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Sample records for trauma victims survival

  1. The development of simple survival prediction models for blunt trauma victims treated at Asian emergency centers.

    Science.gov (United States)

    Kimura, Akio; Nakahara, Shinji; Chadbunchachai, Witaya

    2012-02-02

    For real-time assessment of the probability of survival (Ps) of blunt trauma victims at emergency centers, this study aimed to establish regression models for estimating Ps using simplified coefficients. The data of 10,210 blunt trauma patients not missing both the binary outcome data about survival and the data necessary for Ps calculation by The Trauma and Injury Severity Score (TRISS) method were extracted from the Japan Trauma Data Bank (2004-2007) and analyzed. Half (5,113) of the data was allocated to a derivation data set, with the other half (5,097) allocated to a validation data set. The data of 6,407 blunt trauma victims from the trauma registry of Khon Kaen Regional Hospital in Thailand were analyzed for validation. The logistic regression models included age, the Injury Severity Score (ISS), the Glasgow Coma Scale score (GCS), systolic blood pressure (SBP), respiratory rate (RR), and their coded values (cAGE, 0-1; cISS, 0-4; cSBP, 0-4; cGCS, 0-4; cRR, 0-4) as predictor variables. The coefficients were simplified by rounding off after the decimal point or choosing 0.5 if the coefficients varied across 0.5. The area under the receiver-operating characteristic curve (AUROCC) was calculated for each model to measure discriminant ability. A group of formulas (log (Ps/1-Ps) = logit (Ps) = -9 + cISS - cAGE + cSBP + cGCS + cRR/2, where -9 becomes -7 if the predictor variable of cRR or cISS is missing) was developed. Using these formulas, the AUROCCs were between 0.950 and 0.964. When these models were applied to the Khon Kean data, their AUROCCs were greater than 0.91. These equations allow physicians to perform real-time assessments of survival by easy mental calculations at Asian emergency centers, which are overcrowded with blunt injury victims of traffic accidents. © 2012 Kimura et al; licensee BioMed Central Ltd.

  2. The development of simple survival prediction models for blunt trauma victims treated at Asian emergency centers

    Directory of Open Access Journals (Sweden)

    Kimura Akio

    2012-02-01

    Full Text Available Abstract Background For real-time assessment of the probability of survival (Ps of blunt trauma victims at emergency centers, this study aimed to establish regression models for estimating Ps using simplified coefficients. Methods The data of 10,210 blunt trauma patients not missing both the binary outcome data about survival and the data necessary for Ps calculation by The Trauma and Injury Severity Score (TRISS method were extracted from the Japan Trauma Data Bank (2004-2007 and analyzed. Half (5,113 of the data was allocated to a derivation data set, with the other half (5,097 allocated to a validation data set. The data of 6,407 blunt trauma victims from the trauma registry of Khon Kaen Regional Hospital in Thailand were analyzed for validation. The logistic regression models included age, the Injury Severity Score (ISS, the Glasgow Coma Scale score (GCS, systolic blood pressure (SBP, respiratory rate (RR, and their coded values (cAGE, 0-1; cISS, 0-4; cSBP, 0-4; cGCS, 0-4; cRR, 0-4 as predictor variables. The coefficients were simplified by rounding off after the decimal point or choosing 0.5 if the coefficients varied across 0.5. The area under the receiver-operating characteristic curve (AUROCC was calculated for each model to measure discriminant ability. Results A group of formulas (log (Ps/1-Ps = logit (Ps = -9 + cISS - cAGE + cSBP + cGCS + cRR/2, where -9 becomes -7 if the predictor variable of cRR or cISS is missing was developed. Using these formulas, the AUROCCs were between 0.950 and 0.964. When these models were applied to the Khon Kean data, their AUROCCs were greater than 0.91. Conclusion: These equations allow physicians to perform real-time assessments of survival by easy mental calculations at Asian emergency centers, which are overcrowded with blunt injury victims of traffic accidents.

  3. The effects of secondary trauma on professionals working with victims and survived traumatized individuals

    OpenAIRE

    Konistan, Rita

    2017-01-01

    Research on secondary traumatisation suggests that there is a certain overlap in terminologies used in the literature that are related to the concept of secondary traumatic stress. These interchangeable concepts include vicarious trauma, compassion fatigue, burnout and countertransference. The main aims of the current study are to investigate the differences between various terms associated with post-traumatic stress disorder (PTSD) including secondary traumatic stress, compassion fatigue and...

  4. Victimization, Trauma, and Traumatic Stress.

    Science.gov (United States)

    Figley, Charles R.

    1988-01-01

    Responds to articles by McCann, Sakheim, and Abrahamson and by Downing concerning victimization, noting that the plight of victims is easily overlooked by human service professionals and commending this journal issue devoted to issues of victimization. Identifies four other areas worthy of attention: massive victimization, secondary victimization,…

  5. Undertriage in trauma: Does an organized trauma network capture the major trauma victim? A statewide analysis.

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    Horst, Michael A; Jammula, Shreya; Gross, Brian W; Cook, Alan D; Bradburn, Eric H; Altenburg, Juliet; Von Nieda, Danielle; Morgan, Madison; Rogers, Frederick B

    2018-03-01

    Proper triage of critically injured trauma patients to accredited trauma centers (TCs) is essential for survival and patient outcomes. We sought to determine the percentage of patients meeting trauma criteria who received care at non-TCs (NTCs) within the statewide trauma system that exists in the state of Pennsylvania. We hypothesized that a substantial proportion of the trauma population would be undertriaged to NTCs with undertriage rates (UTR) decreasing with increasing severity of injury. All adult (age ≥15) hospital admissions meeting trauma criteria (ICD-9, 800-959; Injury Severity Score [ISS], > 9 or > 15) from 2003 to 2015 were extracted from the Pennsylvania Health Care Cost Containment Council (PHC4) database, and compared with the corresponding trauma population within the Pennsylvania Trauma Systems Foundation (PTSF) registry. PHC4 contains all hospital admissions within PA while PTSF collects data on all trauma cases managed at designated TCs (Level I-IV). The percentage of patients meeting trauma criteria who are undertriaged to NTCs was determined and Network Analyst Location-Allocation function in ArcGIS Desktop was used to generate geospatial representations of undertriage based on ISSs throughout the state. For ISS > 9, 173,022 cases were identified from 2003 to 2015 in PTSF, while 255,263 cases meeting trauma criteria were found in the PHC4 database over the same timeframe suggesting UTR of 32.2%. For ISS > 15, UTR was determined to be 33.6%. Visual geospatial analysis suggests regions with limited access to TCs comprise the highest proportion of undertriaged trauma patients. Despite the existence of a statewide trauma framework for over 30 years, approximately, a third of severely injured trauma patients are managed at hospitals outside of the trauma system in PA. Intelligent trauma system design should include an objective process like geospatial mapping rather than the current system which is driven by competitive models of financial and

  6. Perioperative care of a pregnant trauma victim: a review of ...

    African Journals Online (AJOL)

    Adele

    2004-05-03

    May 3, 2004 ... while decreasing the time available and the margin of safety. The pregnant trauma victim presents a unique spectrum of challenges to the trauma healthcare team. The surgical diag- nosis may be unknown at the time of incision, as may be the nature and extend of the procedure being undertaken. The fact.

  7. Males as sexual assault victims: multiple levels of trauma.

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    Anderson, C L

    The definite and persistent phenomenon of sexual assault upon males is virtually ignored in the literature, although incidence data reported here suggest the greater scope of the problem. The avoidance of the subject of sexual assault on males creates a negative environment for victims. While the motivation of assailants is briefly discussed, the article focuses on the psychological aftermath for sexual assault victims. A paradigm is offered, consisting of "Set-up," "Attack," and "Aftermath" phases. Male victims suffer "Rape Trauma Syndrome" as described for females, as well as various forms of stigmatization and secondary trauma. Differences and similarities between male and female victims are identified. Victim responses are discussed as they proceed through several stages, with implications for appropriate interventions on both the clinical and community levels. The article concludes with an extensive bibliography.

  8. Patterns of trauma in conflict victims from Timor Leste.

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    Komar, Debra A; Lathrop, Sarah

    2012-01-01

    Understanding population-level trauma patterns has implications for the recognition of war crimes and crimes against humanity. Trauma data were abstracted from autopsy and anthropology reports for 105 victims from the 1999 conflict in Timor Leste. A significant number of individuals displayed no evidence of injury. No trauma was found in 25% of the sample, while a further 5% had only minor, nonlethal wounds. Where trauma was evident, sharp force injuries were most common (35%), followed by gunshot (20%) and blunt force (13.33%). Timorese frequencies of trauma differ significantly from percentages found in prior reports of mass killings from Cambodia, Bosnia, Croatia, and Afghanistan but closely resemble reported trauma patterns in Rwanda. Decomposition and percentage of body recovered were shown to have a significant impact on the presence/absence of trauma. Complete, fleshed remains were 10.4 times more likely than skeletal remains to have evidence of major or lethal trauma. © 2011 American Academy of Forensic Sciences.

  9. Rehabilitation outcomes of terror victims with multiple traumas.

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    Schwartz, Isabella; Tsenter, Jeanna; Shochina, Mara; Shiri, Shimon; Kedary, Michal; Katz-Leurer, Michal; Meiner, Zeev

    2007-04-01

    To describe the rehabilitation outcomes of terror victims with multiple traumas, and to compare those outcomes with those of patients with nonterror-related multiple traumas treated in the same rehabilitation facility over the same time period. Retrospective chart reviews. Rehabilitation department in a university hospital in Jerusalem, Israel. Between September 2000 and September 2004, we treated 72 victims of terrorist attacks who had multiple traumas. Among them, 47 (65%) had multiple traumas without central nervous system involvement (MT subgroup), 19 (26%) had multiple traumas with traumatic brain injury (TBI subgroup), and 6 (8%) had multiple traumas with spinal cord injury (SCI subgroup). We matched, according to their types of injury and demographic data, each terror victim with a control patient treated in the same period in our rehabilitation department. Interdisciplinary inpatient and outpatient rehabilitation. Hospital length of stay (LOS) in acute care departments, inpatient and outpatient rehabilitation departments, functional outcome (FIM instrument score), occupational outcome (returning to previous occupation), and psychologic outcome (Solomon PTSD [post-traumatic stress disorder] Inventory). The mean LOS of terror victims was 218+/-131 days; for the nonterror group it was 152+/-114 days (Pvictims had significantly longer LOS in the acute care and outpatient rehabilitation departments (P=.06) and the terror TBI subgroup had a longer LOS in outpatient department only (Pterror victims and control patients, was significantly longer than that of the other 2 subgroups. The difference between FIM value at entry and discharge (DeltaFIM) was significantly higher for terror victims than for the controls (41.1+/-21.6 vs 30.8+/-21.8, P=.002). This difference was mainly the result of the significantly higher DeltaFIM achieved by the terror MT subgroup than by the MT controls. The rate of PTSD was higher among terror victims than among controls (40.9% vs 24

  10. Facial trauma among victims of terrestrial transport accidents

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    Sérgio d'Avila

    Full Text Available ABSTRACT INTRODUCTION: In developing countries, terrestrial transport accidents - TTA, especially those involving automobiles and motorcycles - are a major cause of facial trauma, surpassing urban violence. OBJECTIVE: This cross-sectional census study attempted to determine facial trauma occurrence with terrestrial transport accidents etiology, involving cars, motorcycles, or accidents with pedestrians in the northeastern region of Brazil, and examine victims' socio-demographic characteristics. METHODS: Morbidity data from forensic service reports of victims who sought care from January to December 2012 were analyzed. RESULTS: Altogether, 2379 reports were evaluated, of which 673 were related to terrestrial transport accidents and 103 involved facial trauma. Three previously trained and calibrated researchers collected data using a specific form. Facial trauma occurrence rate was 15.3% (n = 103. The most affected age group was 20-29 years (48.3%, and more men than women were affected (2.81:1. Motorcycles were involved in the majority of accidents resulting in facial trauma (66.3%. CONCLUSION: The occurrence of facial trauma in terrestrial transport accident victims tends to affect a greater proportion of young and male subjects, and the most prevalent accidents involve motorcycles.

  11. Facial trauma among victims of terrestrial transport accidents.

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    d'Avila, Sérgio; Barbosa, Kevan Guilherme Nóbrega; Bernardino, Ítalo de Macedo; da Nóbrega, Lorena Marques; Bento, Patrícia Meira; E Ferreira, Efigênia Ferreira

    2016-01-01

    In developing countries, terrestrial transport accidents - TTA, especially those involving automobiles and motorcycles - are a major cause of facial trauma, surpassing urban violence. This cross-sectional census study attempted to determine facial trauma occurrence with terrestrial transport accidents etiology, involving cars, motorcycles, or accidents with pedestrians in the northeastern region of Brazil, and examine victims' socio-demographic characteristics. Morbidity data from forensic service reports of victims who sought care from January to December 2012 were analyzed. Altogether, 2379 reports were evaluated, of which 673 were related to terrestrial transport accidents and 103 involved facial trauma. Three previously trained and calibrated researchers collected data using a specific form. Facial trauma occurrence rate was 15.3% (n=103). The most affected age group was 20-29 years (48.3%), and more men than women were affected (2.81:1). Motorcycles were involved in the majority of accidents resulting in facial trauma (66.3%). The occurrence of facial trauma in terrestrial transport accident victims tends to affect a greater proportion of young and male subjects, and the most prevalent accidents involve motorcycles. Copyright © 2015 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

  12. Standard of victims and injuries in trauma with motorcycles

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    Fernanda Soares Simoneti

    2016-04-01

    Full Text Available Introduction: In Brazil, at least one in nine hospitalized patients was a traffic accident victim. The impact of these numbers implies economic, social and administrative repercussions. Objectives: To raise epidemiological data on victims of traumatic events with motorcycles forwarded to a tertiary level hospital (Conjunto Hospitalar de Sorocaba to describe the injuries and discuss the impact on quality of life of these victims. Method: Prospective study that included trauma victims from accidents with motorcycles, between April and September, 2013, referenced to a tertiary level hospital. For data collection, standardized form was drawn up with trauma scores, mechanism of trauma and description of injuries. Results: A total of 143 patients were analyzed: 83.2% men and 16.8% women, with the predominance of the age group between 20–29 years (49.6%. The use of helmets was reported in 98.5% of cases. The male gender accounted for about 86% in the category of the motorcycle driver. The main mechanisms of trauma were collisions (72.7%, followed by drop of motorcycle (15.4%. The most frequent injuries were bruises (72.9% and cut- blunt injuries (13.8%. The most affected anatomical segments were the arms and legs, representing 83% of the cases. All patients were assessed for Revised Trauma Score (RTS; victims with RTS=12 amounted to 97.9%, suggesting relatively light gravity of most patients. Conclusions: The findings of this study, as the standard majority of victims of accidents involving motorcycles are compatible with the literature. The dominance of the economically active population of the country in as costly and disabling events such as motorcycle accidents implies the need for new strategies in traffic management and public health.

  13. Standardized evaluation of accident victims: demands on diagnostic trauma

    International Nuclear Information System (INIS)

    Kanz, K.G.; Mutschler, W.; Linsenmaier, U.; Pfeifer, K.J.

    2002-01-01

    Introduction. Evaluation of trauma systems requires a complete and exact injury classification. The purpose of this study was the introduction of the Abbreviated injury scale (AIS) for radiological trauma scoring. The development of these easy to use coding tools is essential for prompt quality management of trauma.Material and methods. Standardized radiological injury description using a modified Abbreviated injury scale in combination with a Microsoft Excel trademark spreadsheet allows an immediate calculation of the probability of survival according to TRISS methodology.Results. Computed tomography is the main instrument for injury scoring in trauma care. Postmortem scanning provides a direct feedback for trauma teams especially in cases when autopsy is not possible.Conclusion. Computed tomography enables in combination with a standardized injury description exact trauma scoring. Quality management of trauma care depends on a valid and reliable calculation of the probability of survival using TRISS. (orig.) [de

  14. Trauma admissions among victims of domestic violence at a tertiary ...

    African Journals Online (AJOL)

    Background: Despite the growing recognition of domestic violence as a public health and human rights concern, it remains rampant in developing countries and has a negative impact on the victim's health. This study describes the injury characteristics and treatment outcome of trauma associated with domestic violence in ...

  15. A systematic literature review on first aid provided by laypeople to trauma victims.

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    Tannvik, T D; Bakke, H K; Wisborg, T

    2012-11-01

    Death from trauma is a significant and international problem. Outcome for patients suffering out-of-hospital cardiac arrests is significantly improved by early cardiopulmonary resuscitation. The usefulness of first aid given by laypeople in trauma is less well established. The aim of this study was to review the existing literature on first aid provided by laypeople to trauma victims and to establish how often first aid is provided, if it is performed correctly, and its impact on outcome. A systematic review was carried out, according to preferred reporting items for systematic reviews and meta-analysis (PRISMA) guidelines, of all studies involving first aid provided by laypeople to trauma victims. Cochrane, Embase, Medline, Pubmed, and Google Scholar databases were systematically searched. Ten eligible articles were identified involving a total of 5836 victims. Eight studies were related to patient outcome, while two studies were simulation based. The proportion of patients who received first aid ranged from 10.7% to 65%. Incorrect first aid was given in up to 83.7% of cases. Airway handling and haemorrhage control were particular areas of concern. One study from Iraq investigated survival and reported a 5.8% reduction in mortality. Two retrospective autopsy-based studies estimated that correct first aid could have reduced mortality by 1.8-4.5%. There is limited evidence regarding first aid provided by laypeople to trauma victims. Due to great heterogeneity in the studies, firm conclusions can not be drawn. However, the results show a potential mortality reduction if first aid is administered to trauma victims. Further research is necessary to establish this. © 2012 The Authors. Acta Anaesthesiologica Scandinavica © 2012 The Acta Anaesthesiologica Scandinavica Foundation.

  16. Alcohol and brief intervention for trauma victims

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    KARINA DINIZ OLIVEIRA

    Full Text Available Objective:to describe the causes and severities of trauma in patients who met the criteria for alcohol abuse or dependence according to Mini International Neuropsychiatric Interview, and to display the pattern of alcohol consumption and subsequent changes one year after trauma.Methods:a transversal and longitudinal quantitative study carried out between November 2012 and September 2013 in the ED. Medical and nursing students collected blood samples, applied the J section of the Mini International Neuropsychiatric Interview (MINI and submitted alcohol abusers and dependents to BI. One year after admission, patients were contacted and asked about their patterns of alcohol use and their reasons for any changes.Results:from a sample of 507 patients admitted to the ED for trauma, 348 responded to MINI, 90 (25.9% being abusers and 36 (10.3% dependent on alcohol. Among the abusers, the most frequent cause of injury was motorcycle accident (35.6% and among the dependents it was predominantly interpersonal violence (22.2%. Positive blood samples for alcohol were identified in 31.7% of the abusers and 53.1% of the dependents. One year after trauma, 66 abusers and 31 dependents were contacted, and it was ascertained that 36.4% of the abusers and 19.4% of the dependents had decreased alcohol consumption. The main reported reason for the reduction was the experienced trauma.Conclusion:the motorcycle accident was the most common cause of injury. The detection of problematic alcohol use and implementation of BI are important strategies in the ED, however for alcohol abusers and dependents, BI was not the most reported reason for any changes in patterns of alcohol use.

  17. Survival prediction of trauma patients: a study on US National Trauma Data Bank.

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    Sefrioui, I; Amadini, R; Mauro, J; El Fallahi, A; Gabbrielli, M

    2017-12-01

    Exceptional circumstances like major incidents or natural disasters may cause a huge number of victims that might not be immediately and simultaneously saved. In these cases it is important to define priorities avoiding to waste time and resources for not savable victims. Trauma and Injury Severity Score (TRISS) methodology is the well-known and standard system usually used by practitioners to predict the survival probability of trauma patients. However, practitioners have noted that the accuracy of TRISS predictions is unacceptable especially for severely injured patients. Thus, alternative methods should be proposed. In this work we evaluate different approaches for predicting whether a patient will survive or not according to simple and easily measurable observations. We conducted a rigorous, comparative study based on the most important prediction techniques using real clinical data of the US National Trauma Data Bank. Empirical results show that well-known Machine Learning classifiers can outperform the TRISS methodology. Based on our findings, we can say that the best approach we evaluated is Random Forest: it has the best accuracy, the best area under the curve, and k-statistic, as well as the second-best sensitivity and specificity. It has also a good calibration curve. Furthermore, its performance monotonically increases as the dataset size grows, meaning that it can be very effective to exploit incoming knowledge. Considering the whole dataset, it is always better than TRISS. Finally, we implemented a new tool to compute the survival of victims. This will help medical practitioners to obtain a better accuracy than the TRISS tools. Random Forests may be a good candidate solution for improving the predictions on survival upon the standard TRISS methodology.

  18. Are trauma victims susceptible to "false memories"?

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    Zoellner, Lori A; Foa, Edna B; Brigidi, Bartholomew D; Przeworski, Amy

    2000-08-01

    Laboratory studies using word-list paradigms have provided evidence that nontraumatized individuals falsely recall or recognize events that never occurred. In the present study, H. L. Roediger and K. B. McDermott's false-memory paradigm (1995) was utilized to examine possible source monitoring deficits in individuals with PTSD. Traumatized individuals with PTSD were compared with traumatized individuals without PTSD and with nontraumatized control participants. Participants heard lists of related words (e.g., bed, night) that were associates of a critical nonpresented word (e.g., sleep) and were given immediate free recall and later recognition tests. Traumatized participants with and without PTSD generated more false recalls of critical nonpresented words than did nontraumatized participants. False recall was related to trait anxiety and PTSD severity. The results are consistent with a general source-monitoring deficit in trauma-exposed individuals.

  19. Trauma and identification of victims of suicidal terrorism in Israel.

    Science.gov (United States)

    Hiss, J; Kahana, T

    2000-11-01

    The postmortem examination and identification procedures performed by medical and law enforcement personnel involved in mass disaster management in Israel are reported. The Israel National Police, the Israel Defense Forces, and the L. Greenberg Institute of Forensic Medicine's experts examined 171 victims who died in 21 incidents of suicidal terrorism. The trauma sustained by the victims and perpetrators of suicidal bombings included complete body disruption and explosive, flying missile, and blast injuries. The modus operandi of the perpetrators, reconstructed from the distribution and type of injury of the victims, is discussed. Fifty-five victims perished in open space bombings and 91 inside buses. All perpetrators of these bombings died at the time of the incident regardless of their location. Identification of the victims was achieved using fingerprints, dental records, medical intervention signs, anatomic variation, genetic profile, and personal recognition. Prompt identification of the perpetrators allowed speedy apprehension of the accomplices and prevention of similar attacks. Collaboration between the different forensic, military, and law enforcement teams increased the efficiency of disaster management efforts.

  20. Epidemiological evaluation of hepatic trauma victims undergoing surgery

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    Mitre Kalil

    Full Text Available Objective : to evaluate the epidemiological variables and diagnostic and therapeutic modalities related to hepatic trauma patients undergoing laparotomy in a public referral hospital in the metropolitan region of Vitória-ES. Methods : we conducted a retrospective study, reviewing charts of trauma patients with liver injuries, whether isolated or in association with other organs, who underwent exploratory laparotomy, from January 2011 to December 2013. Results : We studied 392 patients, 107 of these with liver injury. The male: female ratio was 6.6 : 1 and the mean age was 30.12 years. Penetrating liver trauma occurred in 78.5% of patients, mostly with firearms. Associated injuries occurred in 86% of cases and intra-abdominal injuries were more common in penetrating trauma (p <0.01. The most commonly used operative technique was hepatorrhaphy and damage control surgery was applied in 6.5% of patients. The average amounts of blood products used were 6.07 units of packed red blood cells and 3.01 units of fresh frozen plasma. The incidence of postoperative complications was 29.9%, the most frequent being infectious, including pneumonia, peritonitis and intra-abdominal abscess. The survival rate of patients suffering from blunt trauma was 60%, and penetrating trauma, 87.5% (p <0.05. Conclusion : despite technological advances in diagnosis and treatment, mortality rates in liver trauma remain high, especially in patients suffering from blunt trauma in relation to penetrating one.

  1. Analysis of the Revised Trauma Score (RTS in 200 victims of different trauma mechanisms

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    BRUNO DURANTE ALVAREZ

    Full Text Available ABSTRACT Objective: to analyze the epidemiological profile and mortality associated with the Revised Trauma Score (RTS in trauma victims treated at a university hospital. Methods: we conducted a descriptive, cross-sectional study of trauma protocols (prospectively collected from December 2013 to February 2014, including trauma victims admitted in the emergency room of the Cajuru University Hospital. We set up three groups: (G1 penetrating trauma to the abdomen and chest, (G2 blunt trauma to the abdomen and chest, and (G3 traumatic brain injury. The variables we analyzed were: gender, age, day of week, mechanism of injury, type of transportation, RTS, hospitalization time and mortality. Results: we analyzed 200 patients, with a mean age of 36.42 ± 17.63 years, and 73.5% were male. The mean age was significantly lower in G1 than in the other groups (p <0.001. Most (40% of the visits occurred on weekends and the most common pre-hospital transport service (58% was the SIATE (Emergency Trauma Care Integrated Service. The hospital stay was significantly higher in G1 compared with the other groups (p <0.01. Regarding mortality, there were 12%, 1.35% and 3.95% of deaths in G1, G2 and G3, respectively. The median RTS among the deaths was 5.49, 7.84 and 1.16, respectively, for the three groups. Conclusion: the majority of patients were young men. RTS was effective in predicting mortality in traumatic brain injury, however failing to predict it in patients suffering from blunt and penetrating trauma.

  2. Postinjury malaria: a study of trauma victims in cambodia.

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    Husum, Hans; Heger, Tove; Sundet, Mads

    2002-02-01

    The pattern of host defense against plasmodium is comparable to the immune response to bacterial infection. Posttraumatic immunosuppression may therefore cause relapses of malaria secondary to trauma and trauma surgery in asymptomatic carriers of the parasites in endemic areas. To our knowledge this has not been validated in epidemiologic studies. Postinjury malaria was registered retrospectively in 342 land mine and war victims from malaria-endemic areas in Cambodia. The incidence rate was analyzed in terms of age, gender, preinjury endemicity, evacuation times, anatomic injury severity, systolic blood pressure at admission, blood transfusion, and duration of the first surgical intervention as independent variables. The rate of postinjury malaria in the study patients was 33.3% (95% CI, 28.3-38.3%). Injury Severity Score (ISS) and surgical operation time were risk factors (area under the curve in receiver operating characteristic plots were 0.73 and 0.79, respectively). The impact of the other risk factors was nonsignificant. Despite difficulties in diagnosing postoperative malaria in endemic areas, the study demonstrates that the rate of postinjury malaria is high. The results legitimate controlled trials of immediate postinjury chemoprophylaxis to severely injured in endemic areas. The authors recommend staged surgical operations with brief primary interventions in victims with severe injuries.

