Search results for: traumatic content

Authors: Lajeesh Jabbar, Shibu T. Varghese

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Being under pain is a very distressing factor that it prolongs the healing of any kind of trauma and add to the post traumatic stressful state. Alleviating the pain from acute traumatic conditions like fracture, degloving injury etc will help in faster recovery and also decrease the incidence of post traumatic stress disorder. Most of the emergency departments in INDIA are using IV opioid analgesics to relieve the patient from pain in cases of acute traumatic injuries. None of the Emergency Departments practice regional blocks in the country. In this study, we are comparing the efficacy of Regional Blocks in relieving the pain in lower limb fractures versus the use of IV analgesics for the same in the emergency department. The site of study is Malabar Institute Of Medical Sciences in Calicut in Kerala in India and is a place which receives approximately 10-20 traumatic fracture cases per day. The fracture sites used for the study purpose are femur fracture and phalangeal fractures.

Keywords: regional blocks, IV analgesia, acute traumatic pain, femur fractures, phalanx fractures

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Authors: Jaseel C. K., Surya M.

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The study explored the post-traumatic growth experiences among divorcees. Although research studies on post-traumatic growth (PTG) are not few in number, the ones conducted in the population are quite rare and lack depth as most of them were solely dependent on the post-traumatic growth inventory scale and its statistical analyses. A total of 10 participants were interviewed (telephonic) using a semi-structured interview schedule prepared based on the research questions and the theoretical framework of post traumatic growth. The interviews were analyzed using thematic analysis, which generated five major themes and 17 subthemes. From the analysis, it was found that enhanced interpersonal relationships, changed perceptions about love and marriage, better management of emotions, prioritization of self, increased pro-social behavior, better character strengths, etc., are the most prominent positive shifts in the lives of divorcees. It was also found that factors like good relationships, professional support, work engagement, response to social stigma, and time facilitated post-traumatic growth in the population. Another interesting finding that came out of the study was that socio-economic status, educational background, and occupational status all have a positive impact on the PTG experiences among the divorced. The results of the study can hopefully help professionals working with divorcees to impart positivity to them and facilitate post-traumatic growth.

Keywords: divorcees, meaning making, positive changes, post traumatic growth, trauma

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Authors: Fadwa Alhalaiqa, Othman Alfuqaha, Anas H. Khalifeh, Mahmoud Alsaraireh, Rami Masa’Deh, Natija S Manaa

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Background: Post-traumatic stress disorders (PTSD) usually occur after traumatic occurrences that exceed the range of common human experience. This study aimed to test the psychometric properties of PCL-5 checklist for the 20 PTSD symptoms from DSM-5 among Lebanese population and to identify the prevalence of PTSD. Methods: A cross sectional survey of PCL5 among 950 Lebanese using the online survey platform by Google form was conducted. Snowball recruitment was used to identify participants for the survey. STROBE guideline was used in reporting the current study. Results: Face content, construct, discriminant, and convergent validity had been accomplished of PCL-5. The reliability by Cronbach alpha, composite, and average variance extracted were set superior. We found also that more than half of the participants (55.6%) scored 33 or above, which is the cutoff score for a likely diagnosis of PTSD. Conclusion: The current study provides further support for the Arabic version PCL-5 validity and reliability among non-Western populations. This support using this tool in the screening of PTSD.

Keywords: post traumatic stress disorder, psychometric properties, stress, adult population

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Authors: Tiera Tanksley, Amanda M. McLeroy

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The advent of technology and social media has ushered in a new era of communication, providing platforms for news dissemination and cause advocacy. However, this digital landscape has also exposed a distressing phenomenon termed "Black death," or trauma porn. This paper delves into the profound effects of repeated exposure to traumatic content on Black youth via social media, exploring the psychological impacts and potential reinforcing of stereotypes. Employing Critical Race Technology Theory (CRTT), the study sheds light on algorithmic anti-blackness and its influence on Black youth's lives and educational experiences. Through ethnographic content analysis, the research investigates common manifestations of Black death encountered online by Black adolescents. Findings unveil distressing viral videos, traumatic images, racial slurs, and hate speech, perpetuating stereotypes. However, amidst the distress, the study identifies narratives of activism and social justice on social media platforms, empowering Black youth to engage in positive change. Coping mechanisms and community support emerge as significant factors in navigating the digital landscape. The study underscores the need for comprehensive interventions and policies informed by evidence-based research. By addressing algorithmic anti-blackness and promoting digital resilience, the paper advocates for a more empathetic and inclusive online environment. Understanding coping mechanisms and community support becomes imperative for fostering mental well-being among Black adolescents navigating social media. In education, the implications are substantial. Acknowledging the impact of Black death content, educators play a pivotal role in promoting media literacy and digital resilience. Creating inclusive and safe online spaces, educators can mitigate negative effects and encourage open discussions about traumatic content. The application of CRTT in educational technology emphasizes dismantling systemic biases and promoting equity. In conclusion, this study calls for educators to be cognizant of the impact of Black death content on social media. By prioritizing media literacy, fostering digital resilience, and advocating for unbiased technologies, educators contribute to an inclusive and just educational environment for all students, irrespective of their race or background. Addressing challenges related to Black death content proactively ensures the well-being and mental health of Black adolescents, fostering an empathetic and inclusive digital space.

