Search results for: trauma recovery
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 2251

Search results for: trauma recovery

2071 Utility of Thromboelastography Derived Maximum Amplitude and R-Time (MA-R) Ratio as a Predictor of Mortality in Trauma Patients

Authors: Arulselvi Subramanian, Albert Venencia, Sanjeev Bhoi

Abstract:

Coagulopathy of trauma is an early endogenous coagulation abnormality that occurs shortly resulting in high mortality. In emergency trauma situations, viscoelastic tests may be better in identifying the various phenotypes of coagulopathy and demonstrate the contribution of platelet function to coagulation. We aimed to determine thrombin generation and clot strength, by estimating a ratio of Maximum amplitude and R-time (MA-R ratio) for identifying trauma coagulopathy and predicting subsequent mortality. Methods: We conducted a prospective cohort analysis of acutely injured trauma patients of the adult age groups (18- 50 years), admitted within 24hrs of injury, for one year at a Level I trauma center and followed up on 3rd day and 5th day of injury. Patients with h/o coagulation abnormalities, liver disease, renal impairment, with h/o intake of drugs were excluded. Thromboelastography was done and a ratio was calculated by dividing the MA by the R-time (MA-R). Patients were further stratified into sub groups based on the calculated MA-R quartiles. First sampling was done within 24 hours of injury; follow up on 3rd and 5thday of injury. Mortality was the primary outcome. Results: 100 acutely injured patients [average, 36.6±14.3 years; 94% male; injury severity score 12.2(9-32)] were included in the study. Median (min-max) on admission MA-R ratio was 15.01(0.4-88.4) which declined 11.7(2.2-61.8) on day three and slightly rose on day 5 13.1(0.06-68). There were no significant differences between sub groups in regard to age, or gender. In the lowest MA-R ratios subgroup; MA-R1 (<8.90; n = 27), injury severity score was significantly elevated. MA-R2 (8.91-15.0; n = 23), MA-R3 (15.01-19.30; n = 24) and MA-R4 (>19.3; n = 26) had no difference between their admission laboratory investigations, however slight decline was observed in hemoglobin, red blood cell count and platelet counts compared to the other subgroups. Also significantly prolonged R time, shortened alpha angle and MA were seen in MA-R1. Elevated incidence of mortality also significantly correlated with on admission low MA-R ratios (p 0.003). Temporal changes in the MA-R ratio did not correlated with mortality. Conclusion: The MA-R ratio provides a snapshot of early clot function, focusing specifically on thrombin burst and clot strength. In our observation, patients with the lowest MA-R time ratio (MA-R1) had significantly increased mortality compared with all other groups (45.5% MA-R1 compared with <25% in MA-R2 to MA-R3, and 9.1% in MA-R4; p < 0.003). Maximum amplitude and R-time may prove highly useful to predict at-risk patients early, when other physiologic indicators are absent.

Keywords: coagulopathy, trauma, thromboelastography, mortality

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2070 Flotation Recovery of Gold-Loaded Fine Activated Carbon Using Emulsified Diesel and Kerosene as Collectors

Authors: Emmanuel Jr. Ballad, Herman Mendoza

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The recovery of fine activated carbon with adsorbed gold in the cyanidation tailings of a small-scale gold plant was investigated due to the high amount of gold present. In the study, collectors that were used are kerosene and diesel. Emulsification of the oils was done to improve its collecting property, thus also the recovery. It was found out that the best hydrophile lypophile balance (HLB) of emulsified diesel and kerosene oil is 13 and 12 respectively. The amount of surfactants (SPAN 20 and TWEEN 20) for the best stability of the emulsified oils was found to be 10% in both kerosene and diesel. Optical microscopy showed that the oil dispersion in the water forms spherical droplets like features. The higher the stability, the smaller the droplets and their number were increasing. The smaller droplets indicate better dispersion of oil in the water. Consequently, it will have a greater chance of oil and activated carbon particle interaction during flotation. Due to the interaction of dispersed oil phase with carbon, the hydrophobicity of the carbon will be improved and will be attached to the bubble. Thus, flotation recovery will be increased. Results showed that the recovery of the fine activated carbon using emulsified diesel or kerosene is three times more effective than using pure diesel or kerosene.

Keywords: emulsified oils, flotation, hydrophile lyophile balance, non-ionic surfactants

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2069 Refining Sexual Assault Treatment: Recovered Survivors and Expert Therapists Concur on Effective Therapy Components

Authors: Avigail Moor, Michal Otmazgin, Hagar Tsiddon, , Avivit Mahazri

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The goal of the present study was to refine sexual assault therapy through the examination of the level of agreement between survivor and therapist assessments of key recovery-promoting therapeutic interventions. This is the first study to explore the level of agreement between those who partake in the treatment process from either position. Semi structured interviews were conducted in this qualitative study with 10 survivors and 10 experienced therapists. The results document considerable concurrence between them regarding relational and trauma processing treatment components alike. Together, these reports outline key effective interventions, both common and specific in nature, concomitantly supported by both groups.