  3. The effects of trauma among kidnap victims in Sardinia, Italy.

    Science.gov (United States)

    Favaro, A; Degortes, D; Colombo, G; Santonastaso, P

    2000-07-01

    No study to date has investigated the effects of the trauma of being kidnapped for ransom. In the present study, we aimed to assess the general health status and the presence of post-traumatic stress disorder (PTSD) and major depression (MDD) in a sample of kidnap victims. We also focused attention on dissociative experiences and on the development of the Stockholm syndrome during captivity. We investigated the traumatic experiences and reported general health status of 24 kidnap victims using a semistructured interview. The Structured Clinical Interview for DSM-IV was used to assess the presence of PTSD and MDD. The Dissociative Experiences Scale was also administered. The lifetime frequency of PTSD and MDD were 45.9% and 37.5% respectively. The Stockholm syndrome had been present in 50% of the sample during captivity. The presence of PTSD can be predicted by the number of violent experiences, whereas the number of humiliating or deprivation experiences predicts the development of the Stockholm syndrome. Subjects with both PTSD and the Stockholm syndrome reported a greater number of physical complaints at the interview. There is no significant connection between PTSD and the Stockholm syndrome. Both are indices of the severity of the trauma of being kidnapped, but they are associated with different aspects of the traumatic experience. The presence of both syndromes appears to have a detrimental effect on physical health.

  4. Profile of thoracic trauma victims submitted to chest drainage

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    CESAR AUGUSTO BROSKA JÚNIOR

    Full Text Available ABSTRACT Objective: to describe and compare the variables involved in trauma victims undergoing thoracic drainage. Methods: we conducted a retrospective, analytical, descriptive, cross-sectional study, with medical records of patients attended at the Trauma Service of the Curitiba Evangelical University Hospital between February 2011 and January 2014. Results: there were 488 patients undergoing chest drainage, 84.7% men and 15.3% women, with an average age of 38.2 years. Attendances usually occurred at night, without predominance between open or closed mechanism, gender or age group. The majority of patients with thoracic trauma requiring drainage were diagnosed by anamnesis and physical examination (41.1% and drained in the emergency room (80.8%. Most of the patients (66.2% had another associated lesion, mostly some abdominal viscera. Complications were present in 16.6% (81 patients, most of them due to drainage positioning error (9.2%. The mean hospital stay was 15 days and drainage lasted for an average of 8.1 days, with no statistical difference between open and closed trauma. The clinical outcome was discharge in most cases. Conclusion: the profile of patients with thoracic trauma is that of young men, attended at night, with some other associated lesion. Although diagnosis and treatment were rapid and most often without the need for complex examinations, the time of drainage, hospitalization and complications were higher than in the literature, which can be explained by the drainage being made at the Emergency Room and the presence of associated injuries.

  5. Analysis of the Revised Trauma Score (RTS) in 200 victims of different trauma mechanisms.

    Science.gov (United States)

    Alvarez, Bruno Durante; Razente, Danilo Mardegam; Lacerda, Daniel Augusto Mauad; Lother, Nicole Silveira; VON-Bahten, Luiz Carlos; Stahlschmidt, Carla Martinez Menini

    2016-01-01

    to analyze the epidemiological profile and mortality associated with the Revised Trauma Score (RTS) in trauma victims treated at a university hospital. we conducted a descriptive, cross-sectional study of trauma protocols (prospectively collected) from December 2013 to February 2014, including trauma victims admitted in the emergency room of the Cajuru University Hospital. We set up three groups: (G1) penetrating trauma to the abdomen and chest, (G2) blunt trauma to the abdomen and chest, and (G3) traumatic brain injury. The variables we analyzed were: gender, age, day of week, mechanism of injury, type of transportation, RTS, hospitalization time and mortality. we analyzed 200 patients, with a mean age of 36.42 ± 17.63 years, and 73.5% were male. The mean age was significantly lower in G1 than in the other groups (p sexo, idade, dia da semana, mecanismo de trauma, tipo de transporte, RTS, tempo de internamento e mortalidade. analisou-se 200 pacientes, com média de idade de 36,42 ± 17,63 anos, sendo 73,5% do sexo masculino. A média de idade no G1 foi significativamente menor do que nos demais grupos (p <0,001). A maioria (40%) dos atendimentos ocorreu nos finais de semana e o serviço de transporte pré-hospitalar mais frequente (58%) foi o SIATE (Serviço Integrado de Atendimento ao Trauma em Emergência). O tempo de internamento foi significativamente maior no G1, em comparação aos demais grupos (p <0,01). Quanto à mortalidade, houve 12%, 1,35% e 3,95% de óbitos nos grupos G1, G2 e G3, respectivamente. A mediana do RTS entre os óbitos foi 5,49, 7,84 e 1,16, respectivamente, para os três grupos. a maioria dos pacientes eram homens jovens. O RTS mostrou-se efetivo na predição de mortalidade no trauma cranioencefálico, entretanto falhou ao analisar pacientes vítimas de trauma contuso e penetrante.

  6. Profile of thoracic trauma victims submitted to chest drainage.

    Science.gov (United States)

    Broska, Cesar Augusto; Botelho, Adriane Barbosa; Linhares, André DE Castro; DE-Oliveria, Mariana Santos; Veronese, Gabriela; Naufel, Carlos Roberto; Batista, Lislaine Cruz; Diogo, Maria Angélica Kurpel

    2017-01-01

    to describe and compare the variables involved in trauma victims undergoing thoracic drainage. we conducted a retrospective, analytical, descriptive, cross-sectional study, with medical records of patients attended at the Trauma Service of the Curitiba Evangelical University Hospital between February 2011 and January 2014. there were 488 patients undergoing chest drainage, 84.7% men and 15.3% women, with an average age of 38.2 years. Attendances usually occurred at night, without predominance between open or closed mechanism, gender or age group. The majority of patients with thoracic trauma requiring drainage were diagnosed by anamnesis and physical examination (41.1%) and drained in the emergency room (80.8%). Most of the patients (66.2%) had another associated lesion, mostly some abdominal viscera. Complications were present in 16.6% (81 patients), most of them due to drainage positioning error (9.2%). The mean hospital stay was 15 days and drainage lasted for an average of 8.1 days, with no statistical difference between open and closed trauma. The clinical outcome was discharge in most cases. the profile of patients with thoracic trauma is that of young men, attended at night, with some other associated lesion. Although diagnosis and treatment were rapid and most often without the need for complex examinations, the time of drainage, hospitalization and complications were higher than in the literature, which can be explained by the drainage being made at the Emergency Room and the presence of associated injuries. descrever e comparar as variáveis envolvidas nos pacientes vítimas de trauma torácico submetidos à drenagem de tórax. estudo transversal descritivo analítico retrospectivo realizado com prontuários de pacientes atendidos no Serviço de Trauma do Hospital Universitário Evangélico de Curitiba entre fevereiro de 2011 e janeiro de 2014. neste período foram atendidos 488 pacientes, 84,7% homens e 15,3% mulheres, com média de idade de 38,2 anos

  7. Thorax computed tomography findings in patients victims of chest trauma

    Directory of Open Access Journals (Sweden)

    Francisco Jose Rodrigues de Moura Filho

    2015-12-01

    Full Text Available Objective: To describe thorax computed tomography findings in patients assisted in the emergency unit of Institute Dr Jose Frota (IJF. Materials and Methods: Descriptive study analyzing 160 consecutive contrast-enhanced thorax computed tomography of patients victims of thoracic trauma admitted to the emergency unit of IJF, between November 1st, 2014 and January 31st, 2015. Results: Abnormal findings were observed in 91,2 % of the patients. Among them, the following findings were most frequently observed: fractures (48%, hemothorax (43%, atelectasis (37%, pneumothorax (26% and lung contusions (17% Rupture of the esophagus was seen in three patients. Conclusion: We recognize that the findings encountered in our study are of similar prevalence to the ones reported in the literature and that CT scan is essencial to quickly diagnose these findings.

  8. Predictors of trauma in bank employee robbery victims.

    Science.gov (United States)

    Mucci, Nicola; Giorgi, Gabriele; Fiz Perez, Javier; Iavicoli, Ivo; Arcangeli, Giulio

    2015-01-01

    In the literature, there are many studies that have investigated the psychological reactions resulting from traumatic events of varying degrees, such as wars, natural disasters, and acts of violence. Few, however, are the searches performed on employees who are victims of robbery. We carried out a research to assess the psychological reactions of 644 bank employees who had been victims of robbery, especially with regard to the possible development of post-traumatic stress disorder (PTSD). The aim of this study was to evaluate the variables pre-, peri-, and postrobbery trauma in relation to the development of psychopathological symptoms. The exploration of the reactions after the robbery was carried out on 644 employees of a banking institution, present throughout the national territory, through a survey, consisting of a general description of the event, the Impact of Event Scale Revised-6 scale, and the General Health Questionnaire-12, during the days after the robbery. The analysis showed that the development of pretrauma variables is not significant and that peritrauma variables are partially significant. In particular, being directly involved in the robbery, the thought of being hurt, and the feeling of intense fear are associated with posttraumatic symptoms. Finally, among the posttrauma variables, anxiety and depression played a major role. Surprisingly, a lower level of self-confidence seems to be related negatively to the PTSD symptomatology.

  9. Predictors of trauma in bank employee robbery victims

    Directory of Open Access Journals (Sweden)

    Mucci N

    2015-10-01

    Full Text Available Nicola Mucci,1 Gabriele Giorgi,2 Javier Fiz Perez,2 Ivo Iavicoli,1 Giulio Arcangeli3 1Institute of Public Health, Catholic University of Sacred Heart, Rome, Italy; 2Department of Psychology, European University of Rome, Rome, Italy; 3Department of Clinical and Experimental Medicine, University of Florence, Florence, Italy Abstract: In the literature, there are many studies that have investigated the psychological reactions resulting from traumatic events of varying degrees, such as wars, natural disasters, and acts of violence. Few, however, are the searches performed on employees who are victims of robbery. We carried out a research to assess the psychological reactions of 644 bank employees who had been victims of robbery, especially with regard to the possible development of posttraumatic stress disorder (PTSD. The aim of this study was to evaluate the variables pre-, peri-, and postrobbery trauma in relation to the development of psychopathological symptoms. The exploration of the reactions after the robbery was carried out on 644 employees of a banking institution, present throughout the national territory, through a survey, consisting of a general description of the event, the Impact of Event Scale Revised-6 scale, and the General Health Questionnaire-12, during the days after the robbery. The analysis showed that the development of pretrauma variables is not significant and that peritrauma variables are partially significant. In particular, being directly involved in the robbery, the thought of being hurt, and the feeling of intense fear are associated with posttraumatic symptoms. Finally, among the posttrauma variables, anxiety and depression played a major role. Surprisingly, a lower level of self-confidence seems to be related negatively to the PTSD symptomatology. Keywords: bank, bank robbery, occupational health, workplace, stress, PTSD

  10. Post-mortem imaging compared with autopsy in trauma victims--A systematic review.

    Science.gov (United States)

    Jalalzadeh, Hamid; Giannakopoulos, Georgios F; Berger, Ferco H; Fronczek, Judith; van de Goot, Frank R W; Reijnders, Udo J; Zuidema, Wietse P

    2015-12-01

    Post-mortem imaging or virtual autopsy is a rapidly advancing field of post-mortem investigations of trauma victims. In this review we evaluate the feasibility of complementation or replacement of conventional autopsy by post-mortem imaging in trauma victims. A systematic review was performed in compliance with the PRISMA guidelines. MEDLINE, Embase and Cochrane databases were systematically searched for studies published between January 2008 and January 2014, in which post-mortem imaging was compared to conventional autopsy in trauma victims. Studies were included when two or more trauma victims were investigated. Twenty-six studies were included, with a total number of 563 trauma victims. Post-mortem computer tomography (PMCT) was performed in 22 studies, post-mortem magnetic resonance imaging (PMMRI) in five studies and conventional radiography in two studies. PMCT and PMMRI both demonstrate moderate to high-grade injuries and cause of death accurately. PMCT is more sensitive than conventional autopsy or PMMRI in detecting skeletal injuries. For detecting minor organ and soft tissue injuries, autopsy remains superior to imaging. Aortic injuries are missed frequently by PMCT and PMMRI and form their main limitation. PMCT should be considered as an essential supplement to conventional autopsy in trauma victims since it detects many additional injuries. Despite some major limitations, PMCT could be used as an alternative for conventional autopsy in situations where conventional autopsy is rejected or unavailable. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  11. Latent classes of childhood poly-victimization and associations with suicidal behavior among adult trauma victims: Moderating role of anger.

    Science.gov (United States)

    Charak, Ruby; Byllesby, Brianna M; Roley, Michelle E; Claycomb, Meredith A; Durham, Tory A; Ross, Jana; Armour, Cherie; Elhai, Jon D

    2016-12-01

    The aims of the present study were first to identify discrete patterns of childhood victimization experiences including crime, child maltreatment, peer/sibling victimization, sexual violence, and witnessing violence among adult trauma victims using latent class analysis; second, to examine the association between class-membership and suicidal behavior, and third to investigate the differential role of dispositional anger on the association between class-membership and suicidal behavior. We hypothesized that those classes with accumulating exposure to different types of childhood victimization (e.g., poly-victimization) would endorse higher suicidal behavior, than the other less severe classes, and those in the most severe class with higher anger trait would have stronger association with suicidal behavior. Respondents were 346 adults (N=346; M age =35.0years; 55.9% female) who had experienced a lifetime traumatic event. Sixty four percent had experienced poly-victimization (four or more victimization experiences) and 38.8% met the cut-off score for suicidal behavior. Three distinct classes emerged namely, the Least victimization (Class 1), the Predominantly crime and sibling/peer victimization (Class 2), and the Poly-victimization (Class 3) classes. Regression analysis controlling for age and gender indicated that only the main effect of anger was significantly associated with suicidal behavior. The interaction term suggested that those in the Poly-victimization class were higher on suicidal behavior as a result of a stronger association between anger and suicidal behavior in contrast to the association found in Class 2. Clinical implications of findings entail imparting anger management skills to facilitate wellbeing among adult with childhood poly-victimization experiences. Copyright © 2016 Elsevier Ltd. All rights reserved.

  12. Trauma history characteristics and subsequent PTSD symptoms in motor vehicle accident victims.

    Science.gov (United States)

    Irish, Leah; Ostrowski, Sarah A; Fallon, William; Spoonster, Eileen; Dulmen, Manfred van; Sledjeski, Eve M; Delahanty, Douglas L

    2008-08-01

    The present study examined the relationship between trauma history characteristics (number and type of traumas, age at first trauma, and subjective responses to prior traumas) and the development of posttraumatic stress disorder (PTSD) symptoms following a motor vehicle accident (MVA). One hundred eighty-eight adult MVA victims provided information about prior traumatization and were evaluated for PTSD symptoms 6 weeks and one year following the MVA. Results indicated that after controlling for demographics and depression, prior trauma history characteristics accounted for a small, but significant amount of the variance in PTSD symptoms. Distress from prior trauma and number of types of prior traumas were the most meaningful trauma history predictors. Results encourage further evaluation of trauma history as a multifaceted construct.

  13. The incidence, pathology of trauma and victim profiles of homicidal deaths in Pretoria, South Africa (2007-2008).

    Science.gov (United States)

    Cocks, Jeannie; Saayman, Gert

    2013-04-01

    This study aimed to establish the incidence of homicide, associated pathology of trauma and victim profiles in cases admitted to or managed as homicidal deaths at the Pretoria Medico-Legal Laboratory (PMLL) over the period of 2007-2008. A total of 1088 cases were reviewed. Homicides accounted for 22.7% of all cases admitted to the PMLL. The majority of homicide victims were male individuals (87.0%). The most common cause of death was gunshot wounds (42.6%), followed by blunt force trauma (25.1%). Homicides are most likely to occur at the victim's place of residence (28.5%) and only 37.4% of victims survive long enough to receive hospital care. The results of this study seem to concur with international findings for the most part, with a few interesting deviations. Highlighting at-risk groups, as well as dangerous locations and incident times, creates the potential to decrease the occurrence of unnecessary deaths by generating an awareness of the trends.

  14. Epidemiological evaluation of hepatic trauma victims undergoing surgery.

    Science.gov (United States)

    Kalil, Mitre; Amaral, Isaac Massaud Amim

    2016-02-01

    to evaluate the epidemiological variables and diagnostic and therapeutic modalities related to hepatic trauma patients undergoing laparotomy in a public referral hospital in the metropolitan region of Vitória-ES. we conducted a retrospective study, reviewing charts of trauma patients with liver injuries, whether isolated or in association with other organs, who underwent exploratory laparotomy, from January 2011 to December 2013. We studied 392 patients, 107 of these with liver injury. The male: female ratio was 6.6 : 1 and the mean age was 30.12 years. Penetrating liver trauma occurred in 78.5% of patients, mostly with firearms. Associated injuries occurred in 86% of cases and intra-abdominal injuries were more common in penetrating trauma (p trauma was 60%, and penetrating trauma, 87.5% (p trauma remain high, especially in patients suffering from blunt trauma in relation to penetrating one.

  15. Teen Dating Violence Victimization, Trauma Symptoms, and Revictimization in Early Adulthood.

    Science.gov (United States)

    Jouriles, Ernest N; Choi, Hye Jeong; Rancher, Caitlin; Temple, Jeff R

    2017-07-01

    This research examined whether experiencing physical teen dating violence (TDV) relates to trauma symptoms, which in turn, predict future physical dating violence victimization in early adulthood. Adolescents (N = 843) recruited from high schools reported on their experiences of physical TDV victimization and trauma symptoms. The sample was followed over a 5-year period to assess for revictimization in early adulthood. Trauma symptoms functioned as a mediator between experiences of physical TDV victimization during adolescence and later revictimization in early adulthood, even in a conservative test of mediation that controlled for baseline trauma symptoms. Multigroup analyses testing for gender differences suggest that this mediation model is significant for females but not for males. The present findings suggest that the mental health consequences of experiencing physical TDV are an important factor contributing to future victimization in early adulthood. This holds potentially important implications for school-based efforts for reducing physical TDV. Specifically, school-based efforts to reduce victimization may be enhanced by supplementing existing efforts with empirically supported programs for addressing trauma symptoms. Copyright © 2017 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  16. Delinquent-Victim Youth-Adapting a Trauma-Informed Approach for the Juvenile Justice System.

    Science.gov (United States)

    Rapp, Lisa

    2016-01-01

    The connection between victimization and later delinquency is well established and most youth involved with the juvenile justice system have at least one if not multiple victimizations in their history. Poly-victimized youth or those presenting with complex trauma require specialized assessment and services to prevent deleterious emotional, physical, and social life consequences. Empirical studies have provided information which can guide practitioners work with these youth and families, yet many of the policies and practices of the juvenile justice system are counter to this model. Many youth-serving organizations are beginning to review their operations to better match a trauma-informed approach and in this article the author will highlight how a trauma-informed care model could be utilized to adapt the juvenile justice system.

  17. Meta-analysis of risk factors for secondary traumatic stress in therapeutic work with trauma victims.

    Science.gov (United States)

    Hensel, Jennifer M; Ruiz, Carlos; Finney, Caitlin; Dewa, Carolyn S

    2015-04-01

    Revisions to the posttraumatic stress disorder (PTSD) diagnostic criteria in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5; American Psychiatric Association, 2013) clarify that secondary exposure can lead to the development of impairing symptoms requiring treatment. Historically known as secondary traumatic stress (STS), this reaction occurs through repeatedly hearing the details of traumatic events experienced by others. Professionals who work therapeutically with trauma victims may be at particular risk for this exposure. This meta-analysis of 38 published studies examines 17 risk factors for STS among professionals indirectly exposed to trauma through their therapeutic work with trauma victims. Small significant effect sizes were found for trauma caseload volume (r = .16), caseload frequency (r = .12), caseload ratio (r = .19), and having a personal trauma history (r = .19). Small negative effect sizes were found for work support (r = -.17) and social support (r = -.26). Demographic variables appear to be less implicated although more work is needed that examines the role of gender in the context of particular personal traumas. Caseload frequency and personal trauma effect sizes were moderated by year of publication. Future work should examine the measurement of STS and associated impairment, understudied risk factors, and effective interventions. Copyright © 2015 International Society for Traumatic Stress Studies.

  18. [An epidemiological survey on motorcycle accident victims assisted at a reference trauma center of Sergipe].

    Science.gov (United States)

    Vieira, Rita de Cássia Almeida; Hora, Edilene Curvelo; de Oliveira, Daniel Vieira; Vaez, Andréia Centenaro

    2011-12-01

    The trauma caused by motorcycle accidents affects a large number of victims and is a serious public health problem in Brazil. This documental study was performed with a quantitative approach with the objective to raise epidemiological data from 554 motorcycle accident victims assisted in September and October 2006 in a referral center for trauma of Sergipe. The result analysis shows a predominance of men (82.7%) with mean age of 27.78 years, who were admitted during the night shift (45.9%), Sunday (27.3%), whose injuries were abrasions (n=169) on the head, face and neck. The victims stayed in the hospital for up to 12 hours (76%) and were discharged. Of the registered cases, 14.6% were suspected of having consumed alcohol and 19.3% were not wearing a helmet during the accident.

  19. Prehospital interventions for penetrating trauma victims: a prospective comparison between Advanced Life Support and Basic Life Support.

    Science.gov (United States)

    Seamon, Mark J; Doane, Stephen M; Gaughan, John P; Kulp, Heather; D'Andrea, Anthony P; Pathak, Abhijit S; Santora, Thomas A; Goldberg, Amy J; Wydro, Gerald C

    2013-05-01

    Advanced Life Support (ALS) providers may perform more invasive prehospital procedures, while Basic Life Support (BLS) providers offer stabilisation care and often "scoop and run". We hypothesised that prehospital interventions by urban ALS providers prolong prehospital time and decrease survival in penetrating trauma victims. We prospectively analysed 236 consecutive ambulance-transported, penetrating trauma patients an our urban Level-1 trauma centre (6/2008-12/2009). Inclusion criteria included ICU admission, length of stay >/=2 days, or in-hospital death. Demographics, clinical characteristics, and outcomes were compared between ALS and BLS patients. Single and multiple variable logistic regression analysis determined predictors of hospital survival. Of 236 patients, 71% were transported by ALS and 29% by BLS. When ALS and BLS patients were compared, no differences in age, penetrating mechanism, scene GCS score, Injury Severity Score, or need for emergency surgery were detected (p>0.05). Patients transported by ALS units more often underwent prehospital interventions (97% vs. 17%; p<0.01), including endotracheal intubation, needle thoracostomy, cervical collar, IV placement, and crystalloid resuscitation. While ALS ambulance on-scene time was significantly longer than that of BLS (p<0.01), total prehospital time was not (p=0.98) despite these prehospital interventions (1.8 ± 1.0 per ALS patient vs. 0.2 ± 0.5 per BLS patient; p<0.01). Overall, 69.5% ALS patients and 88.4% of BLS patients (p<0.01) survived to hospital discharge. Prehospital resuscitative interventions by ALS units performed on penetrating trauma patients may lengthen on-scene time but do not significantly increase total prehospital time. Regardless, these interventions did not appear to benefit our rapidly transported, urban penetrating trauma patients. Copyright © 2013 Elsevier Ltd. All rights reserved.

  20. Complex Sequelae of Psychological Trauma Among Kosovar Civilian War Victims

    NARCIS (Netherlands)

    Morina, N.; Ford, J.D.

    2008-01-01

    Aims: The impact of war trauma on civilians may include, but also extend beyond, post-traumatic stress disorder (PTSD) to include complex sequelae such as those described by the syndrome of Disorders of Extreme Stress Not Otherwise Specified (DESNOS). Methods: In the present study, 102 civilian war

  1. Coping with Trauma: Verbatim Accounts of Victims of Police Torture ...

    African Journals Online (AJOL)

    When individuals go through events that threaten their lives or the lives of those they love, it is traumatic. The trauma leaves in its wake a group of symptoms that, if not addressed, lead to Post Traumatic Stress Disorder (PTSD). Even with PTSD's severe stress reactions, individuals have to continue-though extremely ...

  2. Intentional forgetting of emotional words after trauma: a study with victims of sexual assault.

    Science.gov (United States)

    Blix, Ines; Brennen, Tim

    2011-01-01

    Following exposure to a trauma, people tend to experience intrusive thoughts and memories about the event. In order to investigate whether intrusive memories in the aftermath of trauma might be accounted for by an impaired ability to intentionally forget disturbing material, the present study used a modified Directed Forgetting task to examine intentional forgetting and intrusive recall of words in sexual assault victims and controls. By including words related to the trauma in addition to neutral, positive, and threat-related stimuli it was possible to test for trauma-specific effects. No difference between the Trauma and the Control group was found for correct recall of to-be-forgotten (F) words or to-be-remembered (R) words. However, when recalling words from R-list, the Trauma group mistakenly recalled significantly more trauma-specific words from F-list. "Intrusive" recall of F-trauma words when asked to recall R-words was related to symptoms of post-traumatic stress disorder reported on the Impact of Event Scale and the Post-traumatic Diagnostic Scale. The results are discussed in term of a source-monitoring account.

  3. Intentional forgetting of emotional words after trauma: A study with victims of sexual assault

    Directory of Open Access Journals (Sweden)

    Ines eBlix

    2011-09-01

    Full Text Available Following exposure to a trauma, people tend to experience intrusive thoughts and memories about the event. In order to investigate whether intrusive memories in the aftermath of trauma might be accounted for by an impaired ability to intentionally forget disturbing material, the present study used a modified Directed Forgetting (DF task to examine intentional forgetting and intrusive recall of words in sexual assault victims and controls. By including words related to the trauma in addition to neutral, positive and threat-related stimuli it was possible to test for trauma-specific effects. No difference between the Trauma and the Control group was found for correct recall of to-be-forgotten (F words or to-be-remembered (R words. However, when recalling words from R- list, the Trauma group mistakenly recalled significantly more trauma-specific words from F- list. Intrusive recall of F trauma words when asked to recall R-words was related to symptoms of intrusion reported on the IES.

  4. INTERPLAY OF SOCIAL REPRESENTATIONS, TRAUMA AND VICTIMIZATION IN INTRACTABLE CONFLICTS: THE CASE OF THE CYPRUS CONFLICT

    Directory of Open Access Journals (Sweden)

    Cristiana Lavinia Bădulescu

    2017-12-01

    Full Text Available Intractable conflicts are conflicts that persist over a long period of time, resist various attempts of resolution, and present sporadic episodes of violence juxtaposed with periods of relative calm. Also, they contain a large share of psychosocial factors which lend to their uniqueness while also adding to their complexity. The Cypriot conflict is such a conflict. It has been on the agenda of the international community for over four decades, it has gone through a number of occasional violent episodes that fluctuated in frequency and intensity, and has resisted various peace mediation efforts. As a result, the conflicting parties remained locked in an adversarial relationship and fixed in terms of fundamental grievances. This paper aims to explore the interplay of social representations, trauma and victimization in the Cyprus conflict, and their implications on the prospects for its further settlement. Specifically, using discourse analysis as a research method, this paper analyses both the Greek-Cypriot and Turkish-Cypriot official discourse during 1983-2012 in order to see how the two parties represent the conflict, and whether past trauma and victimization influence their social representations. Close attention to the key themes emerging from the two parties’ official discourse helps to deepen understanding of the role and effect social representations, trauma and victimization play in the perpetuation of the Cyprus conflict.

