Search results for: historical trauma
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 2206

Search results for: historical trauma

2116 In Search of Lost Subject: Marx's Historical Materialism, Subject and Existentialism

Authors: Doruk Atahan Erbas

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This paper concerns the early writings of Karl Marx, specifically The Economic and Philosophic Manuscripts of 1844, The German Ideology and Theses on Feuerbach. The two crucial themes of these early writings are the doctrine called historical materialism and, as a worker, the worker's resistance towards the current condition of society out of the division of labor. After Marx, including his closest friend Friedrich Engels, some of the philosophers, activists, and politicians have considered the historical materialism as a rigorous science which includes the explanation of historical causality manifested in the social, political sphere. However, this consideration, by its description as a science, is completely alienated from the concept of subject (as the suffering worker) nothing other than one of the abovementioned themes. Therefore, from this perspective, Marx's early doctrine seems to be self contradictory. The alternative approach which will be introduced in this essay offers a new basis for a correlation between the concept of subject and historical materiality by means of investigating materiality as phenomenality and ultimately rereading Marx as a creator of an existential subject surrounded by phenomenality. So that, it provides an opportunity to rethink the concept of historical materiality from an existential point of view.

Keywords: existentialism, Karl Marx, materiality, phenomenality, subject

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2115 Ill-Defined and Ill-Equipped: Understanding the Limits of the Concept of Truth in South Africa’S Truth and Reconciliation Commission

Authors: Keo Mbebe

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The South African Truth and Reconciliation Commission (TRC) is widely regarded as a blueprint for countries seeking to transcend the atrocities of their past and create a new human rights-based administration. The aim of these societies is to establish historical truth. Within the TRC, the aspects of truth-finding and truth-telling were considered to be catalysts for national unity and reconciliation. Truth-seeking, in addition, was mandated in the Promotion of National Unity and Reconciliation Act (TRC Act), which is the legislation behind the TRC. However, there is an incongruency between the conception of truth outlined in the Act, and the conception of truth explained in the Report of the TRC proceedings. The aim of this paper is to delineate these two kinds of “truth” and to critically analyze them. Doing so, it will then be evident in the discussion that there is a need for substantial clarity in the conception of truth used in transitional justice settings based on truth-finding and truth-seeking, and the paper will present ways in which such clarity may be achieved. The paper will begin with a philosophical engagement on the notion of historical truth used by the TRC legislation. Thereafter, the historical background to the political context in which the TRC Act was mandated will be provided. The next section would then be a sketch of the conceptions of historical truth and historical injustice in the Act, as well as its supporting documents. Lastly, it will be argued that the subversion of the TRC’s mandate to promote reconciliation and national unity by bringing to light past human rights violations during apartheid is betrayed by its amorphous conception of historical truth.

Keywords: historical truth, human rights, transitional justice, truth commission

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2114 Analysis of Coloring Styles of Brazilian Urban Heritage

Authors: Natalia Naoumova

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Facing changes and continuous growth of the contemporary cities, along with the globalization effects that accelerate cultural dissolution, the maintenance of cultural authenticity, which is implicit in historical areas as a part of cultural diversity, can be considered one of the key elements of a sustainable society. This article focuses on the polychromy of buildings in a historical context as an important feature of urban settings. It analyses the coloring of Brazilian urban heritage, characterized by the study of historical districts in Pelotas and Piratini, located in the State of Rio Grande do Sul, Brazil. The objective is to reveal the coloring characteristics of different historical periods, determine the chromatic typologies of the corresponding building styles, and clarify the connection between the historical chromatic aspects and their relationship with the contemporary urban identity. Architectural style data were collected by different techniques such as stratigraphic prospects of buildings, survey of historical records and descriptions, analysis of images and study of projects with colored facades kept in historical archives. Three groups of characteristics were considered in searching for working criteria in the formation of chromatic model typologies: 1) coloring palette; 2) morphology of the facade, and 3) their relationship. The performed analysis shows the formation of the urban chromatic image of the historical center as a continuous and dynamic process with the development of constant chromatic resources. It establishes that the changes in the formal language of subsequent historical periods lead to the changes in the chromatic schemes, providing a different reading of the facades both in terms of formal interpretation and symbolic meaning.

Keywords: building style, historic colors, urban heritage, urban polychromy

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2113 The Analysis of the Protection of Historical and Cultural Heritage in the Development of Cities: Taking Quzhou Ancient City as an Example

Authors: Zhen Shu

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The historical and cultural heritage demonstrates the wisdom of the entire nation and it has left its own traces in the process of urban construction. It has very important instructional significance for the construction of modern cities and the development of cultural aspects of modern people. The Protection of historical and cultural heritage has become an inevitable choice for the development of modern civilization. This paper discusses the relationship between urban development and historic preservation. And it emphasizes the important value of strengthening the protection of historical and cultural heritage in urban construction, introduces the value of cultural heritage, the process of historic preservation and its problems in Quzhou, Zhejiang Province. In conclusion, we puts forward some Suggestions for strengthening the protection of historical heritage in the process of urban construction.

