Search results for: trauma and grief recovery

Authors: Vincent King Soon Wong, Hong Seng Ng, Florinna Sim

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Negative Bias Temperature Instability (NBTI) is one of the critical degradation mechanisms in semiconductor device reliability that causes shift in the threshold voltage (Vth). However, thorough understanding of this reliability failure mechanism is still unachievable due to a recovery characteristic known as NBTI recovery. This paper will demonstrate the severity of NBTI recovery as well as one of the effective methods used to mitigate, which is the minimization of measurement system delays. Comparison was done in between two measurement systems that have significant differences in measurement delays to show how NBTI recovery causes result deviations and how fast measurement systems can mitigate NBTI recovery. Another method to minimize NBTI recovery without the influence of measurement system known as Fast Wafer Level Reliability (FWLR) NBTI was also done to be used as reference.

Keywords: fast vs slow BTI, fast wafer level reliability (FWLR), negative bias temperature instability (NBTI), NBTI measurement system, metal-oxide-semiconductor field-effect transistor (MOSFET), NBTI recovery, reliability

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Authors: Nina Kaufmans

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Traditional therapies, utilizing spoken narratives as a primary source of intervention, are proven to be limited in effectively treating post traumatic stress disorder. Following the effects of the global pandemic of COVID-19, an increasing number of mental health consumers are beginning to experience somatically-based distress in addition to existing mental health symptoms. Moreover, the aftermath of the rapid increase in demand for mental health services has caused significant burnout in mental health professionals. This paper explores the ramifications of recent changes and challenges in the mental health demands and subsequent response and its consequences for mental health workers. We will begin by investigating the neurobiological mechanisms involved in traumatic experiences, then discuss the premises for "bottom-up" or somatically oriented psychotherapy approaches, and finally offer clinical skills and interventions for clients diagnosed with post traumatic stress disorder. In addition, we will discuss how somatically-based psychotherapy interventions implemented in sessions may decrease burnout and improve the well-being of clinicians. We will discuss how the integration of somatically-based interventions into counseling would increase the effectiveness of mental health recovery and sustain remission while simultaneously providing opportunities for self-care for mental health professionals.

Keywords: somatic psychotherapy interventions, trauma counseling, preventing and treating burnout, adults with PTSD, bottom-up skills, the effectiveness of trauma treatment

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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: Surajbhan Sevda

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Metal containing wastewater is generated in large quintiles due to rapid industrialization. Generally, the metal present in wastewater is not biodegradable and can be accumulated in living animals, humans and plant tissue, causing disorder and diseases. The conventional metal recovery methods include chemical, physical and biological methods, but these are chemical and energy intensive. The recent development in microbial fuel cell (MFC) technology provides a new approach for metal recovery; this technology offers a flexible platform for both reduction and oxidation reaction oriented process. The use of MFCs will be a new platform for more efficient and low energy approach for metal recovery from the wastewater. So far metal recover was extensively studied using chemical, physical and biological methods. The MFCs present a new and efficient approach for removing and recovering metals from different wastewater, suggesting the use of different electrode for metal recovery can be a new efficient and effective approach.

Keywords: metal recovery, microbial fuel cell, wastewater, bioelectricity

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Authors: Golnar Behzadi, Michael O'Sullivan, Tava Olsen, Abraham Zhang

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By definition, increasing supply chain resilience improves the supply chain’s ability to return to normal, or to an even more desirable situation, quickly and efficiently after being hit by a disruption. This is especially critical in agribusiness supply chains where the products are perishable and have a short life-cycle. In this paper, we propose a resilience metric to capture and improve the recovery process in terms of both performance and time, of an agribusiness supply chain following either supply or demand-side disruption. We build a model that determines optimal supply chain recovery planning decisions and selects the best resilient strategies that minimize the loss of profit during the recovery time window. The model is formulated as a two-stage stochastic mixed-integer linear programming problem and solved with a branch-and-cut algorithm. The results show that the optimal recovery schedule is highly dependent on the duration of the time-window allowed for recovery. In addition, the profit loss during recovery is reduced by utilizing the proposed resilient actions.

Keywords: agribusiness supply chain, recovery, resilience metric, risk management

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Authors: Zakaria Hamdi, Mariyamni Awang

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For the past decades, CO₂ flooding has been used as a successful method for enhanced oil recovery (EOR). However, high mobility ratio and fingering effect are considered as important drawbacka of this process. Low temperature injection of CO₂ into high temperature reservoirs may improve the oil recovery, but simulating multiphase flow in the non-isothermal medium is difficult, and commercial simulators are very unstable in these conditions. Furthermore, to best of authors’ knowledge, no experimental work was done to verify the results of the simulations and to understand the pore-scale process. In this paper, we present results of investigations on injection of low temperature CO₂ into a high-pressure high-temperature micromodel with injection temperature range from 34 to 75 °F. Effect of temperature and saturation changes of different fluids are measured in each case. The results prove the proposed method. The injection of CO₂ at low temperatures increased the oil recovery in high temperature reservoirs significantly. Also, CO₂ rich phases available in the high temperature system can affect the oil recovery through the better sweep of the oil which is initially caused by penetration of LCO₂ inside the system. Furthermore, no unfavorable effect was detected using this method. Low temperature CO₂ is proposed to be used as early as secondary recovery.

