Search results for: transmission of intergenerational trauma
2455 Improving Pain Management for Trauma Patients at Two Rwandan Emergency Departments
Authors: Jean Pierre Hagenimana, Paulin Ruhato Banguti, Rebecca Lynn Churchill Anderson, Jean de Dieu Tuyishime, Gaston Nyirigira, Eugene Tuyishime
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Background: Little is known regarding the effectiveness of pain protocols and guidelines used in Emergency Departments (ED) in Sub-Saharan Africa (SSA). Therefore, to shed light on this research gap, this study aimed to evaluate the quality of pain management following the implementation of both the WHO pain ladder-based trauma pain management protocol in two Rwandan teaching hospitals. Methods: This was a pre-and post-intervention study. The intervention was a 1-day acute pain course training for ED clinical staff followed by 1 week of mentorship on the use of the WHO pain ladder-based trauma pain management. Results: 261 participants were enrolled in the study (124 before the intervention and 137 after the intervention). The number of patients with undocumented pain scores decreased from 58% to 24% after the intervention (p-value > 0.001), and most patients (62%) had mild pain. In addition, patients who were satisfied with the quality of pain management increased significantly from 42% before the intervention to 80% (p-value > 0.001). Barriers were identified, however, including inadequate training and experience, shortage of staff, and patient’s reluctance to report pain. Conclusion: The implementation of the WHO pain ladder-based trauma pain management protocol significantly improved the quality of pain management in both CHUK and CHUB referral Hospital emergency departments. Despite this, some barriers remain, such as inadequate training and experience, shortage of staff, and patient’s reluctance to report pain. Appropriate interventions should be implemented to address the identified barriers and ensure adequate pain management for patients admitted at the emergency departments in referral hospitals in Rwanda.Keywords: pain management, trauma, emergency departments, Rwanda
Procedia PDF Downloads 102454 Investigation on the Acoustical Transmission Path of Additive Printed Metals
Authors: Raphael Rehmet, Armin Lohrengel, Prof Dr-Ing
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In terms of making machines more silent and convenient, it is necessary to analyze the transmission path of mechanical vibrations and structure-bone noise. A typical solution for the elimination of structure-bone noise would be to simply add stiffeners or additional masses to change the transmission behavior and, thereby, avoid the propagation of vibrations. Another solution could be to use materials with a different damping behavior, such as elastomers, to isolate the machine dynamically. This research approach investigates the damping behavior of additive printed components made from structural steel or titanium, which have been manufactured in the “Laser Powder Bed Fusion“-process. By using the design flexibility which this process comes with, it will be investigated how a local impedance difference will affect the transmission behavior of the specimens.Keywords: 3D-printed, acoustics, dynamics, impedance
Procedia PDF Downloads 2072453 Secondary Traumatic Stress and Related Factors in Australian Social Workers and Psychologists
Authors: Cindy Davis, Samantha Rayner
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Secondary traumatic stress (STS) is an indirect form of trauma affecting the psychological well-being of mental health workers; STS is found to be a prevalent risk in mental health occupations. Various factors impact the development of STS within the literature; including the level of trauma individuals are exposed to and their level of empathy. Research is limited on STS in mental health workers in Australia; therefore, this study examined STS and related factors of empathetic behavior and trauma caseload among mental health workers. The research utilized an online survey quantitative research design with a purposive sample of 190 mental health workers (176 females) recruited via professional websites and unofficial social media groups. Participants completed an online questionnaire comprising of demographics, the secondary traumatic stress scale and the empathy scale for social workers. A standard hierarchical regression analysis was conducted to examine the significance of covariates, traumatized clients, traumatic stress within workload and empathy in predicting STS. The current research found 29.5% of participants to meet the criteria for a diagnosis of STS. Age and past trauma within the covariates were significantly associated with STS. Amount of traumatized clients significantly predicted 4.7% of the variance in STS, traumatic stress within workload significantly predicted 4.8% of the variance in STS and empathy significantly predicted 4.9% of the variance in STS. These three independent variables and the covariates accounted for 18.5% of the variance in STS. Practical implications include a focus on developing risk strategies and treatment methods that can diminish the impact of STS.Keywords: mental health, PTSD, social work, trauma
Procedia PDF Downloads 3322452 Changing Arbitrary Data Transmission Period by Using Bluetooth Module on Gas Sensor Node of Arduino Board
Authors: Hiesik Kim, Yong-Beom Kim, Jaheon Gu
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Internet of Things (IoT) applications are widely serviced and spread worldwide. Local wireless data transmission technique must be developed to rate up with some technique. Bluetooth wireless data communication is wireless technique is technique made by Special Inter Group (SIG) using the frequency range 2.4 GHz, and it is exploiting Frequency Hopping to avoid collision with a different device. To implement experiment, equipment for experiment transmitting measured data is made by using Arduino as open source hardware, gas sensor, and Bluetooth module and algorithm controlling transmission rate is demonstrated. Experiment controlling transmission rate also is progressed by developing Android application receiving measured data, and controlling this rate is available at the experiment result. It is important that in the future, improvement for communication algorithm be needed because a few error occurs when data is transferred or received.Keywords: Arduino, Bluetooth, gas sensor, IoT, transmission
Procedia PDF Downloads 2772451 Cooperative Communication of Energy Harvesting Synchronized-OOK IR-UWB Based Tags
Authors: M. A. Mulatu, L. C. Chang, Y. S. Han