Keywords: cultural heritage, historic preservation, Quzhou ancient city, urban development

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2112 Exploring the Issue of Occult Hypoperfusion in the Pre-Hospital Setting

Authors: A. Fordham, A. Hudson

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Background: Studies have suggested 16-25% of normotensive trauma patients with no clinical signs of shock have abnormal lactate and BD readings evidencing shock; a phenomenon known as occult hypoperfusion (OH). In light of the scarce quantity of evidence currently documenting OH, this study aimed to identify the prevalence of OH in the pre-hospital setting and explore ways to improve its identification and management. Methods: A quantitative retrospective data analysis was carried out on 75 sets of patient records for trauma patients treated by Kent Surrey Sussex Air Ambulance Trust between November 2013 and October 2014. The KSS HEMS notes and subsequent ED notes were collected. Trends between patients’ SBP on the scene, whether or not they received PRBCs on the scene as well as lactate and BD readings in the ED were assessed. Patients’ KSS HEMS notes written by the HEMS crew were also reviewed and recorded. Results: -Suspected OH was identified in 7% of the patients who did not receive PRBCs in the pre-hospital phase. -SBP heavily influences the physicians’ decision of whether or not to transfuse PRBCs in the pre-hospital phase. Preliminary conclusions: OH is an under-studied and underestimated phenomenon. We suggest a prospective trial is carried out to evaluate whether detecting trauma patients’ tissue perfusion status in the pre-hospital phase using portable devices capable of measuring serum BD and/or lactate could aid more accurate detection and management of all haemorrhaging trauma patients, including patients with OH.

Keywords: occult hypoperfusion, PRBC transfusion, point of care testing, pre-hospital emergency medicine, trauma

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2111 Understanding Trauma Informed Pedagogy in On-Line Education during Turbulent Times: A Mixed Methods Study in a Canadian Social Work Context

Authors: Colleen McMillan, Alice Schmidt-Hanbidge, Beth Archer-Kuhn, Heather Boynton, Judith Hughes

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It is well known that social work students enter the profession with higher scores of adverse childhood experiences (ACE). Add to that the fact that COVID-19 has forced higher education institutions to shift to online teaching and learning, where students, faculty and field educators in social work education have reported increased stressors as well as posing challenges in developing relationships with students and being able to identify mental health challenges including those related to trauma. This multi-institutional project included three Canadian post-secondary institutions at five sites (the University of Waterloo, the University of Calgary and the University of Manitoba) and partners; Desire To Learn (D2L), The Centre for Teaching Excellence at the University of Waterloo and the Taylor Institute for Teaching and Learning. A sequential mixed method research design was used. Survey data was collected from students, faculty and field education staff from the 3 universities using the Qualtrics Insight Platform, followed by virtual focus group data with students to provide greater clarity to the quantitative data. Survey data was analyzed using SPSS software, while focus group data was transcribed verbatim and organized with N-Vivo 12. Thematic analysis used line-by-line coding and constant comparative methods within and across focus groups. The following three objectives of the study were achieved: 1) Establish a Canadian baseline on trauma informed pedagogy and student experiences of trauma informed teaching in the online higher education environment during a pandemic; 2) Identify and document educator and student experiences of online learning regarding the ability to process trauma experiences; and, 3) Transfer the findings into a trauma informed pedagogical model for Social Work as a first step toward developing a universal trauma informed teaching model. The trauma informed pedagogy model would be presented in relation to the study findings.

Keywords: trauma informed pedagogy, higher education, social work, mental health

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2110 The Trauma Suffered by Left behind Children and Its Impact on Their Emotional Development: A Pilot Study with Brazilian Immigrants in the United States

Authors: Liliane Clark

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Immigrating to a different country may imply having to handle many difficult exertions. There is a particular issue that has to be endured by some immigrants: the children they had to leave behind. It is a phenomenon that occurs with certain frequency. Surprisingly, despite the fact that immigration in the United States is such a large proceeding, there is not much research about the topic in America exploring the trauma of the abandonment caused by this separation and its consequences on the mental health of those children. The term “left behind children” is usually applied to children who were left behind by their parents in their original nation under the care of a noteworthy relative, frequently the grandparents, when they moved to another country. This preliminary research, which is a partial study projected for a doctoral thesis, investigated whether the trauma of abandonment experienced by ten left behind children had affected their emotional development. The Strengths and Difficulties Questionnaire (SDQ) and a brief interview were utilized to assess the information. The SDQ explored scales such as emotional symptoms, conduct problems, hyperactivity, peer problems and prosocial behavior. In this pilot study, the results indicated that all these issues had some sort of significant correlation between them. During the interviews, the participants or their parents identified a range of symptoms: anxiety disorder, eating disorders, panic attacks, psychotic-like experiences, drug use and depression. Hence, it seems that there is a connection between the trauma of abandonment suffered due to the separation and the children’s consequent symptomatic behavior. Further studies are indeed necessary to validate the initial results of this investigation.

