Search results for: transmission of intergenerational trauma

Authors: N. Khodarahmi, L. Ford

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Decades of research on the impact of trauma in early childhood suggest severe risks to the mental health, emotional, social and physical development of a young child. Trauma-exposed students can pose a variety of different levels of challenges to schools and educators of young children and to date, few studies have addressed ECE teachers’ role in providing trauma support. The present study aims to contribute to this literature by exploring the beliefs of British Columbia’s (BC) early childhood education (ECE) teachers in their level of readiness and capability to work within a trauma-informed practice (TIP) framework to support their trauma-exposed students. Through a sequential, mix-methods approach, a self-report questionnaire and semi-structured interviews will be used to gauge BC ECE teachers’ knowledge of TIP, their preparedness, and their ability in using this framework to support their most vulnerable students. Teacher participants will be recruited through the ECEBC organization and various school districts in the Greater Vancouver Area. Questionnaire data will be primarily collected through an online survey tool whereas interviews will be taking place in-person and audio-recorded. Data analysis of survey responses will be largely descriptive, whereas interviews, once transcribed, will be employing thematic content analysis to generate themes from teacher responses. Ultimately, this study hopes to highlight the necessity of utilizing the TIP framework in BC ECE classrooms in order to support both trauma-exposed students and provide essential resources to compassionate educators of young children.

Keywords: early childhood education, early learning classrooms, refugee students, trauma-exposed students, trauma-informed practice

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Authors: Juan P. Novoa, Mario A. Rios

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This paper presents a transmission planning methodology that considers the conversion of HVAC transmission lines to HVDC as an alternative of expansion of power systems, as a consequence of restrictions for the construction of new lines. The transmission expansion planning problem formulates an optimization problem that minimizes the total cost that includes the investment cost to convert lines from HVAC to HVDC and possible required reinforcements of the power system prior to the conversion. The costs analysis assesses the impact of the conversion on the reliability because transmission lines are out of service during the conversion work. The presented methodology is applied to a test system considering a planning a horizon of 10 years.

Keywords: transmission expansion planning, HVDC, cost optimization, energy non-supplied

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Authors: M. Walmsley, S. Elmatarri, S. Mannion

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Introduction: Self-inflicted injury is a recognised cause of major trauma in adults and is an independent indicator of a reduced functional outcome compared to non-intentional major trauma. There is little literature available on the inpatient mental health (MH) management of this vulnerable group. A retrospective review was conducted of inpatient MH management of major trauma patients admitted to a UK regional Major Trauma Centre (MTC). Their outcomes were compared to all major trauma patients. This group of patients required multiple MH interventions whilst on the Major Trauma Ward (MTW) and a had worse functional outcome compared to non-intentional trauma. Method: The national TARN (Trauma Audit and Research Network) database was used to identify patients admitted to a regional MTC over a 2-year period from June 2018 to July 2020. Patients with an ISS (Injury Severity Score) of greater than 15 with a mechanism of either self-harm or high-risk behavior were included for further analysis. Inpatient medical notes were reviewed for MH interventions on the MTW. Further outcomes, including mortality, length of stay (LOS) and Glasgow Outcome Score (GOS) were compared with all major trauma patients for the same time period. Results: A total of 60 patients were identified in the time period and of those, 27 spent time on the MTW. A total of 23 (85%) had a prior MH diagnosis, with 11 (41%) under the care of secondary MH services. Adequate inpatient records for review were available for 24 patients. During their inpatient stay, 8 (33%) were reviewed on the ward by the inpatient MH team. There were 10 interventions required for 6 (25%) patients on the MTW including, sections under the Mental Health Act, transfer to specialist MH facility, pharmacological sedation and security being called to the MTW. When compared to all major trauma patients, those admitted due to self-harm or high-risk behavior had a statistically significantly higher ISS (31.43 vs 24.22, p=0.0001) and LOS (23.51d vs 16.06d, p=0.002). Functional outcomes using the GOS were reduced in this group of patients, GOS 5 (low disability) (51.66% vs. 61.01%) and they additionally had a higher level of mortality, GOS 1 (15.00% vs 11.67%). Discussion: Intentional self-harm is a recognised cause of major trauma in adults and this patient group sustains more severe injuries, requiring a longer hospital stay with worse outcomes compared to all major trauma patients. Inpatient MH interventions are required for a significant proportion of these patients and therefore, there needs to be a close relationship with MH services. There is limited available evidence for how this patient group is best managed as an inpatient to aid their recovery and further work is needed on how outcomes in this vulnerable group can be improved.

