and life satisfaction were found to have predictive value on trauma among university students. However, as together, these psychosocial variables did not have predictive value on dissociation. Only, trauma and relationship status had significant predictive value on dissociation. Moreover, there was significant difference between males and females in terms of trauma; however, dissociation scores of participants were not significantly different in terms of gender.

Keywords: childhood trauma, dissociation, perceived social support, relationship status, life satisfaction

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Authors: Latif Duran, Erdem Aydin, Ahmet Baydin, Ali Kemal Erenler, Iskender Aksoy

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Aim: In this retrospective study, we aim to contribute to the literature by presenting the proposals for taking measures to reduce the mortality by examining the demographic characteristics of the pediatric age group patients presenting with trauma and the factors that may cause mortality Material and Method: This study has been performed by retrospectively investigating the data obtained from the patient files and the hospital automation registration system of the pediatric trauma patients who applied to the Adult Emergency Department of the Ondokuz Mayıs University Medical Faculty between January 1, 2016, and December 31, 2016. Results: 289 of 415 patients involved in our study, were males. The median age was 11.3 years. The most common trauma mechanism was falling from the high. A significant statistical difference was found on the association between trauma mechanisms and gender. An increase in the number of trauma cases was found especially in the summer months. The study showed that thoracic and abdominal trauma was relevant to the increased mortality. Computerized tomography was the most common diagnostic imaging modality. The presence of subarachnoid hemorrhage has increased the risk of mortality by 62.3 fold. Eight of the patients (1.9%) died. Scoring systems were statistically significant to predict mortality. Conclusion: Children are vulnerable to trauma because of their unique anatomical and physiological differences compared to adult patient groups. It will be more successful in the mortality rate and in the post-traumatic healing process by administering the patient triage fast and most appropriate trauma centers in the prehospital period, management of the critical patients with the scoring systems and management with standard treatment protocols

Keywords: emergency service, pediatric patients, scoring systems, trauma, age groups

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Authors: Jo Rhodes, Peter Lok, Zahra Sadeghinejad

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The aim of this study is to determine the impact of metacognition on top management team members and firm performance based on full team integration. A survey of 1500 small to medium enterprises (SMEs) was initiated and 140 firms were obtained in this study (with response rate of 9%). The result showed that different metacognitive abilities of managers [knowledge and experience] could enhance team decision-making and problem solving, resulting in greater firm performance. This is a significant finding for SMEs because these organisations have small teams with owner leadership and entrepreneurial orientation.

Keywords: metacognition, behavioural integration, top management team (TMT), performance

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Authors: Sally Shepherd, Jessica Wong, David Read

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Traumatic brachiocephalic artery aneurysm is a rare injury that typically occurs as a result of a blunt chest injury. A 19-year-old female sustained a head-on, high speed motor vehicle crash into a tree. Upon release after 45 minutes of entrapment, she was tachycardic but normotensive, with a significant seatbelt sign across her chest and open deformed right thigh with weak pulses in bilateral lower limbs. A chest XR showed mild upper mediastinal widening. A CT trauma series plus gated CT chest revealed a grade 3a aortic arch transection with brachiocephalic pseudoaneurysm. Endovascular repair of the brachiocephalic artery was attempted post-presentation but was unsuccessful as the first stent migrated to the infrarenal abdominal aorta and the second stent across the brachiocephalic artery origin had a persistent leak at the base. She was transferred to Intensive Care for strict blood pressure control. She returned to theatre 5 hours later for a median sternotomy, aortic arch repair with an 8mm graft extraction, and excision of the innominate artery pseudoaneurysm. She had an uncomplicated post-operative recovery. This case highlights that brachiocephalic artery injury is a rare but potentially lethal injury as a result of blunt chest trauma. Safe management requires a combined Vascular and Cardiothoracic team approach, as stenting alone may be insufficient.

Keywords: blunt chest injury, Brachiocephalic aneurysm, innominate artery, trauma

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