Keywords: abandonment, parent migration, psychological problems, trauma

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2109 Unpacking the Summarising Event in Trauma Emergencies: The Case of Pre-briefings

Authors: Professor Jo Angouri, Polina Mesinioti, Chris Turner

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In order for a group of ad-hoc professional to perform as a team, a shared understanding of the problem at hand and an agreed action plan are necessary components. This is particularly significant in complex, time sensitive professional settings such as in trauma emergencies. In this context, team briefings prior to the patient arrival (pre-briefings) constitute a critical event for the performance of the team; they provide the necessary space for co-constructing a shared understanding of the situation through summarising information available to the team: yet the act of summarising is widely assumed in medical practice but not systematically researched. In the vast teamwork literature, terms such as ‘shared mental model’, ‘mental space’ and ‘cognate labelling’ are used extensively, and loosely, to denote the outcome of the summarising process, but how exactly this is done interactionally remains under researched. This paper reports on the forms and functions of pre-briefings in a major trauma centre in the UK. Taking an interactional approach, we draw on 30 simulated and real-life trauma emergencies (15 from each dataset) and zoom in on the use of pre-briefings, which we consider focal points in the management of trauma emergencies. We show how ad hoc teams negotiate sharedness of future orientation through summarising, synthesising information, and establishing common understanding of the situation. We illustrate the role, characteristics, and structure of pre-briefing sequences that have been evaluated as ‘efficient’ in our data and the impact (in)effective pre-briefings have on teamwork. Our work shows that the key roles in the event own the act of summarising and we problematise the implications for leadership in trauma emergencies. We close the paper with a model for pre-briefing and provide recommendations for clinical practice, arguing that effective pre-briefing practice is teachable.

Keywords: summarising, medical emergencies, interaction analysis, shared/mental models

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2108 A Recognition Method for Spatio-Temporal Background in Korean Historical Novels

Authors: Seo-Hee Kim, Kee-Won Kim, Seung-Hoon Kim

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The most important elements of a novel are the characters, events and background. The background represents the time, place and situation that character appears, and conveys event and atmosphere more realistically. If readers have the proper knowledge about background of novels, it may be helpful for understanding the atmosphere of a novel and choosing a novel that readers want to read. In this paper, we are targeting Korean historical novels because spatio-temporal background especially performs an important role in historical novels among the genre of Korean novels. To the best of our knowledge, we could not find previous study that was aimed at Korean novels. In this paper, we build a Korean historical national dictionary. Our dictionary has historical places and temple names of kings over many generations as well as currently existing spatial words or temporal words in Korean history. We also present a method for recognizing spatio-temporal background based on patterns of phrasal words in Korean sentences. Our rules utilize postposition for spatial background recognition and temple names for temporal background recognition. The knowledge of the recognized background can help readers to understand the flow of events and atmosphere, and can use to visualize the elements of novels.

Keywords: data mining, Korean historical novels, Korean linguistic feature, spatio-temporal background

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2107 Children of Syria: Using Drawings for Diagnosing and Treating Trauma

Authors: Fatten F. Elkomy

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The Syrian refugees are the largest refugee population since World War II. Mostly, children, these individuals were exposed to intense traumatic events in their homeland, throughout their journey, and during settlement in foreign lands. Art is a universal language to express feelings and tough human experiences. It is also a medium for healing and promoting creativity and resilience. Literature review was conducted to examine the use of art to facilitate psychiatric interviews, diagnosis, and therapy with traumatized children. Results show a severe impact of childhood trauma on the increased risk for abuse, neglect, and psychiatric disorders. Clinicians must recognize, evaluated and provide help for these children. In conclusion, drawings are used to tell a story, reflect deep emotions, and create a meaningful self-recognition and determination. Participants will understand art therapy using the expressive therapies continuum framework to evaluate drawings and to promote healing for refugee children.

Keywords: art therapy, children drawings, Syrian refugees, trauma in childhood

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2106 Data Gathering and Analysis for Arabic Historical Documents

Authors: Ali Dulla

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This paper introduces a new dataset (and the methodology used to generate it) based on a wide range of historical Arabic documents containing clean data simple and homogeneous-page layouts. The experiments are implemented on printed and handwritten documents obtained respectively from some important libraries such as Qatar Digital Library, the British Library and the Library of Congress. We have gathered and commented on 150 archival document images from different locations and time periods. It is based on different documents from the 17th-19th century. The dataset comprises differing page layouts and degradations that challenge text line segmentation methods. Ground truth is produced using the Aletheia tool by PRImA and stored in an XML representation, in the PAGE (Page Analysis and Ground truth Elements) format. The dataset presented will be easily available to researchers world-wide for research into the obstacles facing various historical Arabic documents such as geometric correction of historical Arabic documents.

Keywords: dataset production, ground truth production, historical documents, arbitrary warping, geometric correction

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2105 Clinical Correlates of Suicide Attempts in Trauma-Exposed Youth

Authors: Sandra Landy

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Traumatic experiences in youth are a major risk factor for future suicidality. With suicide steadily increasing over the last 20 years as one of the top three leading causes of death in children and adolescents, it is essential to examine the aspects of trauma that contribute to suicidality. A quantitative secondary data analysis of a prospective, multicenter 24-month observational study of youth who have experienced traumatic experiences was utilized to determine the relationship between bullying and suicide attempts, cyberbullying and suicide attempts, and number of traumas and suicide attempts. Data was analyzed with the Spearman-rank correlation test to determine the relationships. Findings supported past research establishing a relationship between bulling, including cyberbullying, and suicide attempts, as well as increasing number of traumatic experiences and suicide attempts. Further large scale studies may be beneficial to support these findings.

