Search results for: trauma recovery

Authors: Ashleigh Cicconi

Abstract:

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

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

Procedia PDF Downloads 30

Authors: Alexandra Sweny

Abstract:

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

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

Procedia PDF Downloads 124

Authors: Kemal Comakli, Meryem Terhan

Abstract:

In this study, the potential of heat recovery from waste flue gas was examined in 60 MW district heating system of a university, and fuel saving was aimed by using the recovered heat in the system as a source again. Various scenarios are intended to make use of waste heat. For this purpose, actual operation data of the system were taken. Besides, the heat recovery units that consist of heat exchangers such as flue gas condensers, economizers or air pre-heaters were designed theoretically for each scenario. Energy analysis of natural gas-fired boiler’s exhaust flue gas in the system, and economic analysis of heat recovery units to predict payback periods were done. According to calculation results, the waste heat loss ratio from boiler flue gas in the system was obtained as average 16%. Thanks to the heat recovery units, thermal efficiency of the system can be increased, and fuel saving can be provided. At the same time, a huge amount of green gas emission can be decreased by installing the heat recovery units.

Keywords: heat recovery from flue gas, energy analysis of flue gas, economical analysis, payback period

Procedia PDF Downloads 264

Authors: Ahmeda Ali, Mary Codd, Susan Brundage

Abstract:

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

Keywords: trauma, education, management, system

Procedia PDF Downloads 227

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

Abstract:

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

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

Procedia PDF Downloads 41

Authors: Sarita Magu, Deepak Singh

Abstract:

Study Design: This prospective study was conducted at the department of Radio Diagnosis, at Pt B.D. Sharma PGIMS, Rohtak in 57 patients of spine injury on radiographs or radiographically normal patients with neurological deficits presenting within 72 hours of injury. Aims: Evaluation of the role of Magnetic Resonance Imaging (MRI) in Spinal Trauma Patients and to compare MRI findings with clinical profile and neurological status of the patient and to correlate the MRI findings with neurological recovery of the patient and predict the outcome. Material and Methods: Neurological status of patients was assessed at the time of admission and discharge in all the patients and at long term interval of six months to one year in 27 patients as per American spine injury association classification (ASIA). On MRI cord injury was categorized into cord hemorrhage, cord contusion, cord edema only, and normal cord. Quantitative assessment of injury on MRI was done using mean canal compromise (MCC), mean spinal cord compression (MSCC) and lesion length. Neurological status at admission and neurological recovery at discharge and long term follow up was compared with various qualitative cord findings and quantitative parameters on MRI. Results: Cord edema and normal cord was associated with favorable neurological outcome. Cord contusion show lesser neurological recovery as compared to cord edema. Cord hemorrhage was associated with worst neurological status at admission and poor neurological recovery. Mean MCC, MSCC, and lesion length values were higher in patients presenting with ASIA A grade injury and showed decreasing trends towards ASIA E grade injury. Patients showing neurological recovery over the period of hospital stay and long term follow up had lower mean MCC, MSCC, and lesion length as compared to patients showing no neurological recovery. The data was statistically significant with p value <.05. Conclusion: Cord hemorrhage and higher MCC, MSCC and lesion length has poor prognostic value in spine injury patients.

Keywords: spine injury, cord hemorrhage, cord contusion, MCC, MSCC, lesion length, ASIA grading

Procedia PDF Downloads 330

Authors: Tugba Altin

Abstract:

In an era marked by pronounced climate change consequences, communities are observed to confront traumatic events that yield both tangible and intangible repercussions. Such events not only cause discernible damage to the landscape but also deeply affect the intangible aspects, including emotional distress and disruptions to cultural landscapes. The Lytton Creek Fire of 2021 serves as a case in point. Beyond the visible destruction, the less overt but profoundly impactful disturbance to place attachment (PA) is scrutinized. PA, representing the emotional and cognitive bonds individuals establish with their environments, is crucial for understanding how such events impact cultural identity and connection to the land. The study underscores the significance of addressing both tangible and intangible traumas for holistic community recovery. As communities renegotiate their affiliations with altered environments, the cultural landscape emerges as instrumental in shaping place-based identities. This renewed understanding is pivotal for reshaping adaptation planning. The research advocates for adaptation strategies rooted in the lived experiences and testimonies of the affected populations. By incorporating both the tangible and intangible facets of trauma, planning efforts are suggested to be more culturally attuned and emotionally insightful, fostering true resonance with the affected communities. Through such a comprehensive lens, this study contributes enriching the climate change discourse, emphasizing the intertwined nature of tangible recovery and the imperative of emotional and cultural healing after environmental disasters. Following the pronounced aftermath of the Lytton Creek Fire in 2021, research aims to deeply understand its impact on place attachment (PA), encompassing the emotional and cognitive bonds individuals form with their environments. The interpretive phenomenological approach, enriched by a hermeneutic framework, is adopted, emphasizing the experiences of the Lytton community and co-researchers. Phenomenology informed the understanding of 'place' as the focal point of attachment, providing insights into its formation and evolution after traumatic events. Data collection departs from conventional methods. Instead of traditional interviews, walking audio sessions and photo elicitation methods are utilized. These allow co-researchers to immerse themselves in the environment, re-experience, and articulate memories and feelings in real-time. Walking audio facilitates reflections on spatial narratives post-trauma, while photo voices captured intangible emotions, enabling the visualization of place-based experiences. The analysis is collaborative, ensuring the co-researchers' experiences and interpretations are central. Emphasizing their agency in knowledge production, the process is rigorous, facilitated by the harmonious blend of interpretive phenomenology and hermeneutic insights. The findings underscore the need for adaptation and recovery efforts to address emotional traumas alongside tangible damages. By exploring PA post-disaster, the research not only fills a significant gap but advocates for an inclusive approach to community recovery. Furthermore, the participatory methodologies employed challenge traditional research paradigms, heralding potential shifts in qualitative research norms.