Keywords: sexual assault, rape treatment, therapist training, psychotherapy

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2068 Water Immersion Recovery for Swimmers in Hot Environments

Authors: Thanura Randula Abeywardena

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This study recognized the effectiveness of cold-water immersion recovery post exhaustive short-term exercise. The purpose of this study was to understand if 16- 20°C of cold-water immersion would be beneficial in a tropical environment to achieve optimal recovery in sprint swim performance in comparison to 10-15°C of water immersion. Two 100m-sprint swim performance times were measured along with blood lactate (BLa), heart rate (HR) and rate of perceived exertion (RPE) in a 25m swimming pool with full body head out horizontal water immersions of 10-15°C, 16-20°C and 29-32°C (pool temperature) for 10 minutes followed by 5 minutes of seated passive rest outside; in between the two swim performances. Twelve well-trained adult swimmers (5 male and 5 female) within the top twenty in the Sri Lankan national swimming championships in 100m Butterfly and Freestyle in the years 2020 & 2021 volunteered for this study. One-way ANOVA analysis (p<0.05) suggested performance time, Bla and HR had no significant differences between the 3 conditions after the second sprint; however, RPE was significantly different with p=0.034 between 10-15°C and 16-20°C immersion conditions. The study suggested that the recovery post the two cold-water immersion conditions were similar in terms of performance and physiological factors; however, the 16-20°C temperature had a better “feel good” factor post sprint 2. Further study is recommended as there was participant bias with the swimmers not reaching optimal levels in sprint 1. Therefore, they might have possibly fully recovered before sprint 2, invalidating the physiological effect of recovery.

Keywords: hydrotherapy, blood lactate, fatigue, recovery, sprint-performance, sprint-swimming

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2067 Post-Disaster Recovery and Impacts on Construction Resources: Case Studies of Queensland Catastrophic Events

Authors: Scott A. Abbott

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This paper examines the increase in the occurrence of natural disasters worldwide and the need to support vulnerable communities in post-disaster recovery. Preparation and implementation of post-disaster recovery projects need to be improved to allow communities to recover infrastructure, housing, economically and socially following a catastrophe. With the continual rise in catastrophic events worldwide due to climate change, impacts on construction resources affect the ability for post-disaster recovery to be undertaken. This research focuses on case studies of catastrophic events in Queensland, Australia, to contribute to the body of knowledge and gain valuable insights on lessons learned from past events and how they have been managed. The aim of this research is to adopt qualitative data using semi-structured interviews from participants predominantly from the insurance sector to understand barriers that have previously and currently exist in post-disaster recovery. Existing literature was reviewed to reveal gaps in knowledge that needed to be tested. Qualitative data was collected and summarised from field research with the results analysed and discussed. Barriers that impacted post-disaster recovery included time, cost, and resource capability and capacity. Causal themes that impacted time and cost were identified as decision making, pre-planning, and preparedness, as well as effective communication across stakeholders. The research study applied a qualitative approach to the existing literature and case studies across Queensland, Australia, to identify existing and new barriers that impact post-disaster recovery. It was recommended to implement effective procurement strategies to assist in cost control; implement pre-planning and preparedness strategies across funder, contractor, and local governments; more effective and timely decision making to reduce time and cost impacts.

Keywords: construction recovery, cost, disaster recovery, resources, time

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2066 Validation of the Recovery of House Dust Mites from Fabrics by Means of Vacuum Sampling

Authors: A. Aljohani, D. Burke, D. Clarke, M. Gormally, M. Byrne, G. Fleming

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Introduction: House Dust Mites (HDMs) are a source of allergen particles embedded in textiles and furnishings. Vacuum sampling is commonly used to recover and determine the abundance of HDMs but the efficiency of this method is less than standardized. Here, the efficiency of recovery of HDMs was evaluated from home-associated textiles using vacuum sampling protocols.Methods/Approach: Living Mites (LMs) or dead Mites (DMs) House Dust Mites (Dermatophagoides pteronyssinus: FERA, UK) were separately seeded onto the surfaces of Smooth Cotton, Denim and Fleece (25 mites/10x10cm2 squares) and left for 10 minutes before vacuuming. Fabrics were vacuumed (SKC Flite 2 pump) at a flow rate of 14 L/min for 60, 90 or 120 seconds and the number of mites retained by the filter (0.4μm x 37mm) unit was determined. Vacuuming was carried out in a linear direction (Protocol 1) or in a multidirectional pattern (Protocol 2). Additional fabrics with LMs were also frozen and then thawed, thereby euthanizing live mites (now termed EMs). Results/Findings: While there was significantly greater (p=0.000) recovery of mites (76% greater) in fabrics seeded with DMs than LMs irrespective of vacuuming protocol or fabric type, the efficiency of recovery of DMs (72%-76%) did not vary significantly between fabrics. For fabrics containing EMs, recovery was greatest for Smooth Cotton and Denim (65-73% recovered) and least for Fleece (15% recovered). There was no significant difference (p=0.99) between the recovery of mites across all three mite categories from Smooth Cotton and Denim but significantly fewer (p=0.000) mites were recovered from Fleece. Scanning Electron Microscopy images of HMD-seeded fabrics showed that live mites burrowed deeply into the Fleece weave which reduced their efficiency of recovery by vacuuming. Research Implications: Results presented here have implications for the recovery of HDMs by vacuuming and the choice of fabric to ameliorate HDM-dust sensitization.