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Energy harvesting tags with cooperative communication capabilities are emerging as possible infrastructure for internet of things (IoT) applications. This paper studies about the \ cooperative transmission strategy for a network of energy harvesting active networked tags (EnHANTs), that is adapted to the available energy resource and identification request. We consider a network of EnHANT-equipped objects to communicate with the destination either directly or by cooperating with neighboring objects. We formulate the the problem as a Markov decision process (MDP) under synchronised On/Off keying (S-OOK) pulse modulation format. The simulation results are provided to show the the performance of the cooperative transmission policy and compared against the greedy and conservative policies of single-link transmission.Keywords: cooperative communication, transmission strategy, energy harvesting, Markov decision process, value iteration
Procedia PDF Downloads 4922450 Systems Contextual Integrated Model for Clinical Psychology and Social Work
Authors: Raymond C. Hawkins II, Catherine A. Hawkins
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The System Contextual Integrated Model (SCIM), developed as a trans-theoretical framework for selecting measures for psychotherapy process and outcome, is reformulated for behavioral health applications. The SCIM “healing cycle” is an allostatic hedonic affective-cognitive right-hemisphere–left-hemisphere coordinated process involving positive alliesthesia that mitigates traumatic pain and generates psychological flexibility. The SCIM “trauma cycle” is an allostatic overload alliesthesia opponent process with long-lasting pathology sequelae. The social ecological context moderates the “healing cycle” and the “trauma cycle.” Repeated evocation of the “healing cycle” in a therapeutic relationship can gradually relieve trauma sequelae. The SCIM is applied to pain, obese binge eating, and substance use disorders.Keywords: allostasis, alliesthesia, opponent process, behavioral health, assessment
Procedia PDF Downloads 1422449 Speed-Up Data Transmission by Using Bluetooth Module on Gas Sensor Node of Arduino Board
Authors: Hiesik Kim, YongBeum Kim
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Internet of Things (IoT) applications are widely serviced and spread worldwide. Local wireless data transmission technique must be developed to speed up with some technique. Bluetooth wireless data communication is wireless technique is technique made by Special Inter Group(SIG) using the frequency range 2.4 GHz, and it is exploiting Frequency Hopping to avoid collision with different device. To implement experiment, equipment for experiment transmitting measured data is made by using Arduino as Open source hardware, Gas sensor, and Bluetooth Module and algorithm controlling transmission speed is demonstrated. Experiment controlling transmission speed also is progressed by developing Android Application receiving measured data, and controlling this speed is available at the experiment result. it is important that in the future, improvement for communication algorithm be needed because few error occurs when data is transferred or received.Keywords: Arduino, Bluetooth, gas sensor, internet of things, transmission Speed
Procedia PDF Downloads 4832448 Reasons and Complexities around Using Alcohol and Other Drugs among Aboriginal People Experiencing Homelessness
Authors: Mandy Wilson, Emma Vieira, Jocelyn Jones, Alice V. Brown, Lindey Andrews, Louise Southalan, Jackie Oakley, Dorothy Bagshaw, Patrick Egan, Laura Dent, Duc Dau, Lucy Spanswick
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Alcohol and drug dependency are pertinent issues for those experiencing homelessness. This includes Aboriginal and Torres Strait Islander people, Australia’s traditional owners, living in Perth, Western Australia (WA). Societal narratives around the drivers behind drug and alcohol dependency in Aboriginal communities, particularly those experiencing homelessness, have been biased and unchanging, with little regard for complexity. This can include the idea that Aboriginal people have ‘chosen’ to use alcohol or other drugs without consideration for intergenerational trauma and the trauma of homelessness that may influence their choices. These narratives have flow-on impacts on policies and services that directly impact Aboriginal people experiencing homelessness. In 2021, we commenced a project which aimed to listen to and elevate the voices of 70-90 Aboriginal people experiencing homelessness in Perth. The project is community-driven, led by an Aboriginal Community Controlled Organisation in partnership with a university research institute. A community-ownership group of Aboriginal Elders endorsed the project’s methods, chosen to ensure their suitability for the Aboriginal community. In this paper, we detail these methods, including semi-structured interviews influenced by an Aboriginal yarning approach – an important style of conversation for Aboriginal people which follows cultural protocols; and photovoice – supporting people to share their stories through photography. Through these engagements, we detail the reasons Aboriginal people in Perth shared for using alcohol or other drugs while experiencing homelessness. These included supporting their survival on the streets, managing their mental health, and coping while on the journey to finding support. We also detail why they sought to discontinue alcohol and other drug use, including wanting to reconnect with family and changing priorities. Finally, we share how Aboriginal people experiencing homelessness have said they are impacted by their family’s alcohol and other drug use, including feeling uncomfortable living with a family who is drug and alcohol-dependent and having to care for grandchildren despite their own homelessness. These findings provide a richer understanding of alcohol and drug use for Aboriginal people experiencing homelessness in Perth, shedding light on potential changes to targeted policy and service approaches.Keywords: Aboriginal and Torres Strait Islander peoples, alcohol and other drugs, homelessness, community-led research
Procedia PDF Downloads 1302447 An Improved Cooperative Communication Scheme for IoT System
Authors: Eui-Hak Lee, Jae-Hyun Ro, Hyoung-Kyu Song