Keywords: adult major trauma, attempted suicide, self-inflicted major trauma, inpatient management

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Authors: Ashleigh Cicconi

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Teachers may not have access to necessary and effective strategies for managing stress, trauma, and emotional exhaustion, which can lead to burnout. This practice-based research focused on the exploration of teacher well-being through participation in a wellness program in order to mitigate high stress levels and feelings of burnout. The purpose of this qualitative research was to explore how a multimodal, trauma-informed yoga and arts-based mindfulness program impacted stress levels and overall well-being for teachers in a school setting. The case study approach was used to investigate participant perceptions of interactions between multimodal accessibility, a trauma-informed wellness program, and teacher well-being. A sample size of 10 teachers employed full-time at a public high school in the Mid-Atlantic region were recruited via email correspondence to participate in the eight-week wellness program. Data were triangulated across semi-structured interviews, journal entries, and focus group guided questions, and transcripts were uploaded into the NVivo software application for thematic analysis. Data showed perceptions of improvements in overall well-being from participation in the wellness program and that utilizing trauma-informed practices may be an effective coping skill for stress. The multimodal design of the program was perceived to positively impact participation and accessibility to wellness strategies. Findings from this study suggest that the inclusion of trauma-informed practices within a wellness program may be effective for managing stress and trauma experienced by teachers, thereby aiding in improvement in overall well-being. Findings also suggest that multimodality may be effective for increasing participation in and accessibility to wellness strategies.

Keywords: trauma informed practices, wellness program, teacher wellbeing, accessible program, multimodal

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Authors: Alexandra Sweny

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This paper contends with the intersection between the act of witnessing and the act of reading in order to consider the relevance of literary testimony and fiction as tools for postcolonial readings of history. J. M. Coetzee's Waiting for the Barbarians elucidates what Primo Levi deems the 'paradoxical' task of testimony: that suffering can only be fully narrated by the sufferer themselves, whose voice and narrative capacity is often foreclosed by the very extent of their trauma. By examining the fictional Magistrate's position as both a reader and translator of history, this paper posits Waiting for the Barbarians as an ethical command against the appropriation of trauma.

Keywords: ethical criticism, limit-experience, postcolonialism, psychic trauma in literature, testimony

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Authors: Nur Ashida Salim, Muhammad Murtadha Othman, Ismail Musirin, Mohd Salleh Serwan

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Uncertainty of system operating conditions is one of the causative reasons which may render to the instability of a transmission system. This will encumber the performance of transmission system to efficiently transmit the electrical power between areas. For that reason, accurate assessment of Transmission Reliability Margin (TRM) is essential in order to ensure effective power transfer between areas during the occurrence of system uncertainties. The power transfer is also called as the Available Transfer Capability (ATC) in which it is the information required by the utilities and marketers to instigate selling and buying the electric energy. This paper proposes a computationally effective approach to estimate TRM and ATC by considering the uncertainties of system cascading collapse and transmission line outages which is identified as the main reasons in power system instability. In accordance to the results that have been obtained, the proposed method is essential for the transmission providers which could help the power marketers and planning sectors in the operation and reserving transmission services based on the ATC calculated.

Keywords: system cascading collapse, transmission line outages, transmission reliability margin, available transfer capability

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Authors: Ahmeda Ali, Mary Codd, Susan Brundage

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Importance: This research focuses on devising and improving Health Service Executive (HSE) policy and legislation and therefore improving patient trauma care and outcomes in Ireland. Objectives: The study measures components of the Trauma System in the district hospital setting of the Cavan/Monaghan Hospital Group (CMHG), HSE, Ireland, and uses the collected data to identify the strengths and weaknesses of the CMHG Trauma System organisation, to include governance, injury data, prevention and quality improvement, scene care and facility-based care, and rehabilitation. The information will be made available to local policy makers to provide objective situational analysis to assist in future trauma service planning and service provision. Design, setting and participants: From 28 April to May 28, 2016 a cross-sectional survey using World Health Organisation (WHO) Trauma System Assessment Tool (TSAT) was conducted among healthcare professionals directly involved in the level III trauma system of CMHG. Main outcomes: Identification of the strengths and weaknesses of the Trauma System of CMHG. Results: The participants who reported inadequate funding for pre hospital (62.3%) and facility based trauma care at CMHG (52.5%) were high. Thirty four (55.7%) respondents reported that a national trauma registry (TARN) exists but electronic health records are still not used in trauma care. Twenty one respondents (34.4%) reported that there are system wide protocols for determining patient destination and adequate, comprehensive legislation governing the use of ambulances was enforced, however, there is a lack of a reliable advisory service. Over 40% of the respondents reported uncertainty of the injury prevention programmes available in Ireland; as well as the allocated government funding for injury and violence prevention. Conclusions: The results of this study contributed to a comprehensive assessment of the trauma system organisation. The major findings of the study identified three fundamental areas: the inadequate funding at CMHG, the QI techniques and corrective strategies used, and the unfamiliarity of existing prevention strategies. The findings direct the need for further research to guide future development of the trauma system at CMHG (and in Ireland as a whole) in order to maximise best practice and to improve functional and life outcomes.