Keywords: wildfire recovery, place attachment, trauma recovery, cultural landscape, visual methodologies

Procedia PDF Downloads 51

Authors: Julie A. LaRose

Abstract:

Native American youth, ages 10-24, have the highest rate of suicide in the United States. The hopelessness experienced by the native American youth is linked to psychosocial reasons more than biological or intrapsychic reasons. Two significant social determinants of health that diminish their hope include historical trauma and cultural loss. Intergenerational grief is caused by historical trauma from hundreds of years of colonization, broken treaties, and forced migration, leading to land, resources, and sovereignty loss. Forced acculturation through boarding schools that native children were required to attend led to the loss of traditions and culture. The result is hopelessness. This paper reviewed peer-reviewed research literature, government reports, non-government organizations reports, and video and written publications by Native Americans. Building hope through healing historical trauma and embracing cultural traditions may reduce suicide rates among Native American youth.

Keywords: culture loss, historical trauma, Native American, suicide, suicide rates

Procedia PDF Downloads 101

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

Abstract:

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

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

Procedia PDF Downloads 172

Authors: Abdullah Alsaeed

Abstract:

Virtualized computing and cloud computing infrastructures are no longer fuzz or marketing term. They are a core reality in today’s corporate Information Technology (IT) organizations. Hence, developing an effective and efficient methodologies for data backup and data recovery is required more than any time. The purpose of data backup and recovery techniques are to assist the organizations to strategize the business continuity and disaster recovery approaches. In order to accomplish this strategic objective, a variety of mechanism were proposed in the recent years. This research paper will explore and examine the latest techniques and solutions to provide data backup and restoration for the cloud computing platforms.

Keywords: data backup, data recovery, cloud computing, business continuity, disaster recovery, cost-effective, data encryption.

Procedia PDF Downloads 59

Authors: Christopher Wearmouth, Jacob Smith

Abstract:

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

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

Procedia PDF Downloads 204

Authors: Suzanne L. Stewart, Mikaela D. Gabriel

Abstract:

Background: Indigenous People face multiple barriers to successful life transitions, including housing, employment, education, and health. Current statistical trends paint devastating life transitions for Indigenous Peoples, but colonization and its intergenerational impacts are typically lacking as the crucial context in which these trends occur. This presentation will illustrate the massive impact of colonization on Indigenous Peoples; its intergenerational transmission, and how it impacts Indigenous clients seeking mental health treatment today. Methods: A qualitative, narrative inquiry methodology was used to honour Indigenous storytelling and knowledge transmission. Indigenous Elders, outreach workers, and homeless clients were interviewed and narratively analyzed for in-depth trends and themes. Impact: This research provides a wealth of in-depth information as to the life transition needs of Indigenous clients, identify the systemic impacts of colonization to the health and wellbeing of Indigenous People, and strategies for mental health treatment.

Keywords: indigenous trauma, indigenous peoples of canada, intergenerational trauma, colonial trauma and treatment

Procedia PDF Downloads 161

Authors: Abdul Basit, Gildas Lhostis, Bernard Durand

Abstract:

Shape memory polymers (SMPs) are replacing shape memory alloys (SMAs) in many applications as SMPs have certain superior properties than SMAs. However, SMAs possess some properties like recovery under stress that SMPs lack. SMPs cannot give complete recovery even under a small load. SMPs are initially heated close to their transition temperature (glass transition temperature or the melting temperature). Then force is applied to deform the heated SMP to a specific position. Subsequently, SMP is allowed to cool keeping it deformed. After cooling, SMP gets the temporary shape. This temporary shape can be recovered by heating it again at the same temperature that was given it while heating it initially. As a result, it will recover its original position. SMP can perform unconstrained recovery and constrained recovery, however; under the load, it only recovers partially. In this work, the recovery under the load of an asymmetrical shape memory composite called as CBCM-SMPC has been investigated. It is found that it has the ability to recover under different loads. Under different loads, it shows powerful complete recovery in reference to initial position. This property can be utilized in many applications.