  5. Multiple traumas and resilience among street children in Haiti: Psychopathology of survival.

    Science.gov (United States)

    Cénat, Jude Mary; Derivois, Daniel; Hébert, Martine; Amédée, Laetitia Mélissande; Karray, Amira

    2018-05-01

    In Haiti, as in several developing countries, the phenomenon of street children has become a major public health issue. These children are often victims of traumas and adverse life events. This article aimed to investigate traumas experienced by street children and their coping and resilience strategies used to deal with adversities in a logic of survival, relying on a mixed method approach. A group of 176 street children, aged 7-18 (n = 21 girls), recruited in Port-au-Prince, completed measures assessing PTSD, social support and resilience. Semi-structured interviews were conducted to document traumatic experiences, factors related to resilience and coping strategies. After performing statistical analyses to evaluate prevalence and predictors associated with PTSD, and level of social support satisfaction and resilience, qualitative analysis using a grounded theory approach was conducted. Results showed that street children experienced multiple traumas such as neglect, maltreatment, psychological, physical and sexual abuse. However, they also showed self-efficacy to face their traumatic experiences and few of them (less than 15%) obtained scores reaching clinical rates of PTSD, while a large majority presented a level of resilience between moderate to very high. A socio-ecological model of multiple traumas and a model of coping, survival and resilience strategies are conceptualized. Data provide a better understanding of the traumas experienced by street children, their coping and resilience strategies. Results underscore ways to develop practices to offer psychological support, social and vocational integration based on the real needs of these children, in a perspective of social justice. Copyright © 2018 Elsevier Ltd. All rights reserved.

  6. Where do I go? A trauma victim's plea in an informal trauma system.

    Science.gov (United States)

    Radjou, Angeline N; Mahajan, Preetam; Baliga, Dillip K

    2013-07-01

    The three pillars of a good trauma system are the prehospital care, definitive care, and rehabilitative services. The prehospital care is a critical component of the efforts to lower trauma mortality. To study the prehospital profile of patients who died due to trauma, compute the time taken to reach our facility, find the cause of delay, and make feasible recommendations. A hospital-based study was performed at a trauma center in Puducherry from June 2009 to August 2010. Puducherry is a union territory of India in the geographical terrain of the state of Tamil Nadu. A total of 241deaths due to trauma were included. Apart from the demographic and injury characteristics, a detailed prehospital log was constructed regarding the time of incident, the referral patterns, care given in the prehospital phase, the distance travelled, and the total time taken to reach our center. The majority (59%) of patients were referred, with stopovers at two consecutive referral centers (30%), needing at least two vehicles to transport to definitive care (70%), clocking unnecessary distances (67%), and delayed due to non therapeutic intervention (87%). The majority of deaths (66%) were due to head injury. Only 2.96% of referred cases reached us within the first hour. Few of the patients coming directly to us had vehicle change due to local availability and lack of knowledge of predestined definitive care facility. Overall, 94.6% of direct cases arrived within 4 h whereas 93.3% of referred cases required up to 7 h to arrive at definitive care. Seriously injured patients lose valuable prehospital time because there is no direction regarding destination and interfacility transfer, a lack of seamless transport, and no concept of initial trauma care. The lack of direction is compounded in geographical areas that are situated at the border of political jurisdictions.

  7. Hypothermia in trauma victims at first arrival of ambulance personnel: an observational study with assessment of risk factors.

    Science.gov (United States)

    Lapostolle, Frédéric; Couvreur, James; Koch, François Xavier; Savary, Dominique; Alhéritière, Armelle; Galinski, Michel; Sebbah, Jean-Luc; Tazarourte, Karim; Adnet, Frédéric

    2017-04-24

    Hypothermia is common in trauma victims and is associated with increased mortality, however its causes are little known. The objective of this study was to identify the risk factors associated with hypothermia in prehospital management of trauma victims. This was an ancillary analysis of data recorded in the HypoTraum study, a prospective multicenter study conducted by the emergency medical services (EMS) of 8 hospitals in France. Inclusion criteria were: trauma victim, age over 18 years, and victim receiving prehospital care from an EMS team and transported to hospital by the EMS team in a medically equipped mobile intensive care unit. The following data were recorded: victim demographics, circumstances of the trauma, environmental factors, patient presentation, clinical data and time from accident to EMS arrival. Independent risk factors for hypothermia were analyzed in a multivariate logistic regression model. A total of 461 trauma patients were included in the study. Road traffic accidents (N = 261; 57%) and falls (N = 65; 14%) were the main causes of trauma. Hypothermia (present in 136/461 cases (29%). Independent factors significantly associated with the presence of hypothermia were: a low GCS (Odds Ratio (OR) = 0,87 ([0,81-0,92]; p measurement and immediate thermal protection should be routine, and special attention should be given to patients who are wet. Prospective, multicenter, open, observational study; Level IV.

  8. What Therapies are Favored in the Treatment of the Psychological Sequelae of Trauma in Human Trafficking Victims?

    Science.gov (United States)

    Salami, Temilola; Gordon, Mollie; Coverdale, John; Nguyen, Phuong T

    2018-03-01

    Human trafficking is a major public health concern that brings about deleterious psychological consequences and sequelae. Although a number of risk and protective factors for the health consequences of human trafficking victims have been identified, there is a dearth of information in the area of treatment. Specifically, we found no articles comparing the different components of prevailing trauma treatment strategies, and the potential usefulness of these strategies in the treatment of human trafficking victims. To this end, we compared and contrasted the different therapeutic treatments typically implemented with victims of trauma (including domestic violence victims and torture victims), and discussed how the different components of these treatments may or may not be helpful for human trafficking victims. We assessed the impact of these treatments on the psychological consequences of trauma and, in particular on posttraumatic stress disorder. We also assessed the potential usefulness of these treatments with co-occurring problems such as substance use, psychosis, dissociation, and other mood and anxiety disorders. On the basis of the prevailing research, we highlighted cognitive therapies as being preferred in addressing the needs of human trafficking victims. Mental health providers who work with human trafficking victims should become aware of and practiced in the use of cognitive therapeutic approaches in treating this population. Efficacy and effectiveness studies are needed to validate our recommendations.

  9. Cinematic narratives of Sonderkommando: Son of saul or narrating the victim, perpetrator, trauma and death

    Directory of Open Access Journals (Sweden)

    Daković Nevena

    2016-01-01

    Full Text Available The aim of this paper is to map out - by analysing the film Son of Saul, but also by its comparison with two other films dealing with the topic, Himmelkommando and The Grey Zone, the narrative mechanism that satisfies the complex ethical and aesthetical demands imposed by the theme of Sonderkommando as the particular episode of the Holocaust. The key element of the narrative structure is the construction of the Levi’s “dead and drowned” witness who “resurrected” through the narrative intervention becomes the only reliable and credible narrator of the historical trauma. The prerequisite for his emergence is the narration and representation of the death which makes but also solves the traumatised - understood as multiple, fragmented, opposed - identities of the members of the special squad. Their entangled identity involves the simultaneous presence of a victim, perpetrator, witness and the authentic narrator of the trauma of the death camp. The death of the perpetrator is the condition sina qua non for the emergence of the figure of the victim-witness narrator but also for making of narrative which overcomes the initial trauma of the Holocaust. The detailed analysis of the film Son of Saul confirms and identifies these narratives as the modernist narration of the post-traumatic film.

  10. Cumulative childhood trauma, emotion regulation, dissociation, and behavior problems in school-aged sexual abuse victims.

    Science.gov (United States)

    Hébert, Martine; Langevin, Rachel; Oussaïd, Essaïd

    2018-01-01

    Child sexual abuse is associated with a plethora of devastating repercussions. A significant number of sexually abused children are likely to experience other forms of maltreatment that can seriously affect their emotion regulation abilities and impede on their development. The aim of the study was to test emotion regulation and dissociation as mediators in the association between cumulative childhood trauma and internalized and externalized behavior problems in child victims of sexual abuse. Participants were 309 sexually abused children (203 girls and 106 boys; Mean age = 9.07) and their non-offending parent. Medical and clinical files were coded for cumulative childhood trauma. At initial evaluation (T1), parents completed measures assessing children's emotion regulation abilities and dissociation. At Time 2 (T2), parents completed a measure assessing children's behavior problems. Mediation analyses were conducted with emotion regulation and dissociation as sequential mediators using Mplus software. Findings revealed that cumulative childhood trauma affects both internalized and externalized behavior problems through three mediation paths: emotion regulation alone, dissociation alone, and through a path combining emotion regulation and dissociation. Both emotion regulation and dissociation were assessed at T1 and thus the temporal sequencing of mediators remains to be ascertained through a longitudinal design. All measures were completed by the parents. Clinicians should routinely screen for other childhood trauma in vulnerable clienteles. In order to tackle behavior problems, clinical interventions for sexually abused youth need to address emotion regulation competencies and dissociation. Copyright © 2017 Elsevier B.V. All rights reserved.

  11. Assailants' sexual dysfunction during rape: prevalence and relationship to genital trauma in female victims.

    Science.gov (United States)

    Jones, Jeffrey S; Rossman, Linda; Wynn, Barbara N; Ostovar, Herald

    2010-05-01

    Partial or complete failure to maintain an erection sufficient for coitus is known to occur in a proportion of sexual assailants during the rape episode. The purpose of this study was to determine whether the presence of coercion, physical violence, and genital injury associated with sexual assaults is influenced by the assailant's erectile impotence. This prospective, observational study evaluated consecutive female patients presenting to a free-standing urban sexual assault clinic during a 3-year study period. Sexual assault victims presenting directly to four downtown emergency departments (EDs) are routinely referred to the clinic for evaluation after triage and initial assessment. The clinic is associated with a university-affiliated emergency medicine residency program and is staffed by forensic nurses trained to perform medical-legal examinations. The primary outcome was to compare the frequency of anogenital findings documented in women whose assailant experienced no erectile dysfunction vs. those victims who reported erectile impotence in the assailant. During the study period, 569 sexual assault victims were eligible to participate in the study; 47 (8.3%) reported that their assailants had experienced erectile impotence. Except for assailant age, the two victim groups were comparable in terms of marital status, alcohol and drug use, known assailant, and time to physical examination. In attacks where erectile dysfunction occurred, there was a higher incidence of physical coercion (60% vs. 32% without physical coercion, p rape episode. Despite this erectile dysfunction, the majority of sexual assault victims sustained anogenital trauma. In the attacks with erectile impotence, there was a higher incidence of intra-rape violence and subsequent non-genital injuries. Copyright (c) 2010 Elsevier Inc. All rights reserved.

  12. Exsanguination protocol improves survival after major hepatic trauma.

    Science.gov (United States)

    Zaydfudim, Victor; Dutton, William D; Feurer, Irene D; Au, Brigham K; Pinson, C Wright; Cotton, Bryan A

    2010-01-01

    Hepatic injury remains an important cause of exsanguination after major trauma. Recent studies have noted a dramatic reduction in mortality amongst severely injured patients when trauma exsanguinations protocols (TEP) are employed. We hypothesised that utilisation of our institution's TEP at the initiation of hospital resuscitation would improve survival in patients with significant hepatic trauma. All patients who (1) sustained intra-abdominal haemorrhage with Grades III-V hepatic injury and (2) underwent immediate operative intervention between February 2004 and January 2008 were included in the study. TEP was instituted in February 2006, and all subsequent patients who met inclusion criteria and were treated with TEP constituted the study group. Patients who met inclusion criteria, were treated before introduction of TEP, and received at least 10 units packed red blood cells in the first 24h constituted pre-TEP comparison group. Univariate and multivariate analyses evaluated the effects of TEP on the study population. Seventy-five patients were included in the study: 39 in the pre-TEP cohort (31% 30-day survival) and 36 in the TEP cohort (53% 30-day survival). There were no differences in demographics, extent of hepatic injury, or operative approach between the patient groups (all p > or = 0.27). Injury Severity Scores were significantly higher in the TEP group (41+/-18 vs. 28+/-15, p<0.01). TEP patients received more plasma and platelets during operative intervention and significantly less crystalloid (all p<0.01). Occurrence of cardiac dysfunction and abdominal compartment syndrome was significantly lower in TEP patients who survived 24-h post-injury (both p < or = 0.04). After adjusting for the significant negative effects of Grade V injury and involvement of major hepatic vasculature (both p < or = 0.02), TEP significantly improved 30-day survival: OR=0.22, 95% CI: 0.06-0.81, p=0.02. TEP allows for an effective use of plasma and platelets during intra

  13. Relationship of early-life trauma, war-related trauma, personality traits, and PTSD symptom severity: a retrospective study on female civilian victims of war

    Directory of Open Access Journals (Sweden)

    Aleksandra Stevanović

    2016-04-01

    Full Text Available Background: Consequences of war-related traumatisation have mostly been investigated in military and predominant male populations, while research on female civilian victims of war has been neglected. Furthermore, research of post-war posttraumatic stress disorder (PTSD in women has rarely included early-life trauma in their prediction models, so the contribution of trauma in childhood and early youth is still unexplored. Objective: To examine the relationship of early-life trauma, war-related trauma, personality traits, and symptoms of posttraumatic stress among female civilian victims of the recent war in Croatia. Method: The cross-sectional study included 394 participants, 293 war-traumatised adult women civilians, and 101 women without war-related trauma. Participants were recruited using the snowball sampling method. The applied instruments included the Clinician-Administrated PTSD Scale (CAPS, the NEO Personality Inventory-Revised (NEO-PI-R, the War Stressors Assessment Questionnaire (WSAQ, and the Early Trauma Inventory Self Report-Short Form (ETISR-SF. A hierarchical multiple regression analysis was performed to assess the prediction model of PTSD symptom severity measured by CAPS score for current PTSD. Results: The prevalence of current PTSD (CAPS cut-off score=65 in this cohort was 20.7%. The regression model that included age, early-life trauma, war-related trauma, neuroticism, and extraversion as statistically significant predictors explained 45.8% of variance in PTSD symptoms. Conclusions: Older age, exposure to early-life trauma, exposure to war-related traumatic events, high neuroticism, and low extraversion are independent factors associated with higher level of PTSD symptoms among women civilian victims of war.

  14. The value of postmortem computed tomography as an alternative for autopsy in trauma victims: a systematic review

    International Nuclear Information System (INIS)

    Scholing, M.; Saltzherr, T.P.; Fung Kon Jin, P.H.P.; Ponsen, K.J.; Goslings, J.C.; Reitsma, J.B.; Lameris, J.S.

    2009-01-01

    The aim of this study was to assess the role of postmortem computed tomography (PMCT) as an alternative for autopsy in determining the cause of death and the identification of specific injuries in trauma victims. A systematic review was performed by searching the EMBASE and MEDLINE databases. Articles were eligible if they reported both PMCT as well as autopsy findings and included more than one trauma victim. Two reviewers independently assessed the eligibility and quality of the articles. The outcomes were described in terms of the percentage agreement on causes of death and amount of injuries detected. The data extraction and analysis were performed together. Fifteen studies were included describing 244 victims. The median sample size was 13 (range 5-52). The percentage agreement on the cause of death between PMCT and autopsy varied between 46 and 100%. The overall amount of injuries detected on CT ranged from 53 to 100% compared with autopsy. Several studies suggested that PMCT was capable of identifying injuries not detected during normal autopsy. This systematic review provides inconsistent evidence as to whether PMCT is a reliable alternative for autopsy in trauma victims. PMCT has promising features in postmortem examination suggesting PMCT is a good alternative for a refused autopsy or a good adjunct to autopsy because it detects extra injuries overseen during autopsies. To examine the value of PMCT in trauma victims there is a need for well-designed and larger prospective studies. (orig.)

  15. The evil of good is better: Making the case for basic life support transport for penetrating trauma victims in an urban environment.

    Science.gov (United States)

    Rappold, Joseph F; Hollenbach, Kathryn A; Santora, Thomas A; Beadle, Dania; Dauer, Elizabeth D; Sjoholm, Lars O; Pathak, Abhijit; Goldberg, Amy J

    2015-09-01

    Controversy remains over the ideal way to transport penetrating trauma victims in an urban environment. Both advance life support (ALS) and basic life support (BLS) transports are used in most urban centers. A retrospective cohort study was conducted at an urban Level I trauma center. Victims of penetrating trauma transported by ALS, BLS, or police from January 1, 2008, to November 31, 2013, were identified. Patient survival by mode of transport and by level of care received was analyzed using logistic regression. During the study period, 1,490 penetrating trauma patients were transported by ALS (44.8%), BLS (15.6%), or police (39.6%) personnel. The majority of injuries were gunshot wounds (72.9% for ALS, 66.8% for BLS, 90% for police). Median transport minutes were significantly longer for ALS (16 minutes) than for BLS (14.5 minutes) transports (p = 0.012). After adjusting for transport time and Injury Severity Score (ISS), among victims with an ISS of 0 to 30, there was a 2.4-fold increased odds of death (95% confidence interval [CI], 1.3-4.4) if transported by ALS as compared with BLS. With an ISS of greater than 30, this relationship did not exist (odds ratio, 0.9; 95% CI, 0.3-2.7). When examined by type of care provided, patients with an ISS of 0 to 30 given ALS support were 3.7 times more likely to die than those who received BLS support (95% CI, 2.0-6.8). Among those with an ISS of greater than 30, no relationship was evident (odds ratio, 0.9; 95% CI, 0.3-2.7). Among penetrating trauma victims with an ISS of 30 or lower, an increased odds of death was identified for those treated and/or transported by ALS personnel. For those with an ISS of greater than 30, no survival advantage was identified with ALS transport or care. Results suggest that rapid transport may be more important than increased interventions. Therapeutic study, level IV.

  16. Penetrating trauma victims in three Tehran hospitals, Sina, Shohada, Fayazbakhsh: Epidemiology and management errors

    Directory of Open Access Journals (Sweden)

    "Zargar M

    2001-05-01

    Full Text Available This is an observational case series study on penetrating trauma admissions in three teaching hospitals in Tehran from 1996 to 1997. in order to describe the epidemiology and determine the ways of improving treatment of penetrating injuries, we selected 410 patients with penetrating injuries and injury severity scores (ISS of more than 7 (the maximum ISS is 75 out of 3580 trauma patients, hospitalized in the three hospitals (Sina, Shohada, Fayzbakhsh since may 1 st 1996 during a period of approximately one year. These hospitals were among the ones with the highest load of trauma patients in Tehran. The in- hospital mortality rate was 2% and the rate of permanent disability was 6%. The most frequent injuries were in the extremities; while the most fatal ones occurred in the head and neck region.The mean ± SE injury severity score was 10.9±0.23 . Cutting was the most prevalent mechanism of injury while gunshot was the ratest. The most fatal mechanism of injury was gunshot followed by stab can cutting injuries. Industrial workers comprised the population at the highest risk for other cutting injuries, which can be avoided by utilizting better protection facilities at work.Our findings show that the improvement of preventive measures in industrial occupations should be considered to be of utmost importance. It seems that faster and direct transporation of patients to appropriate and well- equipped centers, improvement of the technical skills of the emergency staff, appropriate tiage of trauma victims and decreasing the time spent in the emergency room can decrase the mortality rate substantially

  17. Family context, victimization, and child trauma symptoms: variations in safe, stable, and nurturing relationships during early and middle childhood.

    Science.gov (United States)

    Turner, Heather A; Finkelhor, David; Ormrod, Richard; Hamby, Sherry; Leeb, Rebecca T; Mercy, James A; Holt, Melissa

    2012-04-01

    Based on a nationally representative sample of 2,017 children age 2-9 years, this study examines variations in "safe, stable, and nurturing" relationships (SSNRs), including several forms of family perpetrated victimization, and documents associations between these factors and child trauma symptoms. Findings show that many children were exposed to multiple forms of victimization within the family (such as physical or sexual abuse, emotional maltreatment, child neglect, sibling victimization, and witnessing family violence), as evidenced by substantial intercorrelations among the different forms of victimization. Moreover, victimization exposure was significantly associated with several indices of parental dysfunction, family adversity, residential instability, and problematic parenting practices. Of all SSNR variables considered, emotional abuse and inconsistent or hostile parenting emerged as having the most powerful independent effects on child trauma symptoms. Also, findings supported a cumulative risk model, whereby trauma symptom levels increased with each additional SSNR risk factor to which children were exposed. Implications for research and practice are discussed. © 2012 American Orthopsychiatric Association.

  18. The value of postmortem computed tomography as an alternative for autopsy in trauma victims: a systematic review

    NARCIS (Netherlands)

    Scholing, M.; Saltzherr, T. P.; Fung Kon Jin, P. H. P.; Ponsen, K. J.; Reitsma, J. B.; Lameris, J. S.; Goslings, J. C.

    2009-01-01

    The aim of this study was to assess the role of postmortem computed tomography (PMCT) as an alternative for autopsy in determining the cause of death and the identification of specific injuries in trauma victims. A systematic review was performed by searching the EMBASE and MEDLINE databases.

  19. Vicarious resilience in counselors of child and youth victims of interpersonal trauma.

    Science.gov (United States)

    Silveira, Fabiane S; Boyer, Wanda

    2015-04-01

    In this study, we investigated how bearing witness to clients' resilience processes during treatment impacts the personal and professional lives of counselors who work with child and youth victims of interpersonal trauma. We used a qualitative instrumental multiple-case study design and thematic analysis to explore the research question. The participants indicated that they experienced an increased sense of hope and optimism, and were inspired by the strengths of their clients while working with this population. As the participants reflected on the challenges that their clients faced, the participants put their own challenges and strengths into perspective; they reported positive changes in their personal relationships. We suggest that future research might investigate the relationships we found between optimism, hope, and vicarious resilience processes, as well as the potential relationship between the counseling approach that counselors adopt and the development of vicarious resilience responses. © The Author(s) 2014.

  20. Computational Analysis Supports an Early, Type 17 Cell-Associated Divergence of Blunt Trauma Survival and Mortality

    Science.gov (United States)

    Abboud, Andrew; Namas, Rami A.; Ramadan, Mostafa; Mi, Qi; Almahmoud, Khalid; Abdul-Malak, Othman; Azhar, Nabil; Zaaqoq, Akram; Namas, Rajaie; Barclay, Derek A.; Yin, Jinling; Sperry, Jason; Peitzman, Andrew; Zamora, Ruben; Simmons, Richard L.; Billiar, Timothy R.; Vodovotz, Yoram

    2016-01-01

    Objective Blunt trauma patients may present with similar demographics and injury severity, yet differ with regard to survival. We hypothesized that this divergence was due to different trajectories of systemic inflammation, and utilized computational analyses to define these differences. Design, Setting, and Patients From a cohort of 493 victims of blunt trauma, we conducted a pairwise, retrospective, case-control study of patients who survived over 24h but ultimately died (non-survivors; n=19) and patients who, following ICU admission, went on to be discharged (survivors; n=19). Data on systemic inflammatory mediators assessed within the first 24h and over 7d were analyzed with computational modeling to infer dynamic networks of inflammation. A mouse model of trauma/hemorrhage was used to verify hypotheses derived from the clinical study. Interventions None in patients. Neutralizing anti-IL-17A antibody in mice. Measurements and Main Results Network density among inflammatory mediators in non-survivors increased in parallel with organ dysfunction scores over 7d, suggesting the presence of early, self-sustaining, pathological inflammation involving HMGB1, IL-23, and the Th17 pathway. Survivors demonstrated a pattern commensurate with a self-resolving, predominantly lymphoid response, including higher levels of the reparative cytokine IL-22. Mice subjected to trauma/hemorrhage exhibited reduced organ damage when treated with anti-IL-17A. Conclusions Variable type 17 immune responses are hallmarks of organ damage, survival, and mortality following blunt trauma, and suggest a lymphoid cell-based switch from self-resolving to self-sustaining inflammation. PMID:27513538

  1. Therapists Working With Trauma Victims: The Contribution of Personal, Environmental, and Professional-Organizational Resources to Secondary Traumatization.

    Science.gov (United States)

    Dagan, Keren; Itzhaky, Haya; Ben-Porat, Anat

    2015-01-01

    This study examined the contribution of personal variables and resources (age, mastery, tolerance for ambiguity, and stressors), environmental resources (support from family and friends, colleague support), and professional-organizational resources (size of caseload with trauma victims, organizational commitment) to secondary traumatization. The sample consisted of 217 social workers employed at social service departments in Israel who worked with families in situations of distress and crisis and with adolescent girls at risk. The findings indicated that tolerance for ambiguity contributed most significantly to explaining the variance in secondary traumatization, followed by stressors. The size of the social workers' caseload with trauma victims also contributed significantly to explaining the variance in secondary traumatization. In addition, an interaction was found between age and continuance commitment. Among younger social workers, a negative association was found between continuance commitment to the organization and secondary traumatization, whereas among older social workers the association was positive. However, the contribution of the other research variables (mastery, support from family and friends, and colleague support) to explaining the variance in secondary traumatization was not statistically significant. The findings highlight the important role of personal resources and professional-organizational resources in enabling therapists to cope with the negative implications of working with trauma victims.

  2. [Post-traumatic stress reaction in a sample of bank employees victims of robbery in the workplace: the role of pre-trauma and peri-trauma factors].

    Science.gov (United States)

    Converso, Daniela; Viotti, Sara

    2014-07-24

    Robberies are traumatizing events for workers. Consequently, a number of health problems can arise. In the short term, a common reaction is post-traumatic stress (including intrusion, avoidance, and hyperarousal symptoms). The aim of the present study was to identify, among pre-trauma factors (personal characteristics: gender, age, educational level, and prior exposure to robberies) and peri-trauma factors (kind of weapon, duration of the event, number of robbers, and numbers of colleagues and clients involved), those that were most likely to cause post-traumatic symptoms in a sample of bank employees who were victims of a robbery. One-hundred-seventy-two employees at two banks in northwest Italy were involved in the research. A month after a robbery, the employees completed a self-report questionnaire including the Impact of Event Scale-Revised (IES-R) by Weiss and Marmar (39). Analyses found one pre-trauma factor (prior exposure to robbery/ies, and one peri-trauma factor, number of robbers) as significant predictors of intrusion. Two peri-trauma factors (number of robbers and duration of robbery) were identified as predictors of avoidance. Finally, one pre-trauma factor (prior exposure to robbery/ies) and two peri-trauma factors (number of robbers and number of colleagues involved in the robbery) were found to be predictors of hyperarousal. The results showed that several peri-trauma factors can increase the risk of workers developing post-traumatic stress reaction and suggest that these factors should be kept in mind when planning intervention programmes aimed at preventing and contrasting psychological consequences of robbery.