Keywords: allergy, asthma, dead, fabric, fleece, live mites, sampling

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2065 Building Resilient Communities: The Traumatic Effect of Wildfire on Mati, Greece

Authors: K. Vallianou, T. Alexopoulos, V. Plaka, M. K. Seleventi, V. Skanavis, C. Skanavis

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The present research addresses the role of place attachment and emotions in community resiliency and recovery within the context of a disaster. Natural disasters represent a disruption in the normal functioning of a community, leading to a general feeling of disorientation. This study draws on the trauma caused by a natural hazard such as a forest fire. The changes of the sense of togetherness are being assessed. Finally this research determines how the place attachment of the inhabitants was affected during the reorientation process of the community. The case study area is Mati, a small coastal town in eastern Attica, Greece. The fire broke out on July 23rd, 2018. A quantitative research was conducted through questionnaires via phone interviews, one year after the disaster, to address community resiliency in the long-run. The sample was composed of 159 participants from the rural community of Mati plus 120 coming from Skyros Island that was used as a control group. Inhabitants were prompted to answer items gauging their emotions related to the event, group identification and emotional significance of their community, and place attachment before and a year after the fire took place. Importantly, the community recovery and reorientation were examined within the context of a relative absence of government backing and official support. Emotions related to the event were aggregated into 4 clusters related to: activation/vigilance, distress/disorientation, indignation, and helplessness. The findings revealed a decrease in the level of place attachment in the impacted area of Mati as compared to the control group of Skyros Island. Importantly, initial distress caused by the fire prompted the residents to identify more with their community and to report more positive feelings toward their community. Moreover, a mediation analysis indicated that the positive effect of community cohesion on place attachment one year after the disaster was mediated by the positive feelings toward the community. Finally, place attachment contributes to enhanced optimism and a more positive perspective concerning Mati’s future prospects. Despite an insufficient state support to this affected area, the findings suggest an important role of emotions and place attachment during the process of recovery. Implications concerning the role of emotions and social dynamics in meshing place attachment during the disaster recovery process as well as community resiliency are discussed.

Keywords: community resilience, natural disasters, place attachment, wildfire

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2064 Recovery of an Area Degraded by Gullies in the Municipality of Monte Alto (SP), Brazil

Authors: Layane Sara Vieira, Paulo Egidio Bernardo, Roberto Saverio Souza Costa

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Anthropogenic occupations and agricultural explorations without concern for the preservation and sustainability of the activity result in soil degradation that can make rural activity unfeasible. The objective of this work was to characterize and evaluate the recovery costs of an area degraded by major erosion (gully) in the municipality of Monte Alto (SP). Topographic characterization was carried out by means of a planialtimetric survey with a total station. The contours of the gully, internal area, slope height, contribution area, volume, and costs of operations for the recovery of the gully were delimited. The results obtained showed that the gully has a length of 145.56 m, a maximum width of 36.61 m, and a gap of 19.48 m. The external area of the gully is 1,039.8741 m², and the internal area is 119.3470 m². The calculated volume was 3,282.63 m³. The intervention area for breaking slopes was measured at 8,471.29 m², requiring the construction of 19 terraces in this area, vertically spaced at 2.8 m. The estimated costs for mechanical recovery of the gully were R$ 19,167.84 (US$ 3.657,98).

Keywords: erosion, volumetric assessment, soil degradation, terraces

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2063 A Hard Day's Night: Persistent Within-Individual Effects of Job Demands and the Role of Recovery Processes

Authors: Helen Pluut, Remus Ilies, Nikos Dimotakis, Maral Darouei

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This study aims to examine recovery from work as an important daily activity with implications for workplace behavior. Building on affective events theory and the stressor-detachment model as frameworks, this paper proposes and tests a comprehensive within-individual model that uncovers the role of recovery processes at home in linking workplace demands (e.g., workload) and stressors (e.g., workplace incivility) to next-day organizational citizenship behaviors (OCBs). Our sample consisted of 126 full-time employees in a large Midwestern University. For a period of 16 working days, these employees were asked to fill out 3 electronic surveys while at work. The first survey (sent out in the morning) measured self-reported sleep quality, recovery experiences the previous day at home, and momentary effect. The second survey (sent out close to the end of the workday) measured job demands and stressors as well as OCBs, while the third survey in the evening assessed job strain. Data were analyzed using Hierarchical Linear Modeling (HLM). Results indicated that job demands and stressors at work made it difficult to unwind properly at home and have a good night’s sleep, which had repercussions for next day’s morning effect, which, in turn, influenced OCBs. It can be concluded that processes of recovery are vital to an individual’s daily effective functioning and behavior at work, but recovery may become impaired after a hard day’s work. Thus, our study sheds light on the potentially persistent nature of strain experienced as a result of work and points to the importance of recovery processes to enable individuals to avoid such cross-day spillover. Our paper will discuss this implication for theory and practice as well as potential directions for future research.

Keywords: affect, job demands, organizational citizenship behavior, recovery, strain

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2062 Recovery of Copper from Edge Trims of Printed Circuit Boards Using Acidithiobacillus Ferrooxidans: Bioleaching

Authors: Shashi Arya, Nand L. Singh, Samiksha Singh, Pradeep K. Mishra, Siddh N. Upadhyay

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The enormous generation of E- waste and its recycling have greater environmental concern especially in developing countries like India. A major part of this waste comprises printed circuit boards (PCBs). Edge trims of PCBs have high copper content ranging between 25-60%. The extraction of various metals out of these PCBs is more or less a proven technology, wherein various hazardous chemicals are being used in the resource recovery, resulting into secondary pollution. The current trend of extracting of valuable metals is the utilization of microbial strains to eliminate the problem of a secondary pollutant. Keeping the above context in mind, this work aims at the enhanced recovery of copper from edge trims, through bioleaching using bacterial strain Acidithiobacillus ferrooxidans. The raw material such as motherboards, hard drives, floppy drives and DVD drives were obtained from the warehouse of the University. More than 90% copper could be extracted through bioleaching using Acidithiobacillus ferrooxidans. Inoculate concentration has merely insignificant effect over copper recovery above 20% inoculate concentration. Higher concentration of inoculation has the only initial advantage up to 2-4 days. The complete recovery has been obtained between 14- 24 days.