Keywords: enhanced oil recovery, CO₂ flooding, micromodel studies, miscible flooding

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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: Rabia Hunky, Hayat Kalifa, Bai

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The wettability of carbonate reservoirs has been widely recognized as an important parameter in oil recovery by flooding technology. Many surfactants have been studied for this application. However, the importance of wettability alteration in sandstone reservoirs by surfactant has been poorly studied. In this paper, our recent study of the relationship between rock surface wettability and cumulative oil recovery for sandstone cores is reported. In our research, it has been found there is a good agreement between the wettability and oil recovery. Nonionic surfactants, Tomadol® 25-12 and Tomadol® 45-13, are very effective in wettability alteration of sandstone core surface from highly oil-wet conditions to water-wet conditions. By spontaneous imbibition test, Interfacial tension, and contact angle measurement these two surfactants exhibit the highest recovery of the synthetic oil made with heavy oil. Based on these experimental results, we can further conclude that the contact angle measurement and imbibition test can be used as rapid screening tools to identify better EOR surfactants to increase heavy oil recovery from sandstone reservoirs.

Keywords: EOR, oil gas, IOR, WC, IF, oil and gas

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Authors: A. Idawaty, O. Mohamed, A. Z. Zuriati

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This paper presents the development of an event based Discrete Event Simulation (DES) for a recovery algorithm known Backward Recovery Global Preemptive Utility Accrual Scheduling (BR_GPUAS). This algorithm implements the Backward Recovery (BR) mechanism as a fault recovery solution under the existing Time/Utility Function/ Utility Accrual (TUF/UA) scheduling domain for multiprocessor environment. The BR mechanism attempts to take the faulty tasks back to its initial safe state and then proceeds to re-execute the affected section of the faulty tasks to enable recovery. Considering that faults may occur in the components of any system; a fault tolerance system that can nullify the erroneous effect is necessary to be developed. Current TUF/UA scheduling algorithm uses the abortion recovery mechanism and it simply aborts the erroneous task as their fault recovery solution. None of the existing algorithm in TUF/UA scheduling domain in multiprocessor scheduling environment have considered the transient fault and implement the BR mechanism as a fault recovery mechanism to nullify the erroneous effect and solve the recovery problem in this domain. The developed BR_GPUAS simulator has derived the set of parameter, events and performance metrics according to a detailed analysis of the base model. Simulation results revealed that BR_GPUAS algorithm can saved almost 20-30% of the accumulated utilities making it reliable and efficient for the real-time application in the multiprocessor scheduling environment.

Keywords: real-time system (RTS), time utility function/ utility accrual (TUF/UA) scheduling, backward recovery mechanism, multiprocessor, discrete event simulation (DES)

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Authors: Ryan Adams

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Introduction: Major trauma is the leading cause of death in 15-45 year olds and a significant human, social and economic costs. Resuscitation is a stalwart of trauma management, especially in the pre-hospital environment and packed red blood cells (pRBC) are being increasingly used with the advent of permissive hypotension. The evidence in this area is lacking and further research is required to determine its efficacy. Aim: The aim of this retrospective, matched cohort study was to determine if major trauma patients, who received pre-hospital pRBC, have a difference in their initial emergency department cardiovascular status; when compared with injury-profile matched controls. Methods: The trauma databases of the Royal Brisbane and Women's Hospital, Royal Children's Hospital (Herston) and Queensland Ambulance Service were accessed and major trauma patient (ISS>12) data, who received pre-hospital pRBC, from January 2011 to August 2014 was collected. Patients were then matched against control patients that had not received pRBC, by their injury profile. The primary outcomes was cardiovascular status; defined as shock index and Revised Trauma Score. Results: Data for 25 patients who received pre-hospital pRBC was accessed and the injury profiles matched against suitable controls. On admittance to the emergency department, a statistically significant difference was seen in the blood group (Blood = 1.42 and Control = 0.97, p-value = 0.0449). However, the same was not seen with the RTS (Blood = 4.15 and Control 5.56, p-value = 0.291). Discussion: A worsening shock index and revised trauma score was associated with pre-hospital administration of pRBC. However, due to the small sample size, limited matching protocol and associated confounding factors it is difficult to draw any solid conclusions. Further studies, with larger patient numbers, are required to enable adequate conclusions to be drawn on the efficacy of pre-hospital packed red blood cell transfusion.