Keywords: algorithmic anti-Blackness, digital resilience, media literacy, traumatic content

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Authors: S. Shafiee Ardestani, A. Najafi, N. Valizadeh, E. Payani, H. Karimian

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Objectives: Treatment of mild traumatic brain injury in emergency ward patients with any type of traumatic intracranial hemorrhage is flexible. The aim of this study is to assess the clinical outcomes of mild traumatic brain injury patients who had acute traumatic intracranial hemorrhage on initial emergency ward neuroimaging. Materials-Methods: From March 2011 to November 2012 in a retrospective cohort study we enrolled emergency ward patients with mild traumatic brain injury with Glasgow Coma Scale (GCS) scores of 14 or 15 and who had stable vital signs. Patients who had any type of intracranial hemorrhage on first head CT and repeat head CT within 24 hours were included. Patients with initial GCS < 14, injury > 24 hours old, pregnancy, concomitant non-minor injuries, and coagulopathy were excluded. Primary endpoints were neurosurgical procedures and/or death and for discharged patients, return to the emergency ward during one week. Results: Among 755 patients who were referred to the emergency ward and underwent two head CTs during first 24 hours, 302 (40%) were included. The median interval between CT scans was 6 hours (ranging 4 to 8 hours). Consequently, 135 (45%) patients had subarachnoid hemorrhage, 124 (41%) patients had subdural hemorrhage, 15 (5%) patients had epidural hemorrhage, 28 (9%) patients had cerebral contusions, and 54 (18%) patients had intra-parenchymal hemorrhage. Six of 302 patients died within 15 days of injury. 200 patients (66%) have been discharged from the emergency ward, 25 (12%) of whom returned to the emergency ward after one week. Conclusion: Discharge of the head trauma patients after a repeat head CT and brief period of observation in the emergency ward lead to early discharge of mild traumatic brain injury patients with traumatic ICH without adverse events.

Keywords: clinical outcomes, emergency ward, mild traumatic intracranial hemorrhage, Glasgow Coma Scale (GCS)

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Authors: Moon Jung Kim, Guil Rhim

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The clinical sensitivity of the “VEUPLEXTM TBI assay”, a clinical trial medical device, in mild traumatic brain injury was 28.6% (95% CI, 19.7%-37.5%), and the clinical specificity was 94.0% (95% CI, 89.3%). -98.7%). In addition, when the results analyzed by marker were put together, the sensitivity was higher when interpreting the two tests together than the two tests, UCHL1 and GFAP alone. Additionally, when sensitivity and specificity were analyzed based on CT results for the mild traumatic brain injury patient group, the clinical sensitivity for 2 CT-positive cases was 50.0% (95% CI: 1.3%-98.7%), and 19 CT-negative cases. The clinical specificity for cases was 68.4% (95% CI: 43.5% - 87.4%). Since the low clinical sensitivity for the two CT-positive cases was not statistically significant due to the small number of samples analyzed, it was judged necessary to secure and analyze more samples in the future. Regarding the clinical specificity analysis results for 19 CT-negative cases, there were a large number of patients who were actually clinically diagnosed with mild traumatic brain injury but actually received a CT-negative result, and about 31.6% of them showed abnormal results on VEUPLEXTM TBI assay. Although traumatic brain injury could not be detected in 31.6% of the CT scans, the possibility of actually suffering a mild brain injury could not be ruled out, so it was judged that this could be confirmed through follow-up observation of the patient. In addition, among patients with mild traumatic brain injury, CT examinations were not performed in many cases because the symptoms were very mild, but among these patients, about 25% or more showed abnormal results in the VEUPLEXTM TBI assay. In fact, no damage is observed with the naked eye immediately after traumatic brain injury, and traumatic brain injury is not observed even on CT. But in some cases, brain hemorrhage may occur (delayed cerebral hemorrhage) after a certain period of time, so the patients who did show abnormal results on VEUPLEXTM TBI assay should be followed up for the delayed cerebral hemorrhage. In conclusion, it was judged that it was difficult to judge mild traumatic brain injury with the VEUPLEXTM TBI assay only through clinical findings without CT results, that is, based on the GCS value. Even in the case of CT, it does not detect all mild traumatic brain injury, so it is difficult to necessarily judge that there is no traumatic brain injury, even if there is no evidence of traumatic brain injury in CT. And in the long term, more patients should be included to evaluate the usefulness of the VEUPLEXTM TBI assay in the detection of microscopic traumatic brain injuries without using CT.

Keywords: brain injury, traumatic brain injury, GFAP, UCHL1

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Authors: Kinneret Segal

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The work of a midwife is emotionally challenging, both positively and negatively. Midwives share moments of joy when a baby is welcomed into the world, and also attend difficult events of loss and trauma. The relationship that develops with the maternity is the essence of the midwife's care, and it is a fundamental source of motivation and professional satisfaction. This close relationship with the maternity may be used as a double-edged sword in cases of exposure to traumatic events at birth. Birth problems, exposure to emergencies and traumatic events, and loss can affect the professional quality of life and the Compassion satisfaction of the midwife. It seems that the issue of traumatic experiences in the work of midwives, has not been sufficiently explored. The present study examined the associations between exposure to traumatic events, personal resilience and post-traumatic symptoms, professional quality of life and organizational commitment among midwifery nurses in Israeli hospitals. 131 midwives from three hospitals in the country's center in Israel participated in this study. The data were collected during 2021 using a self-report questionnaire that examined sociodemographic characteristics, the degree of exposure to traumatic events in the delivery room, personal resilience, post-traumatic symptoms, professional quality of life, and organizational commitment. The three most difficult traumatic events for the midwives were death or fear of death of a newborn, death or fear of the death of a mother and a quiet birth. The higher the frequency of exposure to traumatic events, the more numerous and intense the onset of post-trauma symptoms. The more numerous and powerful the post-trauma symptoms, the higher the level of professional burnout and/or compassion fatigue, and the lower the level of compassion satisfaction. High levels of compassion satisfaction and/or low professional burnout were expressed in a heightened sense of organizational commitment. Personal resilience, country of birth, traumatic symptoms and organizational commitment, predicted satisfaction from compassion. Midwives are exposed to traumatic events associated with dissatisfaction and impairment of the professional quality of life that accompanies burnout and compassion fatigue. Exposure to traumatic events leads to the appearance of traumatic symptoms, a decrease in organizational commitment, and psychological and mental well-being. The issue needs to be addressed by implementing training programs, organizational support, and policies to improving well-being and quality of care among midwives.