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In internet of things (IoT) system, the communication scheme with reliability and low power is required to connect a terminal. Cooperative communication can achieve reliability and lower power than multiple-input multiple-output (MIMO) system. Cooperative communication increases the reliability with low power, but decreases a throughput. It has a weak point that the communication throughput is decreased. In this paper, a novel scheme is proposed to increase the communication throughput. The novel scheme is a transmission structure that increases transmission rate. And a decoding scheme according to the novel transmission structure is proposed. Simulation results show that the proposed scheme increases the throughput without bit error rate (BER) performance degradation.Keywords: cooperative communication, IoT, STBC, transmission rate
Procedia PDF Downloads 3962446 Modeling Reflection and Transmission of Elastodiffussive Wave Sata Semiconductor Interface
Authors: Amit Sharma, J. N. Sharma
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This paper deals with the study of reflection and transmission characteristics of acoustic waves at the interface of a semiconductor halfspace and elastic solid. The amplitude ratios (reflection and transmission coefficients) of reflected and transmitted waves to that of incident wave varying with the incident angles have been examined for the case of quasi-longitudinal wave. The special cases of normal and grazing incidence have also been derived with the help of Gauss elimination method. The mathematical model consisting of governing partial differential equations of motion and charge carriers diffusion of n-type semiconductors and elastic solid has been solved both analytically and numerically in the study. The numerical computations of reflection and transmission coefficients has been carried out by using MATLAB programming software for silicon (Si) semiconductor and copper elastic solid. The computer simulated results have been plotted graphically for Si semiconductors. The study may be useful in semiconductors, geology, and seismology in addition to surface acoustic wave (SAW) devices.Keywords: quasilongitudinal, reflection and transmission, semiconductors, acoustics
Procedia PDF Downloads 3912445 Study of Effect of Gear Tooth Accuracy on Transmission Mount Vibration
Authors: Kalyan Deepak Kolla, Ketan Paua, Rajkumar Bhagate
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Transmission dynamics occupy major role in customer perception of the product in both senses of touch and quality of sound. The quantity and quality of sound perceived is more concerned with the whine noise of the gears engaged. Whine noise is tonal in nature and tonal noises cause fatigue and irritation to customers, which in turn affect the quality of the product. Transmission error is the usual suspect for whine noise, which can be caused due to misalignments, tolerances, manufacturing variabilities. In-cabin noise is also more sensitive to the gear design. As the details of the gear tooth design and manufacturing are in microns, anything out of the tolerance zone, either in design or manufacturing, will cause a whine noise. This will also cause high variation in stress and deformation due to change in the load and leads to the fatigue failure of the gears. Hence gear design and development take priority in the transmission development process. This paper aims to study such variability by considering five pairs of helical spur gears and their effect on the transmission error, contact pattern and vibration level on the transmission.Keywords: gears, whine noise, manufacturing variability, mount vibration variability
Procedia PDF Downloads 1502444 Technical and Economic Evaluation of Harmonic Mitigation from Offshore Wind Power Plants by Transmission Owners
Authors: A. Prajapati, K. L. Koo, F. Ghassemi, M. Mulimakwenda
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In the UK, as the volume of non-linear loads connected to transmission grid continues to rise steeply, the harmonic distortion levels on transmission network are becoming a serious concern for the network owners and system operators. This paper outlines the findings of the study conducted to verify the proposal that the harmonic mitigation could be optimized and can be managed economically and effectively at the transmission network level by the Transmission Owner (TO) instead of the individual polluter connected to the grid. Harmonic mitigation studies were conducted on selected regions of the transmission network in England for recently connected offshore wind power plants to strategize and optimize selected harmonic filter options. The results – filter volume and capacity – were then compared against the mitigation measures adopted by the individual connections. Estimation ratios were developed based on the actual installed and optimal proposed filters. These estimation ratios were then used to derive harmonic filter requirements for future contracted connections. The study has concluded that a saving of 37% in the filter volume/capacity could be achieved if the TO is to centrally manage the harmonic mitigation instead of individual polluter installing their own mitigation solution.Keywords: C-type filter, harmonics, optimization, offshore wind farms, interconnectors, HVDC, renewable energy, transmission owner
Procedia PDF Downloads 1572443 Equivalent Circuit Representation of Lossless and Lossy Power Transmission Systems Including Discrete Sampler
Authors: Yuichi Kida, Takuro Kida
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In a new smart society supported by the recent development of 5G and 6G Communication systems, the im- portance of wireless power transmission is increasing. These systems contain discrete sampling systems in the middle of the transmission path and equivalent circuit representation of lossless or lossy power transmission through these systems is an important issue in circuit theory. In this paper, for the given weight function, we show that a lossless power transmission system with the given weight is expressed by an equivalent circuit representation of the Kida’s optimal signal prediction system followed by a reactance multi-port circuit behind it. Further, it is shown that, when the system is lossy, the system has an equivalent circuit in the form of connecting a multi-port positive-real circuit behind the Kida’s optimal signal prediction system. Also, for the convenience of the reader, in this paper, the equivalent circuit expression of the reactance multi-port circuit and the positive- real multi-port circuit by Cauer and Ohno, whose information is currently being lost even in the world of the Internet.Keywords: signal prediction, pseudo inverse matrix, artificial intelligence, power transmission
Procedia PDF Downloads 1222442 Optimizing the Readability of Orthopaedic Trauma Patient Education Materials Using ChatGPT-4
Authors: Oscar Covarrubias, Diane Ghanem, Christopher Murdock, Babar Shafiq