Keywords: adolescent(s), suicide, trauma, bullying, cyberbullying

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2104 Posttraumatic Stress and Comorbid Emotional and Behavioral Problems in Sri Lankan Adolescents

Authors: Thyagi Ponnamperuma

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Background: Comorbidity between posttraumatic stress disorder (PTSD) and other psychological problems is common. Recent studies focused to investigate the underlying relationship between PTSD and comorbid psychopathologies. Among adolescents, higher rates of emotional and behavioral problems (EBP) have been reported following trauma, often coexisted with PTSD. The current study, thus, examined the relationship of posttraumatic stress symptoms to EBP in adolescents exposed to a variety of traumatic events. Further, the study investigated the relationship of trauma and comorbid PTSS to the self-perceived negative impact of EBP on daily functioning. Methods: Participants were 729 Sri Lankan adolescents (age 12 to 16 years; 54.9% female) living in areas impacted in varying degrees by the 2004 tsunami. In 2008, school-based screening was conducted and completed measures of, trauma exposure, PTSS, EBP, and related functional impairment. Results: Participants reported a high prevalence of trauma exposure (n = 438), including interpersonal violence (n = 155). DSM-IV criteria for full or partial PTSD were met by 23.7% of the trauma-exposed sample. Across all participants, 13.4% and 16.7% displayed clinically relevant levels of EBP and functional impairment, respectively. Among the trauma-exposed, 7% met criteria for both EBP and PTSD. EBP total scores and caseness were significantly higher in trauma-exposed adolescents with PTSD than in either those without PTSD or the non-traumatized control group. In subscale analysis, higher prevalence of serious emotional, conduct, and hyperactivity problems were reported in the PTSD positive group; the PTSD negative group did not differ significantly from the control group on any of the problem scales. In regression analyses, PTSS (β = .28, p < .001) and interpersonal violence (β = .13, p = .033) were significant predictors of EBP, cumulative trauma (β = .11, p = .076) showed no significant effect. Further, PTSS exacerbated the impact of EBP on daily functioning (β = 0.29, p = .023). Conclusion: PTSS were closely linked to EBP in adolescents, even years after the traumatic experience. PTSD and emotional and behavioral problems together pose a heightened risk for impaired daily functioning. Longitudinal studies are needed to clarify the causal pathway.

Keywords: adolescents, comorbidity, emotional and behavioral problems, functional impairment, posttraumatic stress, traumatic events

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2103 Public Squares and Their Potential for Social Interactions: A Case Study of Historical Public Squares in Tehran

Authors: Asma Mehan

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Under the thrust of technological changes, population growth and vehicular traffic, Iranian historical squares have lost their significance and they are no longer the main social nodes of the society. This research focuses on how historical public squares can inspire designers to enhance social interactions among citizens in Iranian urban context. Moreover, the recent master plan of Tehran demonstrates the lack of public spaces designed for the purpose of people’s social gatherings. For filling this gap, first the current situation of 7 selected primary historical public squares in Tehran including Sabze Meydan, Arg, Topkhaneh, Baherstan, Mokhber-al-dole, Rah Ahan and Hassan Abad have been compared. Later, the influencing elements on social interactions of the public squares such as subjective factors (human relationships and memories) and objective factors (natural and built environment) have been investigated. As a conclusion, some strategies are proposed for improving social interactions in historical public squares like; holding cultural, national, athletic and religious events, defining different and new functions in public squares’ surrounding, increasing pedestrian routs, reviving the collective memory, demonstrating the historical importance of square, eliminating visual obstacles across the square, organization the natural elements of the square, appropriate pavement for social activities. Finally, it is argued that the combination of all influencing factors which are: human interactions, natural elements and built environment criteria will lead to enhance the historical public squares’ potential for social interaction.

Keywords: historical square, Iranian public square, social interaction, Tehran

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2102 Clarifying the Possible Symptomatic Pathway of Comorbid Depression, Anxiety, and Stress Among Adolescents Exposed to Childhood Trauma: Insight from the Network Approach

Authors: Xinyuan Zou, Qihui Tang, Shujian Wang, Yulin Huang, Jie Gui, Xiangping Liu, Gang Liu, Yanqiang Tao

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Childhood trauma can have a long-lasting influence on individuals and contribute to mental disorders, including depression and anxiety. The current study aimed to explore the symptomatic and developmental patterns of depression, anxiety, and stress among adolescents who have suffered from childhood trauma. A total of 3,598 college students (female = 1,617 (44.94%), Mean Age = 19.68, SD Age = 1.35) in China completed the Childhood Trauma Questionnaire (CTQ) and the Depression, Anxiety, and Stress Scales (DASS-21), and 2,337 participants met the selection standard based on the cut-off scores of the CTQ. The symptomatic network and directed acyclic graph (DAG) network approaches were used. The results revealed that males reported experiencing significantly more physical abuse, physical neglect, emotional neglect, and sexual abuse compared to females. However, females scored significantly higher than males on all items of DASS-21, except for “Worthless”. No significant difference between the two genders was observed in the network structure and global strength. Meanwhile, among all participants, “Down-hearted” and “Agitated” appeared to be the most interconnected symptoms, the bridge symptoms in the symptom network, as well as the most vital symptoms in the DAG network. Apart from that, “No-relax” also served as the most prominent symptom in the DAG network. The results suggested that intervention targeted at assisting adolescents in developing more adaptive coping strategies with stress and regulating emotion could benefit the alleviation of comorbid depression, anxiety, and stress.