Keywords: traumatic experirnces, midwives, quality of life, burnout, organizational commitment, personal resilience

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Authors: Kinneret Segal

Abstract:

Background: The work of a midwife is emotionally challenging, both positively and negatively. Midwives share moments of joy when a baby is welcomed into the world and also attend difficult events of loss and trauma. The relationship that develops with the maternity is the essence of the midwife's care, and it is a fundamental source of motivation and professional satisfaction. This close relationship with the maternity may be used as a double-edged sword in cases of exposure to traumatic events at birth. Birth problems, exposure to emergencies and traumatic events, and loss can affect the professional quality of life and the Compassion satisfaction of the midwife. It seems that the issue of traumatic experiences in the work of midwives has not been sufficiently explored. Aim: The present study examined the associations between exposure to traumatic events, personal resilience and post-traumatic symptoms, professional quality of life, and organizational commitment among midwifery nurses in Israeli hospitals. Methods: 131 midwives from three hospitals in the country's center in Israel participated in this study. The data were collected during 2021 using a self-report questionnaire that examined sociodemographic characteristics, the degree of exposure to traumatic events in the delivery room, personal resilience, post-traumatic symptoms, professional quality of life, and organizational commitment. Results: The three most difficult traumatic events for the midwives were death or fear of death of a newborn, death or fear of the death of a mother, and a quiet birth. The higher the frequency of exposure to traumatic events, the more numerous and intense the onset of post-trauma symptoms. The more numerous and powerful the post-trauma symptoms, the higher the level of professional burnout and/or compassion fatigue, and the lower the level of compassion satisfaction. High levels of compassion satisfaction and/or low professional burnout were expressed in a heightened sense of organizational commitment. Personal resilience, country of birth, traumatic symptoms, and organizational commitment predicted satisfaction from compassion. Conclusions: Midwives are exposed to traumatic events associated with dissatisfaction and impairment of the professional quality of life that accompanies burnout and compassion fatigue. Exposure to traumatic events leads to the appearance of traumatic symptoms, a decrease in organizational commitment, and psychological and mental well-being. The issue needs to be addressed by implementing training programs, organizational support, and policies to improving well-being and quality of care among midwives.

Keywords: organizational commitment, traumatic experiences, personal resilience, quality of life

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Authors: Misbah Shahzadi

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The present study was conducted to identify the emotional and behavioral disturbances among the News Reporters covering Traumatic events. In the present study, a sample of 50 News Reporters belonging to the national and the local news agencies were selected from Rawalpindi and Islamabad who had covered any traumatic event in the past one year. Rotter’s Incomplete Sentence Blank (RISB) and Impact of Event Scale interpretations were used to assess a variety of emotional and behavioral patterns of News Reporters. Results showed that some of the frequent emotional and behavioral reactions exhibited by individuals like withdrawal, anxiety\depression, aggression, hyperarousal and avoidance behavior whereas gender-based comparisons indicated that there is no significant gender difference in the News Reporters in manifestations of behavioral and emotional disturbances. It is concluded that significant negative emotional and behavioral reactions are exhibited by the News Reporters who cover traumatic events. The study identifies the negative emotional and behavioral reactions/disturbances after trauma, which can be helpful for identifying problematic areas for counseling and therapeutic interventions for these News Reporters.

Keywords: behavioural disturbance, emotional disturbance, news reporters, traumatic events

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Authors: Barbara Papp

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Purpose: This article aims to rethink the relationship between the trauma and the choice of professions. By studying a homogenous sample of respondents, it seeks answers to the following question: how did personal losses that were caused by historical upheavals motivate people to enter the helping professions. By becoming helping professionals, the respondents of the survey sought to handle both historical representation and self-representation. How did psychotherapists working in the second half of the 20th century (Kádár-era in Hungary) shape their course of life? How did their family members respond to their choice of career? What forces supported or hindered them? How did they become professional helpers? Methodology: When interviewing 40 psychotherapists, the interviewer used the oral history technique. In-depth interviews were made with a focus on motivation. First, the collected material was examined using traditional content analysis tools: searching for content patterns, applying a word frequency analysis, and identifying the connections between key events and key persons. Second, a narrative psychological content analysis (NarrCat) was made. Findings: Interconnections were established between attachment, family and historical traumas and career choices. The history of the mid-20th-century period was traumatic and full of losses for the families of most of the psychotherapists concerned. Those experiences may have considerably influenced their choice of career. Working as helping therapists, they could get the opportunity to revise their losses. Conclusion: The results revealed core components that play a role in the psychotherapists’ choice of career, and also emphasized the importance of post-traumatic growth.