Keywords: trauma, education, management, system

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Authors: Ekow A. Kwofie, Emmanuel K. Anto, Godfred Mensah

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In this paper, CYME Distribution software has been used to assess the impacts of solar Photovoltaic (PV) distributed generation (DG) plant on the Electricity Company of Ghana (ECG) 33 kV sub-transmission network at different PV penetration levels. As ECG begins to encourage DG PV interconnections within its network, there has been the need to assess the impacts on the sub-transmission losses and voltage contribution. In Tema, a city in Accra - Ghana, ECG has a 33 kV sub-transmission network made up of 20 No. 33 kV buses that was modeled. Three different locations were chosen: The source bus, a bus along the sub-transmission radial network and a bus at the tail end to determine the optimal location for DG PV interconnection. The optimal location was determined based on sub-transmission technical losses and voltage impact. PV capacities at different penetration levels were modeled at each location and simulations performed to determine the optimal PV penetration level. Interconnection at a bus along (or in the middle of) the sub-transmission network offered the highest benefits at an optimal PV penetration level of 80%. At that location, the maximum voltage improvement of 0.789% on the neighboring 33 kV buses and maximum loss reduction of 6.033% over the base case scenario were recorded. Hence, the optimal location for DG PV integration within the 33 kV sub-transmission utility network is at a bus along the sub-transmission radial network.

Keywords: distributed generation photovoltaic (DG PV), optimal location, penetration level, sub–transmission network

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Authors: Diane Ghanem, Oscar Covarrubias, Ridge Maxson, Samir Sabharwal, Babar Shafiq

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Introduction: Web-based resources serve as a fundamental educational platform for orthopaedic trauma patients; however, they are notoriously written at a high grade reading level and are often too complicated for patients to benefit from them. The aim of this study is to perform an updated assessment of the readability of the AAOS trauma-related educational articles and compare their readability with that of injury-specific patient education materials developed by the OTA. Methods: All forty-six trauma-related articles on the AAOS patient education website were analyzed for readability. Two independent reviewers used the (1) Flesch-Kincaid Grade Level (FKGL) and the (2) Flesch Reading Ease (FRE) algorithms to calculate the readability level. Mean readability scores were compared across body part categories. One-sample t-test was done to compare mean FKGL with the recommended 6th-grade readability level and the average American adult reading level. Two-sample t-test was used to compare the readability scores of the AAOS trauma-related articles to those of the OTA. Results: The average FKGL and FRE for the AAOS articles were 8.9±0.74 and 57.2±5.8, respectively. All articles were written above the 6th-grade reading level. The average readability of the AAOS articles was significantly greater than the recommended 6th-grade and average American adult reading level. The average FKGL (8.9±0.74 vs 8.1±1.14) and FRE (57.2±5.8 vs 65.6±6.6) for all AAOS articles was significantly greater compared to that of OTA articles. Excellent agreement was observed between raters for the FKGL 0.956 (95%CI 0.922 - 0.975) and FRE 0.993 (95%CI 0.987 – 0.996). Discussion: Our findings suggest that, after almost a decade, the readability of the AAOS trauma-related articles remains unchanged. The AAOS and OTA trauma patient education materials have high readability levels and may be too difficult for patient comprehension. A need remains to improve the readability of these commonly used trauma education materials.

Keywords: american ocademy of orthopaedic surgeons, FKGL, FRE, orthopaedic trauma association, patient education, readability

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Authors: A. Kojah, A. Nacaroğlu

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Single phase transmission lines are used to transfer data or energy between two users. Transient conditions such as switching operations and short circuit faults cause the generation of the fluctuation on the waveform to be transmitted. Spatial voltage distribution on the single phase transmission line may change owing to the position and duration of the short circuit fault in the system. In this paper, the state space representation of the single phase transmission line for short circuit fault and for various types of terminations is given. Since the transmission line is modeled in time domain using distributed parametric elements, the mathematical representation of the event is given in state space (time domain) differential equation form. It also makes easy to solve the problem because of the time and space dependent characteristics of the voltage variations on the distributed parametrically modeled transmission line.

Keywords: energy transmission, transient effects, transmission line, transient voltage, RLC short circuit, single phase

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Authors: Manish Kumar Thakur, Chiranjit Sarkar

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Sedimentation of magnetorheological (MR) fluid affects its working. MR fluid is a smart fluid that has unique qualities such as quick responsiveness and easy controllability. It is used in the MR damper, MR brake, and MR clutch. In this work effect of sedimentation on torque transmission in the shear mode operated MR clutch is investigated. A test rig is developed to test the impact of sedimentation on torque transmission in the MR clutch. Torque transmission capability of MR clutch has been measured under two conditions to confirm the result of sedimentation. The first experiment is done just after filling and the other after one week. It has been observed that transmission torque is decreased after sedimentation. Hence sedimentation affects the working of the MR clutch.

Keywords: clutch, magnetorheological fluid, sedimentation, torque

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Authors: Rika Susanti, Eryati Darwin, Dedi Afandi, Yanwirasti, Syahruddin Said, Noverika Windasari, Zelly Dia Rofinda

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Introduction: Blunt head trauma is one of the leading causes of death associated with murders and other deaths involved in criminal acts. Creatine kinase (CKBB) levels have been used as a biomarker for blunt head trauma. Therefore, it is now used as an alternative to an autopsy. The aim of this study is to investigate CKBB levels in cerebrospinal fluid (CSF) and post-mortem serum in order to deduce the cause and time of death. Method: This investigation was conducted through post-test–only group design involving deaths caused by blunt head trauma, which was compared to deaths caused by ketamine poisoning. Results: There were eight treatment groups, each consisting of six adult rats (Rattus norvegicus) Sprague-Dawley strain. Examinations were done at 0 hours, 1 hour, 2 hours, and 3 hours post-mortem, which followed by brain tissue observation. Data were then analyzed statistically with a repeated-measures general linear model. Conclusion: There were increases in the level of CKBB in CSF and postmortem serum in both blunt head trauma and ketamine poisoning treatment groups. However, there were no significant differences between these two groups.