Keywords: shape memory, polymer composite, thermo-mechanical testing, recovery under load

Procedia PDF Downloads 405

Authors: Imas Istiani

Abstract:

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

Keywords: trauma, healing, home, trauma theory

Procedia PDF Downloads 221

Authors: Vartan Agopian

Abstract:

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

Keywords: children, music, refugees, Syria, war

Procedia PDF Downloads 248

Authors: Samet Aktaş, Nurtekin Erkmen, Faruk Guven, Halil Taskin

Abstract:

This study aimed to determine the effects of 3 versus 3 small-sided games (SSG) with different recovery times on soma physiological parameters in soccer players. Twelve soccer players from Regional Amateur League volunteered for this study (mean±SD age, 20.50±2.43 years; height, 177.73±4.13 cm; weight, 70.83±8.38 kg). Subjects were performing soccer training for five days per week. The protocol of the study was approved by the local ethic committee in School of Physical Education and Sport, Selcuk University. The subjects were divided into teams with 3 players according to Yo-Yo Intermittent Recovery Test. The field dimension was 26 m wide and 34 m in length. Subjects performed two times in a random order a series of 3 bouts of 3-a-side SSGs with 3 min and 5 min recovery durations. In SSGs, each set were performed with 6 min duration. The percent of maximal heart rate (% HRmax), blood lactate concentration (LA) and Rated Perceived Exertion (RPE) scale points were collected before the SSGs and at the end of each set. Data were analyzed by analysis of variance (ANOVA) with repeated measures. Significant differences were found between %HRmax in before SSG and 1st set, 2nd set, and 3rd set in both SSG with 3 min recovery duration and SSG with 5 min recovery duration (p<0.05). Means of %HRmax in SSG with 3 min recovery duration at both 1st and 2nd sets were significantly higher than SSG with 5 min recovery duration (p<0.05). No significant difference was found between sets of either SSGs in terms of LA (p>0.05). LA in SSG with 3 min recovery duration was higher than SSG with 5 min recovery duration at 2nd sets (p<0.05). RPE in soccer players was not different between SSGs (p>0.05).In conclusion, this study demonstrates that exercise intensity in SSG with 3 min recovery durations is higher than SSG with 5 min recovery durations.

Keywords: small-sided games, soccer, heart rate, lactate

Procedia PDF Downloads 437

Authors: Debra L. Stanley, Gabriela Wasileski

Abstract:

Offenders face many challenges as they transition from being incarcerated to the community, ranging from housing and employment needs to long standing problems with addictions and mental health issues. A lack of appropriate behavioral health services in the more remote parts of the United States has led to a significant illegal substance abuse problem, housing instability, and unaddressed mental health and trauma issues. High rates of poverty and unemployment exacerbate the growing behavioral health issues, drug overdoses, co-occurring disorders, and crime that are so prevalent across rural communities. This study examines the challenges of rural jail reentry faced by offenders in a treatment capacity. The client-centered evidence-based program is uniquely designed to provide continuity of care that focuses on issues which affect rural communities. Prior to release from jail, individuals go through comprehensive assessment screenings to measure mental health and substance use disorder as well as trauma and prior crime victimization histories; the assessments help to target client-specific services. The quasi-experimental research design tracks clients throughout their recovery and reintegration into the community. Individuals in a rural program often do not have the benefit of easy access or peer mentoring that is so often found in urban recovery programs. Therefore, much of the support is provided through telehealth and e-services. The goal of this study is to explore the nature of rural reentry programs and measures of recidivism, drug overdoses, and other behavioral health needs and successful reentry to include stable housing and employment.

Keywords: jail reentry, rehabilitation, behavioral health, drug abuse, recidivism

Procedia PDF Downloads 66

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

Abstract:

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

Keywords: trauma, coagulopathy, prediction, model

Procedia PDF Downloads 155

Authors: Chaiyaporn Yuksen, Tapanawat Chaiwan

Abstract:

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

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

Procedia PDF Downloads 97

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

Abstract:

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

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

Procedia PDF Downloads 389

Authors: Surajbhan Sevda

Abstract:

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

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

Procedia PDF Downloads 191

Authors: Nina Kaufmans

Abstract:

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

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

Procedia PDF Downloads 58

Authors: Gabriela Macera DiFilippo

Abstract:

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

Keywords: trauma, children, black psychology, students

Procedia PDF Downloads 27

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

Abstract:

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

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

Procedia PDF Downloads 368

Authors: Zakaria Hamdi, Mariyamni Awang

Abstract:

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

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

Procedia PDF Downloads 322

Authors: Rabia Hunky, Hayat Kalifa, Bai

Abstract:

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

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

Procedia PDF Downloads 75

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

Abstract:

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

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

Procedia PDF Downloads 283

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

Abstract:

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

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

Procedia PDF Downloads 302

Authors: Ryan Adams

Abstract:

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

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

Procedia PDF Downloads 372

Authors: Brian Kristopher Cambra

Abstract:

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

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

Procedia PDF Downloads 124