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Introduction: ChatGPT is an advanced language AI tool designed to understand and generate human-like text. The aim of this study is to assess the ability of ChatGPT-4 to re-write orthopaedic trauma patient education materials at the recommended 6th-grade level. Methods: Two independent reviewers accessed ChatGPT-4 (chat.openai.com) and gave identical instructions to simplify the readability of provided text to a 6th-grade level. All trauma-related articles by the Orthopaedic Trauma Association (OTA) and American Academy of Orthopaedic Surgeons (AAOS) were sequentially provided. The academic grade level was determined using the Flesh-Kincaid Grade Level (FKGL) and Flesch Reading Ease (FRE). Paired t-tests and Wilcox-rank sum tests were used to compare the FKGL and FRE between the ChatGPT-4 revised and original text. Inter-rater correlation coefficient (ICC) was used to assess variability in ChatGPT-4 generated text between the two reviewers. Results: ChatGPT-4 significantly reduced FKGL and increased FRE scores in the OTA (FKGL: 5.7±0.5 compared to the original 8.2±1.1, FRE: 76.4±5.7 compared to the original 65.5±6.6, p < 0.001) and AAOS articles (FKGL: 5.8±0.8 compared to the original 8.9±0.8, FRE: 76±5.5 compared to the original 56.7±5.9, p < 0.001). On average, 14.6% of OTA and 28.6% of AAOS articles required at least two revisions by ChatGPT-4 to achieve a 6th-grade reading level. ICC demonstrated poor reliability for FKGL (OTA 0.24, AAOS 0.45) and moderate reliability for FRE (OTA 0.61, AAOS 0.73). Conclusion: This study provides a novel, simple and efficient method using language AI to optimize the readability of patient education content which may only require the surgeon’s final proofreading. This method would likely be as effective for other medical specialties.Keywords: artificial intelligence, AI, chatGPT, patient education, readability, trauma education
Procedia PDF Downloads 722441 Incidences and Factors Associated with Perioperative Cardiac Arrest in Trauma Patient Receiving Anesthesia
Authors: Visith Siriphuwanun, Yodying Punjasawadwong, Suwinai Saengyo, Kittipan Rerkasem
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Objective: To determine incidences and factors associated with perioperative cardiac arrest in trauma patients who received anesthesia for emergency surgery. Design and setting: Retrospective cohort study in trauma patients during anesthesia for emergency surgery at a university hospital in northern Thailand country. Patients and methods: This study was permitted by the medical ethical committee, Faculty of Medicine at Maharaj Nakorn Chiang Mai Hospital, Thailand. We clarified data of 19,683 trauma patients receiving anesthesia within a decade between January 2007 to March 2016. The data analyzed patient characteristics, traumas surgery procedures, anesthesia information such as ASA physical status classification, anesthesia techniques, anesthetic drugs, location of anesthesia performed, and cardiac arrest outcomes. This study excluded the data of trauma patients who had received local anesthesia by surgeons or monitoring anesthesia care (MAC) and the patient which missing more information. The factor associated with perioperative cardiac arrest was identified with univariate analyses. Multiple regressions model for risk ratio (RR) and 95% confidence intervals (CI) were used to conduct factors correlated with perioperative cardiac arrest. The multicollinearity of all variables was examined by bivariate correlation matrix. A stepwise algorithm was chosen at a p-value less than 0.02 was selected to further multivariate analysis. A P-value of less than 0.05 was concluded as statistically significant. Measurements and results: The occurrence of perioperative cardiac arrest in trauma patients receiving anesthesia for emergency surgery was 170.04 per 10,000 cases. Factors associated with perioperative cardiac arrest in trauma patients were age being more than 65 years (RR=1.41, CI=1.02–1.96, p=0.039), ASA physical status 3 or higher (RR=4.19–21.58, p < 0.001), sites of surgery (intracranial, intrathoracic, upper intra-abdominal, and major vascular, each p < 0.001), cardiopulmonary comorbidities (RR=1.55, CI=1.10–2.17, p < 0.012), hemodynamic instability with shock prior to receiving anesthesia (RR=1.60, CI=1.21–2.11, p < 0.001) , special techniques for surgery such as cardiopulmonary bypass (CPB) and hypotensive techniques (RR=5.55, CI=2.01–15.36, p=0.001; RR=6.24, CI=2.21–17.58, p=0.001, respectively), and patients who had a history of being alcoholic (RR=5.27, CI=4.09–6.79, p < 0.001). Conclusion: Incidence of perioperative cardiac arrest in trauma patients receiving anesthesia for emergency surgery was very high and correlated with many factors, especially age of patient and cardiopulmonary comorbidities, patient having a history of alcoholic addiction, increasing ASA physical status, preoperative shock, special techniques for surgery, and sites of surgery including brain, thorax, abdomen, and major vascular region. Anesthesiologists and multidisciplinary teams in pre- and perioperative periods should remain alert for warning signs of pre-cardiac arrest and be quick to manage the high-risk group of surgical trauma patients. Furthermore, a healthcare policy should be promoted for protecting against accidents in high-risk groups of the population as well.Keywords: perioperative cardiac arrest, trauma patients, emergency surgery, anesthesia, factors risk, incidence
Procedia PDF Downloads 1692440 The Sufi Madad in Arabic Literature and Translation
Authors: Riham Debian
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This paper deals with the translational mystic in Arabic aesthetics and their linguistic and narrative revelation and mediation across textual spaces. The paper particularly engages with the nature of the Egyptian Sufi Madad, its relation to spaces/places, its intergenerational and intertextual manifestations, and its intersection with questions of identity—the historical spaces and geographical places one inhabits and embodies. Opening a repertoire between contextualized stylistics and poetics semiology (Boise-Bier2011; Jackobson 1960), the paper reads in al-Ghitany’s Kitab al-Tagiliat (The Book of Revelation1983), Bassiouny’s Sabil Al-Ghareq (2018) and its translation (Fountain of the Drowning2022). The paper examines the stylistic and poetical encoding and recoding of the Sufi Madads from Ghitany to Bassiouny and their entanglement in the question of Egyptian identity-politics through the embodiment of historical places and geographical spaces. The paper argues for the intergenerational intertextuality of Arabic aesthetics that stylistically and poetically enacts the mysticism of Sufi Madad through historical and geographical semioticization of the Egyptian character continuity across time and space. Both Ghitany and Bassiouny engage with the historical novel as a form of delivery of their Egyptian mystical relation with time and place. Both novelist-historians are involved with the question of place and the life-worlds that spaces generate across time and gender.Keywords: intertextuality, interdiscusivity, madad, egyptian identity