Keywords: pre-hospital, packed red blood cells, severe trauma, emergency medicine

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Authors: Brian Kristopher Cambra

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Millions of displaced families are seeking refuge in countries that are not their own due to war, violence, persecution, political unrest, and natural disasters. This global crisis is forcing researchers and practitioners to consider how refugees are coping with the trauma associated with their migration process. Effective therapeutic approaches are needed in a global effort to address the traumatic impact of forced migration. This meta-analytical study investigates the effectiveness of expressive therapeutic modalities, including play, art, music, sandplay, theatre, and writing therapies, in helping children and adolescents cope with refugee trauma. Seventeen pre-post and between-group comparison studies were analyzed using a random-effects model. The combined effect size for pre-post comparisons was medium (g = 0.58), whereas the combined effect size for between-group comparisons was small (g = 0.32). Overall, art therapy was found to be most effective in treating stress symptoms. Heterogeneity tests, however, suggest effect sizes cannot be interpreted as meaningful due to substantial variance. Nevertheless, findings of this meta-analysis indicate that expressive therapies may be among beneficial modalities to integrate with other trauma-informed approaches.

Keywords: expressive therapies, forced migration, meta-analysis, refugees, trauma

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Authors: Shohreh Ghasemi

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Introduction: Managing oral and maxillofacial trauma is a multifaceted challenge, as it can have life-threatening consequences and significant functional and aesthetic impact. Navigation techniques have been introduced to improve surgical precision to meet this challenge. A machine learning algorithm was also developed to support clinical decision-making regarding treating oral and maxillofacial trauma. Given these advances, this systematic meta-analysis aims to assess the efficacy of navigational techniques in treating oral and maxillofacial trauma and explore the impact of machine learning on their management. Methods: A detailed and comprehensive analysis of studies published between January 2010 and September 2021 was conducted through a systematic meta-analysis. This included performing a thorough search of Web of Science, Embase, and PubMed databases to identify studies evaluating the efficacy of navigational techniques and the impact of machine learning in managing oral and maxillofacial trauma. Studies that did not meet established entry criteria were excluded. In addition, the overall quality of studies included was evaluated using Cochrane risk of bias tool and the Newcastle-Ottawa scale. Results: Total of 12 studies, including 869 patients with oral and maxillofacial trauma, met the inclusion criteria. An analysis of studies revealed that navigation techniques effectively improve surgical accuracy and minimize the risk of complications. Additionally, machine learning algorithms have proven effective in predicting treatment outcomes and identifying patients at high risk for complications. Conclusion: The introduction of navigational technology has great potential to improve surgical precision in oral and maxillofacial trauma treatment. Furthermore, developing machine learning algorithms offers opportunities to improve clinical decision-making and patient outcomes. Still, further studies are necessary to corroborate these results and establish the optimal use of these technologies in managing oral and maxillofacial trauma

Keywords: trauma, machine learning, navigation, maxillofacial, management

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Authors: Nodi Islam

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This paper critically reads Richard Powers’ novel The Echo Maker to read and understand the personal traumas of the characters in the novel depending on the various situations they face throughout the story. Also, the paper attempts to read different traumas and disorders due to their different situations. With a focus on the individual experiences, this paper addresses the core issues of trauma, which triggers their reactions and reads the novel through theories of Freud, Caruth, and other critics in this field. While transcending the boundary of personal and collective trauma, this paper suggests that traumas not only arise from the core mental issues, from both past or present memories; it also depends on places too which can be called, according to Yi-Fu Tuan, topophobia. Intimate places such as home provoke not only attachment and expectation but also produce fear in a person. Failure in identifying with such places means losing a central piece of identity of the individual. In order to analyse the traumas in the novel, the characters’ association with homes and places has been provided. This paper attempts to suggest that people are not traumatised because of what Freud explained as unpleasant memories of the past but also intimacy and lost identities related to a place can trigger trauma.

Keywords: spatial trauma, traumatic stress disorder, identity and place, core mental issues

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Authors: F. S. Alavi, D. Mowla, F. Esmaeilzadeh

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In this paper, the Eclipse 300 simulator was used to perform compositional modeling of gas injection process for enhanced condensate recovery of a real gas condensate well in south of Iran here referred to as SA4. Some experimental data were used to tune the Peng-Robinson equation of state for this case. Different scenarios of gas injection at current reservoir pressure and at abandonment reservoir pressure had been considered with different gas compositions. Methane, carbon dioxide, nitrogen and two other gases with specified compositions were considered as potential gases for injection. According to the obtained results, nitrogen leads to highest pressure maintenance in the reservoir but methane results in highest condensate recovery among the selected injection gases. At low injection rates, condensate recovery percent is strongly affected by gas injection rate but this dependency shifts to zero at high injection rates. Condensate recovery is higher in all cases of injection at current reservoir pressure than injection at abandonment pressure. Using a constant injection rate, increasing the production well bottom hole pressure results in increasing the condensate recovery percent and time of gas breakthrough.