Keywords: symptom network, childhood trauma, depression, anxiety, stress

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2101 Relationship between the Development of Sepsis, Systemic Inflammatory Response Syndrome and Body Mass Index among Adult Trauma Patients at University Hospital in Cairo

Authors: Mohamed Hendawy Mousa, Warda Youssef Mohamed Morsy

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Background: Sepsis is a major cause of mortality and morbidity in trauma patients. Body mass index as an indicator of nutritional status was reported as a predictor of injury pattern and complications among critically ill injured patients. Aim: The aim of this study is to investigate the relationship between body mass index and the development of sepsis, systemic inflammatory response syndrome among adult trauma patients at emergency hospital - Cairo University. Research design: Descriptive correlational research design was utilized in the current study. Research questions: Q1. What is the body mass index profile of adult trauma patients admitted to the emergency hospital at Cairo University over a period of 6 months?, Q2. What is the frequency of systemic inflammatory response syndrome and sepsis among adult trauma patients admitted to the emergency hospital at Cairo University over a period of 6 months?, and Q3. What is the relationship between the development of sepsis, systemic inflammatory response syndrome and body mass index among adult trauma patients admitted to the emergency hospital at Cairo University over a period of 6 months?. Sample: A purposive sample of 52 adult male and female trauma patients with revised trauma score 10 to 12. Setting: The Emergency Hospital affiliated to Cairo University. Tools: Four tools were utilized to collect data pertinent to the study: Socio demographic and medical data tool, Systemic inflammatory response syndrome assessment tool, Revised Trauma Score tool, and Sequential organ failure assessment tool. Results: The current study revealed that, (61.5 %) of the studied subjects had normal body mass index, (25 %) were overweight, and (13.5 %) were underweight. 84.6% of the studied subjects had systemic inflammatory response syndrome and 92.3% were suffering from mild sepsis. No significant statistical relationship was found between body mass index and occurrence of Systemic inflammatory response syndrome (2= 2.89 & P = 0.23). However, Sequential organ failure assessment scores were affected significantly by body mass index was found mean of initial and last Sequential organ failure assessment score for underweight, normal and obese where t= 7.24 at p = 0.000, t= 16.49 at p = 0.000 and t= 9.80 at p = 0.000 respectively. Conclusion: Underweight trauma patients showed significantly higher rate of developing sepsis as compared to patients with normal body weight and obese. Recommendations: based on finding of this study the following are recommended: replication of the study on a larger probability sample from different geographical locations in Egypt; Carrying out of further studies in order to assess the other risk factors influencing trauma outcome and incidence of its complications; Establishment of standardized guidelines for managing underweight traumatized patients with sepsis.

Keywords: body mass index, sepsis, systemic inflammatory response syndrome, adult trauma

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2100 The Use of Venous Glucose, Serum Lactate and Base Deficit as Biochemical Predictors of Mortality in Polytraumatized Patients: Acomparative with Trauma and Injury Severity Score and Acute Physiology and Chronic Health Evalution IV

Authors: Osama Moustafa Zayed

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Aim of the work: To evaluate the effectiveness of venous glucose, levels of serum lactate and base deficit in polytraumatized patients as simple parameters to predict the mortality in these patients. Compared to the predictive value of Trauma and injury severity (TRISS) and Acute Physiology And Chronic Health Evaluation IV (APACHE IV). Introduction: Trauma is a serious global health problem, accounting for approximately one in 10 deaths worldwide. Trauma accounts for 5 million deaths per year. Prediction of mortality in trauma patients is an important part of trauma care. Several trauma scores have been devised to predict injury severity and risk of mortality. The trauma and injury severity score (TRISS) was most common used. Regardless of the accuracy of trauma scores, is based on an anatomical description of every injury and cannot be assigned to the patients until a full diagnostic procedure has been performed. So we hypothesized that alterations in admission glucose, lactate levels and base deficit would be an early and easy rapid predictor of mortality. Patient and Method: a comparative cross-sectional study. 282 Polytraumatized patients attended to the Emergency Department(ED) of the Suez Canal university Hospital constituted. The period from 1/1/2012 to 1/4/2013 was included. Results: We found that the best cut off value of TRISS probability of survival score for prediction of mortality among poly-traumatized patients is = 90, with 77% sensitivity and 89% specificity using area under the ROC curve (0.89) at (95%CI). APACHE IV demonstrated 67% sensitivity and 95% specificity at 95% CI at cut off point 99. The best cutoff value of Random Blood Sugar (RBS) for prediction of mortality was>140 mg/dl, with 89%, sensitivity, 49% specificity. The best cut off value of base deficit for prediction of mortality was less than -5.6 with 64% sensitivity, 93% specificity. The best cutoff point of lactate for prediction of mortality was > 2.6 mmol/L with 92%, sensitivity, 42% specificity. Conclusion: According to our results from all evaluated predictors of mortality (laboratory and scores) and mortality based on the estimated cutoff values using ROC curves analysis, the highest risk of mortality was found using a cutoff value of 90 in TRISS score while with laboratory parameters the highest risk of mortality was with serum lactate > 2.6 . Although that all of the three parameter are accurate in predicting mortality in poly-traumatized patients and near with each other, as in serum lactate the area under the curve 0.82, in BD 0.79 and 0.77 in RBS.