Keywords: blunt head trauma, CKBB, the cause of death, estimated time of death

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Authors: Christopher Wearmouth, Jacob Smith

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Administration of tranexamic acid (TXA) reduces all-cause mortality in trauma patients when given within 3 hours of injury. Due to geographical distance and lack of emergency medical services patients often present late, following trauma, to our emergency department. Additionally, we found patients that may have benefited from TXA did not receive it, often due to lack of staff awareness, staff shortages out of hours and lack of equipment for delivering infusions. Our objective was to develop a protocol for nurse-led administration of TXA in the emergency department. We developed a protocol using physiological observations along with criteria from the South African Triage Scale to allow nursing staff to identify patients with, or at risk of, significant haemorrhage. We will monitor the use of the protocol to ensure appropriate compliance and for any adverse events reported.

Keywords: emergency department, emergency nursing, rural healthcare, tranexamic acid, trauma, triage

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Authors: Anne Giles

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Trauma is generally defined as an experience, or multiple experiences, overwhelming a person's ability to cope. Over time, many people recover from the neurobiological, physical, and emotional effects of trauma on their own. For some people, however, troubling symptoms develop over time that can result in distress and disability. This cluster of symptoms is classified as Post-traumatic Stress Disorder (PTSD). People who meet the criteria for PTSD and other trauma-related disorder diagnoses often hold a set of understandable but unfounded beliefs about traumatic events that cause undue suffering. Becoming aware of unhelpful beliefs—termed "cognitive distortions"—and challenging them is the realm of Cognitive Behavior Therapy (CBT). A form of CBT found by researchers to be especially effective for PTSD is Cognitive Processing Therapy (CPT). Through the compassionate use of CPT, people identify, examine, challenge, and relinquish unhelpful beliefs, thereby reducing symptoms and suffering. Widely-held cultural beliefs can interfere with the progress of recovery from trauma-related disorders. Although highly revered, largely unquestioned, and often stabilizing, cultural beliefs can be founded in simplistic, dichotomous thinking, i.e., things are all right, or all wrong, all good, or all bad. The reality, however, is nuanced and complex. After studying examples of cultural beliefs from China and the United States and how these might interfere with trauma recovery, trauma counselors can help clients derive criteria for preserving helpful beliefs, discover, examine, and jettison unhelpful beliefs, reduce trauma symptoms, and live their lives more freely and fully.

Keywords: cognitive processing therapy (CPT), cultural beliefs, post-traumatic stress disorder (PTSD), trauma recovery

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Authors: Algia Hammami, Abdelfatteh Bouri

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In this work, our objective is to study the transmission of volatility between oil and stock markets in developed (USA, Germany, Italy, France and Japan) and emerging countries (Tunisia, Thailand, Brazil, Argentina, and Jordan) for the period 1998-2015. Our methodology consists of analyzing the monthly data by the GARCH-BEKK model to capture the effect in terms of volatility in the variation of the oil price on the different stock market. The empirical results in the emerging countries indicate that the relationships are unidirectional from the stock market to the oil market. For the developed countries, we find that the transmission of volatility is unidirectional from the oil market to stock market. For the USA and Italy, we find no transmission between the two markets. The transmission is bi-directional only in Thailand. Following our estimates, we also noticed that the emerging countries influence almost the same extent as the developed countries, while at the transmission of volatility there a bid difference. The GARCH-BEKK model is more effective than the others versions to minimize the risk of an oil-stock portfolio.

Keywords: GARCH, oil prices, stock market, volatility transmission

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Authors: Imas Istiani

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The concept of home is usually closely related to the place of safety and security. For people who have travelled far and long, they long to be united with home to feel safe, secure and comfortable. However, for some people, especially for veterans, home cannot offer them those feelings, on the contrary, it can give them the sense of insecurity as well as guilty. Thus, its juxtaposed concept can also put home as an uncanny place that represses and haunt its occupant. As for veterans, 'survivor guilt' overpowers them in the way that it will be hard for them to embrace the comfort that home offers. In Home, Toni Morrison poignantly depicts Frank’s life upon returning from the war. Burdened with his traumatic experiences, Frank finds home full with terror, guilt, fear, grief, and loss. Using Dominick laCapra’s 'Trauma Theory,' the study finds that Frank works through his trauma by being able to distinguish between past and present so that he can overcome those repressed feelings. Aside from his inner healing power, Frank digests the process of working through with the help of home and community, as proposed by Evelyn Jaffe Schreiber claiming that community can help survivors to heal from traumatic experiences. Thus, Home has two juxtaposed functions; both as traumatizing and healing place.