Keywords: biography, identity, narrative psychological content analysis, psychotherapists, trauma

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Authors: S. P. Singh, Shweta Gupta, Kshama Dwivedi, Shivangi Singh

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Aim: To compare the postoperative pupil cosmesis, mydriasis, and anterior chamber depth (ACD) in traumatic and congenital iris defects after Single-Pass Four-Throw pupilloplasty (SFTP). Method: SFTP was performed along with cataract surgery in 6 patients, each of congenital and traumatic iris defects and pupil size, mydriasis, and ACD was compared after three months. Results: SFTP was successful in repairing congenital and traumatic cases except in 1 traumatic case with a large iris defect. Horizontal pupil diameter decreased while ACD increased in both groups and was comparable between the two groups. The traumatic group showed a significant decrease in pupil diameter while there was an insignificant change in the horizontal pupil diameter in the congenital group. Mydriasis was adequate for fundus examination and was comparable between the two groups. The effect of SFTP on ACD was inconclusive due to the confounding effect of cataract surgery. The incidence of iris atrophy was equal in both groups. Conclusion: SFTP results in anatomical and functional restoration in cases of iris defects with no inadvertent effect on mydriasis.

Keywords: anterior chamber depth, mydriasis, pupil cosmesis, single-pass four-throw pupilloplasty

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Authors: Bar Shapira-Youngster, Sima Amram-Vaknin, Yuliya Lipshits-Braziler

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The study examined how 811 Israelis experienced and coped with the COVID-19 lockdown. Stress, uncertainty, and loss of control were reported as common emotional experiences. Two main difficulties were reported: Loneliness and health and emotional concerns. Frequent explanations for the virus's emergence were: scientific or faith reasoning. The most prevalent coping strategies were distraction activities and acceptance. Reducing the use of maladaptive coping strategies has important implications for mental health outcomes. Objectives: COVID-19 has been recognized as a collective, continuous traumatic stressor. The present study examined how individuals experienced, perceived, and coped with this traumatic event during the lockdown in Israel in April 2020. Method: 811 Israelis (71.3% were women; mean age 43.7, SD=13.3)completed an online semi-structured questionnaire consisting two sections: In the first section, participants were asked to report background information. In the second section, they were asked to answer 8 open-ended questions about their experience, perception, and coping with the covid-19 lockdown. Participation was voluntary, and anonymity was assured, they were not offered compensation of any kind. The data were subjected to qualitative content analysis that seeks to classify the participants` answers into an effective number of categories that represent similar meanings. Our content analysis of participants’ answers extended far beyond simple word counts; our objective was to try to identify recurrent categories that characterized participants’ responses to each question. We sought to ensure that the categories regarding the different questions are as mutually exclusive and exhaustive as possible. To ensure robust analysis, the data were initially analyzed by the first author, and a second opinion was then sought from research colleagues. Contribution: The present research expands our knowledge of individuals' experiences, perceptions, and coping mechanisms with continuous traumatic events. Reducing the use of maladaptive coping strategies has important implications for mental health outcomes.

Keywords: Covid-19, emotional distress, coping, continuous traumatic event

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Authors: Savaş Karpuz, Sami Küçükşen

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The aim of this study is to investigate the effectiveness of neurological rehabilitation in patients with traumatic brain injury. Participants were 45 consecutive adults with traumatic brain injury who were received the neurologic rehabilitation. Sociodemographic characteristics of the patients, the cause of the injury, the duration of the coma and posttraumatic amnesia, the length of stay in the other inpatient clinics before rehabilitation, the time between injury and admission to the rehabilitation clinic, and the length of stay in the rehabilitation clinic were recorded. The differences in functional status between admission and discharge were determined with Disability Rating Scale (DRS), Functional Independence Measure (FIM), and Functional Ambulation Scale (FAS) and levels of cognitive functioning determined with Ranchos Los Amigos Scale (RLAS). According to admission time, there was a significant improvement identified in functional status of patients who had been given the intensive in-hospital cognitive rehabilitation program. At discharge time, the statistically significant differences were obtained in DRS, FIM, FAS and RLAS scores according to admission time. Better improvement in functional status was detected in patients with lower scores in DRS, and higher scores FIM and RLAS scores at the entry time. The neurologic rehabilitation significantly affects the recovery of functional status after traumatic brain injury.

Keywords: traumatic brain injury, rehabilitation, functional status, neurological

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Authors: Titap Yazicioglu

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Purpose: To determine the etiological factors responsible for the eye removal surgery and to evaluate our surgical results. Material and Methods: Medical records of 226 patients, who underwent eye removal surgery, were analyzed retrospectively. Demographic information, clinical history, surgical procedure, and histopathological data were all collected. Evisceration surgery was performed under general anesthesia in all patients except tumor cases and one patient with rhino-orbital mucormycosis. The patients were followed for an average of 16.46±10.78 months and checked for the possible complications, cosmesis, and functional results.Results: 144 men, and 82 women,with a mean age of 41.78±22.6 years, were underwent enucleation (n=15) or evisceration (n=211) due to traumatic (n=169) and non-traumatic (n=57) causes. In the traumatic group, 79.8% of 169 patients were injured by penetrating and 14.2% by blunt trauma.3.6% of the patients were injured in a traffic accident, and 2.4% of them were injured by explosives. In the non-traumatic group, 40% of 25 patients had post-traumatic endophthalmitis, 32% had endophthalmitis due to corneal ulceration and melting, and 24% had endophthalmitis after cataract surgery. One patient had panophthalmitis due to rhino-orbital mucormycosis. Another cause in the non-traumatic group was glaucoma, of which 92.3% had neovascular glaucoma, and 8.7% had congenital glaucoma. Of the 14 patients who were enucleated for tumor, 35.7% had retinoblastoma, 14.3% had medulloepithelioma, 42.9% had uveal melanoma, and 7.1% had metastatic tumor from paranasal sinuses.The most common complaint in the follow-up period was discharging, seen in all prosthesis-wearing patients. 13.3% of the patients had itching due to ocular prosthesis. 4.4% of the patients were complaining about deep superior sulcus. 4.4% had pyogenic granuloma, and 17.8% had implant exposure. Conclusion: Etiological factors should be carefully evaluated, and precautions should be taken in order to reduce the devastating effect of the physical loss of the eye.