Keywords: acidithiobacillus ferrooxidans, bioleaching, e-waste, printed circuit boards

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2061 Process for Separating and Recovering Materials from Kerf Slurry Waste

Authors: Tarik Ouslimane, Abdenour Lami, Salaheddine Aoudj, Mouna Hecini, Ouahiba Bouchelaghem, Nadjib Drouiche

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Slurry waste is a byproduct generated from the slicing process of multi-crystalline silicon ingots. This waste can be used as a secondary resource to recover high purity silicon which has a great economic value. From the management perspective, the ever increasing generation of kerf slurry waste loss leads to significant challenges for the photovoltaic industry due to the current low use of slurry waste for silicon recovery. Slurry waste, in most cases, contains silicon, silicon carbide, metal fragments and mineral-oil-based or glycol-based slurry vehicle. As a result, of the global scarcity of high purity silicon supply, the high purity silicon content in slurry has increasingly attracted interest for research. This paper presents a critical overview of the current techniques employed for high purity silicon recovery from kerf slurry waste. Hydrometallurgy is continuously a matter of study and research. However, in this review paper, several new techniques about the process of high purity silicon recovery from slurry waste are introduced. The purpose of the information presented is to improve the development of a clean and effective recovery process of high purity silicon from slurry waste.

Keywords: Kerf-loss, slurry waste, silicon carbide, silicon recovery, photovoltaic, high purity silicon, polyethylen glycol

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2060 Investigation of Enhanced Recovery After Surgery Protocol Outcome on Post Colectomy Patients

Authors: Sharon Baoas, Toni Beninato, Michael Zenilman, Gokhan Ozuner

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Background An enhanced recovery after surgery (ERAS) protocol was implemented to improve quality and cost effectiveness of surgical care in elective colorectal procedures. Results A total of 109 patients, 55 (pre-ERAS) and 54 (post-ERAS) are included in the final analysis. There were no differences in complications were recorded (p = 0.37) and 30-day readmissions (p = 0.785). The mean hospital stay was 5.89 ± 2.62 days in pre-ERAS and 4.94 ± 2.27 days in post-ERAS group which was statistically significant (p = 0.047). Conclusions An ERAS protocol for colorectal surgery harmonised perioperative care and decreased length of stay.

Keywords: 30-day readmission, lenght of stay, Enhanced Recovery after surgery, Surgical site infection

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2059 Closing the Front Door of Child Protection: Rethinking Mandated Reporting

Authors: Miriam Itzkowitz, Katie Olson

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Through an interdisciplinary and trauma-responsive lens, this article reviews the legal and social history of mandated reporting laws and family separation, examines the ethical conundrum of mandated reporting as it relates to evidence-based practice, and discusses alternatives to mandated reporting as a primary prevention strategy. Using existing and emerging data, the authors argue that mandated reporting as a universal strategy contributes to racial disproportionality in the child welfare system and that anti-racist practices should begin with an examination of our reliance on mandated reporting.

Keywords: child welfare, education, mandated reporting, racial disproportionality, trauma

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2058 Waste Heat Recovery Using Spiral Heat Exchanger

Authors: Parthiban S. R.

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Spiral heat exchangers are known as excellent heat exchanger because of far compact and high heat transfer efficiency. An innovative spiral heat exchanger based on polymer materials is designed for waste heat recovery process. Such a design based on polymer film technology provides better corrosion and chemical resistance compared to conventional metal heat exchangers. Due to the smooth surface of polymer film fouling is reduced. A new arrangement for flow of hot flue gas and cold fluid is employed for design, flue gas flows in axial path while the cold fluid flows in a spiral path. Heat load recovery achieved with the presented heat exchanger is in the range of 1.5 kW thermic but potential heat recovery about 3.5 kW might be achievable. To measure the performance of the spiral tube heat exchanger, its model is suitably designed and fabricated so as to perform experimental tests. The paper gives analysis of spiral tube heat exchanger.

Keywords: spiral heat exchanger, polymer based materials, fouling factor, heat load

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2057 The Prevalence of Intubation Induced Dental Complications among Hospitalized Patients

Authors: Dorsa Rahi, Arghavan Tonkanbonbi, Soheila Manifar, Behzad Jafvarnejad

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Background and Aim: Intraoral manipulation is performed during endotracheal intubation for general anesthesia, which can traumatize the soft and hard tissue in the oral cavity and cause postoperative pain and discomfort. Dental trauma is the most common complication of intubation. This study aimed to assess the prevalence of dental complications due to intubation in patients hospitalized in Imam Khomeini Hospital during 2018-2019. Materials and Methods: A total of 805 patients presenting to the Cancer Institute of Imam Khomeini Hospital for preoperative anesthesia consultation were randomly enrolled. A dentist interviewed the patients and performed a comprehensive clinical oral examination preoperatively. The patients underwent clinical oral examination by another dentist postoperatively. Results: No significant correlation was found between dental trauma (tooth fracture, tooth mobility, or soft tissue injury) after intubation with the age or gender of patients. According to the Wilcoxon test and McNemar-Bowker Test, the rate of mobility before the intubation was significantly different from that after the intubation (P=0.000). Maxillary central incisors, maxillary left canine and mandibular right and left central incisors had the highest rate of fracture. Conclusion: Mobile teeth before the intubation are at higher risk of avulsion and aspiration during the procedure. Patients with primary temporomandibular joint disorders are more susceptible to post-intubation trismus.