  3. CRANIOCEREBRAL TRAUMA: NURSING DIAGNOSIS FOR VICTIMS ASSISTANCE ON INTESIVE CARE UNITY.

    Directory of Open Access Journals (Sweden)

    Daniela de Souza Feitoza

    2006-12-01

    Full Text Available SUMMARY: The enfermagem process makes possible a care individualized the customers, characterizing an autonomous work and quality attendance. It was aimed at to Identify diagnoses of Enfermagem in patient traumatismos victims cranium-encefálico (TCE and to elaborate a model of implantation of cares, through the taxonomia NANDA, being used the reasoning of Risner. He/she/you took place descriptive-exploratory study, retrospective to the patients interned in the year 2002, type case study, reference hospital in traumatologia, in Fortaleza-Ce. It was collected the data in the books of registration of UTIs I II, III, IV and, data processing Center, the months of January to March of 2003. It was counted 143 (100% patient interned. They were stood out TCE with 57 (40% of the cases, followed by the politraumatismos with TCE with 30 (21% and traumatismos raqui-medular 11 (7,5%. He/she/you becomes important to implement the enfermagem process that allows to plan the attendance, to optimize time and to guarantee the quality of the care. KEY WORD: Craniocerebral Trauma; Nursing Diagnosis; Quality of Health Care.

  4. Rethinking Traditional Behaviour Management to Better Support Complex Trauma-Surviving Students

    Science.gov (United States)

    Howard, Judith

    2016-01-01

    Children and adolescents who have survived complex trauma have suffered the type of ongoing and repeated traumatic experience that includes factors such as physical, sexual, and/or emotional abuse, significant neglect, and/or family violence. Complex childhood trauma (sometimes referred to as paediatric or child maltreatment-related post traumatic…

  5. From trauma victim to terrorist: redefining superheroes in Post-9/11 Hollywood

    NARCIS (Netherlands)

    Hassler-Forest, D.; Berninger, M.; Ecke, J.; Haberkorn, G.

    2010-01-01

    In this paper I use trauma theory to identify and discuss post-9/11 film adaptation of graphic novels as trauma narratives. I argue, for example, that since the first major recognition of the graphic novel as a legitimate form of literature in the late 1980s, trauma has played an important part in

  6. The correlation between stabbing-related upper extremity wounds and survival of stabbing victims with abdominal and thoracic injuries.

    Science.gov (United States)

    Rozenfeld, Michael; Peleg, Kobi; Givon, Adi; Kessel, Boris

    2017-07-01

    When treating patients with stab injuries of the torso, clinicians often lack timely information about the degree and nature of internal organ damage. An externally observable sign significantly associated with characteristics of torso injuries may therefore be useful for practitioners. One such potential sign is the presence of wounds to the hands, sometimes sustained during victims' attempt to defend themselves during the violent altercation. Thus, the primary aim of this study was to evaluate the association between presence of upper extremity wounds and the severity of the thoracic and intra-abdominal injuries due to stabbing. This study was carried out retrospectively using data on 8714 patients with stabbing-related injuries from 19 trauma centers that participated in the Israeli National Trauma Registry (INTR) between January 1st1997 and December 31st 2013. Patients with wounds of upper extremities in addition to torso injuries (UE group) were compared to other patients with torso injuries (TO group) in terms of demographics, injury characteristics and clinical outcome. The compared groups were found to be homogeneous in terms of age and systolic blood pressure; the number of sustained torso injuries was also identical. The UE group comprised a slightly greater percentage of females, however both groups were predominantly male. Patients with upper extremity injuries had a lower proportion of internal organ damage (36% vs. 38.5%) and lower mortality (0.9% vs. 2%). The higher mortality of patients without upper extremity wounds remained significantly different even when adjusted by other epidemiological parameters (OR 2.46, 95% CI 1.33-5.08).The number of sustained upper extremity injuries was positively associated with deeper penetration of the torso by the stabbing instrument. Patients with stabbing-related upper extremity wounds had a significant survival advantage over patients without such injuries. However, a greater number of sustained upper extremity

  7. The journey from traffic offender to severe road trauma victim: destiny or preventive opportunity?

    Directory of Open Access Journals (Sweden)

    Kwok M Ho

    Full Text Available Road trauma is a leading cause of death and injury in young people. Traffic offences are common, but their importance as a risk indicator for subsequent road trauma is unknown. This cohort study assessed whether severe road trauma could be predicted by a history of prior traffic offences.Clinical data of all adult road trauma patients admitted to the Western Australia (WA State Trauma Centre between 1998 and 2013 were linked to traffic offences records at the WA Department of Transport. The primary outcomes were alcohol exposure prior to road trauma, severe trauma (defined by Injury Severity Score >15, and intensive care admission (ICU or death, analyzed by logistic regression. Traffic offences directly leading to the road trauma admissions were excluded. Of the 10,330 patients included (median age 34 years-old, 78% male, 1955 (18.9% had alcohol-exposure before road trauma, 2415 (23.4% had severe trauma, 1360 (13.2% required ICU admission, and 267 (2.6% died. Prior traffic offences were recorded in 6269 (60.7% patients. The number of prior traffic offences was significantly associated with alcohol-related road trauma (odds ratio [OR] per offence 1.03, 95% confidence interval [CI] 1.02-1.05, severe trauma (OR 1.13, 95%CI 1.14-1.15, and ICU admission or death (OR 1.10, 95%CI 1.08-1.11. Drink-drinking, seat-belt, and use of handheld electronic device offences were specific offences strongly associated with road trauma leading to ICU admission or death--all in a 'dose-related' fashion. For those who recovered from road trauma after an ICU admission, there was a significant reduction in subsequent traffic offences (mean difference 1.8, 95%CI 1.5 to 2.0 and demerit points (mean difference 7.0, 95%CI 6.5 to 7.6 compared to before the trauma event.Previous traffic offences were a significant risk factor for alcohol-related road trauma and severe road trauma leading to ICU admission or death.

  8. The journey from traffic offender to severe road trauma victim: destiny or preventive opportunity?

    Science.gov (United States)

    Ho, Kwok M; Rao, Sudhakar; Burrell, Maxine; Weeramanthri, Tarun S

    2015-01-01

    Road trauma is a leading cause of death and injury in young people. Traffic offences are common, but their importance as a risk indicator for subsequent road trauma is unknown. This cohort study assessed whether severe road trauma could be predicted by a history of prior traffic offences. Clinical data of all adult road trauma patients admitted to the Western Australia (WA) State Trauma Centre between 1998 and 2013 were linked to traffic offences records at the WA Department of Transport. The primary outcomes were alcohol exposure prior to road trauma, severe trauma (defined by Injury Severity Score >15), and intensive care admission (ICU) or death, analyzed by logistic regression. Traffic offences directly leading to the road trauma admissions were excluded. Of the 10,330 patients included (median age 34 years-old, 78% male), 1955 (18.9%) had alcohol-exposure before road trauma, 2415 (23.4%) had severe trauma, 1360 (13.2%) required ICU admission, and 267 (2.6%) died. Prior traffic offences were recorded in 6269 (60.7%) patients. The number of prior traffic offences was significantly associated with alcohol-related road trauma (odds ratio [OR] per offence 1.03, 95% confidence interval [CI] 1.02-1.05), severe trauma (OR 1.13, 95%CI 1.14-1.15), and ICU admission or death (OR 1.10, 95%CI 1.08-1.11). Drink-drinking, seat-belt, and use of handheld electronic device offences were specific offences strongly associated with road trauma leading to ICU admission or death--all in a 'dose-related' fashion. For those who recovered from road trauma after an ICU admission, there was a significant reduction in subsequent traffic offences (mean difference 1.8, 95%CI 1.5 to 2.0) and demerit points (mean difference 7.0, 95%CI 6.5 to 7.6) compared to before the trauma event. Previous traffic offences were a significant risk factor for alcohol-related road trauma and severe road trauma leading to ICU admission or death.

  9. Specificity and generalization of attentional bias in sexual trauma victims suffering from posttraumatic stress disorder.

    Science.gov (United States)

    Fleurkens, Pascal; Rinck, Mike; van Minnen, Agnes

    2011-08-01

    The present study investigated specificity of attentional biases for trauma-related stimuli using an Emotional Stroop Task. Participants were 14 women suffering from posttraumatic stress disorder (PTSD) who had experienced a sexual trauma and 24 healthy non-traumatized women. They were asked to name print colors of 4 different word types: threatening sexual violence words and non-threatening sexual words, threatening accident trauma words, and positive words. Compared to control participants, PTSD patients displayed increased interference by threatening trauma-related, but not by accident trauma and positive words. Interference by non-threatening sexual words occurred as well, but only in those patients who suffered from more severe PTSD arousal symptoms. These findings suggest graded generalization of the attentional bias across stimuli of varying emotional valence, but specificity regarding the trauma topic. Results are discussed in light of current cognitive models of PTSD, and clinical implications are suggested. Copyright © 2011 Elsevier Ltd. All rights reserved.

  10. Cardiac trauma: has survival improved? A university hospital experience in Bangkok, Thailand.

    Science.gov (United States)

    Kritayakirana, Kritaya; Sriussadaporn, Sukanya; Pak-Art, Rattaplee; Prichayudh, Supparerk; Samorn, Pasurachate; Sriussadaporn, Suvit

    2013-02-01

    Cardiac trauma, if not recognized and properly treated, will lead to a fatal outcome. For the past 16 years, the authors' policy for diagnosing and treating cardiac trauma has not changed but the survival rate in our institute has improved when compared between the two cohorts. Study the factors for survival in patients with cardiac trauma. Data was collected from chart review between September 1994 and April 2010. Patients presenting in extremis with suspected cardiac trauma will receive emergency room thoracotomy. Patients with equivocal Focused Assessment with Sonography for Trauma will receive formal transthoracic echocardiography. If still in doubt, the authors' policy will proceed with intra operative subxiphoid window and a set up for median sternotomy. Throughout the study period, 44 patients had cardiac trauma and the overall mortality rate was 13.6%. Four patients had blunt injury resulting in one ventricular septal defect and three ruptured right atrium. Right ventricle was injured the most 44%, right atrium 23%, left ventricle 20%, left atrium 2%, one patient had superior vena cava injury, and another patient had inferior vena cava injury. In this cohort, 30% underwent emergency room thoracotomy. Associated injuries were presented in 38% of cases. High index of suspicion and prompt management for cardiac trauma should be considered in patients presenting with injuries to the chest, which has been the authors' policy for the past 16 years. The mortality rate had dropped from 26% to 4% but is not statistically significant.

  11. The Trauma of Commercial Sexual Exploitation of Youth: A Comparison of CSE Victims to Sexual Abuse Victims in a Clinical Sample.

    Science.gov (United States)

    Cole, Jennifer; Sprang, Ginny; Lee, Robert; Cohen, Judith

    2016-01-01

    This study examined the demographic features, trauma profiles, clinical severity indicators, problem behaviors, and service utilization characteristics of youth victims of commercial sexual exploitation (CSE) compared with a matched sample of sexually abused/assaulted youth who were not exploited in commercial sex. Secondary data analysis and propensity score matching were used to select a sample of 215 help-seeking youth who were exploited in prostitution (n = 43) or who were sexually abused/assaulted but not exploited in prostitution (n = 172) from the National Child Traumatic Stress Network Core Data Set (NCTSN CDS). Propensity Score Matching was used to select a comparison sample based on age, race, ethnicity, and primary residence. Statistically significant differences were noted between the groups on standardized (e.g., UCLA Posttraumatic Stress Disorder Reaction Index [PTSD-RI], Child Behavior Checklist [CBCL]) and other measures of emotional and behavioral problems (e.g., avoidance and hyperarousal symptoms, dissociation, truancy, running away, conduct disorder, sexualized behaviors, and substance abuse). This study provides useful insight into the symptom and service utilization profiles of youth exploited in commercial sex as compared with youth with other types of sexually exploitive experiences. Targeted screening and event-sensitive measures are recommended to more accurately identify youth exploited in commercial sex. More research is needed to determine if and what modifications to trauma therapies may be required to address the more severe symptomatology and behavior problems associated with youth exploited in commercial sex. © The Author(s) 2014.

  12. Upper airway mucus deposition in lung tissue of burn trauma victims.

    Science.gov (United States)

    Cox, Robert A; Mlcak, Ron P; Chinkes, David L; Jacob, Sam; Enkhbaatar, Perenlei; Jaso, Jesse; Parish, Lauren P; Traber, Daniel L; Jeschke, Marc G; Herndon, David N; Hawkins, Hal K

    2008-03-01

    Previous study in an ovine model of smoke inhalation and burn (S + B) injury has shown distal migration of upper airway mucus. This study examines the localization of an upper airway gland specific mucus, mucin 5B (MUC5B) in lung autopsy tissues of burn-only injury and in victims of S + B injury. We hypothesize that victims with S + B injury would exhibit increased distal migration of MUC5B than that seen in victims of burn-only injury. Autopsy lung tissue from victims of burn injury alone (n = 38) and combined S + B injury (n = 22) were immunostained for MUC5B. No normal lung tissues were included in the study. Semiquantitative analysis of the extent of MUC5B in bronchioles and parenchyma was performed on masked slides. Irrespective of injury conditions, all victims showed MUC5B in bronchioles. Mucin 5B was seen in the parenchyma except in two burn victims. No statistically significant difference was seen in the mean bronchiolar and parenchyma MUC5B scores between S + B and burn-only victims (P > 0.05). No strong statistical correlation of MUC5B scores with days postinjury or to the number of ventilatory days was evident. The percentage of pneumonia, identified histologically, was also similar between study groups. This study did not confirm our results in an ovine model of S + B injury. In contrast, virtually all pediatric burn victims, regardless of concomitant inhalation injury, showed MUC5B in their bronchioles and parenchyma. Increased mucus synthesis and/or impaired mucociliary function may contribute to the pulmonary pathophysiology associated with burn injury.

  13. Specificity and generalization of attentional bias in sexual trauma victims suffering from posttraumatic stress disorder

    NARCIS (Netherlands)

    Fleurkens, P.F.T.; Rinck, M.; Minnen, A. van

    2011-01-01

    The present study investigated specificity of attentional biases for trauma-related stimuli using an Emotional Stroop Task. Participants were 14 women suffering from posttraumatic stress disorder (PTSD) who had experienced a sexual trauma and 24 healthy non-traumatized women. They were asked to name

  14. Lifetime trauma victimization and PTSD in relation to psychopathy and antisocial personality disorder in a sample of incarcerated women and men.

    Science.gov (United States)

    Gobin, Robyn L; Reddy, Madhavi K; Zlotnick, Caron; Johnson, Jennifer E

    2015-01-01

    Antisocial personality disorder (ASPD) and psychopathy are similar, but distinct, psychiatric conditions that are common in male and female inmates; a segment of the population with high rates of trauma exposure. It is unclear whether specific types of lifetime trauma are associated with ASPD and psychopathy in incarcerated women and men. Furthermore, the unique roles of post-traumatic stress disorder (PTSD) symptom severity and trauma victimization in antisocial personality disturbance are not well-understood. The paper aims to discuss these issues. This study investigated associations between trauma variables (different kinds of traumatic experiences and PTSD) and antisocial personality variables (ASPD and psychopathy) in a sample of incarcerated women and men who participated in a randomized clinical trial for major depressive disorder. In total, 88 incarcerated men and women were assessed for ASPD diagnosis, psychopathy severity, PTSD symptom severity, and history of physical, sexual, and crime-related trauma. Regression analyses predicted ASPD or psychopathy from trauma variables, controlling for gender. Physical trauma was the only form of trauma that was significantly related to psychopathy. Physical trauma and crime-related trauma were associated with ASPD. PTSD symptom severity was not associated with psychopathy or ASPD. There are associations between some kinds of lifetime trauma exposure and current ASPD/psychopathy in the target sample, but these associations do not appear to be mediated through current PTSD symptoms.

  15. Helmets Matter: Kentucky Motorcycle Crash Victims Seen at a Tennessee Trauma Center.

    Science.gov (United States)

    Testerman, George M; Prior, Daniel C; Wells, Tamie D; Sumner, William C; Johnston, Jeffrey T; Rollins, Sarah E; Meyer, Jeremy M

    2018-01-01

    Motorcycle helmet laws vary by state, with Kentucky requiring helmets only for younger riders. We hypothesized that motorcyclists injured in Kentucky and seen at a Tennessee trauma center would be more likely to be unhelmeted, have more severe head injuries, and sustain more fatal injuries than those injured in Tennessee or Virginia. A Trauma Registry review of 729 injured motorcyclists from January 2005 through June 2015 examined state location of crash, demographics, helmet use, and clinical outcomes. Multivariate logistic regression analysis evaluated predictors for head injury severity and death. Unhelmeted motorcycle rider status predicted more severe head injuries (relative risk 15.3, P motorcycle helmet laws for all ages in states where they are in effect and for upgrading helmet laws that apply only to some riders.

  16. Internally displaced "victims of armed conflict" in Colombia: the trajectory and trauma signature of forced migration.

    Science.gov (United States)

    Shultz, James M; Garfin, Dana Rose; Espinel, Zelde; Araya, Ricardo; Oquendo, Maria A; Wainberg, Milton L; Chaskel, Roberto; Gaviria, Silvia L; Ordóñez, Anna E; Espinola, Maria; Wilson, Fiona E; Muñoz García, Natalia; Gómez Ceballos, Angela Milena; Garcia-Barcena, Yanira; Verdeli, Helen; Neria, Yuval

    2014-10-01

    While conflict-induced forced migration is a global phenomenon, the situation in Colombia, South America, is distinctive. Colombia has ranked either first or second in the number of internally displaced persons for 10 years, a consequence of decades of armed conflict compounded by high prevalence of drug trafficking. The displacement trajectory for displaced persons in Colombia proceeds through a sequence of stages: (1) pre-expulsion threats and vulnerability, (2) expulsion, (3) migration, (4) initial adaptation to relocation, (5) protracted resettlement (the end point for most forced migrants), and, rarely, (6) return to the community of origin. Trauma signature analysis, an evidence-based method that elucidates the physical and psychological consequences associated with exposures to harm and loss during disasters and complex emergencies, was used to identify the psychological risk factors and potentially traumatic events experienced by conflict-displaced persons in Colombia, stratified across the phases of displacement. Trauma and loss are experienced differentially throughout the pathway of displacement.

  17. Implicit and explicit avoidance in sexual trauma victims suffering from posttraumatic stress disorder: a pilot study

    Directory of Open Access Journals (Sweden)

    Pascal Fleurkens

    2014-02-01

    Full Text Available Background: Avoidance of stimuli that are associated with the traumatic event is a key feature of posttraumatic stress disorder (PTSD. Thus far, studies on the role of avoidance in the development and maintenance of PTSD focused primarily on strategic or explicit avoidance. However, patients may also show implicit avoidance behavior, which may remain even when explicit avoidance is reduced. Objectives: The present pilot study was designed to test the hypothesis that PTSD patients show implicit avoidance of threatening, trauma-related stimuli. In addition, it was tested whether this avoidance behavior also occurs for other stimuli. Methods: The Approach-Avoidance Task was used as an indirect measure of avoidance. Participants were 16 women suffering from PTSD who had experienced a sexual trauma, and 23 healthy non-traumatized women. Using a joystick, they pulled pictures closer to themselves or pushed them away. The pictures varied in content, being either high-threat sexual, non-threat sexual, high-threat accident, or positive. Results: Compared to control participants, PTSD patients avoided high-threat sexual pictures, and the degree of avoidance was predicted by self-reported arousal level. Moreover, PTSD patients with high levels of self-reported explicit avoidance, depressive symptoms, and PTSD symptom severity also avoided high-threat accident pictures. Conclusions: These findings point to the possible importance of threat value instead of trauma-relatedness in explaining implicit avoidance. The results are discussed in light of cognitive-behavioral models of PTSD, and clinical implications are suggested.

  18. THE CHILD VICTIM OF TRAUMA AND NURSING CARE SYSTEMATIZATION (SAE: A LITERATURE REVIEW

    Directory of Open Access Journals (Sweden)

    Geilsa Soraia Cavalcanti Valente

    2011-05-01

    Full Text Available Objetivo: Identificar na literatura existente a relação entre os acidentes e traumas mais comuns em crianças, evidenciando os cuidados de enfermagem prestados e correlacionar com a sistematização da assistência de enfermagem. Metodologia: Estudo qualitativo, do tipo revisão bibliográfica, tendo como fonte o acervo da Biblioteca Virtual de Saúde (BVS. Foram selecionados 16 artigos, indexados nas bases de dados, LILACS, BDENF e SCIELO. As categorias após analise foram: 1- Epidemiologia e Identificação de Acidentes e 2- Assistência de enfermagem e prevenção de acidentes. Resultados: A literatura analisada aponta a abrangência e magnitude dos acidentes e traumas em crianças. Tornando-se um sério problema de saúde pública. No tocante a saúde publica, o enfermeiro como educador está apto para realizar programas educacionais que envolvam pais e crianças, abordando a necessidade da prevenção de acidentes. Apenas três estudos analisados enfatizaram a assistência de enfermagem a criança vitima de trauma, estando relacionados à avaliação de conhecimento de cuidados e subjetividade do enfermeiro a essa população. Conclusão: Sugere-se a realização de novos estudos que complementem as lacunas do conhecimento,  a fim de fundamentar ainda mais as ações da enfermagem e contribuir para maior visibilidade no que se relaciona a assistência de enfermagem por parte destes profissionais.

  19. The contribution of the Israeli trauma system to the survival of road traffic casualties.

    Science.gov (United States)

    Goldman, Sharon; Siman-Tov, Maya; Bahouth, H; Kessel, B; Klein, Y; Michaelson, M; Miklosh, B; Rivkind, A; Shaked, G; Simon, D; Soffer, D; Stein, M; Peleg, Kobi

    2015-01-01

    According to the World Health Organization, over one million people die annually from traffic crashes, in which over half are pedestrians, bicycle riders and two-wheel motor vehicles. In Israel, during the last decade, mortality from traffic crashes has decreased from 636 in 1998 to 288 in 2011. Professionals attribute the decrease in mortality to enforcement, improved infrastructure and roads and behavioral changes among road users, while no credit is given to the trauma system. Trauma systems which care for severe and critical casualties improve the injury outcomes and reduce mortality among road casualties. 1) To evaluate the contribution of the Israeli Health System, especially the trauma system, on the reduction in mortality among traffic casualties. 2) To evaluate the chance of survival among hospitalized traffic casualties, according to age, gender, injury severity and type of road user. A retrospective study based on the National Trauma Registry, 1998-2011, including hospitalization data from eight hospitals. During the study period, the Trauma Registry included 262,947 hospitalized trauma patients, of which 25.3% were due to a road accident. During the study period, a 25% reduction in traffic related mortality was reported, from 3.6% in 1998 to 2.7% in 2011. Among severe and critical (ISS 16+) casualties the reduction in mortality rates was even more significant, 41%; from 18.6% in 1998 to 11.0% in 2011. Among severe and critical pedestrian injuries, a 44% decrease was reported (from 29.1% in 1998 to 16.2% in 2011) and a 65% reduction among bicycle injuries. During the study period, the risk of mortality decreased by over 50% from 1998 to 2011 (OR 0.44 95% 0.33-0.59. In addition, a simulation was conducted to determine the impact of the trauma system on mortality of hospitalized road casualties. Presuming that the mortality rate remained constant at 18.6% and without any improvement in the trauma system, in 2011 there would have been 182 in-hospital deaths

  20. Dead or Alive? Factors Affecting the Survival of Victims during Attacks by Saltwater Crocodiles (Crocodylus porosus in Australia.

    Directory of Open Access Journals (Sweden)

    Yusuke Fukuda

    Full Text Available Conflicts between humans and crocodilians are a widespread conservation challenge and the number of crocodile attacks is increasing worldwide. We identified the factors that most effectively decide whether a victim is injured or killed in a crocodile attack by fitting generalized linear models to a 42-year dataset of 87 attacks (27 fatal and 60 non-fatal by saltwater crocodiles (Crocodylus porosus in Australia. The models showed that the most influential factors were the difference in body mass between crocodile and victim, and the position of victim in relation to the water at the time of an attack. In-water position (for diving, swimming, and wading had a higher risk than on-water (boating or on-land (fishing, and hunting near the water's edge positions. In the in-water position a 75 kg person would have a relatively high probability of survival (0.81 if attacked by a 300 cm crocodile, but the probability becomes much lower (0.17 with a 400 cm crocodile. If attacked by a crocodile larger than 450 cm, the survival probability would be extremely low (<0.05 regardless of the victim's size. These results indicate that the main cause of death during a crocodile attack is drowning and larger crocodiles can drag a victim more easily into deeper water. A higher risk associated with a larger crocodile in relation to victim's size is highlighted by children's vulnerability to fatal attacks. Since the first recently recorded fatal attack involving a child in 2006, six out of nine fatal attacks (66.7% involved children, and the average body size of crocodiles responsible for these fatal attacks was considerably smaller (384 cm, 223 kg than that of crocodiles that killed adults (450 cm, 324 kg during the same period (2006-2014. These results suggest that culling programs targeting larger crocodiles may not be an effective management option to improve safety for children.

  1. Barriers and facilitators to provide effective pre-hospital trauma care for road traffic injury victims in Iran: a grounded theory approach

    Directory of Open Access Journals (Sweden)

    Hasselberg Marie

    2010-11-01

    Full Text Available Abstract Background Road traffic injuries are a major global public health problem. Improvements in pre-hospital trauma care can help minimize mortality and morbidity from road traffic injuries (RTIs worldwide, particularly in low- and middle-income countries (LMICs with a high rate of RTIs such as Iran. The current study aimed to explore pre-hospital trauma care process for RTI victims in Iran and to identify potential areas for improvements based on the experience and perception of pre-hospital trauma care professionals. Methods A qualitative study design using a grounded theory approach was selected. The data, collected via in-depth interviews with 15 pre-hospital trauma care professionals, were analyzed using the constant comparative method. Results Seven categories emerged to describe the factors that hinder or facilitate an effective pre-hospital trauma care process: (1 administration and organization, (2 staff qualifications and competences, (3 availability and distribution of resources, (4 communication and transportation, (5 involved organizations, (6 laypeople and (7 infrastructure. The core category that emerged from the other categories was defined as "interaction and common understanding". Moreover, a conceptual model was developed based on the categories. Conclusions Improving the interaction within the current pre-hospital trauma care system and building a common understanding of the role of the Emergency Medical Services (EMS emerged as key issues in the development of an effective pre-hospital trauma care process.