Keywords: trauma, healing, home, trauma theory

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Authors: Vartan Agopian

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Millions of Syrian families have been displaced since the beginning of the Syrian war, and the negative effects of post-war trauma have shown detrimental effects on the mental health of refugee children. While educational strategies have focused on vocational training and academic achievement, little has been done to include music in the school curriculum to help these children improve their mental health. The literature of music education and psychology, on the other hand, shows the positive effects of music on traumatized children, especially when it comes to dealing with stress. This paper presents a brief literature review of trauma, music therapy, and music in the classroom, after having introduced the Syrian war and refugee situation. Furthermore, the paper highlights the benefits of using music with traumatized children from the literature and offers strategies for teachers (such as singing, playing an instrument, songwriting, and others) to include music in their classrooms to help Syrian refugee children deal with post-war trauma.

Keywords: children, music, refugees, Syria, war

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Authors: K. Iskandar, N. H. Radzi, R. Aziz, M. S. Kamaruddin, M. N. Abdullah, S. A. Jumaat

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Nowadays many developing countries have been undergoing a restructuring process in the power electricity industry. This process has involved disaggregating former state-owned monopoly utilities both vertically and horizontally and introduced competition. The restructuring process has been implemented by the Australian National Electricity Market (NEM) started from 13 December 1998, began operating as a wholesale market for supply of electricity to retailers and end-users in Queensland, New South Wales, the Australian Capital Territory, Victoria and South Australia. In this deregulated market, one of the important issues is the transmission pricing. Transmission pricing is a service that recovers existing and new cost of the transmission system. The regulation of the transmission pricing is important in determining whether the transmission service system is economically beneficial to both side of the users and utilities. Therefore, an efficient transmission pricing methodology plays an important role in the Australian NEM. In this paper, the transmission pricing methodologies that have been implemented by the Australian NEM which are the Cost Reflective Network Pricing (CRNP) and Modified Cost Reflective Network Pricing (MCRNP) methods are investigated for allocating the transmission service charges to the transmission users. A case study using 6-bus system is used in order to identify the best method that reflects a fair and equitable transmission service charge.

Keywords: cost-reflective network pricing method, modified cost-reflective network pricing method, restructuring process, transmission pricing

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Authors: Alireza Fard Kashani

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This study reports on the experiences and attitudes of six Iranian migrant families, from two groups of asylum seekers and skilled workers, with regard to their language, identity, and acculturation in Australia. The participants included first generation parents and 1.5-generation adolescents, who had lived in Australia for a minimum of three years. For this investigation, Mendoza’s (1984, 2016) acculturation model, as well as poststructuralist views of identity, were employed. The semi-structured interview results have highlighted that Iranian parents and adolescents face low degrees of intergenerational conflicts in most domains of their acculturation. However, the structural and lawful patterns in Australia have caused some internal conflicts for the parents, especially fathers (e.g., their power status within the family or their children’s freedom). Furthermore, while most participants reported ‘cultural eclecticism’ as their preferred acculturation orientation, female participants seemed to be more eclectic than their male counterparts who showed inclination towards keeping more aspects of their home culture. This finding, however, highlights a meaningful effort on the part of husbands that in order to make their married lives continue well in Australia they need to re-consider the traditional male-dominated customs they used to have in Iran. As for identity, not only the parents but also the adolescents proudly identified themselves as Persians. In addition, with respect to linguistic behaviour, almost all adolescents showed enthusiasm to retain the Persian language at home to be able to maintain contacts with their relatives and friends in Iran and to enjoy many other benefits the language may offer them in the future.

Keywords: acculturation, asylum seekers, identity, intergenerational conflicts, language, skilled workers, 1.5 generation

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Authors: Venencia Albert, Arulselvi Subramanian, Hara Prasad Pati, Asok K. Mukhophadhyay