Procedia PDF Downloads 962439 Comparative Study of Radiation Protection in a Hospital Environment
Authors: Lahoucine Zaama, Sanae Douama
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In this work, we present the results of a dosimetry study in a Moroccan radiology department . The results are compared with those of a similar study in France. Furthermore, it determines the coefficient of transmission of the lead sheets of different thicknesses depending on the voltage (KV) in a direct exposure. The objective of this study is to choose the thickness of the radiation means to determine the leaf sample sealed with the smallest percentage value radiation transmission, and that in the context of optimization. Thus the comparison among the studies is essential to consider conduct studies and research in this framework to achieve the goal of optimization.Keywords: radiology, dosimetry, radiation, dose, transmission
Procedia PDF Downloads 4942438 Trauma Informed Healthy Lifestyle Program for Young Adults
Authors: Alicia Carranza, Hildemar Dos Santos, W. Lawrence Beeson, R. Patti Herring, Kimberly R. Freeman, Adam Arechiga
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Early exposure to trauma can impact health-related behaviors later in life, which poses a considerable challenge for young adults transitioning into independence when they are lacking the necessary skills and support to live a healthy life. The study will be a non-experimental, mixed methods pre- and post-test (where subjects will serve as their own controls) to determine the impact of an eight-week trauma-informed healthy lifestyle program on self-efficacy for adopting health-promoting behaviors and health outcomes among young adults. Forty-two adults, ages 18-24 who are living in Orange County, CA will be recruited to participate in the eight-week trauma-informed healthy living program. Baseline and post-intervention assessments will be conducted to assess changes in self-efficacy for nutrition and physical exercise, sleep quality and quantity, body mass index (kg/m2), and coping skills used by comparing pre- to post-intervention. Some of the planned activities include cooking demonstrations, mindful eating activities and media literacy using Instagram. Frequencies analyses, paired t-test, and multiple regression will be used to determine if there was a change in coping skills. The results of this study can serve to assess the potential for mitigating the effects of Adverse Childhood Experiences (ACEs), or other toxic stress, experienced during adolescence across the lifespan. Young adults who learn how to cope with stress in a healthy way and engage in a healthy lifestyle can be better prepared to role model that behavior to their children.Keywords: nutrition, healthy lifestyle, trauma-informed, stress management
Procedia PDF Downloads 1062437 Evaluation of Percutaneous Tube Thoracostomy Performed by Trainee in Both Trauma and Non-Trauma Patients
Authors: Kulsum Maula, Md Kamrul Alam, Md Ibrahim Khalil, Md Nazmul Hasan, Mohammad Omar Faruq
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Background: Percutaneous Tube Thoracostomy (PTT) is an invasive procedure that can save a life now and then in different traumatic and non-traumatic conditions. But still, it is an enigma; how our trainee surgeons are at home in this procedure. Objectives: To evaluate the outcome of the percutaneous tube thoracostomy performed by trainees in both trauma and non-trauma patients. Study design: Prospective, Observational Study. The duration of the study was September 2018 to February 2019. Methods: All patients who need PTT in traumatic and non-traumatic conditions were selected by purposive sampling. Thereafter, they were scrutinized according to eligibility criteria and 96 patients were finalized. A pre-tested, observation-based, peer-reviewed data collection sheet was prepared before the study. Data regarding clinical and surgical outcome profiles were recorded. Data were compiled, edited, and analyzed. Results: Among 96 patients, the highest 32.29% belonged to age group 31-40 years and the lowest 9.37% belonged to the age group ≤20. The mean age of the respondents was 29.19±9.81. We found out of 96 patients, 70(72.91%) were indicated PTT for traumatic conditions and the rest 26(27.08%) were indicated PTT for non-traumatic chest conditions, where 36(37.5%) had simple penumothorax, 21(21.87%) haemothorax, 14(14.58%) massive pleural effusion, 13(13.54%) tension pneumothorax, 10(10.41%) haemopneumothorax, and 2(2.08%) had pyothorax respectively. In 53.12% of patients had right-sided intercostal chest tube (ICT) insertion, whereas 46.87% had left-sided ICT insertion. In our study, 89.55 % of the tube was placed at the normal anatomical position. Besides, 10.41% of tube thoracostomy were performed deviated from anatomical site. Among 96 patients 62.5% patients had length of incision 2-3cm, 35.41% had >3cm and 2.08% had <2cm respectively. Out of 96 patients, 75(78.13%) showed uneventful outcomes, whereas 21(21.87%) had complications, including 11.15%(11) each had wound infection, 4.46%(4) subcutaneous emphysema, 4.28%(3) drain auto expulsion, 2.85%(2) hemorrhage, 1.45%(1) had a non-functioning drain and empyema with ascending infection respectively (p=<0.05). Conclusion: PTT is a life-saving procedure that is most frequently implemented in chest trauma patients in our country. In the majority of cases, the outcome of PTT was uneventful (78.13). Besides this, more than one-third of patients had a length of incision more than 3 cm that needed extra stitches and 10.41% of cases of PTT were placed other than the normal anatomical site. Trainees of Dhaka Medical College Hospitals are doing well in their performance of PTT insertion, but still, some anatomical orientations are necessary to avoid operative and post-operative complications.Keywords: PTT, trainee, trauma, non-chest trauma patients
Procedia PDF Downloads 1212436 Establishing an Evidence-Based Trauma Informed Care Pathway for Survivors of Modern Slavery
Authors: I. Brezeanu, J. Mackrill, A. Cajo, C. Mogollon