  2. Does prehospital time affect survival of major trauma patients where there is no prehospital care?

    Directory of Open Access Journals (Sweden)

    S B Dharap

    2017-01-01

    Full Text Available Background: Survival after major trauma is considered to be time dependent. Efficient prehospital care with rapid transport is the norm in developed countries, which is not available in many lower middle and low-income countries. The aim of this study was to assess the effect of prehospital time and primary treatment given on survival of major trauma patients in a setting without prehospital care. Materials and Methods: This prospective observational study was carried out in a university hospital in Mumbai, from January to December 2014. The hospital has a trauma service but no organized prehospital care or defined interhospital transfer protocols. All patients with life- and/or limb-threatening injuries were included in the study. Injury time and arrival time were noted and the interval was defined as “prehospital time” for the directly arriving patients and as “time to tertiary care” for those transferred. Primary outcome measure was in-hospital death (or discharge. Results: Of 1181 patients, 352 were admitted directly from the trauma scene and 829 were transferred from other hospitals. In-hospital mortality was associated with age, mechanism and mode of injury, shock, Glasgow Coma Score <9, Injury Severity Score ≥16, need for intubation, and ventilatory support on arrival; but neither with prehospital time nor with time to tertiary care. Transferred patients had a significantly higher mortality (odds ratio = 1.869, 95% confidence interval = 1.233–2.561, P = 0.005 despite fewer patients with severe injury. Two hundred and ninety-four (35% of these needed airway intervention while 108 (13% needed chest tube insertion on arrival to the trauma unit suggesting inadequate care at primary facility. Conclusion: Mortality is not associated with prehospital time but with transfers from primary care; probably due to deficient care. To improve survival after major trauma, enhancement of resources for resuscitation and capacity building of on

  3. Dimensional structure of DSM-5 posttraumatic stress symptoms in Spanish trauma victims.

    Science.gov (United States)

    Soberón, Carmen; Crespo, María; Del Mar Gómez-Gutiérrez, María; Fernández-Lansac, Violeta; Armour, Cherie

    2016-01-01

    Confirmatory factor analytic studies have shown that posttraumatic stress disorder (PTSD) symptoms included in the fifth edition of the Diagnostic and Statistical Manual Disorders (DSM-5) may be better explained by two 6-factor models (the Externalizing Behaviours model and the Anhedonia model) and a 7-factor Hybrid model. The latter model comprises the symptom clusters of intrusion, avoidance, negative affect, anhedonia, externalizing behaviours, and anxious and dysphoric arousal. This model has received empirical support mainly in American samples. Of note, there have been a limited number of studies conducted on samples from other countries. This study aimed to examine the underlying dimensionality of DSM-5 PTSD symptoms in a Spanish clinical sample exposed to a range of traumatic events. Participants included 165 adults (78.8% females) seeking treatment in trauma services in the Madrid area (Spain). PTSD was assessed using the Global Assessment of Posttraumatic Stress Scale 5, a Spanish self-report instrument assessing posttraumatic symptoms according to the DSM-5 criteria. Confirmatory factor analyses were conducted in Mplus. Both the 7-factor Hybrid model and the 6-factor Anhedonia model demonstrated good and equivalent fit to the data. The findings of this study replicate and extend previous research by providing support for both the 7-factor Hybrid model and the 6-factor Anhedonia model in a clinical sample of Spanish trauma survivors. Given equivalent fit for these two models and the fewer number of latent factors in the Anhedonia model, it was selected as optimal in a traumatized Spanish sample. Implications and future research directions are discussed.

  4. Dimensional structure of DSM-5 posttraumatic stress symptoms in Spanish trauma victims

    Directory of Open Access Journals (Sweden)

    Carmen Soberón

    2016-12-01

    Full Text Available Background: Confirmatory factor analytic studies have shown that posttraumatic stress disorder (PTSD symptoms included in the fifth edition of the Diagnostic and Statistical Manual Disorders (DSM-5 may be better explained by two 6-factor models (the Externalizing Behaviours model and the Anhedonia model and a 7-factor Hybrid model. The latter model comprises the symptom clusters of intrusion, avoidance, negative affect, anhedonia, externalizing behaviours, and anxious and dysphoric arousal. This model has received empirical support mainly in American samples. Of note, there have been a limited number of studies conducted on samples from other countries. Objective: This study aimed to examine the underlying dimensionality of DSM-5 PTSD symptoms in a Spanish clinical sample exposed to a range of traumatic events. Method: Participants included 165 adults (78.8% females seeking treatment in trauma services in the Madrid area (Spain. PTSD was assessed using the Global Assessment of Posttraumatic Stress Scale 5, a Spanish self-report instrument assessing posttraumatic symptoms according to the DSM-5 criteria. Confirmatory factor analyses were conducted in Mplus. Results: Both the 7-factor Hybrid model and the 6-factor Anhedonia model demonstrated good and equivalent fit to the data. Conclusions: The findings of this study replicate and extend previous research by providing support for both the 7-factor Hybrid model and the 6-factor Anhedonia model in a clinical sample of Spanish trauma survivors. Given equivalent fit for these two models and the fewer number of latent factors in the Anhedonia model, it was selected as optimal in a traumatized Spanish sample. Implications and future research directions are discussed. Highlights of the article:

  5. CRANIOCEREBRAL TRAUMA: NURSING DIAGNOSIS FOR VICTIMS ASSISTANCE ON INTESIVE CARE UNITY.

    Directory of Open Access Journals (Sweden)

    Rita Edna da Silveira

    2004-08-01

    Full Text Available The enfermagem process makes possible a care individualized the customers, characterizing anautonomous work and quality attendance. It was aimed at to Identify diagnoses of Enfermagem in patienttraumatismos victims cranium-encefálico (TCE and to elaborate a model of implantation of cares, through thetaxonomia NANDA, being used the reasoning of Risner. He/she/you took place descriptive-exploratory study,retrospective to the patients interned in the year 2002, type case study, reference hospital in traumatologia, inFortaleza-Ce. It was collected the data in the books of registration of UTIs I II, III, IV and, data processing Center, themonths of January to March of 2003. It was counted 143 (100% patient interned. They were stood out TCE with 57(40% of the cases, followed by the politraumatismos with TCE with 30 (21% and traumatismos raqui-medular 11(7,5%. He/she/you becomes important to implement the enfermagem process that allows to plan the attendance, tooptimize time and to guarantee the quality of the care.

  6. TRAUMA

    African Journals Online (AJOL)

    Increasing temperatures are associated with increased attendances. Soccer matches and their outcomes have no significant effect on IPV-related attendances. Conclusion: Temporal and weather factors can help predict which trauma unit shifts will be busiest. Keywords: trauma unit, assault, motor vehicle collision, weather, ...

  7. Analysis of 126 hospitalized elder maxillofacial trauma victims in central China.

    Science.gov (United States)

    Li, Rui; Zhang, Rui; Li, Wenlu; Pei, Fei; He, Wei

    2015-07-01

    The aim of this study was to analyzed the characteristics and treatment of maxillofacial injuries in the elder patients with maxillofacial injuries in central China. We retrospectively analyzed the characteristics and treatment of maxillofacial injuries in the patients over the age of 60 to analyze the trends and clinical characteristics of maxillofacial trauma in elder patients from the First Affiliated Hospital of Zhengzhou University (from 2010 to 2013) in central China and to present recommendations on prevention and management. Of the 932 patients with maxillofacial injuries, 126 aged over 60 years old accounting for 13.52% of all the patients (male:female, 1.74:1; mean age, 67.08 years old). Approximately 52% of the patients were injured by falls. The most frequently observed type of injuries was soft tissue injuries (100%), followed by facial fractures (83.05%). Of the patients with soft tissue injuries, the abrasions accounted the most, followed by lacerations. The numbers of patients of midface fracture (60 patients) were almost similar to the number of lower face fractures (66 patients). Eighty two patients (65.08%%) demonstrated associated injuries, of which craniocerebral injuries were the most prevalent. One hundred and four patients (82.54%) had other systemic medical conditions, with cardiovascular diseases the most and followed by metabolic diseases and musculoskeletal conditions. Furthermore, the study indicated a relationship between maxillofacial fractures and musculoskeletal conditions. Only 13 patients (10.32%) sustained local infections, of whom had other medical conditions. Most of the facial injuries (85.71%) in older people were operated including debridement, fixing loose teeth, reduction, intermaxillary fixation and open reduction and internal fixation (ORIF). Our analysis of the characteristics of maxillofacial injuries in the elder patents may help to promote clinical research to develop more effective treatment and possibly prevent

  8. Why Did This Happen to Me? Cognitive Schema Disruption and Posttraumatic Stress Disorder in Victims of Sexual Trauma

    Science.gov (United States)

    Wright, Caroline Vaile; Collinsworth, Linda L.; Fitzgerald, Louise F.

    2010-01-01

    Many trauma researchers have proposed cognitive schemas as a heuristic device to understand the elusive process of integrating traumatic events. We examined the schemas of a sample (N = 257) of female participants classified by exposure to sexual trauma, nonsexual trauma, and no trauma experience. Cognitive schema was assessed with the Traumatic…

  9. High ratio plasma resuscitation does not improve survival in pediatric trauma patients.

    Science.gov (United States)

    Cannon, Jeremy W; Johnson, Michael A; Caskey, Robert C; Borgman, Matthew A; Neff, Lucas P

    2017-08-01

    Damage control resuscitation including balanced resuscitation with high ratios of plasma (PLAS) and platelets (PLT) to packed red blood cells (PRBC) improves survival in adult patients. We sought to evaluate the effect of a high ratio PLAS to PRBC resuscitation strategy in massively transfused pediatric patients with combat injuries. The Department of Defense Trauma Registry was queried from 2001 to 2013 for pediatric trauma patients (trauma, and older teens were excluded. Those who received massive transfusion (≥40 mL/kg total blood products in 24 hours) and early deaths who received any blood products were then evaluated. Primary outcomes were mortality at 24 hours and in-hospital. Secondary outcomes included blood product utilization over 24 hours, ventilator-free days, intensive care unit-free days, and hospital length of stay. The Department of Defense Trauma Registry yielded 4,980 combat-injured pediatric trauma patients, of whom 364 met inclusion criteria. Analysis of PLAS/PRBC ratios across the entire spectrum of possible ratios in these patients demonstrated no clear inflection point for mortality. Using a division between low (LO) and high (HI) ratios of PLAS/PRBC 1:2, there was no difference in all-cause mortality at 24 hours (LO, 9.2% vs. HI, 8.0%; p = 0.75) and hospital discharge (LO, 21.5% vs. HI, 17.1%; p = 0.39). HI ratio patients received less PRBC but more PLAS and PLT and more total blood products. Those in the HI ratio group also had longer hospital length of stay. Regression analysis demonstrated no associated mortality benefit with a HI ratio (hazards ratio, 2.04; 95% confidence interval, 0.48-8.73; p = 0.34). In combat-injured children undergoing a massive transfusion, a high ratio of PLAS/PRBC was not associated with improved survival. Further prospective studies should be performed to determine the optimal resuscitation strategy in critically injured pediatric patients. Therapeutic study, level III.

  10. Promovendo resiliência em vítimas de trauma psicológico Promoviendo resiliencia en víctimas de trauma psicológico Fostering resilience in psychological trauma victims

    Directory of Open Access Journals (Sweden)

    Julio F. P. Peres

    2005-08-01

    reestructuración cognitiva pueden ayudar a las víctimas de experiencias traumáticas a evolucionar a partir de sus experiencias negativas, con el desarrollo de diálogos internos saludable y resilientes.Exposure to life-threatening and violent events is relatively common in a significant portion of the population. Efforts aimed at understanding responses to traumas have also focused on the contribution of personality factors. The way people process the stressful event is of paramount importance for the determination of trauma. The brain does not store records of facts; rather, it keeps traces of information that are later used to recreate memories, which do not always express a completely faithful picture of the past experience. Whenever a traumatic event is retrieved, it may undergo cognitive and emotional changes. We postulate that therapists must go beyond the traumatic event itself and work with the internal dialogs that maintain the pathological relationship with the past episode. Therapy based on exposure and cognitive restructuring may help trauma victims experience psychological growth from their negative experiences, by fostering resilient internal dialogues.

  11. A NEW METHOD FOR PREDICTING SURVIVAL AND ESTIMATING UNCERTAINTY IN TRAUMA PATIENTS

    Directory of Open Access Journals (Sweden)

    V. G. Schetinin

    2017-01-01

    Full Text Available The Trauma and Injury Severity Score (TRISS is the current “gold” standard of screening patient’s condition for purposes of predicting survival probability. More than 40 years of TRISS practice revealed a number of problems, particularly, 1 unexplained fluctuation of predicted values caused by aggregation of screening tests, and 2 low accuracy of uncertainty intervals estimations. We developed a new method made it available for practitioners as a web calculator to reduce negative effect of factors given above. The method involves Bayesian methodology of statistical inference which, being computationally expensive, in theory provides most accurate predictions. We implemented and tested this approach on a data set including 571,148 patients registered in the US National Trauma Data Bank (NTDB with 1–20 injuries. These patients were distributed over the following categories: (1 174,647 with 1 injury, (2 381,137 with 2–10 injuries, and (3 15,364 with 11–20 injuries. Survival rates in each category were 0.977, 0.953, and 0.831, respectively. The proposed method has improved prediction accuracy by 0.04%, 0.36%, and 3.64% (p-value <0.05 in the categories 1, 2, and 3, respectively. Hosmer-Lemeshow statistics showed a significant improvement of the new model calibration. The uncertainty 2σ intervals were reduced from 0.628 to 0.569 for patients of the second category and from 1.227 to 0.930 for patients of the third category, both with p-value <0.005. The new method shows the statistically significant improvement (p-value <0.05 in accuracy of predicting survival and estimating the uncertainty intervals. The largest improvement has been achieved for patients with 11–20 injuries. The method is available for practitioners as a web calculator http://www.traumacalc.org.

  12. TRAUMA

    African Journals Online (AJOL)

    Blunt trauma. (n = 17). 3 (17.6%). 2. 14 (82.4%). 0. Table 2. Types of complications according to Clavien-Dindo classification. Clavien-Dindo Grading. Postoperative Complications (number). I. Wound Sepsis (3), Ileus (1). II. Pneumonia (2). III a. Nil. III b. Empyema of chest (1)*. IV a. Acute Kidney Injury (1), Respiratory Failure ...

  13. TRAUMA

    African Journals Online (AJOL)

    2017-11-04

    Nov 4, 2017 ... and via a password protected mobile application program within 6 hours. The alcohol levels were reported in grams. TRAUMA. Serum alcohol levels ..... restricts advertising on alcohol consumption.22 In addition, the South African Department of Health has published the. MiniDrug MasterPlan 23 which ...

  14. Partner preferences among survivors of betrayal trauma.

    Science.gov (United States)

    Gobin, Robyn L

    2012-01-01

    Betrayal trauma theory suggests that social and cognitive development may be affected by early trauma such that individuals develop survival strategies, particularly dissociation and lack of betrayal awareness, that may place them at risk for further victimization. Several experiences of victimization in the context of relationships predicated on trust and dependence may contribute to the development of relational schema whereby abuse is perceived as normal. The current exploratory study investigates interpersonal trauma as an early experience that might impact the traits that are desired in potential romantic partners. Participants in the current study were asked to rate the desirability of several characteristics in potential romantic partners. Although loyalty was desirable to most participants regardless of their trauma history, those who reported experiences of high betrayal trauma rated loyalty less desirable than those who reported experiences of traumas that were low and medium in betrayal. Participants who reported experiences of revictimization (defined as the experience of trauma perpetrated by a close other during 2 different developmental periods) differed from participants who only reported 1 experience of high betrayal trauma in their self-reported desire for a romantic partner who possessed the traits of sincerity and trustworthiness. Preference for a partner who uses the tactic of verbal aggression was also associated with revictimization status. These preliminary findings suggest that victimization perpetrated by close others may affect partner preferences.

  15. Childhood Trauma.

    Science.gov (United States)

    Falasca, Tony; Caulfield, Thomas J.

    1999-01-01

    Describes some classic causes of trauma and symptoms that can result when a child has been traumatized. Lists several factors that effect the degree to which a child is affected by trauma. Categories a wide range of behaviors displayed by the victims into three groups: affect, memories, and behaviors. Discusses various considerations when…

  16. Psychoanalytic perspectives on early trauma: interviews with thirty analysts who treated an adult victim of a circumscribed trauma in early childhood.

    Science.gov (United States)

    Gaensbauer, Theodore J; Jordan, Leslie

    2009-08-01

    Information on the long-term effects of early trauma and how such effects are manifested in treatment was obtained through interviews with thirty analysts who had treated an adult patient with a circumscribed trauma in the first four years of life. Childhood traumas fell into four categories: medical/accidental; separation/loss; witnessing a traumatic event; and physical/sexual abuse. Traumatic carryover was recorded in terms of explicit memories, implicit memories (somatic reliving, traumatic dreams, affective memories, behavioral reenactments, and transference phenomena), and global carryover effects (generalized traumatic affective states, defensive styles, patterns of object relating, and developmental disruptions). Linkages between the early trauma and adult symptomatology could be posited in almost every case, yet the clinical data supporting such linkages was often fragmented and ambiguous. Elements of patients' traumas appeared to be dispersed along variable avenues of expression and did not appear amenable to holistic, regressive reworking in treatment. The data did not support linear models of traumatic carryover or the idea that early traumatic experiences will be directly accessible in the course of an analysis. Factors that we believe help explain why traumatic aftereffects in our sample were so heterogeneous and difficult to track over the long term are discussed.

  17. The trauma of peer victimization: psychophysiological and emotional characteristics of memory imagery in subjects with social anxiety disorder.

    Science.gov (United States)

    Sansen, Lisa M; Iffland, Benjamin; Neuner, Frank

    2015-01-01

    The study investigated the role of an associative information network as a mechanism underlying the relation of peer victimization and social anxiety disorder (SAD). A sample of N = 80 was divided according to diagnosis (SAD vs. no diagnosis) and amount of peer victimization (low vs. high). Responses to memory of a personally experienced aversive social situation and to imagining a standardized negative social situation were assessed. In terms of skin conductance level, subjects with SAD and peer victimization were more reactive to the memory script than the other three groups while responses to the standardized script did not vary. As to heart rate, there were no differences between the groups. Emotional responses presented with an inconsistent pattern. The results provide a first indication that associative memory structures resulting from aversive social experiences might play a role in the development and maintenance of SAD, but further research is needed. Copyright © 2014 Society for Psychophysiological Research.

  18. Time Interval between Trauma and Arthroscopic Meniscal Repair Has No Influence on Clinical Survival.

    Science.gov (United States)

    van der Wal, Robert J P; Thomassen, Bregje J W; Swen, Jan-Willem A; van Arkel, Ewoud R A

    2016-07-01

    Arthroscopic meniscal repair is the gold standard for longitudinal peripheral meniscal tears. The time interval between trauma and meniscal repair remains controversial. The aim of this study was to evaluate failure rates and clinical outcome of arthroscopic meniscal repair in relation to chronicity of injury. A total of 238 meniscal repairs were performed in 234 patients. Anterior cruciate ligament (ACL) was reconstructed in almost all ACL-deficient knees (130 out of 133). Time interval between injury and repair was divided into acute ( 2 to  12 weeks). Patients completed postal questionnaires to evaluate clinical outcome and failure rates. Study instruments included Lysholm, Knee injury and Osteoarthritis Outcome Score (KOOS), and Tegner scoring systems. At a median follow-up of 41 months (interquartile range [IQR], 34-53 months) 55 medial and 10 lateral meniscal repairs failed (overall failure rate, 27%). There was a significant higher failure rate for medial meniscal repair (p meniscal repair has no influence on the failure rate. Differences in survival rate of meniscal repair are more dependent on location of the lesion and ACL status, rather than chronicity of injury. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  19. Acidentes de trânsito: caracterização das vitimas segundo o "Revised Trauma Score" medido no período pré-hospitalar Accidentes de transito: caracterización de las víctimas según el "Revised Trauma Score" medido en el periodo pre-hospitalario Motor vehicle crash: victims' characterization throughout prehospital "Revised Trauma Score"

    Directory of Open Access Journals (Sweden)

    Marisa Amaro Malvestio

    2002-12-01

    Full Text Available O estudo descreve idade, sexo, aspectos do mecanismo e procedimentos realizados em. 643 acidentados de trânsito atendidos nas Marginais Tietê e Pinheiros, considerando os valores do Revised Trauma Score (RTS do período pré-hospitalar. As vítimas com RTS=12 somaram 90,8%, com RTS=11, 4,0% e RTSEste estudio tiene como obje tivo describer, considerando el Revised Trauma Score (RTS obtenido en el periodo pré hospitalario, edad, sexo, aspectos del mecanismo e procedimientos realizados en 643 víctimas de accidente de tránsito. Las víctimas con RTS=12 sumaron 90,8%, con RTS=11, 4,0% y RTSThis report describes age, gender, trauma mechanics aspects and procedures from 643 motor vehicle crashes, MVC, victims in Tietê and Pinheiros expressways, by considering the prehospital Revised Trauma Score (RTS. The RTS=12 victims' were 90,8%, with RTS=11 added 4,0% and in group with RTS<10, 5,2%. Among the RTS<10 victims, the pedestrians stand out (36,4%, the frontal impacts (24,2% and the projected (36,4% or trapped victims (15,1%, and those that received advanced life support procedures.The motorcyclists and the male victims with 21 with 30 years of age were predominant. This study is expected to contribute to a better assistance to MVC victims.

  20. Bayesian Decision Trees for predicting survival of patients: a study on the US National Trauma Data Bank.

    Science.gov (United States)

    Schetinin, Vitaly; Jakaite, Livia; Jakaitis, Janis; Krzanowski, Wojtek

    2013-09-01

    Trauma and Injury Severity Score (TRISS) models have been developed for predicting the survival probability of injured patients the majority of which obtain up to three injuries in six body regions. Practitioners have noted that the accuracy of TRISS predictions is unacceptable for patients with a larger number of injuries. Moreover, the TRISS method is incapable of providing accurate estimates of predictive density of survival, that are required for calculating confidence intervals. In this paper we propose Bayesian inference for estimating the desired predictive density. The inference is based on decision tree models which split data along explanatory variables, that makes these models interpretable. The proposed method has outperformed the TRISS method in terms of accuracy of prediction on the cases recorded in the US National Trauma Data Bank. The developed method has been made available for evaluation purposes as a stand-alone application. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  1. Mesenteric thrombosis in patient victim of blunt abdominal trauma Trombose mesentérica em vítima de trauma abdominal fechado

    Directory of Open Access Journals (Sweden)

    Iwan Augusto Collaço

    2008-06-01

    Full Text Available INTRODUCTION: Mesenteric thrombosis related to trauma is an uncommon entity and has poor prognosis when associated to low perfusion and hemorrhagic shock. Usually presents a challenging diagnosis and high mortality rates, despite appropriate treatment. OBJECTIVE: To relate a case of a car accident and blunt abdominal trauma with terminal ileum and right colon necrosis. CASE REPORT: After initial procedures, complementary exams showed ribs and humerus fractures. Computerized tomography evidenced aerial distension in small bowel, gastric stasis and hidro-pneumothorax. Hypotension was observed during clinical observation followed by cardiopulmonary arrest, responding to reanimation. At surgery, it was found extensive necrosis of right colon and terminal ileum, and an ileum-transversostomy was performed with primary anastomosis. During the staying in intensive care unit, oliguria, miosis, convulsion and pulseless electric activity happened with death in three days after hospital admission. CONCLUSION: Although uncommon, mesenteric ischemia with venous thrombosis might be secondary to blunt abdominal trauma and must be considered in a bad abdominal evolution.INTRODUÇÃO: Trombose mesentérica, relacionada à trauma é entidade incomum com pobre prognóstico quando seguida de estados de baixo fluxo e choque hipovolêmico. Geralmente se apresenta com quadro de difícil diagnóstico, mortalidade elevada a despeito de tratamento adequado. OBJETIVO: Apresentar um caso de vítima de atropelamento que evoluiu com necrose de cólon direito e íleo terminal. RELATO DO CASO: Após admissão hospitalar e atendimento inicial, os exames complementares mostraram fratura de costela e úmero. Tomografia computadorizada evidenciou distensão aérea em intestino delgado associada à estase gástrica e hidropneumotórax. O paciente evoluiu com hipotensão durante o período de observação clínica, com parada cardiorespiratória, respondendo à reanimação. Levado

  2. Survival outcomes after prolonged intensive care unit length of stay among trauma patients: The evidence for never giving up.

    Science.gov (United States)

    Kisat, Mehreen T; Latif, Asad; Zogg, Cheryl K; Haut, Elliott R; Zafar, Syed Nabeel; Hashmi, Zain G; Oyetunji, Tolulope A; Cornwell, Edward E; Zafar, Hasnain; Haider, Adil H

    2016-09-01

    Prolonged intensive care unit length of stay (ICU-LOS) is associated with high mortality for medical and surgical patients. Existing literature suggests that this may not be true for trauma patients. The objective of this study was to determine mortality associated with varying ICU-LOS among trauma patients and to assess for independent predictors of mortality. Adult ICU patients (16-64 years) in the National Trauma Data Bank (2007-2012) were categorized by ICU-LOS: 1, 2-9, 10-40, and >40 days (determined based on inflection points). Multivariable logistic regression was used to determine associations with mortality for each. Models accounted for clustering of patients within hospitals and potential confounding associated with: age, gender, race/ethnicity, insurance status, Injury Severity Score, blunt/penetrating injury, Glasgow Coma Scale, in-hospital complications, ventilator dependency, and emergency department disposition. Among the 596,598 patients included, 6.5% (n = 38,812) died. Mortality varied with ICU-LOS: 9.9%, 4.9%, 6.6%, and 9.8%. Age >35 years was a significant predictor of mortality in each. Injury Severity Score and the Glasgow Coma Scale independently predicted mortality in patients with LOS ≤40 days as did penetrating injuries, cardiac arrest, and renal failure. Identification with non-Hispanic black race/ethnicity was also consistently significant. Once patients survived 9 days, mortality steadily decreased, remaining relatively stable until 40 days. Thereafter, trauma patients continued to demonstrate high survival with >87% remaining alive in the ICU >90 days. The results reveal that in contrast to expectations of high mortality associated with prolonged ICU-LOS, critically injured adult trauma patients who do not die within the first few days demonstrate an enhanced ability to survive, with an overall survival of >92% and maintained at >85% among extreme ICU-LOS (>40 days). The data advocate the utility of aggressive critical

  3. Entrapped victims in motor vehicle collisions: characteristics and prehospital care in the city of São Paulo, Brazil

    Directory of Open Access Journals (Sweden)

    Adriano Rogério Navarro Dias

    2011-01-01

    Full Text Available OBJECTIVE: To examine the severity of trauma in entrapped victims and to identify risk factors for mortality and morbidity. INTRODUCTION: Triage and rapid assessment of trauma severity is essential to provide the needed resources during prehospital and hospital phases and for outcome prediction. It is expected that entrapped victims will have greater severity of trauma and mortality than non-entrapped subjects. METHODS: A transverse, case-control, retrospective study of 1203 victims of motor vehicle collisions treated during 1 year by the prehospital service in São Paulo, Brazil was carried out. All patients were drivers, comprising 401 entrapped victims (33.3% and 802 non-entrapped consecutive controls (66.7%. Sex, age, mortality rates, Glasgow Coma Scale (GCS, Revised Trauma Score (RTS, corporal segments, timing of the prehospital care and resource use were compared between the groups. The results were analysed by χ2, Zres, analysis of variance and Bonferroni tests. RESULTS: Entrapped victims were predominantly men (84.8%, aged 32±13.1 years, with immediate mortality of 10.2% and overall mortality of 11.7%. They had a probability of death at the scene 8.2 times greater than that of non-entrapped victims. The main cause of death was hemorrhage for entrapped victims (45.2% and trauma for non-entrapped victims. Of the entrapped victims who survived, 18.7% had a severe GCS (OR = 10.62, 12% a severe RTS (OR = 9.78 and 23.7% were in shock (OR = 3.38. Entrapped victims were more commonly transported to advanced life support units and to tertiary hospitals. CONCLUSION: Entrapped victims had greater trauma severity, more blood loss and a greater mortality than respective, non-entrapped controls.