Keywords: oral trauma, dental trauma, intubation, anesthesia

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2056 Progression of Trauma: Myth Mess Mastery, Addressing and Grooming

Authors: Stuart Bassman

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Services that focus on the synthesis of research and clinical practice are vital in providing efficacious change for the men and women who have been victims of childhood sexual abuse. This study will address what processes have been helpful in being a catalyst in changing one’s inner life as well as providing meaningful applications and fulfilling experiences. Initially, we would focus on the Myths regarding childhood sexual abuse. This would include Grooming behaviors and Delayed Disclosures. Subsequently, we would address the Mess that follows from not recognizing the adverse impairments that result from Childhood Sexual Abuse. Finally, we would conclude by looking at the Mastery that could arise from moving from being a Victim to a Survivor and a Thriver.

Keywords: trauma, childhood, somatic, treatment

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2055 Seed Germination and Recovery Responses of Suaeda Heterophylla to Abiotic Stresses

Authors: Abdul Hameed, Muhammad Zaheer Ahmed, Salman Gulzar, Bilquees Gul, Jan Alam, Ahmad K. Hegazy, Abdel Rehman A. Alatar, M. Ajmal Khan

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Seed germination and recovery from salt stress of an annual halophyte Suaeda heterophylla (Kar. and Kir.) Bunge to different iso-osmotic concentrations (0, -0.46, -0.92, -1.38, -1.84, and -2.30 MPa) of NaCl and PEG-6000 at 15/25, 20/30 and 25/35°C in both 12-h temperature and light regimes and in complete darkness were studied. Maximum number of seeds germinated in distilled water and increase in concentrations of both NaCl and PEG-6000 decreased germination at all temperature regimes, light and dark conditions, with higher inhibition in NaCl than PEG-6000. Recovery of germination and viability of seeds were lower in NaCl than PEG-6000 both in the light and dark. Moderate alternate temperatures (20/30°C) and 12-h photoperiod were found to be the optimal for seed germination and recovery. Better seed germination of S. heterophylla when osmotic potential caused both by NaCl and PEG 6000 is lower, temperature regime of 20/30°C and light regime is for 12 h.

Keywords: seed germination, abiotic stresses, Suaeda heterophylla, molecular biology

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2054 Correlation Analysis between Physical Fitness Norm and Cardio-Pulmonary Signals under Graded Exercise and Recovery

Authors: Shyan-Lung Lin, Cheng-Yi Huang, Tung-Yi Lin

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Physical fitness is the adaptability of the body to physical work and the environment, and is generally known to include cardiopulmonary-fitness, muscular-fitness, body flexibility, and body composition. This paper is aimed to study the ventilatory and cardiovascular activity under various exercise intensities for subjects at distinct ends of cardiopulmonary fitness norm. Three graded upright biking exercises, light, moderate, and vigorous exercise, were designed for subjects at distinct ends of cardiopulmonary fitness norm from their physical education classes. The participants in the experiments were 9, 9, and 11 subjects in the top 20%, middle 20%, and bottom 20%, respectively, among all freshmen of the Feng Chia University in the academic year of 2015. All participants were requested to perform 5 minutes of upright biking exercise to attain 50%, 65%, and 85% of their maximum heart rate (HRmax) during the light, moderate, and vigorous exercise experiment, respectively, and 5 minutes of recovery following each graded exercise. The cardiovascular and ventilatory signals, including breathing frequency (f), tidal volume (VT), heart rate (HR), mean arterial pressure (MAP), and ECG signals were recorded during rest, exercise, and recovery periods. The physiological signals of three groups were analyzed based on their recovery, recovery rate, and percentage variation from rest. Selected time domain parameters, SDNN and RMSSD, were computed and spectral analysis was performed to study the hear rate variability from collected ECG signals. The comparison studies were performed to examine the correlations between physical fitness norm and cardio-pulmonary signals during graded exercises and exercise recovery. No significant difference was found among three groups with VT during all levels of exercise intensity and recovery. The top 20% group was found to have better performance in heart recovery (HRR), frequency recovery rate (fRR) and percentage variation from rest (Δf) during the recovery period of vigorous exercise. The top 20% group was also found to achieve lower mean arterial pressure MAP only at rest but showed no significant difference during graded exercises and recovery periods. In time-domain analysis of HRV, the top 20% group again seemed to have better recovery rate and less variation in terms of SDNN during recovery period of light and vigorous exercises. Most assessed frequency domain parameters changed significantly during the experiment (p<0.05, ANOVA). The analysis showed that the top 20% group, in comparison with middle and bottom 20% groups, appeared to have significantly higher TP, LF, HF, and nHF index, while the bottom 20% group showed higher nLF and LF/HF index during rest, three graded levels of exercises, and their recovery periods.