Keywords: gas-condensate reservoir, case-study, compositional modelling, enhanced condensate recovery, gas injection

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Authors: Zabihullah Mahdi, Khwaja Naweed Seddiqi, Shigeo Honma

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Through many types of research and practical studies, it has been identified that the average oil recovery factor of a petroleum reservoir is about 30 to 35 %. This study is focused on enhanced oil recovery by laboratory experiment and graphical investigation based on Buckley-Leverett theory. Horizontal oil displacement by water, in a petroleum reservoir is analyzed under the Buckley-Leverett frontal displacement theory. The extraction and prerequisite of this theory are based and pursued focusing on the key factors that control displacement. The theory is executable to the waterflooding method, which is generally employed in petroleum engineering reservoirs to sustain oil production recovery, and the techniques for evaluating the average water saturation behind the water front and the oil recovery factors in the reservoirs are presented. In this paper, the Buckley-Leverett theory handled to an experimental model and the amount of recoverable oil are investigated to be over 35%. The irreducible water saturation, viz. connate water saturation, in the reservoir is also a significant inspiration for the recovery.

Keywords: Buckley-Leverett theory, waterflooding technique, petroleum engineering, immiscible displacement

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Authors: Duane Booysen, Ashraf Kagee

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There is a high prevalence of violent crime and trauma exposure in South African society. Considering the prevalence of continuous violent crimes and traumatization in South Africa, the public mental health sector is required to combat the burgeoning effect of traumatic stress in South Africa. Trauma counselors, especially, provide important mental health services at primary health care to persons affected by traumatic events. Therefore, the evaluation and implementation of evidence-based trauma therapies is essential at a primary health care level in treating traumatic stress. A single-case design was used to evaluate the treatment effect of a Brief Trauma Treatment Programme treating persons who present with symptoms of posttraumatic stress disorder at a primary care trauma centre in Cape Town, South Africa. The sample consisted of six adult participants who presented with symptoms of posttraumatic stress and were assessed at baseline, during treatment, post-intervention and at 3-month follow. All participants received six sessions of trauma therapy. Assessment measures included the posttraumatic stress disorder symptom scale interviews for Diagnostic and Statistical Manual fifth edition (DSM5), the posttraumatic disorder checklist for DSM5, Beck Depression Inventory and Beck Anxiety Inventory. Results demonstrate that participants had noticeable reduced symptoms for traumatic stress, anxiety and depression despite living in contexts of violent crime and trauma. In conclusion, the article critically reflects on the need to evaluate and implement evidence-based treatments for the South African context, and how evidence-based treatments are used in developing socio-economic and cultural diverse contexts with continuous levels of violence and traumatization.

Keywords: psychological interventions, public mental health, traumatic stress, single-case design

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Authors: Sanjaykumar R. Patel, Parth R. Kayastha

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α-lactose monohydrate is widely used in the pharmaceutical industries as an inactive substance that acts as a vehicle or a medium for a drug or other active substance. It is a byproduct of dairy industries, and the recovery of lactose from whey not only boosts the improvement of the economics of whey utilization but also causes a reduction in pollution as lactose recovery can reduce the BOD of whey by more than 80%. In the present study, levels of process parameters were kept as initial lactose concentration (30-50% w/w), sonication amplitude (20-40%), sonication time (2-6 hours), and crystallization temperature (10-20 ^oC) for the recovery of lactose in ultrasound assisted cooling crystallization. In comparison with cooling crystallization, the use of ultrasound enhanced the lactose recovery by 39.17% (w/w). The parameters were optimized for the lactose recovery using Taguchi Method. The optimum conditions found were initial lactose concentration at level 3 (50% w/w), amplitude of sonication at level 2 (40%), the sonication time at level 3 (6 hours), and crystallization temperature at level 1 (10 °C). The maximum recovery was found to be 85.85% at the optimum conditions. Sonication time and the initial lactose concentration were found to be significant parameters for the lactose recovery.

Keywords: crystallization, lactose, Taguchi method, ultrasound

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Authors: Meet Bhatia

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Well stimulation and heavy oil recovery continue to be a hot topic in our industry, particularly with formation damage and viscous oil respectively. Cyclic steam injection has been recognised for most of the operations related to heavy oil recovery. However, the cost of implementation is high and operation is time-consuming, moreover most of the viscous oil reservoirs such as oil sands, Bitumen deposits and oil shales require additional treatment of well stimulation. The use of hydrogen peroxide can efficiently replace the cyclic steam injection process as it can be used for both well stimulation and heavy oil recovery simultaneously. The decomposition of Hydrogen peroxide produces oxygen, superheated steam and heat. The increase in temperature causes clays to shrink, destroy carbonates and remove emulsion thus it can efficiently remove the near wellbore damage. The paper includes mechanisms, parameters to be considered and the challenges during the treatment for the effective hydrogen peroxide injection for both conventional and heavy oil reservoirs.