  4. Childhood Victimization and Lifetime Revictimization

    Science.gov (United States)

    Widom, Cathy Spatz; Czaja, Sally J.; Dutton, Mary Ann

    2008-01-01

    Objective: To examine the fundamental hypothesis that childhood victimization leads to increased vulnerability for subsequent (re)victimization in adolescence and adulthood and, if so, whether there are differences in rates of experiencing traumas and victimizations by gender, race/ethnicity, and type of childhood abuse and/or neglect. Methods:…

  5. Surviving early childhood trauma : effects of the holocaust on survivors' psychological and physiolocial well-being

    NARCIS (Netherlands)

    Fridman, Ayala

    2011-01-01

    Psychological, neurobiological and genetics characteristics of Holocaust child survivors and their daughters were studied in population-wide demographic sample in comparison to matched control groups. Sixty years following the occurrence of the trauma, survivors still report more dissociative

  6. Internally Displaced “Victims of Armed Conflict” in Colombia: The Trajectory and Trauma Signature of Forced Migration

    Science.gov (United States)

    Shultz, James M.; Garfin, Dana Rose; Espinel, Zelde; Araya, Ricardo; Oquendo, Maria A.; Wainberg, Milton L.; Chaskel, Roberto; Gaviria, Silvia L.; Ordóñez, Anna E.; Espinola, Maria; Wilson, Fiona E.; García, Natalia Muñoz; Ceballos, Ángela Milena Gómez; Garcia-Barcena, Yanira; Verdeli, Helen; Neria, Yuval

    2016-01-01

    While conflict-induced forced migration is a global phenomenon, the situation in Colombia, South America, is distinctive. Colombia has ranked either first or second in the number of internally displaced persons for 10 years, a consequence of decades of armed conflict compounded by high prevalence of drug trafficking. The displacement trajectory for displaced persons in Colombia proceeds through a sequence of stages: (1) pre-expulsion threats and vulnerability, (2) expulsion, (3) migration, (4) initial adaptation to relocation, (5) protracted resettlement (the end point for most forced migrants), and, rarely, (6) return to the community of origin. Trauma signature analysis, an evidence-based method that elucidates the physical and psychological consequences associated with exposures to harm and loss during disasters and complex emergencies, was used to identify the psychological risk factors and potentially traumatic events experienced by conflict-displaced persons in Colombia, stratified across the phases of displacement. Trauma and loss are experienced differentially throughout the pathway of displacement. PMID:25135775

  7. Thrombopoietin Receptor Agonist Mitigates Hematopoietic Radiation Syndrome and Improves Survival after Whole-Body Ionizing Irradiation Followed by Wound Trauma

    Directory of Open Access Journals (Sweden)

    Juliann G. Kiang

    2017-01-01

    Full Text Available Ionizing radiation combined with trauma tissue injury (combined injury, CI results in greater mortality and H-ARS than radiation alone (radiation injury, RI, which includes thrombocytopenia. The aim of this study was to determine whether increases in numbers of thrombocytes would improve survival and mitigate H-ARS after CI. We observed in mice that WBC and platelets remained very low in surviving RI animals that were given 9.5 Gy 60Co-γ-photon radiation, whereas only lymphocytes and basophils remained low in surviving CI mice that were irradiated and then given skin wounds. Numbers of RBC and platelets, hemoglobin concentrations, and hematocrit values remained low in surviving RI and CI mice. CI induced 30-day mortality higher than RI. Radiation delayed wound healing by approximately 14 days. Treatment with a thrombopoietin receptor agonist, Alxn4100TPO, after CI improved survival, mitigated body-weight loss, and reduced water consumption. Though this therapy delayed wound-healing rate more than in vehicle groups, it greatly increased numbers of platelets in sham, wounded, RI, and CI mice; it significantly mitigated decreases in WBC, spleen weights, and splenocytes in CI mice and decreases in RBC, hemoglobin, hematocrit values, and splenocytes and splenomegaly in RI mice. The results suggest that Alxn4100TPO is effective in mitigating CI.

  8. Living in "survival mode:" Intergenerational transmission of trauma from the Holodomor genocide of 1932-1933 in Ukraine.

    Science.gov (United States)

    Bezo, Brent; Maggi, Stefania

    2015-06-01

    Qualitative methodology was used to investigate the intergenerational impact of the 1932-1933 Holodomor genocide on three generations in 15 Ukrainian families. Each family, residing in Ukraine, consisted of a first generation survivor, a second generation adult child and a third generation adult grandchild of the same line. The findings show that the Holodomor, a genocide that claimed millions of lives by forced starvation, still exerts substantial effects on generations born decades later. Specifically, thematic analysis of the 45 semi-structured, in-depth interviews, done between July and November 2010, revealed that a constellation of emotions, inner states and trauma-based coping strategies emerged in the survivors during the genocide period and were subsequently transmitted into the second and third generations. This constellation, summarized by participants as living in "survival mode," included horror, fear, mistrust, sadness, shame, anger, stress and anxiety, decreased self-worth, stockpiling of food, reverence for food, overemphasis on food and overeating, inability to discard unneeded items, an indifference toward others, social hostility and risky health behaviours. Since both the family and community-society were found to be involved in trauma transmission, the findings highlight the importance of multi-framework approaches for studying and healing collective trauma. Copyright © 2015 Elsevier Ltd. All rights reserved.

  9. Attitudes of Future Human Service Professionals: The Effects of Victim and Helper Qualities.

    Science.gov (United States)

    Liebkind, Karmela; Eranen, Liisa

    2001-01-01

    Investigates the attitudes of future members in human service professions toward victims, based on the qualities effected by trauma victims and their helpers. Reports that the high-trauma and poorly adapted victims elicited more negative attitudes than did the low-trauma and well-adapted victims. (CMK)

  10. Long-Term Survival on Medical Therapy Alone after Blunt-Trauma Aortic Regurgitation: Report of a New Case with Summary of 95 Others.

    Science.gov (United States)

    Tsugu, Toshimitsu; Murata, Mitsushige; Mahara, Keitaro; Iwanaga, Shiro; Fukuda, Keiichi

    2016-10-01

    Aortic regurgitation resulting from blunt chest trauma has been reported only 95 times, to our knowledge. The noncoronary and right coronary cusps are the cardiac structures most often injured. Although the aortic leaflets can appear to be undamaged after nonpenetrating trauma, they can have pathologic abnormalities and insufficient function. Some cases of posttraumatic aortic regurgitation progress slowly. Aortic valve replacement is the optimal treatment. We present the case of a then-62-year-old man who has lived more than 5 years after blunt-trauma aortic regurgitation. His is the only case of long-term survival on medical therapy alone among the 96 cases summarized in this report.

  11. Revictimization of Victims Sexually Abused by Women

    Directory of Open Access Journals (Sweden)

    Małgorzata H. Kowalczyk

    2017-07-01

    Full Text Available Victims experiencing the sexual abuse are surviving not only physical injustice but above all deep traumas, which very often in different forms, are keeping them company through the entire life. Quite often at establishing different results a sex is underestimated for the perpetrator. Therefore knowing the problem of sexual abuses from a perspective of close as well as distant results is very important in the event that a woman was a perpetrator of these acts – mother, minder. In the present article based on analysis of literature, a problem of results of the sexual abuse was presented at victims which experienced these behaviours on the part of women. In order to draw up discussing the survived specificity by victims was both of sex of the trauma connected with the sexual application as well as close and distant consequences of these events in the form prime victimisation and revictimisation for figure being noticeable in the adult life of psychosexual disorders and social shortages. Amongst the consequence isolated traumatic factors are deserving the particular attention about dynamic character which are provoking the appearance of many symptoms characteristic of children which experienced the sexual violence. Recalled factors it: traumatic sexualisation of child, the betrayal, the stigmatization and the helplessness. The specificity of these factors results from the fact that they will leave distant “tracks” in the psyche and they can undergo the additional reinforcement if a woman is a perpetrator of the sexual violence. It results from frequent attitudes of “denying” towards the sexual violence applied by women. In the study they pointed also at one of possible consequences of the revictimisation process copying patterns of behaviour connected with the sexual exploitation of children in their more late life by victims is which. This process resulting from the alternating identification of the perpetrator and the victim is starting

  12. The Effect of Knowing a Rape Victim on Reactions to Other Victims.

    Science.gov (United States)

    Barnett, Mark A.; And Others

    1992-01-01

    Examined whether having had a friend or family member experience rape heightens empathy for rape victims. Subjects who knew a rape victim reported experiencing more empathy for a patient presented on videotape than did subjects not knowing a rape victim. This empathy extended to all victims of trauma. (RJM)

  13. Youth Internet victimization in a broader victimization context.

    Science.gov (United States)

    Mitchell, Kimberly J; Finkelhor, David; Wolak, Janis; Ybarra, Michele L; Turner, Heather

    2011-02-01

    To examine past-year and lifetime rates of online victimization and associations with offline victimizations, trauma symptomatology, and delinquency among adolescents. Data were collected through telephone interviews from a nationally representative sample of 2,051 adolescents (ages, 10-17) as part of the National Survey of Children's Exposure to Violence. Data were collected between January and May, 2008. Six percent of youth reported a past-year online victimization and 9% a lifetime online victimization. Almost all youth reporting a past-year online victimization (96%) reported offline victimization during the same period. The offline victimizations most strongly associated to online victimization were sexual victimizations (e.g., sexual harassment, being flashed, rape) and psychological and emotional abuse. Online victims also reported elevated rates of trauma symptomatology, delinquency, and life adversity. Prevention and intervention should target a broader range of behaviors and experiences rather than focusing on the Internet component exclusively. Internet safety educators need to appreciate that many online victims may be at risk not because they are naive about the Internet, but because they face complicated problems resulting from more pervasive experiences of victimization and adversity. Copyright © 2011 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  14. Severity of trauma victims admitted in intensive care units: comparative study among different indexes Gravedad de las víctimas de trauma, admitidas en unidades de terapia intensiva: estudio comparativo entre diferentes índices Gravidade das vítimas de trauma, admitidas em unidades de terapia intensiva: estudo comparativo entre diferentes índices

    Directory of Open Access Journals (Sweden)

    Lilia de Souza Nogueira

    2009-12-01

    Full Text Available This study compared the performance of the Injury Severity Score (ISS with the New Injury Severity Score (NISS and also the Simplified Acute Physiology Score II (SAPS II with the Logistic Organ Dysfunction System (LODS in trauma victims, in order to predict mortality and length of stay in Intensive Care Units (ICU, besides identifying which indexes have been the most effective to estimate these results. A retrospective analysis was done in the records of 185 victims admitted in ICU between June and December 2006. None of the four indexes properly discriminated the patients according to length of stay at the ICU. The ISS and the NISS did not show a good discriminating capacity in case of death, but the SAPS II and the LODS presented good performance to estimate mortality at the ICU. Results pointed towards the use of SAPS II and LODS when trauma victims are admitted in an ICU.Este estudio tuvo por objetivo comparar en víctimas de trauma el desempeño del Injury Severity Score (IS, con el New Injury Severity Score (NIS y, también, del Simplified Acute Physiology Score II (SAPS II, con el Logistic Organ Dysfunction System (LODS para predecir la mortalidad y el tiempo de permanencia en unidades de terapia intensiva (UTI, y también para identificar cuales índices fueron los más efectivos para estimar esos resultados. Fue realizado un análisis retrospectivo de las fichas de 185 víctimas, admitidas en una UTI, entre junio y diciembre de 2006. Los cuatro índices no discriminaron adecuadamente a los pacientes según el tiempo de permanencia en la UTI. El IS y el NIS no mostraron una buena capacidad discriminatoria para la ocurrencia de muerte, diferente del SAPS II y del LODS que presentaron un mejor desempeño para estimar la mortalidad en UTI. Los resultados apuntaron para el uso del SAPS II y del LODS cuando víctimas de trauma son internadas en una UTI.Este estudo objetivou comparar em vítimas de trauma o desempenho do Injury Severity Score

  15. Sexual Trauma, Spirituality, and Psychopathology

    Science.gov (United States)

    Krejci, Mark J.; Thompson, Kevin M.; Simonich, Heather; Crosby, Ross D.; Donaldson, Mary Ann; Wonderlich, Stephen A.; Mitchell, James E.

    2004-01-01

    This study assessed the association between spirituality and psychopathology in a group of sexual abuse victims and controls with a focus on whether spirituality moderated the association between sexual trauma and psychopathology. Seventy-one sexual trauma victims were compared to 25 control subjects on spiritual well-being, the Eating Disorder…

  16. The level of knowledge of the advanced trauma life support protocol ...

    African Journals Online (AJOL)

    2012-04-17

    59.1%) filled and returned their .... to improve survival of trauma victims. However, no medically qualified doctor is entirely lacking in the ... ATLS Student Course Manual. 8th ed. Chicago IL; 2008. 2. Peden M, McGee K, Sharma G.

  17. Augmented survival of out-of-hospital cardiac arrest victims with the use of mobile phones for emergency communication under the DA-CPR protocol getting information from callers beside the victim.

    Science.gov (United States)

    Maeda, Tetsuo; Yamashita, Akira; Myojo, Yasuhiro; Wato, Yukihiro; Inaba, Hideo

    2016-10-01

    To investigate the impacts of emergency calls made using mobile phones on the quality of dispatcher-assisted cardiopulmonary resuscitation (DA-CPR) and survival from out-of-hospital cardiac arrests (OHCAs) that were not witnessed by emergency medical service (EMS). In this prospective study, we collected data for 2530 DA-CPR-attempted medical emergency cases (517 using mobile phones and 2013 using landline phones) and 2980 non-EMS-witnessed OHCAs (600 using mobile phones and 2380 using landline phones). Time factors and quality of DA-CPR, backgrounds of callers and outcomes of OHCAs were compared between mobile and landline phone groups. Emergency calls are much more frequently placed beside the arrest victim in mobile phone group (52.7% vs. 17.2%). The positive predictive value and acceptance rate of DA-CPR in mobile phone group (84.7% and 80.6%, respectively) were significantly higher than those in landline group (79.2% and 70.9%). The proportion of good-quality bystander CPR in mobile phone group was significantly higher than that in landline group (53.5% vs. 45.0%). When analysed for all non-EMS-witnessed OHCAs, rates of 1-month survival and 1-year neurologically favourable survival in mobile phone group (7.8% and 3.5%, respectively) were higher than those in landline phone group (4.6% and 1.9%; pmobile phone calls were associated with increased 1-month survival in the subgroup of OHCAs receiving bystander CPR (adjusted odds ratio, 1.84; 95% CI, 1.15-2.92). Emergency calls made using mobile phones are likely to augment the survival from OHCAs by improving DA-CPR. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  18. How formative courses about damage control surgery and non-operative management improved outcome and survival in unstable politrauma patients in a Mountain Trauma Center.

    Science.gov (United States)

    Bellanova, Giovanni; Buccelletti, Francesco; Berletti, Riccardo; Cavana, Marco; Folgheraiter, Giorgio; Groppo, Francesca; Marchetti, Chiara; Marzano, Amelia; Massè, Alessandro; Musetti, Antonio; Pelanda, Tina; Ricci, Nicola; Tugnoli, Gregorio; Papadia, Damiano; Ramponi, Claudio

    2016-01-01

    Aim of this study is to analyze how the starting of Course of Trauma in our hospital improved survival and organization in management of polytraumatized patients. We analysed all major trauma patients (Injury Severity Score (Injury Severity Score (ISS)> 15) treated at Emergency Department of the Santa Chiara Hospital between January 2011 and December 2014. The training courses (TC) were named "management of polytrauma" (MP) and "clinical cases discussion" (CCD), and started in November 2013. We divided the patients between two groups: before November 2013 (pre-TC group) and after November 2013 (post-TC group). MTG's courses (EMC accredited), CCD and MP courses started in November 2013. The target of these courses was the multidisciplinary management of polytrauma patient; the courses were addressed to general surgeons, anaesthesiologists, radiologists, orthopaedics and emergency physicians. Respectively 110 and 78 doctors were formed in CCD's and MP's courses. Patients directly transported to our trauma centre rose from 67.5% to 83% (pOperative Management, Trauma Course, Trauma Team, Trauma Center.

  19. Captopril Increases Survival after Whole-Body Ionizing Irradiation but Decreases Survival when Combined with Skin-Burn Trauma in Mice.

    Science.gov (United States)

    Islam, Aminul; Bolduc, David L; Zhai, Min; Kiang, Juliann G; Swift, Joshua M

    2015-09-01

    Past and recent radiation events have involved a high incidence of radiation combined injury where victims often succumb to serious infections as a consequence of bacterial translocation and subsequent sepsis. The risk of infection is exacerbated in radiation combined skin-burn injury (RCI), which increase vulnerability. Furthermore, no suitable countermeasures for radiation combined skin-burn injury have been established. In this study, we evaluated captopril as a potential countermeasure to radiation combined skin-burn injury. Captopril is an FDA-approved angiotensin-converting enzyme inhibitor that was previously reported to stimulate hematopoietic recovery after exposure to ionizing radiation. Female B6D2F1/J mice were whole-body bilateral (60)Co gamma-photon irradiated (dose rate of 0.4 Gy/min) with 9.5 Gy (LD70/30 for RCI), followed by nonlethal dorsal skin-burn injury under anesthesia (approximately 15% total-body surface-area burn). Mice were provided with acidified drinking water with or without dissolved captopril (0.55 g/l) for 30 days immediately after injury and were administered topical gentamicin (0.1% cream; day 1-10) and oral levofloxacin (90-100 mg/kg; day 3-16). Surviving mice were euthanized on day 30 after analyses of water consumption, body weight and survival. Our data demonstrate that, while treatment with captopril did mitigate mortality induced by radiation injury (RI) alone (55% captopril vs. 80% vehicle; n = 20, P captopril vs. 41% vehicle; n = 22, P captopril administration via drinking water produced an uneven dosage pattern among the different injury groups ranging from 74 ± 5.4 to 115 ± 2.2 mg/kg/day. Captopril treatment also did not counteract the negative alterations in hematology, splenocytes or bone marrow cellularity after either radiation injury or radiation combined skin-burn injury. These data suggest that captopril may exert its actions differently between the two injury models (RI vs. RCI) and that captopril dosing, when

  20. Extracorporeal life support use in pediatric trauma: a review of the National Trauma Data Bank.

    Science.gov (United States)

    Watson, Joshua A; Englum, Brian R; Kim, Jina; Adibe, Obinna O; Rice, Henry E; Shapiro, Mark L; Daneshmand, Mani A; Tracy, Elisabeth T

    2017-01-01

    As the role of extracorporeal life support (ECLS) continues to evolve in the adult and pediatric populations, smaller studies and case reports have described successful use of ECLS in specific groups of pediatric trauma patients. To further define the role of ECLS in pediatric trauma, we examined indications and outcomes for use of ECLS in injured children using a large national database. All trauma patients ≤18years old were identified from the 2007 to 2011 National Trauma Data Bank. We collected patient demographics, mechanism of injury, injury severity, use of ECLS, and survival to discharge. Children undergoing ECLS were compared to those who did not undergo ECLS, using a 3:1 propensity matched analysis to compare outcomes between ECLS and non-ECLS patients with similar injury patterns. Of 589,895 pediatric trauma patients identified, 36 patients underwent ECLS. Within the ECLS cohort, 21/36 (58%) survived, and 10/36 (28%) were discharged directly home. Most ECLS patients were between 15 and 18years 20/36 (56%). Mechanisms of injury (MOI) resulting in ECLS use included: motor vehicle collision (MVC) 16/36 (44%), gunshot wound (GSW) 6/36 (17%), burns 6/36 (17%), and drowning/suffocation (D/S) 5/36 (14%). Among the ECLS cohort, survival varied by MOI from 75% in D/S to 56% in MVC and 33% in GSW and was 55% in patients with significant head injuries. Using propensity analysis for matched injury patterns, survival for ECLS and non-ECLS patients was similar (58% vs. 65%, p=0.61). In the largest study to date of ECLS support in pediatric trauma patients, we found encouraging survival rates to discharge, comparable to patients not undergoing ECLS with similar injuries. These results support further use and focused research of ECLS in pediatric trauma, including drowning, burn, and MVC victims and those with significant head injuries. Level III; treatment study. Copyright © 2017. Published by Elsevier Inc.

  1. Reduced in-hospital survival rates of out-of-hospital cardiac arrest victims with obstructive pulmonary disease

    DEFF Research Database (Denmark)

    Blom, M T; Warnier, M J; Bardai, A

    2013-01-01

    , to hospital discharge, and at 30 days after OHCA, of OPD-patients and non-OPD patients, using logistic regression analysis. We also compared 30-day survival of patients who were admitted to hospital, using multivariate logistic regression analysis. RESULTS: OPD patients (n=178) and non-OPD patients (n=994......) had comparable survival to ER (75% vs. 78%, OR 0.9 [95% CI: 0.6-1.3]) and to hospital admission (56% vs. 57%, OR 1.0 [0.7-1.4]). However, survival to hospital discharge was significantly lower among OPD patients (21% vs. 33%, OR 0.6 [0.4-0.9]). Multivariate regression analysis among patients who were...

  2. The trauma of peer abuse: Effects of relational peer victimization and social anxiety disorder on physiological and affective reactions to social exclusion

    Directory of Open Access Journals (Sweden)

    Benjamin eIffland

    2014-03-01

    Full Text Available Background: Social exclusion elicits emotional distress, negative mood and physiological stress. Recent studies showed that these effects were more intense and persisting in socially anxious subjects. The present study examined whether the abnormal reactions of socially anxious subjects can be traced back to previous experiences of relational peer victimization during childhood and adolescence. Methods: Participants (N = 74 were patients with a diagnosis of social anxiety disorder as well as healthy controls. The patient and control groups were subdivided into two subgroups according to the subject’s reports about previous relational peer victimization. Immediate and delayed physiological (skin conductance level and heart rate and affective reactions to a simulated social exclusion in a ball-toss game (Cyberball were recorded.Results: Overall, subjects’ immediate reactions to social exclusion were an increase in skin conductance and a reduction of positive affect. Regardless of the diagnostic status, subjects with a history of relational peer victimization showed a more intense self-reported affective change that was accompanied by a blunted skin conductance response. However, the mood of the subjects with a history of peer victimization recovered during a 15 min waiting period. A diagnosis of social anxiety disorder did not affect the reactions to social exclusion on any measure.Conclusions: Findings indicate that stress reactions to social exclusion depend more on previous experiences of peer victimization than on a diagnosis of social anxiety disorder. The findings indicate that memories of negative social experiences can determine the initial stress reaction to social threats.

  3. The trauma of peer abuse: effects of relational peer victimization and social anxiety disorder on physiological and affective reactions to social exclusion.

    Science.gov (United States)

    Iffland, Benjamin; Sansen, Lisa Margareta; Catani, Claudia; Neuner, Frank

    2014-01-01

    Social exclusion elicits emotional distress, negative mood, and physiological stress. Recent studies showed that these effects were more intense and persisting in socially anxious subjects. The present study examined whether the abnormal reactions of socially anxious subjects can be traced back to previous experiences of relational peer victimization during childhood and adolescence. Participants (N = 74) were patients with a diagnosis of social anxiety disorder as well as healthy controls. The patient and control groups were subdivided into two subgroups according to the subject's reports about previous relational peer victimization. Immediate and delayed physiological (skin conductance level and heart rate) and affective reactions to a simulated social exclusion in a ball-toss game (Cyberball) were recorded. Overall, subjects' immediate reactions to social exclusion were an increase in skin conductance and a reduction of positive affect. Regardless of the diagnostic status, subjects with a history of relational peer victimization showed a more intense self-reported affective change that was accompanied by a blunted skin conductance response. However, the mood of the subjects with a history of peer victimization recovered during a 15 min waiting period. A diagnosis of social anxiety disorder did not affect the reactions to social exclusion on any measure. Findings indicate that stress reactions to social exclusion depend more on previous experiences of peer victimization than on a diagnosis of social anxiety disorder. The findings indicate that memories of negative social experiences can determine the initial stress reaction to social threats.

  4. Victims of rape show increased cortisol responses to trauma reminders: a study in individuals with war- and torture-related PTSD.

    Science.gov (United States)

    Gola, Hannah; Engler, Harald; Schauer, Maggie; Adenauer, Hannah; Riether, Carsten; Kolassa, Stephan; Elbert, Thomas; Kolassa, Iris-Tatjana

    2012-02-01

    Studies investigating cortisol responses to trauma-related stressors in patients with posttraumatic stress disorder (PTSD) have yielded inconsistent results, demonstrating that cortisol responses were enhanced or unaffected when confronted with trauma reminders. This study investigated the effect of the type of trauma experienced on both salivary and plasma cortisol responses during confrontation with trauma-related material. Participants were 30 survivors of war and torture, with and without rape among the traumatic events experienced. Participants of both groups (raped vs. non-raped) fulfilled DSM-IV criteria of PTSD. Plasma and salivary cortisol levels were measured at three time points during a standardized clinical interview: once before and twice after assessing individual traumatic experiences. Results show that groups did not differ in basal plasma and salivary cortisol levels. However, differential salivary cortisol responses were observed in PTSD patients who had been raped compared to those who had not been raped (prape (praped showed a significant cortisol increase when reminded of their traumatic events (p<.001). This effect was not found in plasma cortisol. Our results indicate that the type of traumatic stress experienced contributes to cortisol responses during the confrontation with trauma-related material. We hypothesize, that the nearness of the perpetrator during the traumatic event might shape later psychophysiological responding to trauma reminders. Copyright © 2011 Elsevier Ltd. All rights reserved.