Keywords: enucleation, evisceration, ocular injury, etiology, frequency

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Authors: A. Duncan, A. Blake, A. O'Gara, J. Fitzgerald

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Introduction: Acute traumatic rib fractures have significant morbidity and mortality and are a commonly seen injury in trauma patients. Rib fracture pain can often be acute and can prove challenging to manage. We performed an audit on patients with acute traumatic rib fractures with the aim of composing a referral and treatment pathway for such patients. Methods: From January 2021 to January 2022, the pain medicine service encouraged early referral of all traumatic rib fractures to the pain service for a multi-modal management approach. A retrospective audit of analgesic management was performed on a select cohort of 24 patients, with a mean age of 67, of which 19 had unilateral rib fractures. Results: 17 of 24 patients (71%) underwent local, regional block as part of a multi-modal analgesia regime. Only one regional complication was observed, seen with hypotension occurring in one patient with a thoracic epidural. The group who did not undergo regional block had a length of stay (LOS) 17 days longer than those who did (27 vs. 10) and higher rates of pneumonia (29% vs. 18%). Conclusion: Early referral to pain specialists is an important component of the effective management of acute traumatic rib fractures. From our audit, it is evident that regional blocks can be effectively used in these cases as part of a multi-modal analgesia regime and may confer benefits in terms of respiratory complications and length of stay.

Keywords: rib fractures, regional blocks, thoracic epidural, erector spina block

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Authors: Sonal Khosla

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A research is proposed in the present paper to explore the role of flow in coping with traumatic experiences and attaining post-traumatic growth. A grounded theory research is proposed to be carried by analyzing memoirs of people who have been through trauma. A pilot study was carried out on two memoirs of women who were held captive for over ten years and were sexually assaulted repeatedly. The role of flow in their coping experiences was explored by analyzing the books. Some of the flow activities that were used by them were- drawing and daydreaming. Their narratives show the evidence for flow as having cathartic and healing effects on them. Applicability of the findings can take two forms: 1. Flow can be applied as a preventive technique to help the people who are going through trauma, 2. Flow can be adopted into a positive intervention to help people suffering from PTSD.

Keywords: flow, positive intervention, PTSD, PTG

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Authors: Jiping Cai, Ningzhi Wangyang, Jun Shao

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Traumatic brain injury (TBI) is one of the major causes of morbidity and mortality that leads to structural and functional damage in several parts of the brain, such as cranial nerves, optic nerve tract or other circuitry involved in vision and occipital lobe, depending on its location and severity. As a result, the function associated with vision processing and perception are significantly affected and cause blurred vision, double vision, decreased peripheral vision and blindness. Here two cases complaining of monocular vision loss (actually temporal hemianopia) due to traumatic chiasmal syndrome after frontal head injury were reported, and were compared the findings with individual case reports published in the literature. Reported cases of traumatic chiasmal syndrome appear to share some common features, such as injury to the frontal bone and fracture of the anterior skull base. The degree of bitemporal hemianopia and visual loss acuity have a variable presentation and was not necessarily related to the severity of the craniocerebral trauma. Chiasmal injury may occur even in the absence bony chip impingement. Isolated bitemporal hemianopia is rare and clinical improvement usually may not occur. Mechanisms of damage to the optic chiasm after trauma include direct tearing, contusion haemorrhage and contusion necrosis, and secondary mechanisms such as cell death, inflammation, edema, neurogenesis impairment and axonal damage associated with TBI. Beside visual field test, MRI evaluation of optic pathways seems to the strong objective evidence to demonstrate the impairment of the integrity of visual systems following TBI. Therefore, traumatic chiasmal syndrome should be considered as a differential diagnosis by both neurosurgeons and ophthalmologists in patients presenting with visual impairment, especially bitemporal hemianopia after head injury causing frontal and anterior skull base fracture.

Keywords: bitemporal hemianopia, brain injury, optic chiasma, traumatic chiasmal syndrome.

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Authors: Marko Živanović, Jovana Bjekić, Maša Vukčević Marković