Keywords: hydrogen peroxide, well stimulation, heavy oil recovery, steam injection

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Authors: Vimi Jham

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The banking sector has undergone tremendous change in all forms of service it provides to its customers. The efforts of the banks is to avoid customer defection and lead to customer satisfaction. The purpose of the study was to examine the linkages among the constructs such as customer perceived service quality, perceived service recovery quality and customer satisfaction in the banking industry. The moderating effect of negative brand perception due to service failure on recovery satisfaction were investigated. Random sampling methods are used to draw the sample from the population. Data was collected from 262 banking customers and were analyzed with the help of structural equation modelling approach using Smart PLS to understand the relationship among variables being studied. The results of the study contribute to the research by proving that customer service recovery satisfaction is dependent on customer perceived service quality and the moderating effect of negative brand perception due to service failure was insignificant.

Keywords: service recovery satisfaction, perceived service recovery quality, perceived service quality, structural equation modelling

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Authors: Jeerasak Wisatphan, Nara Samattapapong

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This study's goals were to enhance nitroglycerin manufacturing efficiency through simulation, recover nitroglycerin from the storage facility, and enhance nitroglycerine recovery and purge systems. It was found that the problem was nitroglycerin reflux. Therefore, the researcher created three alternatives to solve the problem. The system of Nitroglycerine Recovery and Purge was then simulated using the FlexSim program, and each alternative was tested. The results demonstrate that the alternative system-led Nitroglycerine Recovery and Nitroglycerine Purge System collaborate to produce Nitroglycerine, which is more efficient than other alternatives and can reduce production time. It can also improve the recovery of nitroglycerin. It also serves as a guideline for developing a real-world system and modeling it for training staff without wasting raw chemical materials or fuel energy.

Keywords: efficiency increase, nitroglycerine recovery and purge system, production improvement, simulation

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Authors: Mohammad Ansari, Ahmed Ismail, Satinder Mann

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Overcrowding in Emergency departments (ED) of United Kingdom has become a common problem. Urgent Care centres were developed nearly a decade ago to reduce pressure on EDs. Unfortunately, the development of Urgent Care centres has failed to produce the projected effects. It was thought that nearly 40% patients attending ED would go to Urgent Care centres and these would be staffed by Primary care Physicians. Data reveals that no more than 20% patients were seen by Primary Care Physicians even when the Urgent Care Centre was based in the ED. This study was carried out at the ED of George Eliot Hospital, Nuneaton, UK where the Urgent Care centre was based in the ED and employed Primary Care Physicians with special interest in trauma for nearly one year. This was then followed by a Primary Care Physician and Advanced Nurse Practitioner. We compared the number of patients seen during these periods and the cost-effectiveness of the service.We randomly selected a week of patients seen by Primary Care Physicians with special interest in Trauma and by Primary Care Physicians and the Advanced Nurse Practitioner. We compared the number and type of patients seen during these two periods. Nearly 38% patients were seen by Primary care Physician with special interest in Trauma, whilst only 14.3% patients were seen by the Primary care Physician and Advanced Nurse Practitioner. The Primary Care Physicians with special interest in trauma were paid less. Our study confirmed that unless Primary Care Physicians are able to treat minor trauma and interpret x-rays, the urgent care service is not going to be cost effective. Numerous previous studies have shown that 15 to 20% patients attending ED can be treated by Primary Care Physicians who do not require any investigations for their management. It is advantageous to have Urgent Care Centres within the ED because if the patient deteriorates they can be transferred to ED. We recommend that the Urgent care Centres should be a part of ED. Our study shows that Urgent care Centres in the ED can be helpful and cost effective if staffed by either senior Emergency Physicians or Primary Care Physicians with special interest and experience in the management of minor trauma.

Keywords: urgent care centres, primary care physician, advanced nurse practitioner, trauma

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Authors: Andriana E. Tran, Anna Chur-Hansen