  5. Factors associated with children and teenagers’ trauma of victims treated at a referral center in Southern BrazilFatores associados a crianças e adolescentes vítimas de trauma atendidas em um centro de referência no sul do Brasil

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    Karin Viegas

    2016-06-01

    Full Text Available INTRODUCTION: Physical trauma is one of the most common causes of death and disability in children's development and adolescents. By consequence, pediatric trauma is a topic that needs further studies. OBJECTIVE: The identification of factors associated with child and adolescent victims of trauma treated at a referral center in Southern Brazil relating to trauma in children and adolescents from birth to age 14 years treated in a hospital emergency room. METHODS: A retrospective study using secondary data from a hospital service, performed the analysis of associated factors among 375 children and adolescents (range 0-14 years admitted to the emergency room for any kind of physical trauma and the variables described about the traumas. The period was June 14 to December 14, 2013. RESULTS: Most patients were male (65.1%, white (89.1%; they were attended nightly (45.9% and belonging to the age group 10-14 years (40.3%, head and neck prevailed in number occurrences with 33.6% of cases, followed by the upper and lower limbs 27.7% and 26.9%, respectively. Falls represented 45.6% of cases, followed by exposure to inanimate mechanical forces (12% and exposure to animated mechanical forces (5.9%. The neurosurgery service was the most referenced for younger age groups, while for the older groups were the maxillofacial services (p = 0.001. CONCLUSION: This study showed results that draw the community’s attention not only academic, but also to call the attention of caregivers to work with constant prevention alternatives to the monitoring of the course of children’s development.

  6. Análise comparativa entre as lesões encontradas em motociclistas envolvidos em acidentes de trânsito e vítimas de outros mecanismos de trauma fechado Comparative analysis of injuries observed in motorcycle riders involved in traffic accidents and victims of other blunt trauma mechanisms

    Directory of Open Access Journals (Sweden)

    José Gustavo Parreira

    2012-02-01

    Full Text Available OBJETIVO: Realizar uma análise comparativa entre as lesões encontradas em motociclistas envolvidos em acidentes de trânsito e vítimas de outros mecanismos de trauma fechado. MÉTODOS: Análise dos protocolos (colhidos prospectivamente dos traumatizados com idade superior a 13 anos, admitidos de 10/06/2008 a 01/09/2009, vítimas de trauma fechado. Foram coletadas informações sobre mecanismo de trauma, dados vitais à admissão, exames complementares, lesões e tratamento. A estratificação da gravidade do trauma e das lesões foi realizada pelo cálculo dos índices de trauma: RTS, escala de coma de Glasgow (ECG, AIS, ISS e TRISS. Comparamos as variáveis entre os motociclistas (grupo A e os demais (grupo B. Consideramos graves as lesões com AIS > 3. Para a análise estatística, utilizamos os testes t de Student, Mann Whitney, qui-quadrado e Fisher, considerando p OBJECTIVE: To conduct a comparative analysis of the lesions found among motorcycle riders involved in traffic accidents and victims of other mechanisms of blunt trauma. METHODS: Analysis of data prospectively collected on protocols for trauma patients older than 13 years, admitted from 06/10/2008 to 09/01/2009, victims of blunt trauma. Data collected included trauma mechanism, vital signs at admission, laboratory tests, injuries, and treatment.Stratification of trauma and lesion severity was performed by calculating the trauma index: Glasgow Coma Scale (GCS, Revised Trauma Score (RTS, Abbreviated Injury Scale (AIS, Injury Severity Score (ISS and TRISS. We compared the variables between motorcycle riders (group A and the others (group B. Severe injuries were considered when AIS > 3. For statistical analysis, we used Student's t, Mann Whitney, chi-square and Fisher's test, with p < 0.05 considered statistically significant. RESULTS: The study included 3,783 blunt trauma victims, aged 14 to 99 years, of which 76.0% were males. The most frequent trauma mechanisms were accidents

  7. Financial Disaster as a Risk Factor for Posttraumatic Stress Disorder: Internet Survey of Trauma in Victims of the Madoff Ponzi Scheme

    Science.gov (United States)

    Freshman, Audrey

    2012-01-01

    There are no known studies to date examining the risk of posttraumatic stress disorder (PTSD) associated with sudden and dramatic personal financial loss. A Web-based, online, nonprobability convenience survey of 172 Madoff victims (56 percent female; mean age, 60.9 years) using the Posttraumatic Stress List Checklist, civilian version was…

  8. Qualidade de vida de vítimas de trauma seis meses após a alta hospitalar Calidad de vida de víctimas de trauma seis meses después de alta hospitalaria Quality of life in trauma victims six months after hospital discharge

    Directory of Open Access Journals (Sweden)

    Ana Laura A Alves

    2009-02-01

    sus domicilios, seis meses después de haber recibido el alta hospitalaria. Fue aplicado el instrumento "World Health Organization Quality of Life", versión corta, para evaluación de los dominios físico, psicológico, relaciones sociales y medio ambiente. Las asociaciones entre los escores de los dominios y las variables permanencia hospitalaria, edad, sexo y "Injury Severity Store" fueron exploradas por modelo de regresión lineal. RESULTADOS: Se observó disminución significativa en la calidad de vida del grupo estudiado, cuando se compara con muestras de personas normales en estudios nacionales e internacionales, en particular en los dominios físico, psicológico y de medio ambiente. El dominio relaciones sociales presentó el mayor promedio de escores, con 69,7 puntos, mientras que el dominio medio ambiente recibió la menor puntuación (52,4, ambos en la escala de porcentaje. Las variables asociadas a dominio físico fueron permanencia hospitalaria (p=0,02, edad (pOBJECTIVE: Trauma is the third most important cause of death in Brazil. However, its impact on survivors' quality of life has been scarcely studied in this country. This study aimed to assess trauma victims' quality of life, cared for in an emergency hospital unit, six months after discharge. METHODS: A total of 35 patients from the emergency unit of a university hospital in the city of Ribeirão Preto, Southeastern Brazil, were included in this study, between 2005 and 2006. Patients were interviewed in their homes, six months after hospital discharge. The short version of the World Health Organization Quality of Life (WHOQOL-BREF instrument was applied to assess the physical, psychological, social relationships, and environmental domains. Associations between domain scores and hospital stay, age, sex and Injury Severity Score variables were analyzed with linear regression models. RESULTS: Significant reduction in quality of life was found in the group studied, when compared to samples of normal

  9. Os efeitos das alterações comportamentais das vítimas de trauma crânio-encefálico para o cuidador familiar Los efectos de las alteraciones comportamentales de las victimas de trauma cráneo encefálico para el cuidador familiar Effect of the behavioral alterations of victims of traumatic brain injury for the family caregiver

    Directory of Open Access Journals (Sweden)

    Edilene Curvelo Hora

    2005-02-01

    variación de humor. Los seis primeros comportamientos mencionados fueron los que más incidieron negativamente sobre el cuidador. No se encontró relación entre el tiempo transcurrido y los efectos de las alteraciones comportamentales.This study aimed to identify alterations in the intensity at which the negative behaviors of the victims of traumatic brain injury (TBI affect the main family caregiver comparing the periods before and after the trauma and to verify the relation between the intensity of these alterations and time passed after the traumatic event. Participants were 50 caregivers of victims with different levels of dependence after TBI. The effect of the victim’s behaviors on the caregiver was measured by means of a Likert scale, in view of eleven negative behaviors cited in literature. According to the caregiver, the victim was more aggressive, anxious, dependent, depressed, irritated, and forgetful after the trauma, with a more explosive temperament, more self-centered, impulsive, with greater social inadequacy and mood oscillation. The first six cited behaviors were the ones that affected the caregiver more negatively. No relation was found between the passed time and the effect of the behavioral alterations

  10. Victimization and pain

    Directory of Open Access Journals (Sweden)

    Małgorzata K. Szerla

    2013-12-01

    Full Text Available Pain has several causes. It can be caused not only by operative trauma or cancer. Some patients suffer from pain as a result of being victims of violence. The aim of the study was to introduce diagnosis and treatment of pain problems in patients who are victims of violence, from a physician’s and a psychologist’s common perspective. Physical pain-related primary effects experienced by the victims of domestic violence go far beyond the results which are noticeable directly and confirmed visually in a forensic examination. In the present paper we introduce an ‘invisible’ group of secondary effects of violence. They appear in time, often after several years, in the form of a variety of psychosomatic disorders. The body is devastated insidiously and the secondary effects are visible as vegetative symptoms, a variety of psychosomatic disorders and pain, difficult to diagnose and treat.

  11. Gravidade do trauma avaliada na fase pré-hospitalar Trauma severity assessment in prehospital setting

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    I.Y. Whitaker

    1998-06-01

    Full Text Available A avaliação da gravidade do trauma e a instituição de manobras para manutenção básica da vida, no local do evento, podem representar a oportunidade de sobrevida para as vítimas de trauma até a sua chegada ao hospital. OBJETIVO: Estudar vítimas de causas externas avaliadas por um índice fisiológico denominado Trauma Score modificado (TSm aplicado durante o atendimento pré-hospitalar. MATERIAL E MÉTODO: Analisaram-se, retrospectivamente, 1.414 vítimas de causas externas atendidas pelo Sistema de Atendimento Móvel às Urgências (SAMU-RESGATE-SP no município de São Paulo, no ano de 1991. Os dados foram obtidos da ficha de atendimento pré-hospitalar e laudo de necropsia. RESULTADOS: O atendimento pré-hospitalar em 81,31% ocorreu até 40 minutos, dos quais 83,96% das vítimas não-fatais obtiveram escores TSm 12 e 11, e 53,96% das vítimas fatais obtiveram escores 0, 1 e 2. Superfície externa (30,25% e região da cabeça/pescoço (20,98% foram as mais acometidas. Das vítimas fatais, 63,63% com Injury Severity Score (ISS > ou = 16 morreram nas primeiras 24 horas. No cotejamento dos escores TSm e ISS, verificou-se que vítimas fatais com escore TSm entre 0 e 11 foram confirmadas como com ISS crítico (ISS > ou = 16. CONCLUSÃO: Constataram-se fortes indícios de que vítimas fatais com escores TSm baixos relacionaram-se com escores ISS altos.The trauma severity assessment and basic life support maneuvers in prehospital setting can represent to the trauma victim the opportunity of survival until his/her can get assistance in the hospital. PURPOSE: To study external cause victims assessed in the prehospital phase by the physiologic index named Trauma Score modificado (TSm. METHODS: Retrospective analyses were made of 1414 victims attended by Sistema de Atendimento Móvel às Urgências (SAMU-RESGATE-SP in the Municipality of São Paulo during 1991. Data were gathered from prehospital data recording sheets and necropsy records

  12. Victimization, polyvictimization , and health in Swedish adolescents

    Directory of Open Access Journals (Sweden)

    Aho N

    2016-08-01

    Full Text Available Nikolas Aho, Marie Proczkowska Björklund, Carl Göran Svedin Division of Child and Adolescent Psychiatry, Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden Abstract: The main objective of this article was to study the relationship between the different areas of victimization (eg, sexual victimization and psychological symptoms, taking into account the full range of victimization domains. The final aim was to contribute further evidence regarding the bias that studies that focus on just one area of victimization may be introduced into our psychological knowledge. The sample included 5,960 second-year high school students in Sweden with a mean age of 17.3 years (range =16–20 years, standard deviation =0.652, of which 49.6% were females and 50.4% males. The Juvenile Victimization Questionnaire and the Trauma Symptom Checklist for Children were used to assess victimization and psychological problems separately. The results show that a majority of adolescents have been victimized, females reported more total events and more sexual victimization and childhood maltreatment, and males were more often victims of conventional crime. The majority of victimization domains as well as the sheer number of events (polyvictimization [PV] proved to be harmful to adolescent health, affecting females more than males. PV explained part of the health effect and had an impact on its own and in relation to each domain. This suggests the possibility that PV to a large degree explains trauma symptoms. In order to understand the psychological effects of trauma, clinicians and researchers should take into account the whole range of possible types of victimization. Keywords: victimization, childhood trauma, psychological symptoms, JVQ, TSCC

  13. Evaluation of multiple trauma victims with 16-row multidetector CT (MDCT): a time analysis; Anwendung der 16-Zeilen-Mehrdetektor-CT in der Initialdiagnostik beim Polytrauma: Eine Zeitanalyse

    Energy Technology Data Exchange (ETDEWEB)

    Heyer, C.M.; Nicolas, V. [Bochum Univ. (Germany). Inst. fuer Diagnostische Radiologie, Interventionelle Radiologie und Nuklearmedizin; Rduch, G.J. [Bochum Univ. (Germany). Klinik fuer Chirurgie; Wick, M.; Muhr, G. [Bochum Univ. (Germany). Medizinische Klinik III, Pneumologie, Allergologie und Schlafmedizin; Bauer, T.T. [Berufsgenossenschaftliche Kliniken Bergmannsheil, Ruhr-Univ. Bochum (Germany)

    2005-12-15

    Purpose: Description and time analysis of a 16-row MDCT protocol in the evaluation of multiple trauma patients considering transport, time of scanning, patient positioning, image reconstruction, and image interpretation. Materials and methods: Between May and December 2004, 60 multiple trauma patients underwent 16-row MDCT (Sensation, Siemens, Erlangen, Germany). The protocol included serial scanning of the head, spiral scanning of the cervical spine and contrast-enhanced spiral scanning of the thorax/abdomen with multiplanar reformations (MPR) of the thoracic/lumbar spine and the pelvis. All time intervals including transport, patient positioning, scanning, duration of MPR, total time in the examination room, and time to first and final image interpretation were prospectively evaluated. Furthermore, patient characteristics, trauma profiles, and mortality rates were recorded. Results: 46 male and 14 female patients (mean age 43.6 years) were enrolled in the study. Time analysis of 16-row MDCT revealed the following results (mean time standard deviation): Emergency room treatment and transport 19.2{+-}6.7 min, patient positioning 16.5{+-}6.5 min, scan duration 8.0{+-}3.3 min, total time in examination room 24.5{+-}7.2 min, image reconstruction including MPR 32.0{+-}16.4 min, and time of first (16.4{+-}4.7 min) and final image interpretation (82.5{+-}30.4 min). Trauma profiles revealed thoracic injuries in 35/60 patients (58.3%), head injuries in 23/60 patients (38.3%), abdominal injuries in 15/60 patients (25.0%), injuries of the cervical (9/60 patients, 15.0%), thoracic (12/60 patients, 20.0%), and lumbar spine (19/60 patients, 31.7%), pelvic injuries in 13/60 patients (21.7%), and injuries of extremities in 39/60 patients (65.0%). The mortality rate was 21.7%. (orig.)

  14. Ciprofloxacin Enhances Stress Erythropoiesis in Spleen and Increases Survival after Whole-Body Irradiation Combined with Skin-Wound Trauma

    Science.gov (United States)

    2014-02-28

    rheumatoid arthritis [10], and chemotherapy-induced neutropenia [11]. These observations convincingly demonstrate that immunomodulation is a result of...Introduction Victims of nuclear disasters often suffer from a combination of radiation injury (RI) along with other insults such as physical wounds and...from 40% to 50%, but the increase was not significant (Figure 1A top left panel). In addition, none of the CI mice died after completion of CIP therapy

  15. Factors affecting mortality after penetrating cardiac injuries: 10-year experience at urban level I trauma center.

    Science.gov (United States)

    Mina, Michael J; Jhunjhunwala, Rashi; Gelbard, Rondi B; Dougherty, Stacy D; Carr, Jacquelyn S; Dente, Christopher J; Nicholas, Jeffrey M; Wyrzykowski, Amy D; Salomone, Jeffrey P; Vercruysse, Gary A; Feliciano, David V; Morse, Bryan C

    2017-06-01

    Despite the lethality of injuries to the heart, optimizing factors that impact mortality for victims that do survive to reach the hospital is critical. From 2003 to 2012, prehospital data, injury characteristics, and clinical patient factors were analyzed for victims with penetrating cardiac injuries (PCIs) at an urban, level I trauma center. Over the 10-year study, 80 PCI patients survived to reach the hospital. Of the 21 factors analyzed, prehospital cardiopulmonary resuscitation (odds ratio [OR] = 30), scene time greater than 10 minutes (OR = 58), resuscitative thoracotomy (OR = 19), and massive left hemothorax (OR = 15) had the greatest impact on mortality. Cardiac tamponade physiology demonstrated a "protective" effect for survivors to the hospital (OR = .08). Trauma surgeons can improve mortality after PCI by minimizing time to the operating room for early control of hemorrhage. In PCI patients, tamponade may provide a physiologic advantage (lower mortality) compared to exsanguination. Copyright © 2016 Elsevier Inc. All rights reserved.

  16. [Minor Victims of Violent Acts in the Context of the Victim Reparation Law].

    Science.gov (United States)

    Hellwig, Katharina; Kröger, Christoph; Franke, Stefanie; Wehrmeyer, Matthias; Heinrichs, Nina

    2018-03-01

    A descriptive analysis of victim compensation applications for children and adolescents as well as sociodemographic and trauma-specific information concerning victims and perpetrators. We did analysis of 100 victim-compensation application files based on a self-developed category system. The files included solely interpersonal trauma, 59 % of which are type II trauma. The most frequent form is sexual violence. The perpetrators stem mostly from children’s homes or peripherals. 79 % of the victims received a diagnosis of a mental disorder, most often posttraumatic stress disorder. Sexually abused children and adolescents make up the majority of the target population in OEG-related trauma outpatient units. Such outpatient units should therefore offer a specific expertise in treating sexually abused children and adolescents.

  17. Is paediatric trauma severity overestimated at triage?

    DEFF Research Database (Denmark)

    DO, H Q; Hesselfeldt, R; Steinmetz, J

    2014-01-01

    BACKGROUND: Severe paediatric trauma is rare, and pre-hospital and local hospital personnel experience with injured children is often limited. We hypothesised that a higher proportion of paediatric trauma victims were taken to the regional trauma centre (TC). METHODS: This is an observational fol...

  18. Social and economic profile of young trauma victims and alcohol addicts - doi: 10.4025/actascihealthsci.v35i2.13054

    Directory of Open Access Journals (Sweden)

    Ivonete Arnauts

    2013-06-01

    Full Text Available The social and economic profile of alcohol-traumatized young people and alcohol users is provided through an exploratory and transversal analysis with 10-24-year-old young people attended to at the Emergency Section of a hospital in the western region of the state of Paraná, Brazil. Data were processed by Statistica 8.0. One hundred and twelve young people were classified in three groups according to alcohol intake: trauma associated with alcoholic beverage consumption; alcohol consumers without any alcohol intake during the previous six hours; teetotalers. Alcohol trauma was predominant in male young people with complete primary schooling, family income between R$ 901 and R$ 1500, without any personal income and working regularly. Higher occurrence lay within the 15-20 years age bracket regardless of their alcohol intake pattern. Results show that young people’s social and economical profile affects the capacity of people in acknowledging and managing the dangers to which they are exposed. Interventions are relevant when the historical and social contexts are taken into account so that changes in health, disease and care processes could be enhanced.

  19. Mesenteric thrombosis in patient victim of blunt abdominal trauma with fatal outcome Trombose mesentérica em vítima de trauma abdominal fechado com desfecho fatal

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    Iwan Augusto Collaço

    2010-03-01

    Full Text Available BACKGROUND: Mesenteric thrombosis related to trauma is an uncommon entity and has poor prognosis when have low flow and hemorrhagic shock. It usually presents with a challenging diagnosis and high mortality rates, despite appropriate treatment. CASE REPORT: Patient with blunt trauma was admitted and initial treatment, complementary exams showed ribs and humerus fractures. Computerized tomography showed aerial distension in small bowels along with gastric stasis and hidropneumothorax. The patient had hypotension during clinical observation and cardiopulmonary arrest, responding to reanimation. Taken to surgery for damage control, it was found extensive necrosis of right colon, which was excised and performed primary anastomosis. He was admitted in the intensive care unit, evolving with oliguria, miosis, convulsion, and pulseless electric activity, dying three days after hospital admission. CONCLUSION: Although uncommon, mesenteric ischemia with venous thrombosis might be secondary to systemic hypotension, frequently followed by fatal outcomes.INTRODUÇÃO: Trombose mesentérica, relacionada a trauma é entidade incomum, com pobre prognóstico quando seguida de estados de baixo fluxo e choque hipovolêmico. Geralmente apresenta-se com quadro de difícil diagnóstico, cuja mortalidade é elevada a despeito de tratamento adequado. RELATO DO CASO: Paciente submetido a trauma, após admissão hospitalar e atendimento inicial, exames radiológicos demonstraram fratura de costela e úmero. Tomografia computadorizada evidenciou distensão aérea em intestino delgado associada à estase gástrica e hidropneumotórax. O paciente evoluiu com hipotensão durante o período de observação clínica e parada cardiorrespiratória que respondeu à reanimação. Levado para operação para controle de danos, encontrou-se extensa necrose de cólon ascendente. Realizou-se hemicolectomia direita com íleotransversostomia. Levado à unidade de terapia intensiva

  20. Understanding Victimization

    DEFF Research Database (Denmark)

    Barslund, Mikkel; Rand, John; Tarp, Finn

    2007-01-01

    that the probability of being victimized is increasing in income, but at a diminishing rate. The effect of income is dependent on the type of crime, and poorer households are vulnerable. While less at risk of victimization, they suffer relatively greater losses when such shocks occur. Lower inequality and increased...... community level employment emerge as effective avenues to less crime....

  1. Childhood Victimization and Crime Victimization

    Science.gov (United States)

    McIntyre, Jared Kean; Widom, Cathy Spatz

    2011-01-01

    The purpose of this study is to determine whether abused and neglected children are at increased risk for subsequent crime victimization. We ask four basic questions: (a) Does a history of child abuse/neglect increase one's risk of physical, sexual, and property crime victimization? (b) Do lifestyle characteristics (prostitution, running away,…

  2. Childhood victimization and crime victimization.

    Science.gov (United States)

    McIntyre, Jared Kean; Widom, Cathy Spatz

    2011-03-01

    The purpose of this study is to determine whether abused and neglected children are at increased risk for subsequent crime victimization. We ask four basic questions: (a) Does a history of child abuse/neglect increase one's risk of physical, sexual, and property crime victimization? (b) Do lifestyle characteristics (prostitution, running away, homelessness, criminal history, drug abuse, and alcohol abuse) increase a person's risk for crime victimization? (c) Do lifestyle characteristics mediate the relationship between child abuse/ neglect and crime victimization? (d) Do these relationships vary by a person's sex or race/ethnicity? Using data from a prospective cohort design study, children with documented histories of physical and sexual abuse and/or neglect (n = 497) were matched with nonabused and nonneglected children (n = 395), followed up, and interviewed in middle adulthood (approximate age 39.5). Logistic and ordinary least square regressions were conducted to assess risk for crime victimization and test for mediation. Child abuse and/ or neglect increased a person's risk for physical (OR = 2.56, p crime victimization. For the sample overall, running away served as a partial mediator between child abuse and neglect and physical and sexual crime victimization. In addition, results revealed sex and race/ethnicity differences in patterns of mediation. Implications of these findings for research and practice are discussed.

  3. Prospects after Major Trauma

    NARCIS (Netherlands)

    Holtslag, H.R.

    2007-01-01

    Introduction. After patients survived major trauma, their prospects, in terms of the consequences for functioning, are uncertain, which may impact severely on patient, family and society. The studies in this thesis describes the long-term outcomes of severe injured patients after major trauma. In

  4. Advances in Violence and Trauma: Toward Comprehensive Ecological Models

    Science.gov (United States)

    Hughes, Honore M.; Humphrey, Natalie N.; Weaver, Terri L.

    2005-01-01

    The most important things learned about violence and trauma in the past 20 years are that interpersonal violence is prevalent, with different forms co-occurring, and that victims' reactions are complex. Researchers are called to consider models that include the ecological context within which victims experience violence and trauma to gain a better…

  5. Psychodynamics and treatment of sexual assualt victims.

    Science.gov (United States)

    Schuker, E

    1979-10-01

    This paper discusses (1) how my own interest in the treatment of sexual assualt victims developed and how I view the scope of this problem; (2) myths and facts about sexual assault; (3) common reactions of those who work with rape victims; (4) the rape trauma syndrome; (5) an approach to immediate and short-term treatment; and (6) the long-term effects of sexual assault and related treatment issues.

  6. Trauma from a global perspective.

    Science.gov (United States)

    Ray, Susan L

    2008-01-01

    Trauma from widespread collective violence such as genocide and ethnic cleansing has not been discussed from a global perspective. It will be argued that the Western medical model of diagnostic labeling is inadequate for understanding victims of collective violence from around the world. Phenomenology and liberation philosophy will be discussed as alternatives to understanding trauma from collective violence that move beyond the Western medical model of diagnostic labeling. The insights gained from these alternative approaches will contribute to the development of nursing education, research, and practice relevant to the health of victims of collective violence around the globe.

  7. Trauma team activation: Not just for trauma patients

    Directory of Open Access Journals (Sweden)

    Phoenix Vuong

    2017-01-01

    Full Text Available Specialized trauma teams have been shown to improve outcomes in critically injured patients. At our institution, an the American College of Surgeons Committee on trauma level I Trauma center, the trauma team activation (TTA criteria includes both physiologic and anatomic criteria, but any attending physician can activate the trauma team at their discretion outside criteria. As a result, the trauma team has been activated for noninjured patients meeting physiologic criteria secondary to nontraumatic hemorrhage. We present two cases in which the trauma team was activated for noninjured patients in hemorrhagic shock. The utilization of the TTA protocol and subsequent management by the trauma team are reviewed as we believe these were critical factors in the successful recovery of both patients. Beyond the primary improved survival outcomes of severely injured patients, trauma center designation has a “halo effect” that encompasses patients with nontraumatic hemorrhage.

  8. Australian Aboriginal Memoir and Memory: A Stolen Generations Trauma Narrative

    Directory of Open Access Journals (Sweden)

    Justine Seran

    2015-10-01

    Full Text Available This article proposes a re-reading of Aboriginal author Sally Morgan’s Stolen Generations narrative My Place (1987 in post-Apology Australia (2008–present. The novel tells the story of Morgan’s discovery of her maternal Aboriginal origins through the life-stories of her mother and grandmother; the object of a quest for the past that is both relational and matrilineal; incorporating elements of autobiography and as-told-to memoirs to create a form of choral autoethnography. Morgan’s text explores the intergenerational consequences of child removal in the Aboriginal context and is representative of Indigenous-authored narratives in its suggestion that the children and grand-children of victims of colonial policies and practices can work through the trauma of their ancestors. I examine the literary processes of decolonization of the Indigenous writing/written self and community; as well as strategies for individual survival and cultural survivance in the Australian settler colonial context; especially visible through the interactions between traumatic memories and literary memoirs, a genre neglected by trauma theory’s concern with narrative fragmentation and the proliferation of “themed” life-writing centered on a traumatic event. This article calls for a revision of trauma theory’s Eurocentrism through scholarly engagement with Indigenous experiences such as Morgan’s and her family in order to broaden definitions and take into account collective, historical, and inherited trauma.