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Professionals and volunteers involved in refugee protection and support are on a daily basis faced with people who have experienced numerous traumatic experiences and, as such, are subjected to secondary traumatization (ST). The aim of this study was to provide insight into risk factors for ST in helpers working with refugees in Serbia. A total of 175 participants working with refugees fulfilled: Secondary Traumatization Questionnaire, checklist of refugees’ traumatic experiences, Hopkins Symptoms Checklist (HSCL) assessing depression and anxiety symptoms, quality of life questionnaire (MANSA), HEXACO personality inventory, and COPE assessing coping mechanisms. In addition, participants provided information on work-related problems. Qualitative analysis of answers to the question about most difficult part of their job has shown that burnout-related issues are clustered around three recurrent topics that can be considered as the most prominent generators of stress, namely: ‘lack of organization and cooperation’, ‘not been able to do enough’, and ‘hard to take it and to process it’. Factor analysis (Maximum likelihood extraction, Promax rotation) have shown that ST comprises of two correlated factors (r = .533, p < .01), namely Psychological deficits and Intrusions. Results have shown that risk factor for ST could be find in three interrelated sources: 1) work-related problems; 2) personality-related risk factors and 3) clients’ traumatic experiences. Among personality related factors, it was shown that risk factor for Intrusions could be find in – high Emotionality (β = .221, p < .05), and Altruism (β = .322, p < .01), while low Extraversion (β = -.365, p < .01) represents risk factor for Psychological deficits. In addition, usage of maladaptive coping mechanisms –mental disengagement (r = .253, p < .01), behavioral disengagement (r = .274, p < .01), focusing on distress and venting of emotions (r = .220, p < .05), denial (r = .164, p < .05), and substance use (r = .232, p < .01) correlate with Psychological deficits while Intrusions corelate with Mental disengagement (r = .251, p < .01) and denial (r = .183, p < .05). Regarding clients’ traumatic experiences it was shown that both quantity of traumatic events in country of origin (for Deficits r = .226, p < .01; for Intrusions r = .174, p < .05) and in transit (for Deficits r = .288, p < .01), as well as certain content-related features of such experiences (especially experiences which are severely dislocated from ‘everyday reality’) are related to ST. In addition, Psychological deficits and Intrusions have shown to be accompanied by symptoms of depression (r = .760, p < .01; r = .552, p < .01) and anxiety (r = .740, p < .01; r = .447, p < .01) and overall lower life quality (r = -.454, p < .01; r = .256, p < .01). Results indicate that psychological vulnerability of persons who are working with traumatized individuals can be found in certain personality traits, and usage of maladaptive coping mechanisms, which disable one to deal with work-related issues, and to cope with quantity and quality of traumatic experiences they were faced with, affecting ones’ psychological well-being. Acknowledgement: This research was funded by IRC Serbia.

Keywords: mental health, refugees, secondary traumatization, traumatic experiences

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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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Authors: E. Botchway, C. Godfrey, V. Anderson, C. Catroppa

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Introduction: Sleep disturbances are common after childhood traumatic brain injury (TBI). This systematic review aimed to assess the prevalence, types, and predictors of sleep disturbances in childhood TBI. Methods: Medline, Pubmed, PsychInfo, Web of Science, and EMBASE databases were searched. Out of the 547 articles assessed, 15 met selection criteria for this review. Results: Sleep disturbances were common in children and adolescents with TBI, irrespective of injury severity. Excessive daytime sleepiness and insomnia were the most common sleep disturbances reported. Sleep disturbance was predicted by sex, injury severity, pre-existing sleep disturbances, younger age, pain, and high body mass index. Conclusions: Sleep disturbances are highly prevalent in childhood TBI, regardless of the injury severity. Routine assessment of sleep in survivors of childhood TBI is recommended.

Keywords: traumatic brain injury, sleep diatiurbances, childhood, systematic review

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Authors: Asamaporn Puetpaiboon, Sunisa Chatmongkolchart, Nalinee Kovitwanawong, Osaree Akaraborworn

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Traumatic patients with massive bleeding require intensive resuscitation. The actual cost of anesthesia per case has never been clarified, so our study aimed to quantify the direct cost, and cost-to-charge ratio of anesthetic care in traumatic patients with intraoperative massive bleeding. This study was a prospective, observational, cost analysis study, conducted in Prince of Songkla University hospital, Thailand, with traumatic patients, of any mechanisms being recruited. Massive bleeding was defined as estimated blood loss of at least one blood volume in 24 hours, or a half of blood volume in 3 hours. The cost components were identified by the micro-costing method, and valued by the bottom-up approach. The direct cost was divided into 4 categories: the labor cost, the capital cost, the material cost and the cost of drugs. From September 2017 to August 2018, 10 patients with multiple injuries were included. Seven patients had motorcycle accidents, two patients fell from a height and another one was in a minibus accident. Two patients died on the operating table, and another two died within 48 hours. The median Sequential Organ Failure Assessment (SOFA) score was 8. The median intraoperative blood loss was 3,500 ml. The median direct cost, per case, was 250 United States Dollars (2017 exchange rate), and the cost-to-charge ratio was 0.53. In summary, the direct cost was nearly half of the hospital charge, for these traumatic patients with massive bleeding. However, our study did not analyze the indirect cost.

Keywords: cost, cost-to-charge ratio, micro-costing, trauma

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Authors: Jason Maffia, Maria D’urso, Robert Crupi, Margaret Cartmell

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The emotional aspects of traumatic events such as workplace violence are often ignored, causing low productivity, disillusionment, and resentment within an organization. As a result, if workplace violence, particularly in healthcare settings, is not adequately addressed, it will become a phenomenon, undermining the peace and stability among the active communities while also posing a risk to the population's health and well-being. This review intends to identify the risk factors and the implications of workplace violence in healthcare settings and highlight the collaborative efforts needed in sustaining control and prevention measures against workplace violence. It is essential that health care organizations are prepared physically and emotionally for traumatic situations. This study explores the theoretical nature of addressing work-related violence in healthcare settings as well as traumatic stress reactivity and the context within which reactions occur and recovery takes place. Cognitive, social, and organizational influences on response are identified and used to tentatively offer explanations for identifying security risks, development, and implementation of de-escalation teams, CISM programs and training staff in violence prevention are among strategies hospitals are employing to keep workers and patients safe. General conclusion regarding the implications for intervention effectiveness and design are discussed.