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Acute traumatic coagulopathy in an endogenous dysregulation of the intrinsic coagulation system in response to the injury, associated with three-fold risk of poor outcome, and is more amenable to corrective interventions, subsequent to early identification and management. Multiple definitions for stratification of the patients' risk for early acute coagulopathy have been proposed, with considerable variations in the defining criteria, including several trauma-scoring systems based on prehospital data. We aimed to develop a clinically relevant definition for acute coagulopathy of trauma based on conventional coagulation assays and to assess its efficacy in comparison to recently established prehospital prediction models. Methodology: Retrospective data of all trauma patients (n = 490) presented to our level I trauma center, in 2014, was extracted. Receiver operating characteristic curve analysis was done to establish cut-offs for conventional coagulation assays for identification of patients with acute traumatic coagulopathy was done. Prospectively data of (n = 100) adult trauma patients was collected and cohort was stratified by the established definition and classified as "coagulopathic" or "non-coagulopathic" and correlated with the Prediction of acute coagulopathy of trauma score and Trauma-Induced Coagulopathy Clinical Score for identifying trauma coagulopathy and subsequent risk for mortality. Results: Data of 490 trauma patients (average age 31.85±9.04; 86.7% males) was extracted. 53.3% had head injury, 26.6% had fractures, 7.5% had chest and abdominal injury. Acute traumatic coagulopathy was defined as international normalized ratio ≥ 1.19; prothrombin time ≥ 15.5 s; activated partial thromboplastin time ≥ 29 s. Of the 100 adult trauma patients (average age 36.5±14.2; 94% males), 63% had early coagulopathy based on our conventional coagulation assay definition. Overall prediction of acute coagulopathy of trauma score was 118.7±58.5 and trauma-induced coagulopathy clinical score was 3(0-8). Both the scores were higher in coagulopathic than non-coagulopathic patients (prediction of acute coagulopathy of trauma score 123.2±8.3 vs. 110.9±6.8, p-value = 0.31; trauma-induced coagulopathy clinical score 4(3-8) vs. 3(0-8), p-value = 0.89), but not statistically significant. Overall mortality was 41%. Mortality rate was significantly higher in coagulopathic than non-coagulopathic patients (75.5% vs. 54.2%, p-value = 0.04). High prediction of acute coagulopathy of trauma score also significantly associated with mortality (134.2±9.95 vs. 107.8±6.82, p-value = 0.02), whereas trauma-induced coagulopathy clinical score did not vary be survivors and non-survivors. Conclusion: Early coagulopathy was seen in 63% of trauma patients, which was significantly associated with mortality. Acute traumatic coagulopathy defined by conventional coagulation assays (international normalized ratio ≥ 1.19; prothrombin time ≥ 15.5 s; activated partial thromboplastin time ≥ 29 s) demonstrated good ability to identify coagulopathy and subsequent mortality, in comparison to the prehospital parameter-based scoring systems. Prediction of acute coagulopathy of trauma score may be more suited for predicting mortality rather than early coagulopathy. In emergency trauma situations, where immediate corrective measures need to be taken, complex multivariable scoring algorithms may cause delay, whereas coagulation parameters and conventional coagulation tests will give highly specific results.

Keywords: trauma, coagulopathy, prediction, model

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Authors: Chaiyaporn Yuksen, Tapanawat Chaiwan

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Introduction: Emergency medical service (EMS) care for trauma patients must be provided on-scene assessment and essential treatment and have appropriate transporting to the trauma center. The shock index (SI), reverse shock index Glasgow Coma Scale (rSIG), and National Early Warning Score (NEWS) triage tools are easy to use in a prehospital setting. There is no standardized on-scene triage protocol in prehospital care. The primary objective was to determine the accuracy of SI, rSIG, and NEWS to predict the severity of trauma patients in the emergency department (ED). Methods: This was a retrospective cross-sectional and diagnostic research conducted on trauma patients transported by EMS to the ED of Ramathibodi Hospital, a university-affiliated super tertiary care hospital in Bangkok, Thailand, from January 2015 to September 2022. We included the injured patients receiving prehospital care and transport to the ED of Ramathibodi Hospital by the EMS team from January 2015 to September 2022. We compared the on-scene parameter (SI, rSIG, and NEWS) and ED (Emergency Severity Index) with the area under ROC. Results: 218 patients were traumatic patients transported by EMS to the ED. 161 was ESI level 1-2, and 57 was level 3-5. NEWS was a more accurate triage tool to discriminate the severity of trauma patients than rSIG and SI. The area under the ROC was 0.743 (95%CI 0.70-0.79), 0.649 (95%CI 0.59-0.70), and 0.582 (95%CI 0.52-0.65), respectively (P-value <0.001). The cut point of NEWS to discriminate was 6 points. Conclusions: The NEWs was the most accurate triage tool in prehospital seeing in trauma patients.

Keywords: on-scene triage, trauma patient, ED triage, accuracy, NEWS

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Authors: Ömer Ateş, Atilla Savaş

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Reducers and transmission systems are power and speed transfer tools that have been used for many years in the technology world and in all engineering fields. Since today's transmissions have a threaded tap system, torque interruption occurs during tap change. besides, breakdown and manufacturing costs are high. Another problem is the limited torque and rpm setting in stepped gearbox systems. In this study, a new type of transmission system is designed to solve these problems. This new type of transmission system has been called the Continuously Variable Pulley. The most important feature of the transmission system in the study is that it can be adjusted Revolutions Per Minute-wise and torque-wise at the millimeter (precision) adjustment level. In order to make adjustments at this level, an adjustable pulley with the help of hydraulic piston is designed. The efficiency of the designed transmission system is 97 percent, the efficiency of today's transmissions is in the range of 85-95 percent. examined at the analysis and calculations, it is seen that the designed system gives realistic results and can be compared with today's transmissions and reducers. Therefore, this new type of transmission has been proven to be usable in production areas and the world of technology.