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Modern Slavery is a serious crime, where often the victims are unable to leave their situation of exploitation, being controlled by threats, punishment, violence, coercion, and deception. In the UK, this term encompasses both Slavery and Human Trafficking. The number of potential victims who were referred to the National Referral Mechanism (NRM) increased exponentially in the past decade, passing from fewer than 700 potential victims referred in 2010 to more than 12.000 in 2021. Our study aims to explore how the concept of Trauma-Informed Care (TIC) approach can be adopted by services working with survivors of Modern Slavery and Trafficking (MST). Notably, in this paper, we will elaborate on how the complex needs of survivors are related to their traumatic experiences and what are the necessary steps and resources for implementing a Modern Slavery Trauma-Informed model. While there are relatively few services in the UK that have a deep understanding of the survivors’ and practitioners’ views of how trauma impacts their daily life, there is a strong need for developing services that are organised and delivered in ways that prevent retraumatisation and enable trauma survivors to engage safely with the right professionals at the right time, promoting healing through positive relationships. Such models, known as Trauma-Informed Approaches (TIAs), are seen as crucial to the empowerment of survivors, yet they remain a marginal implementation model by governments, law enforcement, judiciary, or care providers, who are frequently survivors’ first point of contact in the recovery process. In order to understand better how to provide best practice and to adopt the concept, this study is based on a multi-disciplinary approach, encompassing both theoretical perspectives and co-production. By combining qualitative and quantitative research and comparing different analysis of applied examples of TIC in the US and the UK, we gained important insights about the prevention and impact of trauma on survivors’ life. The articulation between more general expertise on Trauma-Informed Care developed by other institutions operating in the field, and the SJOG delivery, based on the Salvation Army’s Modern Slavery Victim Care and Coordination Contract (MSVCC) and the Care Quality Commission regulations, allowed to identify on one side what are the complex needs of survivors derived from their traumatic experiences, and on the other side, how could MST services prevent retraumatisation. Additional, two in-depth interviews with survivors, who receive support from one of our services at Olallo House in London, and a survey shared among all colleagues working with MST services completed the findings of the research with their personal experience and knowledge. Ultimately, we developed an evidence-based Trauma-Informed Care Pathway that aims to improve the wellbeing of survivors and to support them to live a meaningful life. The establishedpathway delivers three main outcomes belonging to the social determinants of health criteria – health and wellbeing, purpose and relationship, and covers key themes of the context of trauma, needs of individuals, and service support.Keywords: trauma-informed care, modern slavery, human trafficking, trauma, retraumatisation
Procedia PDF Downloads 962435 Caring for the Bedridden Older Members: Beliefs and Values of Northern Thai Families
Authors: Budsarin Padwang, Darunee Jongudomkarn, Thawan Nieamsup, Autchareeya Patumwan, Rutja Phuphaibul
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In Northern Thailand, a pilot study by the qualitative data, on caring for family members with chronic illness/bedridden based on in-depth interviews of the 12 elderly caregivers in family was carried out during November to December 2017. There are four families that living with three generations in the family. This report is part of a larger study of 'The intergenerational contract of the family in long-term care for older members' to understand the situation and context related to the research questions. Content analysis was obtained and the results revealed as followings. 1) No choice and no freedom: most caregivers were asked by their family members to do the care giving roles because of various appropriate reasons and they could not refuse and felt like having no freedom. 2) ‘Katanyu’ to the parents: The Thai ideology of making merit by taking care of parents was beliefs to do the best in their caregiver roles. 3) The family commitments: The issues of family caring and relationships were the key value of keeping family members to take care of older members with chronic illness/bedridden. The preliminary findings can be beneficial for other regions and will lead to in-depth explore to answer the research questions of the larger study in the future.Keywords: intergenerational contract, long term care, older members, generational family
Procedia PDF Downloads 1562434 The Effect of Incorporating Animal Assisted Interventions with Trauma Focused Cognitive Behavioral Therapy
Authors: Kayla Renteria
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This study explored the role animal-assisted psychotherapy (AAP) can play in treating Post-Traumatic Stress Disorder (PTSD) when incorporated into Trauma-informed cognitive behavioral therapy (TF-CBT). A review of the literature was performed to show how incorporating AAP could benefit TF-CBT since this treatment model often presents difficulties, such as client motivation and avoidance of the exposure element of the intervention. In addition, the fluidity of treatment goals during complex trauma cases was explored, as this issue arose in the case study. This study follows the course of treatment of a 12-year-old female presenting with symptoms of PTSD. Treatment consisted of traditional components of the TF-CBT model, with the added elements of AAP to address typical treatment obstacles in TF-CBT. A registered therapy dog worked with the subject in all sessions throughout her treatment. The therapy dog was incorporated into components such as relaxation and coping techniques, narrative therapy techniques, and psychoeducation on the cognitive triangle. Throughout the study, the client’s situation and clinical needs required the therapist to switch goals to focus on current safety and stability. The therapy dog provided support and neurophysiological benefits to the client through AAP during this shift in treatment. The client was assessed quantitatively using the Child PTSD Symptom Scale Self Report for DSM-5 (CPSS-SR-5) before and after therapy and qualitatively through a feedback form given after treatment. The participant showed improvement in CPSS-SR-V scores, and she reported that the incorporation of the therapy animal improved her therapy. The results of this study show how the use of AAP provided the client a solid, consistent relationship with the therapy dog that supported her through processing various types of traumas. Implications of the results of treatment and for future research are discussed.Keywords: animal-assisted therapy, trauma-focused cognitive behavioral therapy, PTSD in children, trauma treatment