Keywords: healthcare settings, stress reactions, traumatic events, workplace violence

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Authors: Grace Baptie, Jackie Andrade, Alison Bacon, Alyson Norman

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Background: Many women experience their childbirth as traumatic, and 4-6% of mothers present with postnatal posttraumatic stress disorder (PTSD) as a result of their birth. Aims: To measure the relationship between obstetric and subjective experience of childbirth on mothers’ experience of postnatal trauma and identify salient aspects of the birth experience considered traumatic. Methods: Women who had given birth within the last year completed an online mixed-methods survey reporting on their subjective and obstetric birth experience as well as symptoms of postnatal trauma, depression and anxiety. Findings: 29% of mothers experienced their labour as traumatic and 15% met full or partial criteria for PTSD. Feeling supported and in control mediated the relationship between obstetric intervention and postnatal trauma symptoms. Five key themes were identified from the qualitative data regarding aspects of the birth considered traumatic including: obstetric complications; lack of control; concern for baby; psychological trauma and lack of support. Conclusion: Subjective birth experience is a significantly stronger predictor of postnatal trauma than level of medical intervention, the psychological consequences of which can be buffered by an increased level of support and control.

Keywords: birth trauma, perinatal mental health, postnatal PTSD, subjective experience

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Authors: Cindy Davis, Samantha Rayner

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Secondary traumatic stress (STS) is an indirect form of trauma affecting the psychological well-being of mental health workers; STS is found to be a prevalent risk in mental health occupations. Various factors impact the development of STS within the literature; including the level of trauma individuals are exposed to and their level of empathy. Research is limited on STS in mental health workers in Australia; therefore, this study examined STS and related factors of empathetic behavior and trauma caseload among mental health workers. The research utilized an online survey quantitative research design with a purposive sample of 190 mental health workers (176 females) recruited via professional websites and unofficial social media groups. Participants completed an online questionnaire comprising of demographics, the secondary traumatic stress scale and the empathy scale for social workers. A standard hierarchical regression analysis was conducted to examine the significance of covariates, traumatized clients, traumatic stress within workload and empathy in predicting STS. The current research found 29.5% of participants to meet the criteria for a diagnosis of STS. Age and past trauma within the covariates were significantly associated with STS. Amount of traumatized clients significantly predicted 4.7% of the variance in STS, traumatic stress within workload significantly predicted 4.8% of the variance in STS and empathy significantly predicted 4.9% of the variance in STS. These three independent variables and the covariates accounted for 18.5% of the variance in STS. Practical implications include a focus on developing risk strategies and treatment methods that can diminish the impact of STS.

Keywords: mental health, PTSD, social work, trauma

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Authors: Daniel Azizyan, Marina Vardanyan, Astghik Dallakyan

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The objective of this literature review is to bring valuable and much-needed insight into Virtual Reality Exposure Therapy (VRET) for the treatment of Post-Traumatic Stress Disorder (PTSD) among military personnel. As the issues regarding war veterans who suffer from PTSD become more and more widespread, the task of finding possible solutions that would provide alternative approaches to existing methods being used today becomes more relevant than ever. By analyzing the previous applications of VRET, this literature review covers the state of the research done currently on the topic, reviews the known information while identifying the main problems, and aims to use missed opportunities and find potential solutions. It provides the answers to the most relevant questions concerning VRET and leads to important conclusions in the hope of making the technology more practical, widespread, and effective.

Keywords: military PTSD, post-traumatic stress disorder, prolonged exposure, virtual reality exposure therapy, VRE

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Authors: Muchiri Josephine, Qdero Agnes

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The current study was conducted during the coronavirus pandemic (COVID-19) period, soon after the lifting of the lockdown measures and schools had just re-opened. It investigated the sociodemographic correlates of Post-Traumatic Stress Disorder (PTSD) among adolescents (13-18 years) who had undergone domestic violence (DV) in Kajiado County, Kenya. The adolescents were administered a sociodemographic questionnaire to ascertain the forms of domestic violence experienced, and those who met the criteria were assessed for the presence of PTSD using the Harvard Trauma Questionnaire (HTQ). Overall, 93(90.3%) had experienced domestic violence, and 57(61.3%) had PTSD; where the severity and prevalence of PTSD increased with increased age, and it also increased significantly among those in higher academic levels, indicating that PTSD prevalence was chronic and additionally influenced by increased academic pressure. Social connections seemed to mitigate PTSD prevalence, whereas, regarding the family background, those living with guardians seemed to have more severe PTSD.

Keywords: age, education level, gender, post-traumatic stress disorder

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Authors: Khadeeja Munawar, Shamsul Haque

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The claim that traumatic events influence the recalled memories and mental health has received mixed empirical support. This study examines the memories of a sample drawn from Pakistan, a country that has witnessed many life-changing socio-political events, wars, and natural disasters in 72 years of its history. A sample of 210 senior citizens (Mage = 64.35, SD = 6.33) was recruited from Pakistan. The aim was to investigate if participants retrieved more memories related to past traumatic events using a word-cueing technique. Each participant reported ten memories to ten neutral cue words. The results revealed that past traumatic events were not adversely affecting the memories and mental health of participants. When memories were plotted with respect to the ages at which the events happened, a pronounced bump at 11-20 years of age was seen. Memories within as well as outside of the bump were mostly positive. The multilevel logistic regression modelling showed that the memories recalled were personally important and played a role in enhancing resilience. The findings revealed that despite facing an array of ethnic, religious, political, economic, and social conflicts, the participants were resilient, recalled predominantly positive memories, and had intact mental health. The findings have clinical implications in Cognitive Behavioral Therapy (CBT). The patients can be made aware of their negative emotions, troublesome/traumatic memories, and the distorted thinking patterns and their memories can be restructured. The findings can also be used to teach Memory Specificity Training (MEST) by psycho-educating the patients around changes in memory functioning and enhancing the recall of memories, which are more specific, vivid, and filled with sensory details.