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Sexual health is an important aspect of overall wellbeing. This study aimed to explore the sexual health experiences of men aged 50 years and over from the perspective of health care professional participants who were specializing in sexual health care and who consulted with older men. A total of ten interviews were conducted. Eleven themes were identified regarding men’s experiences with sexual health care as reported by participants. 1) Biologically focused: older male clients focus largely on the biological aspect of their sexual health without consideration of other factors which might affect their functioning. 2) Psychological concerns: there is an interaction between mental and sexual health but older male clients do not necessarily see this. 3) Medicalization of sexual functioning: advances in medicine that aid with erectile difficulties which consequently mean that older men tend to favor a medical solution to their sexual concerns. 4) Masculine identity: sexual health concerns are linked to older male clients’ sense of masculinity. 5) Penile functionality: most concerns that older male clients have center on their penile functionality. 6) Relationships: many male clients seek sexual help as they believe it improves relationships. Conversely, having supportive partners may mean older male clients focus less on the physicality of sex. 7) Grief and loss: men experience grief and loss – the loss of their sexual functioning, grief from loss of a long-term partner, and loss of intimacy and privacy when moving from independent living to residential care. 8) Social stigma: older male clients experience stigma around aging sexuality and sex in general. 9) Help-seeking behavior: older male clients will usually seek mechanistic solution for biological sexual concerns, such as medication used for penile dysfunction. 10) Dismissed by health care professionals: many older male clients seek specialist sexual health care without the knowledge of their doctors as they feel dismissed due to lack of expertise, lack of time, and the doctor’s personal attitudes and characteristics. Finally, 11) Lack of resources: there is a distinct lack of resources and training to understand sexuality for healthy older men. These findings may inform future research, professional training, public health campaigns and policies for sexual health in older men.

Keywords: ageing, biopsychosocial model, men's health, sexual health

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Authors: G. Kaushik, A. Gupta, S. Lalwani, K. D. Soni, S. Kumar, S. Sagar

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Objective: Alcohol is a leading risk factor associated with the disability and death due to RTI. Present study aims to demonstrate the demographic profile, injury pattern, physiological parameters of victims of trauma following alcohol consumption arriving in the emergency department (ED) and mortality in alcohol intoxicated trauma patients admitted to Apex Trauma Center in Delhi. Design and Methods: Present study was performed in randomly selected 182 alcohol breath analyzer tested RTI patients from the emergency department of Jai Prakash Narayan Apex Trauma Center (JPNATC), All India Institute of Medical Sciences, New Delhi for over a period of 3 months started from September 2013 to November 2013. Results: A total 182 RTI patients with blunt injury were selected between 30-40 years of age and equally distributed to male and female group. Of these, 93 (51%) were alcohol negative and 89 (49%) were alcohol positive. In 89 alcohol positive patients, 47 (53%) had Artificial Airway as compared to 17 (18%), (p < 0.001) in the other group. The Glasgow Coma Scale (GCS) score was lower (p < 0.001) and higher Injury Severity Score (ISS) was observed in alcohol positive group as compared to other group (p < 0.03). Increased number of patients (58%) were admitted to Intensive Care Unit (ICU), in alcohol positive group (p < 0.001) and they were in ICU for longer time compare to other group (p < 0.001). The alcohol positive patients were on ventilator support for longer duration as compared to non-alcoholic group (p < 0.001). Mortality rate was higher in alcohol intoxicated patients as compared to non-alcoholic RTI patients, however, the difference was not statistically significant. Conclusion: This study revealed that GCS, mean ISS, ICU stay, ventilation time etc. might have considerable impact on mortality in alcohol intoxicated patients as compared to non-alcoholic group.

Keywords: road traffic injuries, alcohol, trauma, emergency department

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Authors: Tony Feng, Rea Thomson, Kathryn Greenslade, Ross Medine, Jennifer Easterbrook, Calum Arthur, Matilda Powell-bowns

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There are clear guidelines on taking group and screen samples (G&S) for elective arthroplasty and major trauma. However, there is limited guidance on blood grouping for other trauma patients. The purpose of this study was to review the level of blood grouping at a major trauma centre and validate a protocol that limits the expensive processing of G&S samples. After reviewing the national guidance on transfusion samples in orthopaedic patients, data was prospectively collected for all orthopaedic admissions in the Royal Infirmary of Edinburgh between January to February 2023. The cause of admission, number of G&S samples processed on arrival and need for red cells was collected using the hospital blood bank. A new protocol was devised based on a multidisciplinary meeting which limited the requirement for G&S samples only to presentations in “category X”, including neck-of-femur fractures (NOFs), pelvic fractures and major trauma. A re-audit was completed between April and May after departmental education and institution of this protocol. 759 patients were admitted under orthopaedics in the major trauma centre across two separate months. 47% of patients were admitted with presentations falling in category X (354/759) and patients in this category accounted for 88% (92/104) of those requiring post-operative red cell transfusions. Of these, 51% were attributed to NOFs (47/92). In the initial audit, 50% of trauma patients outwith category X had samples sent (116/230), estimated to cost £3800. Of these 230 patients, 3% required post-operative transfusions (7/230). In the re-audit, 23% of patients outwith category X had samples sent (40/173), estimated to cost £1400, of which 3% (5/173) required transfusions. None of the transfusions in these patients in either audit were related to their operation and the protocol achieved an estimated cost saving of £2400 over one month. This study highlights the importance of sending samples for patients with certain categories of orthopaedic trauma (category X) due to the high demand for post-operative transfusions. However, the absence of transfusion requirements in other presentations suggests over-testing. While implementation of the new protocol has markedly reduced over-testing, additional interventions are required to reduce this further.