Keywords: physical fitness, cardio-pulmonary signals, graded exercise, exercise recovery

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2053 Introduction of Digital Radiology to Improve the Timeliness in Availability of Radiological Diagnostic Images for Trauma Care

Authors: Anuruddha Jagoda, Samiddhi Samarakoon, Anil Jasinghe

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In an emergency department ‘where every second count for patient’s management’ timely availability of X- rays play a vital role in early diagnosis and management of patients. Trauma care centers rely heavily on timely radiologic imaging for patient care and radiology plays a crucial role in the emergency department (ED) operations. A research study was carried out to assess timeliness of availability of X-rays and total turnaround time at the Accident Service of National Hospital of Sri Lanka which is the premier trauma center in the country. Digital Radiology system was implemented as an intervention to improve the timeliness of availability of X-rays. Post-implementation assessment was carried out to assess the effectiveness of the intervention. Reduction in all three aspects of waiting times namely waiting for initial examination by doctors, waiting until X –ray is performed and waiting for image availability was observed after implementation of the intervention. However, the most significant improvement was seen in waiting time for image availability and reduction in time for image availability had indirect impact on reducing waiting time for initial examination by doctors and waiting until X –ray is performed. The most significant reduction in time for image availability was observed when performing 4-5 X rays with DR system. The least improvement in timeliness was seen in patients who are categorized as critical.

Keywords: emergency department, digital radilogy, timeliness, trauma care

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2052 Post-Exercise Effects of Cold Water Immersion over a 48-Hour Recovery Period on the Physical and Haematological Parameters of Male University-Level Rugby Players

Authors: Adele Broodryk, Cindy Pienaar, Martinique Sparks, Ben Coetzee

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Background: Cold water immersion (CWI) is a popular recovery modality utilised. However, discrepancies exist regarding the results over a 48 hour recovery period. Aim: To evaluate the effects of CWI and passive recovery (PAR) on a range of haematological and physical parameters over a 48-hour using a cross-sectional, pre-post-test design. Subjects and Methods: Both the and physical parameters were evaluated at baseline, after a 15-min fitness session, and at 0, 24 and 48 hours post-recovery in 23 male university rugby players. The CWI group sat in a cold water pool (8°C) for 20 min whereas the PAR group remained seated. Results: At 0 hours post-CWI, three (blood lactate (BLa-), Sodium (Na+) and haemoglobin) returned to baseline values, however Vertical Jump Test (VJT) height results decreased whereas after PAR it improved. From 0 to 24 and/or 48 h, four (Partial Oxygen (PO2) VJT-height, plasma glucose, and Na+) significantly increased (p ≤ 0.05) in either and/or both groups. Significant intergroup differences (p ≤ 0.05) were noticed in the physical tests. Conclusions: PAR is superior as an acute modality (0 hours) due to CWI cooling the body down. However, CWI demonstrates advantageous over a 24-hour period in a wide range of haematological variables.

Keywords: cryotherapy, recuperation, haematological, rugby

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2051 Prediction Modeling of Compression Properties of a Knitted Sportswear Fabric Using Response Surface Method

Authors: Jawairia Umar, Tanveer Hussain, Zulfiqar Ali, Muhammad Maqsood

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Different knitted structures and knitted parameters play a vital role in the stretch and recovery management of compression sportswear in addition to the materials use to generate this stretch and recovery behavior of the fabric. The present work was planned to predict the different performance indicators of a compression sportswear fabric with some ground parameters i.e. base yarn stitch length (polyester as base yarn and spandex as plating yarn involve to make a compression fabric) and linear density of the spandex which is a key material of any sportswear fabric. The prediction models were generated by response surface method for performance indicators such as stretch & recovery percentage, compression generated by the garment on body, total elongation on application of high power force and load generated on certain percentage extension in fabric. Certain physical properties of the fabric were also modeled using these two parameters.

Keywords: Compression, sportswear, stretch and recovery, statistical model, kikuhime

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2050 From Victim to Ethical Agent: Oscar Wilde's The Ballad of Reading Gaol as Post-Traumatic Writing

Authors: Mona Salah El-Din Hassanein

Abstract:

Faced with a sudden, unexpected, and overwhelming event, the individual's normal cognitive processing may cease to function, trapping the psyche in "speechless terror", while images, feelings and sensations are experienced with emotional intensity. Unable to master such situation, the individual becomes a trauma victim who will be susceptible to traumatic recollections like intrusive thoughts, flashbacks, and repetitive re-living of the primal event in a way that blurs the distinction between past and present, and forecloses the future. Trauma is timeless, repetitious, and contagious; a trauma observer could fall prey to "secondary victimhood". Central to the process of healing the psychic wounds in the aftermath of trauma is verbalizing the traumatic experience (i.e., putting it into words) – an act which provides a chance for assimilation, testimony, and reevaluation. In light of this paradigm, this paper proposes a reading of Oscar Wilde's The Ballad of Reading Gaol, written shortly after his release from prison, as a post-traumatic text which traces the disruptive effects of the traumatic experience of Wilde's imprisonment for homosexual offences and the ensuing reversal of fortune he endured. Post-traumatic writing demonstrates the process of "working through" a trauma which may lead to the possibility of ethical agency in the form of a "survivor mission". This paper draws on fundamental concepts and key insights in literary trauma theory which is characterized by interdisciplinarity, combining the perspectives of different fields like critical theory, psychology, psychiatry, psychoanalysis, history, and social studies. Of particular relevance to this paper are the concepts of "vicarious traumatization" and "survivor mission", as The Ballad of Reading Gaol was written in response to Wilde's own prison trauma and the indirect traumatization he experienced as a result of witnessing the execution of a fellow prisoner whose story forms the narrative base of the poem. The Ballad displays Wilde's sense of mission which leads him to recognize the social as well as ethical implications of personal tragedy. Through a close textual analysis of The Ballad of Reading Gaol within the framework of literary trauma theory, the paper aims to: (a) demonstrate how the poem's thematic concerns, structure and rhetorical figures reflect the structure of trauma; (b) highlight Wilde's attempts to come to terms with the effects of the cataclysmic experience which transformed him into a social outcast; and (c) show how Wilde manages to transcend the victim status and assumes the role of ethical agent to voice a critique of the Victorian penal system and the standards of morality underlying the cruelties practiced against wrong doers and to solicit social action.