Keywords: cognitive behavioral therapy, memories, mental health, resilience, trauma

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Authors: Jeounghee Kim

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Objective: To describe the incidence of complication, according to the stage of Traumatic Spinal Cord Injury (TSCI) which was treated at Asan Medical Center (AMC), Korea. Hereafter, it should be developed in nursing management protocol of traumatic SCI. Methods. Retrospectively reviewed hospital records about the patients who were admitted AMC Patients with traumatic spinal cord injury until January 2005 and December 2016 were analyzed (n=97). AMC is a single institution of 2,700 beds where patients with trauma and severe trauma can be treated. Patients who were admitted to the emergency room due to spinal cord injury and who underwent intensive care unit, general ward, and rehabilitation ward. To identify long-term complications, we excluded patients who were operated on to other hospitals after surgery. Complications such as respiratory(pneumonia, atelectasis, pulmonary embolism, and others), cardiovascular (hypotension), urinary (autonomic dysreflexia, urinary tract infection (UTI), neurogenic bladder, and others), and skin systems (pressure ulcers) from the time of admission were examined through medical records and images. Results: SCI was graded according to ASIA scale. The initial grade was checked at admission. (grade A 55(56.7%), grade B 14(14.4)%, grade C 11(11.3%), grade D 15(15.5%), and grade E 2(2.1%). The grade was rechecked when the patient was discharged after treatment. (grade A 43(44.3%), grade B 15(15.5%), grade C 12(12.4%), grade D 21(21.6%), and grade E 6(6.2%). The most common complication after SCI was UTI 24cases (mean 36.5day), sore 24cases (40.5day), and Pneumonia which was 23 cases after 10days averagely. The other complications after SCI were neuropathic pain 19 cases, surgical site infection 4 cases. 53.6% of patient who had SCI were educated about intermittent catheterization at discharge from hospital. The mean hospital stay of all SCI patients was 61days. Conclusion: The Complications after traumatic SCI were developed at various stages from acute phase to chronic phase. Nurses need to understand fully the time-course of complication in traumatic SCI to provide evidence-based practice.

Keywords: spinal cord injury, complication, nursing, rehabilitation

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Authors: Jarek Krajewski, Andre Wittenborn, Martin Sauerland

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This abstract describes a promising approach for estimating post-traumatic stress disorder (PTSD) based on prosodic speech characteristics. It illustrates the validity of this method by briefly discussing results from an Arabic refugee sample (N= 47, 32 m, 15 f). A well-established standardized self-report scale “Reaction of Adolescents to Traumatic Stress” (RATS) was used to determine the ground truth level of PTSD. The speech material was prompted by telling about autobiographical related sadness inducing experiences (sampling rate 16 kHz, 8 bit resolution). In order to investigate PTSD-induced speech changes, a self-developed set of 136 prosodic speech features was extracted from the .wav files. This set was adapted to capture traumatization related speech phenomena. An artificial neural network (ANN) machine learning model was applied to determine the PTSD level and reached a correlation of r = .37. These results indicate that our classifiers can achieve similar results to those seen in speech-based stress research.

Keywords: speech prosody, PTSD, machine learning, feature extraction

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Authors: Radmila Maksimovic, Sonja Ketin, Rade Biocanin, Jelena Maksimovic

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The abnormal conditions of life and work genetic factors often play a major role in incidence of diabetes-diabetes, heart disease and vascular disease, jaundice, and post traumatic stress. Trauma and post traumatic stress are most common in the displaced persons,and the focus of this paper is to shed light on this issue in former Yugoslavia, Yugoslavia and now in our country. This is caused by increased beta-cell sensitivity to viruses, the development of autoimmune antibodies against its own pancreascells, degenerative changes in cells that r esult in change of structure and insulin. In this paper, we dealt with traumatic events and long-term psycho social consequences for internally displaced persons, several years after displacement, and found a high level of PTSD symptoms. This stress is present in almost 1/3 of internally displaced persons, and every sixth person is suffering from PTSD in the past. Respondents generally suffer from symptoms of intrusion, but there was a large number of symptoms, avoidance and increased arousal. We also found that gender, age andeducation related to the symptoms. Females, and older respondents and internally displaced persons with lower levels of education how a higher level of PTSD symptoms, especially symptoms of intrusion and increase darousal. It is a highly traumatized sample in which more than 1/2 of respondents experienced more than three traumatic events in life,although the number of traumas experienced before, during and after the conflict varies.We found that during the war, internally displaced persons haveexperienced more traumatic events compared with the periodbefore and after the conflict. Trauma are different in type. No significant correlation between the number of experienced trauma and PTSD, suggesting that it is necessary to further study the structure of past traumas and the intermediary effects of certain risk factors and protective factors.

Keywords: living environment, displaced persons, jaundice, diabetes, trauma, diabetic hypertension, post-traumatic stress (PTSD), treatment

Procedia PDF Downloads 360