Keywords: blood transfusion, quality improvement, orthopaedics, trauma

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Authors: Charlotte Lucke

Abstract:

This study contributes to the body of literature that analyzes and complicates oversimplified and sensationalized representations of trauma and violence through a close examination and complication of representations of perpetrators of domestic violence in the mass media. This study determines the ways the media frames perpetrators of domestic violence through a qualitative content analysis and socio-ecological approach to the perpetration of violence. While the qualitative analysis has not been carried out, through preliminary research, this study hypothesizes that the media represents perpetrators through tropes such as the 'predator' or 'offender,' or as a demonized 'other.' It is necessary to expose and work through such stereotypes because cultivation theory demonstrates that the mass media determines societal beliefs about and perceptions of the world. Thus, representations of domestic violence in the mass media can lead people to believe that perpetrators of violence are mere animals or criminals and overlook the trauma that many perpetrators experience. When the media represents perpetrators as pure evil, monsters, or absolute 'others,' it leaves out the complexities of what moves people to commit domestic violence. By analyzing and placing media representations of perpetrators into conversation with the socio-ecological approach to violence perpetration, this study complicates domestic violence stereotypes. The socio-ecological model allows researchers to consider the way the interplay between individuals and their families, friends, communities, and cultures can move people to act violently. Using this model, along with psychological and psychoanalytic approaches to the etiology of domestic violence, this paper argues that media stereotypes conceal the way people’s experiences of trauma, along with community and cultural norms, perpetuates the cycle of systemic trauma and violence in the home.

Keywords: domestic violence, media images, representing trauma, theorising trauma

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Authors: Joana PaScoa Pinheiro, David Goncalves Ferreira, Filipe Ramos, Joaquim Soares Do Brito, Samuel Martins, Marco Sarmento

Abstract:

Introduction: The SARS-CoV-2 (COVID-19) pandemic was identified in January 2020 in China, in the city of Wuhan. The increase in the number of cases over the following months was responsible for the restructuring of hospitals and departments in order to accommodate admissions related to COVID-19. Essential services, such as trauma, had to readapt to maintain their functionality and thus guarantee quick and safe access in case of an emergency. Objectives: This study describes the impact of COVID-19 on a Level III Trauma Center and particularly on the clinical management of hospitalized patients with spine injuries. Study Design & Methods: This is a retrospective cohort study whose results were obtained through the medical records of patients with spine injuries who underwent surgical intervention in the years 2019 and 2020 (period from March 1st to December 31st). A comparison between the two groups was made. In the study patients with injuries in the context of trauma were included who underwent surgery in the periods previously described. Patients hospitalized with a spine injury in a non-traumatic context and/or were not surgically treated were excluded. Results: In total, 137 patients underwent trauma spine surgery of which 71 in 2019 (51.8%) were without significant differences in intergroup comparisons. The most frequent injury mechanism in 2019 was motor vehicle crash (47.9%) compared to 2020 which was of a person falling from a height between 2-4 meters (37.9%). Cervical trauma was reported to be the most frequent spine injury in both years. There was a significant decrease in the need for intensive care in 2020, 51.4% vs 30.3%, p = .015 and the number of complications was also lower in 2020 (1.35% vs 0.98%), including the number of deaths, being the difference marginally significant. There were no significant differences regarding time for presentation to surgery or in the total days of hospitalization. Conclusions: The restructuring made in the trauma unit at a Level III Trauma Center in the context of the current COVID-19 pandemic was effective, with no significant differences between the years of 2019 vs 2020 when compared with the time for presentation to surgery or the number of days of hospitalization. It was also found that lockdown rules in 2020 were probably responsible for the decrease in the number of road traffic accidents, which justifies a significant decrease in the need for intensive care as well as in the number of complications in patients hospitalized in the context of spine trauma.

Keywords: trauma, spine, impact, covid-19

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Authors: Sercan Basit, Muhlis N. Sarıdede

Abstract:

Metal amounts of copper based compounds in the various wastes have been recovered successfully by hydrometallurgical treatment methods in the literature. X-ray diffraction pattern of the brass melting slag demonstrates that it contains sufficient amount of recoverable copper. Recovery of copper from brass melting dross by sulfuric acid leaching and the effect of temperature and acid and oxidant concentration on recovery rate of copper have been investigated in this study. Experiments were performed in a temperature-controlled reactor in sulfuric acid solution in different molarities using solid liquid ratio of 100 g/L, with leaching time of 300 min. Temperature was changed between 25 °C and 80 °C and molarity was between 0.5 and 3M. The results obtained showed that temperature has important positive effect on recovery whereas it decreases with time. Also copper was recovered in larger amounts from brass dross in the presence of H2O2 as an oxidant according to the case that oxidant was not used.