Keywords: ballad of reading of reading, post-traumatic writing, trauma theory, Wilde

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2049 A Perspective on Emergency Care of Gunshot Injuries in Northern Taiwan

Authors: Liong-Rung Liu, Yu-Hui Chiu, Wen-Han Chang

Abstract:

Firearm injuries are high-energy injuries. The ballistic pathways could cause severe burns or chemical damages to vessels, musculoskeletal or other major organs. The high mortality rate is accompanied by complications such as sepsis. As laws prohibit gun possession, civilian gunshot wounds (GSW) are relatively rare in Taiwan. Our hospital, Mackay Memorial Hospital, located at the center of Taipei city is surrounded by nightclubs and red-light districts. Due to this unique location, our hospital becomes the first-line trauma center managing gunshot victims in Taiwan. To author’s best knowledge, there are few published research articles regarding this unique situation. We hereby analyze the distinct characteristics and length of stay (LOS) of GSW patients in the emergency room (ER) at Mackay Memorial Hospital. A 6-year retrospective analysis of 27 patients treated for GSW injuries from January 2012 to December 2017 was performed. The patients’ records were reviewed for the following analyses, 1) wound position and the correlated clinical presentations; 2) the LOS in ED of patients receiving emergency surgery for major organ or vascular injuries. We found males (96.3%) were injured by guns more often than females (3.7%) in all age groups. The most common injured site was in the extremities. With regards to the ER LOS, the average time were 72.2 ± 34.5 minutes for patients with triage I and 207.4 ± 143.9 minutes for patients with triage II. The ED LOS of patients whose ISS score were more than 15 was 59.9 ± 25.6 minutes, and 179.4 ± 119.8 minutes for patients whose ISS score were between 9 to 15, respectively. Among these 27 patients, 10 patients had emergency surgery and their average ED stay time was 104.5 ± 33.3 minutes. Even more, the average ED stay time could be shortened to 88.8 ± 32.3 minutes in the 5 patients with trauma team activation. In conclusion, trauma team activation in severe GSW patients indeed shortens the ED LOS and might initially improve the quality of patient care. This is the result of better trauma systems, including advances in care from emergency medical services and acute care surgical management.

Keywords: gunshot, length of stay, trauma, mortality

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2048 Practices Supporting the Wellbeing of Healthcare Staff Post-disaster: Findings from a Narrative Inquiry

Authors: Julaine Allan, Katarzyna Olcon, Padmini Pai, Lynne Keevers, Mim Fox, Maria Mackay, Ruth Everingham

Abstract:

Effective local responses to community needs are grounded in contextual knowledge and build on existing resources. The Stability, Encompassing, Endurance & Direction (SEED) Wellbeing Program was created in 2020 in response to cumulative disasters, bushfires, floods and COVID, experienced by healthcare staff in the Illawarra Shoalhaven Local Health District, NSW Australia. SEED used a participatory action methodology to bring healthcare staff teams together to engage in restorative activities in the workplace. Guided by Practice Theory, this study identified the practices that supported the recovery of healthcare staff.

Keywords: mental health and wellbeing, workplace wellness, healthcare providers, natural disasters, COVID-19, burnout, occupational trauma

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2047 Changes in the Quality of Life of Turkish Patients with Trauma-Related Phthisis Bulbi

Authors: Titap Yazicioglu

Abstract:

Purpose: Losing an eye due to trauma is a challenging situation that reduces the quality of life by causing physical, cosmetic, and serious psychological problems. This study aimed to evaluate the effect of aesthetic rehabilitation on the change in psychological status and quality of life of patients with eye loss resulting in phthisis bulbi. Materials and Methods: The files of 25 males and 15 females with an average age of 27.5 years who had trauma-related phthisic eye and had applied to the Department of Ophthalmology at the Dr. Lütfi Kırdar Kartal Education and Research Hospital, Istanbul, Turkey, for aesthetic rehabilitation during the years 2015-19 were retrospectively analyzed. The Beck Depression Inventory (BDI), Beck Anxiety Scale(BAS), and Short Form 36 quality-of-life survey (SF-36) were used to collect data on admission and one-year follow-up. Results: Of the patients reviewed, 65% stated that eye loss had caused their avoidance of family and social environments; 30% had moderate anxiety and depression. The post-operative sub-dimension scores of general health, emotional role function, and physical and social functions were statistically significant (p = 0.001; p<0.01), but the variations in the sub-dimension scores of vitality, mental health, and total physical health were not (p>0.05). Conclusion: Lossing an eye is a traumatic event that can affect all aspects of a person’s social and professional life. A patient who has suffered from the psychological damage of physical loss of eye needs a prosthesis that can give the desired function and appearance in different aspects of life.