Procedia PDF Downloads 2172433 Polyvictimization and the Risk of Harm to Self and Others among Children and Youth
Authors: Shannon L. Stewart, Ashley Toohey, Natalia Lapshina
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There is a well-established relationship between childhood maltreatment and negative outcomes (e.g., physical and mental health problems, social skill deficits, poor quality of life). The goal of this study was to examine the relationship between polyvictimization (multiple types of trauma) and risk of harm to self and others, taking into account possible age and sex differences. A total of 8980 children and youth were recruited from over 50 mental health facilities across Ontario, Canada. Among this sample, 29% of children and youth had experienced polyvictimization. Results showed that female children and youth who had experienced trauma were at greater risk of harm to themselves, while their male counterparts were at greater risk of harming others. Further, findings from this study highlight that experiencing polyvictimization, regardless of age or sex, increased the risk of harm to self and others. These findings add to extant literature as to the cumulative relationship between polyvictimization and risk in relation to harming oneself or others. Further, results from this study have significant implications for assessment and care-planning for those children and youth presenting with a trauma background.Keywords: children's mental health, polyvictimization, risk of harm, sex differences
Procedia PDF Downloads 1342432 Effectiveness Evaluation of a Machine Design Process Based on the Computation of the Specific Output
Authors: Barenten Suciu
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In this paper, effectiveness of a machine design process is evaluated on the basis of the specific output calculus. Concretely, a screw-worm gear mechanical transmission is designed by using the classical and the 3D-CAD methods. Strength analysis and drawing of the designed parts is substantially aided by employing the SolidWorks software. Quality of the design process is assessed by manufacturing (printing) the parts, and by computing the efficiency, specific load, as well as the specific output (work) of the mechanical transmission. Influence of the stroke, travelling velocity and load on the mechanical output, is emphasized. Optimal design of the mechanical transmission becomes possible by the appropriate usage of the acquired results.Keywords: mechanical transmission, design, screw, worm-gear, efficiency, specific output, 3D-printing
Procedia PDF Downloads 1432431 Investigation of Multiple Dynamic Vibration Absorbers' Performance in Overhead Transmission Lines
Authors: Pedro F. D. Oliveira, Rangel S. Maia, Aline S. Paula
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As the electric energy consumption grows, the necessity of energy transmission lines increases. One of the problems caused by an oscillatory response to dynamical loads (such as wind effects) in transmission lines is the cable fatigue. Thus, the dynamical behavior of transmission cables understanding and its control is extremely important. The socioeconomic damage caused by a failure in these cables can be quite significant, from large economic losses to energy supply interruption in large regions. Dynamic Vibration Absorbers (DVA) are oscillatory elements used to mitigate the vibration of a primary system subjected to harmonic excitation. The positioning of Stockbridge (DVA for overhead transmission lines) plays an important role in mitigating oscillations of transmission lines caused by airflows. Nowadays, the positioning is defined by technical standards or commercial software. The aim of this paper is to conduct an analysis of multiple DVAs performances in cable conductors of overhead transmission lines. The cable is analyzed by a finite element method and the model is calibrated by experimental results. DVAs performance is analyzed by evaluating total cable energy, and a study of multiple DVAs positioning is conducted. The results are compared to the existing regulations showing situations where proper positioning, different from the standard, can lead to better performance of the DVA. Results also show situations where the use of multiple DVAs is appropriate.Keywords: dynamical vibration absorber, finite element method, overhead transmission lines, structural dynamics
Procedia PDF Downloads 1262430 Channels Splitting Strategy for Optical Local Area Networks of Passive Star Topology
Authors: Peristera Baziana
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In this paper, we present a network configuration for a WDM LANs of passive star topology that assume that the set of data WDM channels is split into two separate sets of channels, with different access rights over them. Especially, a synchronous transmission WDMA access algorithm is adopted in order to increase the probability of successful transmission over the data channels and consequently to reduce the probability of data packets transmission cancellation in order to avoid the data channels collisions. Thus, a control pre-transmission access scheme is followed over a separate control channel. An analytical Markovian model is studied and the average throughput is mathematically derived. The performance is studied for several numbers of data channels and various values of control phase duration.Keywords: access algorithm, channels division, collisions avoidance, wavelength division multiplexing
Procedia PDF Downloads 2962429 Design of Reconfigurable and Non-reciprocal Metasurface with Independent Controls of Transmission Gain, Attenuation and Phase
Authors: Shi Yu Wang, Qian Wei Zhang, He Li, Hao Han He, Yun Bo Li
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The spatial controls of electromagnetic (EM) waves have always been a research hot spot in recent years. And the rapid development of metasurface-based technologies has provided more freedoms for manipulating the EM waves. Here we propose the design of reconfigurable and non-reciprocal metasurface with independent controls of transmission gain, attenuation and phase. The proposed meta-atom mainly consists of the cascaded textures including the receiving antenna, the middle layer in which the power amplifiers (PAs), programmable attenuator and phase shifter locate, and the transmitting antenna. The programmable attenuator and phase shifter can realize the dynamic controls of transmission amplitude and phase independently, and the PA devices in the meta-atom can actualize the performance of non-reciprocal transmission. The proposed meta-atom is analyzed applying field-circuit co-simulation and a sample of the meta-atom is fabricated and measured under using two standard waveguides. The measured results verify the ability of the independent manipulation for transmission amplitude and phase of the proposed the meta-atom and the design method has been verified very well correspondingly.Keywords: active circuits, independent controls of multiple electromagnetic features, non-reciprocal electromagnetic transmission, reconfigurable and programmable