Keywords: APACHE IV, emergency department, polytraumatized patients, serum lactate

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2099 Remembrance and Mourning: Taking the History of Poetry and on the Burning of the Old Summer Palace by the Anglo-French Forces as the Core of the Research

Authors: Wang Hsiao-Wen

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This paper is based on the burning of the Old Summer Palace by the Anglo-French forces. The Old Summer Palace, Yuanmingyuan, is an imperial garden located outside Beijing, but it was looted and burned down by the Anglo-French troops. Hundreds of guards died, and Emperor Xianfeng also fled from the back door to the Chengde Mountain Resort in a hurry. It is a very shameful piece of Chinese imperial history. At that time, it was well known that the capital was almost occupied. However, the detailed process of the whole incident and the subsequent accountability was regarded as a national shame, which was omitted in the historical records and rarely mentioned by scholars, especially under the rulings of Xianfeng and Tongzhi. Due to this, the researcher explored how the incident was documented in historical poetry and how the war was recalled and evaluated from different perspectives so that rich and diverse historical interpretations can be constructed. The issues explored and discussed in this paper are divided into two parts: (i) the historical writing of the Incident in Gengshen Year, which mainly focuses on the Historical Poetry on the Burning of the Old Summer Palace by the Anglo-French forces, and (ii) the different identities of poets and their perspectives of mourning, which leads to the homogeneity or heterogeneity of their interpretations.

Keywords: Anglo-French expedition to China, the Incident in Gengshen Year, burning of the Old Summer Palace, historical poetry

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2098 Factors Associated with Acute Kidney Injury in Multiple Trauma Patients with Rhabdomyolysis

Authors: Yong Hwang, Kang Yeol Suh, Yundeok Jang, Tae Hoon Kim

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Introduction: Rhabdomyolysis is a syndrome characterized by muscle necrosis and the release of intracellular muscle constituents into the circulation. Acute kidney injury is a potential complication of severe rhabdomyolysis and the prognosis is substantially worse if renal failure develops. We try to identify the factors that were predictive of AKI in severe trauma patients with rhabdomyolysis. Methods: This retrospective study was conducted at the emergency department of a level Ⅰ trauma center. Patients enrolled that initial creatine phosphokinase (CPK) levels were higher than 1000 IU with acute multiple trauma, and more than 18 years older from Oct. 2012 to June 2016. We collected demographic data (age, gender, length of hospital day, and patients’ outcome), laboratory data (ABGA, lactate, hemoglobin. hematocrit, platelet, LDH, myoglobin, liver enzyme, and BUN/Cr), and clinical data (Injury Mechanism, RTS, ISS, AIS, and TRISS). The data were compared and analyzed between AKI and Non-AKI group. Statistical analyses were performed using IMB SPSS 20.0 statistics for Window. Results: Three hundred sixty-four patients were enrolled that AKI group were ninety-six and non-AKI group were two hundred sixty-eight. The base excess (HCO3), AST/ALT, LDH, and myoglobin in AKI group were significantly higher than non-AKI group from laboratory data (p ≤ 0.05). The injury severity score (ISS), revised Trauma Score (RTS), Abbreviated Injury Scale 3 and 4 (AIS 3 and 4) were showed significant results in clinical data. The patterns of CPK level were increased from first and second day, but slightly decreased from third day in both group. Seven patients had received hemodialysis treatment despite the bleeding risk and were survived in AKI group. Conclusion: We recommend that HCO3, CPK, LDH, and myoglobin should be checked and be concerned about ISS, RTS, AIS with injury mechanism at the early stage of treatment in the emergency department.

Keywords: acute kidney injury, emergencies, multiple trauma, rhabdomyolysis

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2097 Reinvestment of the Urban Context in Historic Cities: The Case Study of El Sheikh Kandil Street, Rosetta, Egypt

Authors: Riham A. Ragheb, Ingy M. Naguib

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Conservation and urban investment are a prerequisite to improve the quality of life. Since the historic street is a part of the economic system, it should be able to play an important role in the city development by upgrading all services, public open spaces and reuse of historical buildings and sites. Furthermore, historical conservation enriches the political, economic, social, cultural and functional aspects of the site. Rosetta has been selected as an area of study because it has a unique character due to its possession of a variety of monuments and historical buildings. The aim of this research is to analyze the existing situation of an historic street named El Sheikh Kandil, to be able to identify the potentials and problems. The paper gives a proposal for the redesign and reinvestment of the street and the reuse for the historical buildings to serve the community, users and visitors. Then, it concludes with recommendations to improve quality of life through the rehabilitation of the historical buildings and strengthening of the cultural and historical identity of the street. Rosetta city can benefit from these development proposals by preserving and revitalizing its unique character which leads to tourism development and benefits from the new investments.

Keywords: adaptive reuse, heritage street, historic investment, restoration, urban design

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2096 Words Spotting in the Images Handwritten Historical Documents

Authors: Issam Ben Jami

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Information retrieval in digital libraries is very important because most famous historical documents occupy a significant value. The word spotting in historical documents is a very difficult notion, because automatic recognition of such documents is naturally cursive, it represents a wide variability in the level scale and translation words in the same documents. We first present a system for the automatic recognition, based on the extraction of interest points words from the image model. The extraction phase of the key points is chosen from the representation of the image as a synthetic description of the shape recognition in a multidimensional space. As a result, we use advanced methods that can find and describe interesting points invariant to scale, rotation and lighting which are linked to local configurations of pixels. We test this approach on documents of the 15th century. Our experiments give important results.