Keywords: gearbox, reducer, transmission, torque

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Authors: Mao Huasong, Tang Siqi, Cheng Yu

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The cognition and practice of Chinese landscapes have distinct uniqueness. The intergenerational inheritance of urban and rural landscapes is a common objective fact which has created a unique type of heritage in China - scenic heritage. The current generalization of the concept of scenic heritage has affected the lack of innovation in corresponding protection practices. Therefore, clarifying the concepts and connotations of scenery and scenic heritage, clarifying the protection objects of scenic heritage and the methods and approaches in intergenerational inheritance can provide theoretical support for the practice of Chinese scenic heritage and contribute Chinese wisdom to the transformation of world heritage sites. Taking ancient Shaoxing, which has a long time span and rich descriptions of scenic types and quantities, as the research object and using local chronicles as the basic research material, based on text analysis, word frequency analysis, case statistics, and historical, geographical spatial annotation methods, this study traces back to ancient scenic practices and conducts in-depth descriptions in both text and space. it have constructed a scenic heritage identification method based on the basic connotation characteristics and morphological representation characteristics of natural and cultural correlations, combined with the intergenerational and representative characteristics of scenic heritage; Summarized the bidirectional integration of "scenic spots" and "form scenic spots", "outstanding people" and "local spirits" in the formation process of scenic heritage; In inheritance, guided by Confucian values of education; In communication, the cultural interpretation constructed by scenery and the way of landscape life are used to strengthen the intergenerational inheritance of natural, artificial material elements, and intangible spirits. As a unique type of heritage in China, scenic heritage should improve its standards, values, and connotations in current protection practices and actively absorb historical experience.

Keywords: scenic heritage, heritage protection, cultural landscape, shaoxing, chinese landscape

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Authors: K. Thiagarajan, K. Saranya, A. Veeraiah, B. Sudha

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This paper presents a novel algorithm for secure, reliable and flexible transmission of big data in two hop wireless networks using cooperative jamming scheme. Two hop wireless networks consist of source, relay and destination nodes. Big data has to transmit from source to relay and from relay to destination by deploying security in physical layer. Cooperative jamming scheme determines transmission of big data in more secure manner by protecting it from eavesdroppers and malicious nodes of unknown location. The novel algorithm that ensures secure and energy balance transmission of big data, includes selection of data transmitting region, segmenting the selected region, determining probability ratio for each node (capture node, non-capture and eavesdropper node) in every segment, evaluating the probability using binary based evaluation. If it is secure transmission resume with the two- hop transmission of big data, otherwise prevent the attackers by cooperative jamming scheme and transmit the data in two-hop transmission.

Keywords: big data, two-hop transmission, physical layer wireless security, cooperative jamming, energy balance

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Authors: Amir Lotfi, Seyed Hamid Hosseini

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During the recent past, due to the increase of electrical energy demand and governmental resources constraints in creating additional capacity in the generation, transmission, and distribution, privatization, and restructuring in electrical industry have been considered. So, in most of the countries, different parts of electrical industry like generation, transmission, and distribution have been separated in order to create competition. Considering these changes, environmental issues, energy growth, investment of private equity in energy generation units and difficulties of transmission lines expansion, distributed generation (DG) units have been used in power systems. Moreover, reduction in the need for transmission and distribution, the increase of reliability, improvement of power quality, and reduction of power loss have caused DG to be placed in power systems. On the other hand, considering low liquidity need, private investors tend to spend their money for DGs. In this project, the main goal is to offer an algorithm for planning and placing DGs in order to reduce the need for transmission and distribution network.

Keywords: planning, transmission, distributed generation, power security, power systems

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Authors: Nicola Harrison

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Familial childhood sexual abuse (FCSA) prevalence rates in Aotearoa, New Zealand, are amongst the highest globally, particularly in indigenous communities. However, such statistics seem incongruent with indigenous paradigms of unity, care, and connection. The inability of policymakers and mainstream service providers to acknowledge the direct links between the social contexts created by colonisation for indigenous families in Aotearoa and intergenerational FCSA has meant there has been little meaningful success in combatting this significant social problem. This research traces the conditions of intergenerational FCSA to the systemic inequalities created by colonization. Kaupapa Māori methodologies were applied to this qualitative piece of empirical research wherein 17 indigenous contributors shared their stories of FCSA. From these stories and existing literature, we can identify how the machinations of colonisation are mirrored by techniques used to perpetrate abuse. Once identified, we are then able to recommend actions for halting FCSA for future generations.

Keywords: indigenity, family violence, childhood sexual abuse, colonization

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Authors: Gabriela Macera DiFilippo

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The world watched in disbelief as George Floyd was killed by a policeman. The images from the scene were made more memorable by Mr. Floyd’s pleas and cries for his mother. In the aftermath of this tragedy, the Black Lives Matter movement gained momentum. Weeks and months after the protests, global interest in learning about tackling systemic racism erupted. One must wonder how school children of color viewed and processed this trauma. This study will examine the kinds of trauma experienced by children of color and the opportunity for school mental health providers to support these children. This study used literature searches that were previously conducted for proven and practical assessment methods that can help deal with racial trauma for children. As part of the assessment, trauma symptoms experienced by children of color were summarized and characterized in a non-imperial manner. The research was also will be done in practical ways to make adequate and effective mental health services available in schools and lessen the stigma. This research study found that there is a need to provide an analysis of the ongoing racial trauma of children of color after the death of George Floyd. Impactful and appropriate assessment methods, such as surveys, were presented to all school professionals. Lastly, this paper attempted to provide mental health professionals with the tools to screen and provide guidance based on unequivocal, unbiased methods for helping these children. There is a need for both schools and community leaders to ensure that every child has access to mental health care and is being assessed for their overall well-being. There is a need to educate the communities about racial trauma and its impact on individuals, especially children. School mental health professionals are encouraged to offer and educate schools and communities about racial trauma awareness, its importance, and ways to cope with it in different settings. The delivery of these informed services should focus on behavioral health and must be sensitive to children of color and different ways of self-care.