Keywords: eye loss, phthisis bulbi, quality of life, psychological trauma

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2046 A Scenario-Based Experiment Comparing Managerial and Front-Line Employee Apologies in Terms of Customers' Perceived Justice, Satisfaction, and Commitment

Authors: Ioana Dallinger, Vincent P. Magnini

Abstract:

Due to the many moving parts and high human component, mistakes and failures sometimes occur during transactions in service environments. Because a certain portion of such failures is unavoidable, many service providers constantly look for guidance regarding optimal ways by which they should manage failures and recoveries. Through the use of a scenario-based experiment, the findings of this study run counter to the empowerment approach (i.e. that frontline employees should be empowered to resolve failure situations on their own doing). Specifically, this study finds that customers’ perceptions of distributive, procedural, and interactional justice are significantly higher [p-values < .05] when a manager delivers an apology as opposed to the frontline provider. Moreover, customers’ satisfaction with the recovery and commitment to the firm are also significantly stronger [p-values < .05] when a manager apologizes. Interestingly, this study also empirically tests the effects of combined apologies of both the manager and employee and finds that the combined approach yields better results for customers’ interactional justice perceptions and for their satisfaction with recovery, but not for their distributive or procedural justice perceptions or consequent commitment to the firm. This study can serve a springboard for further research. For example, perceptions and attitudes regarding employee empowerment vary based upon country culture. Furthermore, there are likely a number of factors that can moderate the cause and effect relationship between a failure recovery and customers’ post-recovery perceptions [e.g. the severity of the failure].

Keywords: apology, empowerment, service failure recovery, service recovery

Procedia PDF Downloads 273
2045 Resiliency in Fostering: A Qualitative Study of Highly Experienced Foster Parents

Authors: Ande Nesmith

Abstract:

There is an ongoing shortage of foster parents worldwide to take on a growing population of children in need of out-of-home care. Currently, resources are primarily aimed at recruitment rather than retention. Retention rates are extraordinarily low, especially in the first two years of fostering. Qualitative interviews with 19 foster parents averaging 20 years of service provided insight into the challenges they faced and how they overcame them. Thematic analysis of interview transcripts identified sources of stress and resiliency. Key stressors included lack of support and responsiveness from the children’s social workers, false maltreatment allegations, and secondary trauma from children’s destructive behaviors and emotional dysregulation. Resilient parents connected with other foster parents for support, engaged in creative problem-solving, recognized that positive feedback from children usually arrives years later, and through training, understood the neurobiological impact of trauma on child behavior. Recommendations include coordinating communication between the foster parent licensing agency social workers and the children’s social workers, creating foster parent support networks and mentoring, and continuous training on trauma including effective parenting strategies. Research is needed to determine whether these resilience indicators in fact lead to long-term retention. Policies should include a mechanism to develop a cohesive line of communication and connection between foster parents and the children’s social workers as well as their respective agencies.

Keywords: foster care stability, foster parent burnout, foster parent resiliency, foster parent retention, trauma-informed fostering

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2044 Migrant Youth: Trauma-Informed Interventions

Authors: Nancy Daly

Abstract:

Migrant youth who have experienced traumatic events in their home countries or in their passage to the United States may require interventions or formal services to support varying levels and types of needs. The manner in which such youth are engaged and evaluated, as well as the framework of evaluation, can impact their educational services and placement. Evidenced-based trauma-informed practices that engage and support migrant youth serve as an important bridge to stabilization; however, ensuring long-term growth may require a range of integrated services, including special education and mental health services. Special education evaluations which consider the eligibility of Emotional Disturbance for migrant youth must carefully weigh issues of mental health needs against the exclusionary criteria of lack of access to education, limited language skills, as well as other environmental factors. Case studies of recently arrived migrant youth reveal both commonalities and differences in types and levels of need which underscores the importance of adept evaluation and case management to ensure the provision of services that support growth and resiliency.

Keywords: migrant youth, trauma-informed care, mental health services, special education

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2043 Gas Sweetening Process Simulation: Investigation on Recovering Waste Hydraulic Energy

Authors: Meisam Moghadasi, Hassan Ali Ozgoli, Foad Farhani

Abstract:

In this research, firstly, a commercial gas sweetening unit with methyl-di-ethanol-amine (MDEA) solution is simulated and comprised in an integrated model in accordance with Aspen HYSYS software. For evaluation purposes, in the second step, the results of the simulation are compared with operating data gathered from South Pars Gas Complex (SPGC). According to the simulation results, the considerable energy potential contributed to the pressure difference between absorber and regenerator columns causes this energy driving force to be applied in power recovery turbine (PRT). In the last step, the amount of waste hydraulic energy is calculated, and its recovery methods are investigated.

Keywords: gas sweetening unit, simulation, MDEA, power recovery turbine, waste-to-energy

Procedia PDF Downloads 151
2042 Practices Supporting the Wellbeing of Healthcare Staff: Findings From a Narrative Inquiry

Authors: Julaine Allan, Katarzyna Olcon, Padmini Pai, Lynne Keevers, Mim Fox, Maria Mackay, Ruth Everingham, Sue Cutmore, Chris Degeling, Kristine Falzon, Summer Finlay

Abstract:

Effective local responses to community needs are grounded in contextual knowledge and built on existing resources. The SEED Wellbeing Program was created in 2020 in response to cumulative disasters, bushfires, floods and COVID experienced by healthcare staff in the Illawarra Shoalhaven Local Health District, NSW, Australia. SEED used a participatory action methodology to bring healthcare staff teams together to engage in restorative activities in the workplace. Guided by Practice Theory, this study identified the practices that supported the recovery of healthcare staff.

Keywords: mental health and wellbeing, workplace wellness, healthcare providers, natural disasters, COVID-19, burnout, occupational trauma

Procedia PDF Downloads 115