Keywords: feature matching, historical documents, pattern recognition, word spotting

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2095 Time to CT in Major Trauma in Coffs Harbour Health Campus - The Australian Rural Centre Experience

Authors: Thampi Rawther, Jack Cecire, Andrew Sutherland

Abstract:

Introduction: CT facilitates the diagnosis of potentially life-threatening injuries and facilitates early management. There is evidence that reduced CT acquisition time reduces mortality and length of hospital stay. Currently, there are variable recommendations for ideal timing. Indeed, the NHS standard contract for a major trauma service and STAG both recommend immediate access to CT within a maximum time of 60min and appropriate reporting within 60min of the scan. At Coffs Harbour Health Campus (CHHC), a CT radiographer is on site between 8am-11pm. Aim: To investigate the average time to CT at CHHC and assess for any significant relationship between time to CT and injury severity score (ISS) or time of triage. Method: All major trauma calls between Jan 2021-Oct 2021 were audited (N=87). Patients were excluded if they went from ED to the theatre. Time to CT is defined as the time between triage to the timestamp on the first CT image. Median and interquartile range was used as a measure of central tendency as the data was not normally distributed, and Chi-square test was used to determine association. Results: The median time to CT is 51.5min (IQR 40-74). We found no relationship between time to CT and ISS (P=0.18) and time of triage to time to CT (P=0.35). We compared this to other centres such as John Hunter Hospital and Gold Coast Hospital. We found that the median CT acquisition times were 76min (IQR 52-115) and 43min, respectively. Conclusion: This shows an avenue for improvement given 35% of CT’s were >30min. Furthermore, being proactive and aware of time to CT as an important factor to trauma management can be another avenue for improvement. Based on this, we will re-audit in 12-24months to assess if any improvement has been made.

Keywords: imaging, rural surgery, trauma surgery, improvement

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2094 Research on the Landscape of Xi'an Ancient City Based on the Poetry Text of Tang Dynasty

Authors: Yihui Zou

Abstract:

The integration of the traditional landscape of the ancient city and the poet's emotions and symbolization into ancient poetry is the unique cultural gene and spiritual core of the historical city, and re-understanding the historical landscape pattern from the poetry is conducive to continuing the historical city context and improving the current situation of the gradual decline of the poetry of the modern historical urban landscape. Starting from Tang poetry, using semantic analysis methods combined with text mining technology, entry mining, word frequency analysis, and cluster analysis of the landscape information of Tang Chang'an City were carried out, and the method framework for analyzing the urban landscape form based on poetry text was constructed. Nearly 160 poems describing the landscape of Tang Chang'an City were screened, and the poetic landscape characteristics of Tang Chang'an City were sorted out locally in order to combine with modern urban spatial development to continue the urban spatial context.

Keywords: Tang Chang'an City, poetic texts, semantic analysis, historical landscape

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2093 Automatic Processing of Trauma-Related Visual Stimuli in Female Patients Suffering From Post-Traumatic Stress Disorder after Interpersonal Traumatization

Authors: Theresa Slump, Paula Neumeister, Katharina Feldker, Carina Y. Heitmann, Thomas Straube

Abstract:

A characteristic feature of post-traumatic stress disorder (PTSD) is the automatic processing of disorder-specific stimuli that expresses itself in intrusive symptoms such as intense physical and psychological reactions to trauma-associated stimuli. That automatic processing plays an essential role in the development and maintenance of symptoms. The aim of our study was, therefore, to investigate the behavioral and neural correlates of automatic processing of trauma-related stimuli in PTSD. Although interpersonal traumatization is a form of traumatization that often occurs, it has not yet been sufficiently studied. That is why, in our study, we focused on patients suffering from interpersonal traumatization. While previous imaging studies on PTSD mainly used faces, words, or generally negative visual stimuli, our study presented complex trauma-related and neutral visual scenes. We examined 19 female subjects suffering from PTSD and examined 19 healthy women as a control group. All subjects did a geometric comparison task while lying in a functional-magnetic-resonance-imaging (fMRI) scanner. Trauma-related scenes and neutral visual scenes that were not relevant to the task were presented while the subjects were doing the task. Regarding the behavioral level, there were not any significant differences between the task performance of the two groups. Regarding the neural level, the PTSD patients showed significant hyperactivation of the hippocampus for task-irrelevant trauma-related stimuli versus neutral stimuli when compared with healthy control subjects. Connectivity analyses revealed altered connectivity between the hippocampus and other anxiety-related areas in PTSD patients, too. Overall, those findings suggest that fear-related areas are involved in PTSD patients' processing of trauma-related stimuli even if the stimuli that were used in the study were task-irrelevant.

Keywords: post-traumatic stress disorder, automatic processing, hippocampus, functional magnetic resonance imaging

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2092 Knowledge, Attitudes, and Practices of Army Soldiers on Prehospital Trauma Care in Matara District

Authors: Hatharasinghe Liyanage Saneetha Chathaurika, Shreenika De Silva Weliange

Abstract:

Background and Significance of the Study: Natural and human-induced disasters have become more common due to rapid development and climate change. Therefore hospitalization due to injuries has increased in the midst of advancement in medicine. Prehospital trauma care is critical in reducing morbidity and mortality following injury. Army soldiers are one of the first responder categories after a major disaster causing injury. Thus, basic life support measures taken by trained lay first responders is life-saving, it is important to build up their capacities by updating their knowledge and practices while cultivating positive attitudes toward it. Objective: To describe knowledge, attitudes and practices on prehospital trauma care among army soldiers in Matara District. Methodology: A descriptive cross sectional study was carried out among army soldiers in Matara district. The whole population was studied belonging to the above group during the study period. Self-administered questionnaire was used as the study instrument. Cross tabulations were done to identify the possible associations using chi square statistics. Knowledge and practices were categorized in to two groups as “Poor” and “Good” taking 50% as the cut off. Results: The study population consists of 266 participants (response rate 97.79%).The overall level of knowledge on prehospital trauma care is poor (78.6%) while knowledge on golden hour of trauma (77.1%), triage system (74.4%), cardio pulmonary resuscitation (92.5%) and transportation of patients with spinal cord injury (69.2%) was markedly poor. Good knowledge is significantly associated with advance age, higher income and higher level of education whereas it has no significant association with work duration. More than 80% of them had positive attitudes on most aspects of prehospital trauma care while majority thinks it is good to have knowledge on this topic and they would have performed better in disaster situations if they were trained on pre-hospital trauma care. With regard to the practice, majority (62.8%) is included in the group of poor level of practice. They lack practice on first-aid, cardiopulmonary resuscitation and safe transportation of the patients. Moreover, they had less opportunity to participate in drills/simulation programs done on disaster events. Good practice is significantly associated with advance age and higher level of education but not associated with level of income and working duration of army soldiers. Highly significant association was observed between the level of knowledge and level of practice on prehospital trauma care of army soldiers. It is observed that higher the knowledge practices become better. Conclusion: A higher proportion of army soldiers had poor knowledge and practice on prehospital trauma care while majority had positive attitudes regarding it. Majority lacks knowledge and practice in first-aid and cardiopulmonary resuscitation. Due to significant association observed between knowledge and practice it can be recommended to include a training session on prehospital trauma care in the basic military curriculum which will enhance the ability to act as first responders effectively. Further research is needed in this area of prehospital trauma care to enhance the qualitative outcome.

Keywords: disaster, prehospital trauma care, first responders, army soldiers

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2091 Impact of Mucormycosis Infection In Limb Salvage for Trauma Patients

Authors: Katie-Beth Webster

Abstract:

Mucormycosis is a rare opportunistic fungal infection that, if left untreated, can cause large scale tissue necrosis and death. There are a number of cases of this in the literature, most commonly in the head and neck region arising from sinuses. It is also usually found in immunocompromised patient subgroups. This study reviewed a number of cases of mucormycosis in previously fit and healthy young trauma patients to assess predisposing factors for infection and adequacy of current treatment paradigms. These trauma patients likely contracted the fungal infection from the soil at the site of the incident. Despite early washout and debridement of the wounds at the scene of the injury and on arrival in hospital, both these patients contracted mucormycosis. It was suspected that inadequate early debridement of soil contaminated limbs was one of the major factors that can lead to catastrophic tissue necrosis. In both cases, this resulted in the patients having a higher level of amputation than would have initially been required based on the level of their injury. This was secondary to cutaneous and soft tissue necrosis secondary to the fungal infiltration leading to osteomyelitis and systemic sepsis. In the literature, it appears diagnosis is often protracted in this condition secondary to inadequate early treatment and long processing times for fungal cultures. If fungal cultures were sent at the time of first assessment and adequate debridements are performed aggressively early, it could lead to these critically unwell trauma patients receiving appropriate antifungal and surgical treatment earlier in their episode of care. This is likely to improve long term outcomes for these patients.

Keywords: mucormycosis, plastic surgery, osteomyelitis, trauma

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2090 Energy Saving, Heritage Conserving Renovation Methods in Case of Historical Building Stock

Authors: Viktória Sugár, Zoltán Laczó, András Horkai, Gyula Kiss, Attila Talamon

Abstract:

The majority of the building stock of Budapest inner districts was built around the turn of the 19th and 20th century. Although the structural stability of the buildings is not questioned, as the load bearing structures are in sufficient state, the secondary structures are aged, resulting unsatisfactory energetic state. The renovation of these historical buildings requires special methodology and technology: their ornamented facades and custom-made fenestration cannot be insulated or exchanged with conventional solutions without damaging the heritage values. The present paper aims to introduce and systematize the possible technological solutions for heritage respecting energy retrofit in case of a historical residential building stock. Through case study, the possible energy saving potential is also calculated using multiple renovation scenarios.

Keywords: energy efficiency, heritage, historical building, renovation

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2089 Secondary Traumatic Stress and Related Factors in Australian Social Workers and Psychologists

Authors: Cindy Davis, Samantha Rayner

Abstract:

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

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2088 Systems Contextual Integrated Model for Clinical Psychology and Social Work

Authors: Raymond C. Hawkins II, Catherine A. Hawkins

Abstract:

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

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2087 The Future Shrouded by the Ghost of History: Palestinian Science Fiction "The Key"

Authors: KongQue

Abstract:

Palestinian novelist Anwar Hamed’s work "The Key" is a science fiction that profoundly metaphors the Palestinian issue. In the novel, Anwar Hamed uses the "key", a popular symbol of Palestinian resistance culture, to symbolize the history of "Nakba" and the Palestinians' right to return, and uses the ghost lingering outside the door of the Israelis as a metaphor Palestinians and the Palestinian issue, for being covered, hidden, and turned a blind eye. Through the literary genre of science fiction, Anwar Hamed continues the literary tradition of Palestinian writers recreating the historical trauma of the Palestinians, explores the causes of the inability to communicate between Palestine and Israel, and attempts to reawaken concern over the plight of Palestinian refugees.

Keywords: palestine, key, science fiction, arabic literature

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