Keywords: trauma, children, black psychology, students

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Authors: Tan Xin Zhong Timothy, Chang Chen Jie Victor, Yew Kwan Tong, Lim Geok Peng Sandy

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Background: Leaders in crisis response teams such as Trauma Teams in hospitals are essential to the effective coordination and direction of the team. The response to emergency trauma situations must be accurate, rapid, and well executed. To this end, the team leader’s social, technical and leadership skills are essential factors that implicate the success of an emergency trauma intervention. While each emergency trauma case varies in severity and complexity, and the experience and expertise of team leaders may vary, it would be productive to identify certain coordinative and directive functions that improve the capacity for leading a team. Methods: This qualitative study of Trauma Team physicians in Singapore General Hospital (SGH) involved 50 in-depth interviews with doctors and nurses involved in Trauma Team activations, observations of Trauma Teams managing emergency patients, and reviews of audio/video recordings of 65 trauma activations. The interviews were conducted with doctors of various ranks across the relevant departments, 12 from the Emergency Department (ED), 11 from General Surgery (GS) and 8 from Orthopaedics, while the 6 nurses were from ED. In accordance with the grounded theory approach, the content of the interviews was coded and analysed in order to derive broad leadership themes that corresponded with certain behavioural traits exhibited by trauma team leaders, supplemented with the observational and audio/video data. Results: The leadership behaviours of the team leaders could be typified into three broad categories: team orientation, engagement and activeness. Team orientation corresponds with the source and form of cognitive responsibility, decision-making and informational contributions, divisible into individualistic and consultative sub-categories. Engagement refers to the type of activity that leaders prefer to engage in, and which implicates their attentional focus, divisible into participatory and supervisory sub-categories. Activeness is a function of the leader’s attitudes towards the behavioural regulation of the team, which manifests in inactivity or activity to augment or merely align with protocol. These factors are not exhaustive and are contextually sensitive, but collectively implicate a significant portion of the leadership activity observed in trauma teams.

Keywords: trauma team activations, critical event management, leadership, teamwork

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Authors: Jeong-Hwan Choi, Hyo-Sang Park, Tae-Hyung Lee

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The transmission tower is one of the crucial lifeline structures in a modern society, and it needs to be protected against extreme loading conditions. However, the transmission tower is a very complex structure and, therefore, it is very difficult to simulate the actual damage and the collapse behavior of the tower structure. In this study, the actual collapse behavior of the transmission tower due to lateral loading conditions such as wind load is evaluated through the computational simulation. For that, a progressive collapse procedure is applied to the simulation. In this procedure, after running the simulation, if a member of the tower structure fails, the failed member is removed and the simulation run again. The 154kV transmission tower is selected for this study. The simulation is performed by nonlinear static analysis procedure, namely pushover analysis, using OpenSEES, an earthquake simulation platform. Three-dimensional finite element models of those towers are developed.

Keywords: transmission tower, OpenSEES, pushover, progressive collapse

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Authors: Monika Foltyn-Zarychta

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Climate change mitigation investment activities are inevitably extended in time extremely. The project cycle does not last for decades – sometimes it stretches out for hundreds of years and the project outcomes impact several generations. The longevity of those activities raises multiple problems in the appraisal procedure. One of the pivotal issues is the choice of the discount rate, which affect tremendously the net present value criterion. The paper aims at estimating the value of social discount rate for intergenerational investment projects in Poland based on individual intertemporal preferences. The analysis is based on questionnaire surveying Polish citizens and designed as contingent valuation method. The analysis aimed at answering two questions: 1) whether the value of the individual discount rate decline with increased time of delay, and 2) whether the value of the individual discount rate changes with increased spatial distance toward the gainers of the project. The valuation questions were designed to identify respondent’s indifference point between lives saved today and in the future due to hypothetical project mitigating climate changes. Several project effects’ delays (of 10, 30, 90 and 150 years) were used to test the decline in value with time. The variability in regard to distance was tested by asking respondents to estimate their indifference point separately for gainers in Poland and in Latvia. The results show that as the time delay increases, the average discount rate value decreases from 15,32% for 10-year delay to 2,75% for 150-year delay. Similar values were estimated for Latvian beneficiaries. There should be also noticed that the average volatility measured by standard deviation also decreased with time delay. However, the results did not show any statistically significant difference in discount rate values for Polish and Latvian gainers. The results showing the decline of the discount rate with time prove the possible economic efficiency of the intergenerational effect of climate change mitigation projects and may induce the assumption of the altruistic behavior of present generation toward future people. Furthermore, it can be backed up by the same discount rate level declared by Polish for distant in space Latvian gainers. The climate change activities usually need significant outlays and the payback period is extremely long. The more precise the variables in the appraisal are, the more trustworthy and rational the investment decision is. The discount rate estimations for Poland add to the vivid discussion concerning the issue of climate change and intergenerational justice.

Keywords: climate change, social discount rate, investment appraisal, intergenerational justice

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