Keywords: brass dross, copper recovery, hydrogen peroxide, leaching

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Authors: A. O. Adebayo, G. A. Idowu, F. Odegbemi

Abstract:

Investigations on the recovery of nickel from aqueous solution using 2-hydroxy-5-nonyl- acetophenone oxime (LIX-84I) impregnated on activated charcoal was carried out. The LIX-84I was impregnated onto the pores of dried activated charcoal by dry method and optimum conditions for different equilibrium parameters (pH, adsorbent dosage, extractant concentration, agitation time and temperature) were determined using a simulated solution of nickel. The kinetics and adsorption isotherm studies were also evaluated. It was observed that the efficiency of recovery with LIX-84I impregnated on charcoal was dependent on the pH of the aqueous solution as there was little or no recovery at pH below 4. However, as the pH was raised, percentage recovery increases and peaked at pH 5.0. The recovery was found to increase with temperature up to 60ºC. Also it was observed that nickel adsorbed onto the loaded charcoal best at a lower concentration (0.1M) of the extractant when compared with higher concentrations. Similarly, a moderately low dosage (1 g) of the adsorbent showed better recovery than larger dosages. These optimum conditions were used to recover nickel from the leachate of Ni-MH batteries dissolved with sulphuric acid, and a 99.6% recovery was attained. Adsorption isotherm studies showed that the equilibrium data fitted best to Temkin model, with a negative value of constant, b (-1.017 J/mol) and a high correlation coefficient, R² of 0.9913. Kinetic studies showed that the adsorption process followed a pseudo-second order model. Thermodynamic parameter values (∆G⁰, ∆H⁰, and ∆S⁰) showed that the adsorption was endothermic and spontaneous. The impregnated charcoal appreciably recovered nickel using a relatively smaller volume of extractant than what is required in solvent extraction. Desorption studies showed that the loaded charcoal is reusable for three times, and so might be economical for nickel recovery from waste battery.

Keywords: charcoal, impregnated, LIX-84I, nickel, recovery

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Authors: A. Errasti, F. Doffagne, O. Foucrier, S. Kao, A. Meigne, H. Pellae, T. Rouland

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Renewable energy recovery is an important domain of research in past few years in view of protection of our ecosystem. Several industrial companies are setting up widespread recovery systems to exploit wave energy. Most of them have a large size, are implanted near the shores and exploit current flows. However, as oceans represent 70% of Earth surface, a huge space is still unexploited to produce energy. Present analysis focuses on surface small scale wave energy recovery. The principle is exactly the opposite of wheel damper for a car on a road. Instead of maintaining the car body as non-oscillatory as possible by adapted control, a system is designed so that its oscillation amplitude under wave action will be maximized with respect to a boat carrying it in view of differential potential energy recuperation. From parametric analysis of system equations, interesting domains have been selected and expected energy output has been evaluated.

Keywords: small scale wave, potential energy, optimized energy recovery, auto-adaptive system

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Authors: Trevor R. Higgins

Abstract:

To speed/enhance recovery from sport, cold water immersion (CWI) and contrast water therapy (CWT) have become common practice within the high-level team sport. Initially, research into CWI and CWT protocols and recovery was sparse; athletes relied solely upon an anecdotal support. However, an increase into recovery research has occurred. A number of reviews have subsequently been conducted to clarify scientific evidence. However, as the nature of physiological stress and training status of participants will impact on results, an opportunity existed to narrow the focus to a more exacting review evaluating hydrotherapy for recovery in a team sport. A Boolean logic [AND] keyword search of databases was conducted: SPORTDiscus; AMED; CINAHL; MEDLINE. Data was extracted and the standardized mean differences were calculated with 95% CI. The analysis of pooled data was conducted using a random-effect model, with Heterogeneity assessed using I2. 23 peer reviewed papers (n=606) met the criteria. Meta-analyses results indicated CWI was likely beneficial for recovery at 24h (Countermovement Jump (CMJ): p= 0.05, CI -0.004 to 0.578; All-out sprint: p=0.02, -0.056 to 0.801; DOMS: p=0.08, CI -0.092 to 1.936) and at 72h (accumulated sprinting: p=0.07, CI -0.062 to 1.209; DOMS: p=0.09, CI -0.121 to 1.555) following team sport. Whereas CWT was likely beneficial for recovery at 1h (CMJ: p= 0.07, CI -0.004 to 0.863) and at 48h (fatigue: p=0.04, CI 0.013 to 0.942) following team sport. Athlete’s perceptions of muscle soreness and fatigue are enhanced with CWI and/or CWT, however even though CWI and CWT were beneficial in attenuating decrements in neuromuscular performance 24 hours following team sport, indications are those benefits were no longer Sydney evident 48 hours following team sport.

Keywords: cold water immersion, contrast water therapy, recovery, team sport

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