Procedia PDF Downloads 792428 Intergenerational Influences on Automobile Brand Preferences in Pakistan
Authors: Amena Sibghatullah
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The purpose of this study was to examine the existence of Inter-generational Influence (IGI) between two successive generations in the selection of automobile brands. IGI was examined between mother-daughter dyads and father-son dyads. A total sample of 320 respondents (80 fathers and their 80 sons, 80 mothers, and their 80 daughters) from the upper-middle class was selected. Three important findings from this study are; (a) the difference in proportion of agreements Brand-In-Use versus Brand-In-Mind appeared to be statistically significant in the Automobile product category. Thus agreements Brand-In-Use situation between parent and child has more agreements than Brand-In-Mind situation; (b) the difference in proportions between women and men (women means mother-daughter dyad agreement, and men means father-son dyad agreement) is statistically significant in automobile brand preferences. This means that mother-daughter dyad brand preferences, both brand-in-mind and brand-in-use are more significant than that of a father-son dyad, and (c) dominance of the top three brands has been exhibited in automobiles both Brand-In-Use and Brand-In-Mind. These three brands hold more than 57% of auto brand preferences. This means that the three brands occupy distinct and strong positions in the minds of consumers. These results reflect that there is significant evidence of IGI presence between parent and adult child. Marketers of auto brands need to understand this sort of influence on their target consumers.Keywords: autombile brands, branding, intergenerational influence, preferences
Procedia PDF Downloads 1442427 Simulation and Performance Evaluation of Transmission Lines with Shield Wire Segmentation against Atmospheric Discharges Using ATPDraw
Authors: Marcio S. da Silva, Jose Mauricio de B. Bezerra, Antonio E. de A. Nogueira
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This paper aims to make a performance analysis of shield wire transmission lines against atmospheric discharges when it is made the option of sectioning the shield wire and verify if the tolerability of the change. As a goal of this work, it was established to make complete modeling of a transmission line in the ATPDraw program with shield wire grounded in all the towers and in some towers. The methodology used to make the proposed evaluation was to choose an actual transmission line that served as a case study. From the choice of transmission line and verification of all its topology and materials, complete modeling of the line using the ATPDraw software was performed. Then several atmospheric discharges were simulated by striking the grounded shield wires in each tower. These simulations served to identify the behavior of the existing line against atmospheric discharges. After this first analysis, the same line was reconsidered with shield wire segmentation. The shielding wire segmentation technique aims to reduce induced losses in shield wires and is adopted in some transmission lines in Brazil. With the same conditions of atmospheric discharge the transmission line, this time with shield wire segmentation was again evaluated. The results obtained showed that it is possible to obtain similar performances against atmospheric discharges between a shield wired line in multiple towers and the same line with shield wire segmentation if some precautions are adopted as verification of the ground resistance of the wire segmented shield, adequacy of the maximum length of the segmented gap, evaluation of the separation length of the electrodes of the insulator spark, among others. As a conclusion, it is verified that since the correct assessment and adopted the correct criteria of adjustment a transmission line with shielded wire segmentation can perform very similar to the traditional use with multiple earths. This solution contributes in a very important way to the reduction of energy losses in transmission lines.Keywords: atmospheric discharges, ATPDraw, shield wire, transmission lines
Procedia PDF Downloads 1692426 Migration and Provision of Support to Left-Behind Parents in Rural Cambodia
Authors: Benjamas Penboon, Zachary Zimmer, Aree Jampaklay
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Cambodia is a country where labor migration has been consistently high. Coupled with advancing labor opportunities in urban areas, a function partly of globalization, this is resulting in massive migration out of rural areas. This is particularly true in Cambodia where there are high migration and a very large proportion of adult children living some distant from their parents. This paper explores characteristics associated with migrant providing support to parents in rural Cambodia. With reference to perspectives of family altruism and solidarity, this analysis particularly focusses on how a series of variables representing family integration and residential location associates with intergenerational monetary and instrumental support from migrants. The study hypothesizes that migrants are more likely to provide support when parents are in need, and there are no alternative means of support. Data come from The Rural Household Survey (N=3,713), part of the 2011 Cambodian Rural Urban Migration Project (CRUMP). Multilevel multinomial models indicate international migrants are likely to give money, while internal migrants are likely to provide both money and instrumental support, especially when migrants have no sibling and their parent in poor health status. In addition, employed migrants are two times providing monetary compared to those unemployed. Findings elucidate the decision to which and why support occurs more often when no other source of support exists and also depends on the ability to provide of migrants themselves.Keywords: migration, left-behind parent, intergenerational relations, support, rural, Cambodia
Procedia PDF Downloads 164