  9. Part II: Differences between Sexually Victimized and Nonsexually Victimized Male Adolescent Sexual Abusers and Delinquent Youth--Further Group Comparisons of Developmental Antecedents and Behavioral Challenges

    Science.gov (United States)

    Leibowitz, George S.; Burton, David L.; Howard, Alan

    2012-01-01

    In a recent paper published in the "Journal of Child Sexual Abuse," we assessed the differences between sexually victimized and nonsexually victimized male adolescent sexual abusers (Burton, Duty, & Leibowitz, 2011). We found that the sexually victimized group had more severe developmental antecedents (e.g., trauma and early exposure to…

  10. Depression, anxiety and loss of resilience after multiple traumas: an illustration of a mediated moderation model of sensitization in a group of children who survived the Nazi Holocaust.

    Science.gov (United States)

    Fossion, Pierre; Leys, Christophe; Kempenaers, Chantal; Braun, Stephanie; Verbanck, Paul; Linkowski, Paul

    2013-12-01

    Depressive and anxiety disorders (DAD) have become a major public health problem. Multiple trauma is known to increase the risk of DAD through a sensitization mechanism. We investigate the hypothesis that resilience is a mediator of this mechanism. Former Hidden Children (FHC), the Jewish youths who spent World War II in various hideaway shelters across Nazi-occupied Europe, were compared with a control group. In each group, we measured the presence of multiple traumas, the resilience with the Resilience Scale for Adults, which has a six factors solution, and the DAD with the Hopkins Symptoms Checklist. We test a mediated moderation model with childhood trauma as the predictor; Later trauma as the moderator; Resilience as the mediator; and DAD as the outcome variable. Results are consistent with a sensitization model of DAD mediated by resilience: confrontation with a primary trauma during childhood followed by secondary trauma(s) after childhood damages resilience, which, in turn, results in higher level of DAD. We are unable to differentiate if the sensitization process is a consequence of the nature of the trauma endured by FHC (long-standing exposure to extreme external events) or a consequence of the fact that this first trauma occurred during childhood. Resilience construct is multi-factorial and a limited damaging of some of the factors is sufficient to lead to DAD even if other factors remain unaltered. Resilience can be altered by multiple traumas and, therefore, needs to be bolstered in therapy sessions. Copyright © 2013. Published by Elsevier B.V.

  11. Medicolegal Evaluation of Elderly Trauma Patients

    Directory of Open Access Journals (Sweden)

    Dilek Durak

    2016-04-01

    Conclusion: The results of our study indicate that most of the geriatric victims were admitted to the medical centers with traumatic causes. Thus, it is necessary to increase our social sensitivity to trauma and the ways in can be prevented in the geriatric age group. Key words: Trauma; Geriatric; Forensic case; Injury.

  12. Vulvar and genital trauma in pediatric and adolescent gynecology.

    Science.gov (United States)

    Merritt, Diane F

    2004-10-01

    This review will look critically at recent research articles that pertain to children and adolescents who present with genital injuries. Many recently published articles have noted that the history as given by the child or adolescent is the most important factor in determining the etiology of genital injuries as abuse or accidental. The history is more important than any documented or lack of documented findings on physical examination. Distinguishing whether the injury was accidental or caused by abuse is of significance to the family and the injured child or adolescent. Genital examinations of victims of documented abuse are often normal. Examinations of pregnant adolescents may appear normal, the only evidence that intercourse has taken place being pregnancy. Documented accidental genital injuries are described; unfortunately such injuries can easily be confused with sexual abuse. Photographic documentation of injuries by colposcopic photography has allowed a new level of peer review, improving the understanding of what are normal and non-specific findings, many of which were considered to be abnormal in the past. The psychological impact of living in a violent, war-torn culture, or surviving a traumatic genital injury are reviewed. New ideas on the management of genital trauma are also reported. Increasingly, victims of sexual abuse are found to have normal examinations, and the victim's history becomes the most important determining factor. Peer review has led to a better understanding of the wide variations in the normal genital examination. Psychological support for these victims is important in the management of genital injuries.

  13. A Men's Support Group for Significant Others of Rape Victims.

    Science.gov (United States)

    Rodkin, Lawrence I.; And Others

    1982-01-01

    Discusses the trauma experienced by women rape victims and focuses on a men's support group for male-significant-others of women who have been raped. Describes the developmental phases through which the male significant others of rape victims achieve resolution and the impact of the male's response upon the relationship. (Author)

  14. Sexual Harassment Victims: Psycholegal and Family Therapy Considerations.

    Science.gov (United States)

    Woody, Robert Henley; Perry, Nancy Walker

    1993-01-01

    Examines legal proscriptions and practical definitions of sexual harassment, describes psychological effects of sexual harassment (Sexual Harassment Trauma Syndrome) for victim-client and impact on family system, and offers guidance for family therapy. Focuses on vulnerability of victim-client, reconstruction of self-concept as primary goal of…

  15. Nonpathologizing trauma interventions in abnormal psychology courses.

    Science.gov (United States)

    Hoover, Stephanie M; Luchner, Andrew F; Pickett, Rachel F

    2016-01-01

    Because abnormal psychology courses presuppose a focus on pathological human functioning, nonpathologizing interventions within these classes are particularly powerful and can reach survivors, bystanders, and perpetrators. Interventions are needed to improve the social response to trauma on college campuses. By applying psychodynamic and feminist multicultural theory, instructors can deliver nonpathologizing interventions about trauma and trauma response within these classes. We recommend class-based interventions with the following aims: (a) intentionally using nonpathologizing language, (b) normalizing trauma responses, (c) subjectively defining trauma, (d) challenging secondary victimization, and (e) questioning the delineation of abnormal and normal. The recommendations promote implications for instructor self-reflection, therapy interventions, and future research.

  16. Cyberstalking victimization

    Directory of Open Access Journals (Sweden)

    Vilić Vida

    2013-01-01

    Full Text Available Global social networks contributed to the creation of new, inconspicuous, technically perfect shape of criminality which is hard to suppress because of its intangible characteristics. The most common forms of virtual communications’ abuse are: cyberstalking and harassment, identity theft, online fraud, manipulation and misuse of personal information and personal photos, monitoring e-mail accounts and spamming, interception and recording of chat rooms. Cyberstalking is defined as persistent and targeted harassment of an individual by using electronic communication. The victim becomes insecure, frightened, intimidated and does not figure out the best reaction which will terminate the harassment. The aim of this paper is to emphasize the importance and necessity of studying cyberstalking and to point out its forms in order to find the best ways to prevent this negative social phenomenon. Basic topics that will be analyzed in this paper are the various definitions of cyberstalking, forms of cyberstalking, and the most important characteristics of victims and perpetators.

  17. Terrorism, Trauma and Children.

    Science.gov (United States)

    Harjai, M M; Chandrashekhar, N; Raju, Uma; Jog, S S; Arora, P

    2005-10-01

    Terrorist attacks, armed conflict and all forms of catastrophe, tax our ability to cope, understand and respond to the situation. Children are more vulnerable. 16 children, victims of a terrorist attack in an army residential camp were managed for their physical injuries and evaluated for psychological trauma. All patients recovered from physical injuries, except one baby of two months, who died due to severe chest trauma. 5 children presented with Acute Stress Reaction. 3 recovered well and two, showed persistent poor scholastic performance even after one year. A terrorist attack, not only results in physiscal scars but also causes psychological trauma, which requires emotional support and needs to be followed up on a long term basis.

  18. Predictors of Trauma-Related Symptoms among Runaway Adolescents

    Science.gov (United States)

    McCarthy, Michael D.; Thompson, Sanna J.

    2010-01-01

    Little is known about trauma-related symptoms among runaway adolescents. Precocious departure from familial homes often exposes youth to traumatic victimization. This study examined the extent to which runaway adolescents present trauma symptomotology and assessed factors that predict trauma symptoms. Participants (N = 350) were 12-18 years of age…

  19. Handbook for Domestic Violence Victims.

    Science.gov (United States)

    Illinois Coalition Against Domestic Violence, Springfield.

    This handbook provides guidance for women in Illinois who are victims of domestic violence and spouse abuse. It consists of facts about domestic violence, a survival sheet telling what to do before, during, and after incidents of domestic violence, and advice on seeking emergency assistance and shelter. It then provides advice and resources on…

  20. Bystander first aid in trauma - prevalence and quality: a prospective observational study.

    Science.gov (United States)

    Bakke, H K; Steinvik, T; Eidissen, S-I; Gilbert, M; Wisborg, T

    2015-10-01

    Bystander first aid and basic life support can likely improve victim survival in trauma. In contrast to bystander first aid and out-of-hospital cardiac arrest, little is known about the role of bystanders in trauma response. Our aim was to determine how frequently first aid is given to trauma victims by bystanders, the quality of this aid, the professional background of first-aid providers, and whether previous first-aid training affects aid quality. We conducted a prospective 18-month study in two mixed urban-rural Norwegian counties. The personnel on the first ambulance responding to trauma calls assessed and documented first aid performed by bystanders using a standard form. A total of 330 trauma calls were included, with bystanders present in 97% of cases. Securing an open airway was correctly performed for 76% of the 43 patients in need of this first-aid measure. Bleeding control was provided correctly for 81% of 63 patients for whom this measure was indicated, and prevention of hypothermia for 62% of 204 patients. Among the first-aid providers studied, 35% had some training in first aid. Bystanders with documented first-aid training gave better first aid than those where first-aid training status was unknown. A majority of the trauma patients studied received correct pre-hospital first aid, but still there is need for considerable improvement, particularly hypothermia prevention. Previous first-aid training seems to improve the quality of first aid provided. The effect on patient survival needs to be investigated. © 2015 The Authors. The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

  1. Rape victim assessment: Findings by psychiatrists and ...

    African Journals Online (AJOL)

    The evaluators also suggested that the collateral reports given by caregivers regarding the victims' functioning may well underreport trauma-related symptoms. In addition, Au et al.[4] found that cooccurring and comparably severe PTSD and depression symptoms are pervasive among female sexual assault survivors.

  2. [Pancreatic trauma: analysis of 29 cases].

    Science.gov (United States)

    Nadal, S R; Duarte Júnior, E; Speranzini, M B

    1991-01-01

    To investigate the relationship between complications and the kind of pancreatic lesion and surgery performed. KIND OF STUDY: Retrospective. The patients were operated on at the Pronto Socorro--Mandaqui Hospital Complex, from January 1987 to January 1990. The authors analyzed 29 patients victims of penetrating or blunt abdominal trauma who were operated on in that period. 27 of them were male. 20 (69%) were shotgun victims; 5 (17.2%) were victims of cold steels; and 4 (13.8%) were victims of blunt trauma. In pancreatic head lesions (5 cases), hemostasis and drainage were performed in three cases; duodenopancreatectomy in one case; and suture in one case. In traumas to the pancreatic body (13 cases), six pancreatectomies, five drainages, and two sutures were performed. In traumas to the pancreatic tail (11 cases), six pancreatectomies, four sutures and one drainage were performed. Complications occurred in all patients with pancreatic head lesions, in eight patients with trauma to the pancreatic body, and in five patients trauma to the pancreatic tail. The most frequent complications were intracavitary abscesses (seven cases), and pancreatic fistulae (five cases). Morbidity rate was 72.4% and mortality rate was 17.2%. The authors conclude that indication of pancreatectomy in ductal lesions should be done, exception being made to cases of pancreatic head trauma, for which a suture or simple drainage can be used in superficial lesions. In doubt, an expert surgeon may be called.

  3. Lesão encefálica hipóxica em vítimas fatais de acidente de trânsito: prevalência, distribuição e associação com tempo de sobrevida e outras lesões cranioencefálicas e extracranianas Hypoxic brain damage in victims of fatal road traffic accident: prevalence, distribution and association with survival time and other head and extracranial injuries

    Directory of Open Access Journals (Sweden)

    Sebastião Silva Gusmão

    2002-09-01

    Full Text Available OBJETIVO: Descrever a prevalência e a distribuição da lesão encefálica hipóxica e sua associação com tempo de sobrevida e outras lesões cranioencefálicas e extracranianas. MÉTODO: Realizou-se o estudo anátomo-patológico macro e microscópico de 120 vítimas fatais de acidente de trânsito, independente do tempo de sobrevida, necropsiadas no Instituto Médico Legal de Minas Gerais, em Belo Horizonte, no período entre 1989 e 1993. O estudo foi prospectivo e os indivíduos foram selecionados aleatoriamente. RESULTADOS: Das 120 vítimas, 51 eram motoristas ou passageiros de veículos motorizados e 69 eram pedestres. Oitenta e três pacientes (69,2% faleceram no local do acidente ou com menos de 24 horas de sobrevida e 37 (30,8% sobreviveram um ou mais dias. Evidência histológica de lesão encefálica hipóxica foi detectada em 23 (19,2% dos 120 encéfalos. A prevalência foi de 4,8% entre os pacientes que sobreviveram menos de 24 horas e 51,4% para aqueles com um ou mais dias de sobrevida. A lesão encefálica hipóxica foi encontrada principalmente no hipocampo e subiculum (65,2%, tálamo (34,8%, neocórtex cerebral (26,1% e núcleos da base (21,7%. Não se observou associação significativa entre lesão encefálica hipóxica e hipertensão intracraniana, trauma tóraco-abdominal e pneumonia e/ou meningite nos pacientes com sobrevida igual ou superior a um dia. CONCLUSÃO: A lesão encefálica hipóxica ocorre em alta frequência em vítimas fatais de acidente de trânsito com um ou mais dias de sobrevida, não estando significativamente associada a hipertensão intracraniana, trauma tóraco-abdominal e pneumonia e/ou meningite.OBJECTIVE: To describe the prevalence and distribution of hypoxic brain damage and its association with survival time and other head and extracranial injuries. METHOD: A macro and microscopical study of brain lesions in 120 victims of fatal road traffic accident, independent of the survival time, was made

  4. The value of trauma registries.

    Science.gov (United States)

    Moore, Lynne; Clark, David E

    2008-06-01

    Trauma registries are databases that document acute care delivered to patients hospitalised with injuries. They are designed to provide information that can be used to improve the efficiency and quality of trauma care. Indeed, the combination of trauma registry data at regional or national levels can produce very large databases that allow unprecedented opportunities for the evaluation of patient outcomes and inter-hospital comparisons. However, the creation and upkeep of trauma registries requires a substantial investment of money, time and effort, data quality is an important challenge and aggregated trauma data sets rarely represent a population-based sample of trauma. In addition, trauma hospitalisations are already routinely documented in administrative hospital discharge databases. The present review aims to provide evidence that trauma registry data can be used to improve the care dispensed to victims of injury in ways that could not be achieved with information from administrative databases alone. In addition, we will define the structure and purpose of contemporary trauma registries, acknowledge their limitations, and discuss possible ways to make them more useful.

  5. Trauma in pregnancy

    Directory of Open Access Journals (Sweden)

    A Rudra

    2007-01-01

    Full Text Available Trauma is the most common non-obstetrical cause of death in pregnant women. Pregnancy must always be suspected in any female trauma patient of childbearing age until proved otherwise. Unique changes in anatomy and physiology that takes place during pregnancy alter the pathophysiology and location of maternal injuries in pregnancy, which may be significantly different from the non-pregnant state. Trauma from road traffic accidents, falls and domestic violence are the most common causes of abdominal blunt trauma. As pregnancy progresses, the change of accidental injury increases. Head and neck injuries, respiratory failure, and hypovolemic shock constitute the most frequent causes of trauma related maternal death in pregnancy. Even the pregnant woman with minor injuries should be carefully observed. Initial management is directed at resuscitation and stabilization of the mother that takes precedence over that of the fetus, unless vital signs cannot be maintained and perimortem cesarean section decided upon. Fetal monitoring should be maintained after satisfactory resuscitation and stabilization of the mother. Preventive measures include proper seat belt use and identifying and counseling victims of suspected domestic violence.

  6. Crime victims in the criminal justice system

    Directory of Open Access Journals (Sweden)

    Ćopić Sanja M.

    2003-01-01

    Full Text Available Negative social reaction and inadequate reaction of the agencies of the formal control on the primary victimization is leading to the so called secondary victimization that can be a source of trauma and frustration as much as the primary victimization. Due to that, relation of the police and the judiciary towards the crime victims is of a great importance regarding victims’ willingness to report the victimization, their confidence in these agencies, and cooperation during clearing up the crime. In order to realize the victim’s position in the criminal justice system, this paper contains an overview of how the police, prosecutor’s office and courts are functioning. The paper is based on the interviews made with the representatives of these state agencies, as well as on the previous knowledge and realized surveys concerning this topic. The aim of the paper is to emphasize the position and the role of the victim support service in the system of the state intervention, based upon the obtained data, as well as to give some basic information on how victims could report the crime, what are their rights and duties, what can they expect from the competent agencies.

  7. The biological effects of childhood trauma.

    Science.gov (United States)

    De Bellis, Michael D; Zisk, Abigail

    2014-04-01

    Trauma in childhood is a psychosocial, medical, and public policy problem with serious consequences for its victims and for society. Chronic interpersonal violence in children is common worldwide. Developmental traumatology, the systemic investigation of the psychiatric and psychobiological effects of chronic overwhelming stress on the developing child, provides a framework and principles when empirically examining the neurobiological effects of pediatric trauma. This article focuses on peer-reviewed literature on the neurobiological sequelae of childhood trauma in children and in adults with histories of childhood trauma. Copyright © 2014 Elsevier Inc. All rights reserved.

  8. The role of perceived social support in crime victimization.

    Science.gov (United States)

    Yap, Marie B H; Devilly, Grant J

    2004-03-01

    There has been extensive research into social support (SS) and trauma, but there remains a paucity of knowledge concerning the dynamics of these factors with respect to victims of crime. This review considers the temporal dimension of SS or perceived social support (PSS) in particular, conceptualizing it as an endogenous, dynamic resource Lepore et al. [J. Pers. Soc. Psychol. 61 (1991) 899] that can be depleted by chronic stressors. Based on a discussion of existing research, an explanation is proposed for the inconsistent findings of PSS as a moderator to distress in some cases and a mediator in others. In particular, some researchers have posited that since PSS can deteriorate, it can lose its buffering capacity and thus qualitatively change in its role from a stress moderator to a mediator in the stress-distress relationship. From a review of the literature, it would seem that PSS can act as a moderator of distress in the early stages, but that as the stressors become numerous or chronic PSS turns into a mediator between the stressor and psychological distress. This article applies such a dynamic perspective of PSS to victims of crime and argues that one's perspective of victim status may be well served by taking into account the history of victimization and trauma that these individuals have experienced. It is proposed that a history of chronic exposure to victimization or trauma erodes victims' perceptions of the SS available to them. In turn, these low levels of PSS result in higher levels of distress experienced in the face of subsequent victimization or trauma. The implications of a dynamic perspective of SS and victimization for research and practical interventions for victims of crime are discussed.

  9. Emergency Department Management of Trauma

    DEFF Research Database (Denmark)

    MacKenzie, Colin; Lippert, Freddy

    1999-01-01

    services (EMS) response times and advanced prehospital care increase the number of critically injured patients surviving sufficiently long to reach a hospital “in extremis.” Both scenarios provide challenges in the management of traumatized patients. This article addresses the management of severely......Initial assessment and management of severely injured patients may occur in a specialized area of an emergency department or in a specialized area of a trauma center. The time from injury until definitive management is of essence for survival of life-threatening trauma. The initial care delivered...... injured patients after these patients reach a hospital emergency department or a trauma center....

  10. Negotiated knowledge positions : communication in trauma teams

    OpenAIRE

    Härgestam, Maria

    2015-01-01

    Background Within trauma teams, effective communication is necessary to ensure safe and secure care of the patient. Deficiencies in communication are one of the most important factors leading to patient harm. Time is an essential factor for rapid and efficient disposal of trauma teams to increase patients’ survival and prevent morbidity. Trauma team training plays an important role in improving the team’s performance, while the leader of the trauma team faces the challenge of coordinating and...

  11. Childhood victimization experiences of young adults in St. Petersburg, Russia.

    Science.gov (United States)

    Bogolyubova, Olga; Skochilov, Roman; Smykalo, Lyubov

    2015-04-01

    The purpose of this study was to assess the prevalence of childhood victimization experiences in a sample of young adults in St. Petersburg, Russia. The study sample included 743 students aged 19 to 25 from 15 universities in St. Petersburg, Russia. All of the study participants completed a reliable questionnaire assessing the following types of childhood victimization: conventional crime, child maltreatment, peer victimization, sexual victimization, and witnessing violence. Participation in the study was anonymous. High rates of victimization and exposure to violence were reported by the study participants. The majority of the sample experienced at least one type of victimization during childhood or adolescence, and poly-victimization was reported frequently. The most common type of victimization reported was peer or sibling assault (66.94%), followed by witnessing an assault without weapon (63.91%), personal theft (56.19%), vandalism (56.06%), and emotional bullying (49.99%). Sexual assault by a known adult was reported by 1.45% males and 5.16% of females. This study provides new information on the scope of childhood victimization experiences in Russia. Further research is warranted, including epidemiological research with representative data across the country and studies of the impact of trauma and victimization on mental health and well-being of Russian adults and children. © The Author(s) 2014.

  12. Pathways from Trauma to Psychotic Experiences: A Theoretically Informed Model of Posttraumatic Stress in Psychosis

    Directory of Open Access Journals (Sweden)

    Amy Hardy

    2017-05-01

    Full Text Available In recent years, empirical data and theoretical accounts relating to the relationship between childhood victimization and psychotic experiences have accumulated. Much of this work has focused on co-occurring Posttraumatic Stress Disorder or putative causal mechanisms in isolation from each other. The complexity of posttraumatic stress reactions experienced in psychosis remains poorly understood. This paper therefore attempts to synthesize the current evidence base into a theoretically informed, multifactorial model of posttraumatic stress in psychosis. Three trauma-related vulnerability factors are proposed to give rise to intrusions and to affect how people appraise and cope with them. First, understandable attempts to survive trauma become habitual ways of regulating emotion, manifesting in cognitive-affective, behavioral and interpersonal responses. Second, event memories, consisting of perceptual and episodic representations, are impacted by emotion experienced during trauma. Third, personal semantic memory, specifically appraisals of the self and others, are shaped by event memories. It is proposed these vulnerability factors have the potential to lead to two types of intrusions. The first type is anomalous experiences arising from emotion regulation and/or the generation of novel images derived from trauma memory. The second type is trauma memory intrusions reflecting, to varying degrees, the retrieval of perceptual, episodic and personal semantic representations. It is speculated trauma memory intrusions may be experienced on a continuum from contextualized to fragmented, depending on memory encoding and retrieval. Personal semantic memory will then impact on how intrusions are appraised, with habitual emotion regulation strategies influencing people’s coping responses to these. Three vignettes are outlined to illustrate how the model accounts for different pathways between victimization and psychosis, and implications for therapy are

  13. Predictors of poor outcomes after significant chest trauma in multiply injured patients: a retrospective analysis from the German Trauma Registry (Trauma Register DGU®)

    Science.gov (United States)

    2014-01-01

    Background Blunt thoracic trauma is one of the critical injury mechanisms in multiply injured trauma victims. Although these patients present a plethora of potential structural damages to vital organs, it remains debated which injuries actually influence outcome and thereby should be addressed initially. Hence, the aim of this study was to identify the influence of critical structural damages on mortality. Methods All patients in the database of the TraumaRegister DGU® (TR-DGU) from 2002–2011 with AIS Chest ≥ 2, blunt trauma, age of 16 or older and an ISS ≥ 16 were analyzed. Outcome parameters were in-hospital mortality as well as ventilation time in patients surviving the initial 14 days after trauma. Results 22613 Patients were included (mean ISS 30.5 ± 12.6; 74.7% male; Mean Age 46.1 ± 197 years; mortality 17.5%; mean duration of ventilation 7.3 ± 11.5; mean ICU stay 11.7 ± 14.1 days). Only a limited number of specific injuries had a significant impact on survival. Major thoracic vessel injuries (AIS ≥5), bilateral lung contusion, bilateral flail chest, structural heart injury (AIS ≥3) significantly influence mortality in study patients. Several extrathoracic factors (age, blood transfusion, systolic blood pressure and extrathoracic severe injuries) were also predictive of increased mortality. Most injuries of the thoracic wall had no or only a moderate effect on the duration of ventilation. Injuries to the lung (laceration, contusion or pneumothoraces) had a moderate prolonging effect. Cardiac injuries and severe injuries to the thoracic vessels induced a substantially prolonged ventilation interval. Conclusions We demonstrate quantitatively the influence of specific structural damages of the chest on critical outcome parameters. While most injuries of the chest wall have no or only limited impact in the study collective, injuries to the lung overall show adverse outcome. Injuries to the heart or thoracic vessels have a

  14. Trauma care in Germany: an inclusive system.

    Science.gov (United States)

    Sturm, Johannes A; Pape, Hans-Christoph; Dienstknecht, Thomas

    2013-09-01

    Development of trauma systems is a demanding process. The United States and Germany both have sophisticated trauma systems. This manuscript is a summary of political, economic, and medical changes that have led to the development of both trauma systems and the current high-quality standards. We specifically asked three questions: (1) What tasks are involved in developing a modern trauma system? (2) What is the approach to achieve this task? (3) Do these systems work? We conducted a systematic review of relevant articles by searching electronic databases (PubMed, Embase, Cochrane library) using the following search terms: "trauma system", "polytrauma", "trauma networks", and "trauma registry". Of 2573 retrieved manuscripts, the authors made a personal selection of studies. A personal study selection from our experiences was added when their contribution to the topic was judged important. Worldwide, similar tasks concerning trauma care have to be addressed. In most societies, traffic accidents and firearm-related injuries contribute to a high number of trauma victims. The German approach has been to decrease the number of accidents through injury prevention and to provide better care by establishing an emergency medical system. For in-hospital treatment, clinical care has constantly improved and a close interaction with members from the American Association for the Surgery of Trauma and the Orthopaedic Trauma Association has helped a great deal to achieve these improvements. The German healthcare system was developed as a powerful healthcare tool covering patients from injury to rehabilitation. In addition, trauma and injury research has been strengthened to deal with various questions of trauma care. Organized injury prevention programs and systematized professional patient care can address the issues associated with the global burden of trauma. These trauma systems require constant monitoring and improvement.

  15. Facial trauma

    Science.gov (United States)

    Maxillofacial injury; Midface trauma; Facial injury; LeFort injuries ... Hockberger RS, Walls RM, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice . 8th ed. Philadelphia, PA: Elsevier ...

  16. Pancreatic trauma

    International Nuclear Information System (INIS)

    Sosa Martin, Gimel; Morales Portuondo, Kelvis; Baez Franco, Zenia

    2010-01-01

    Pancreas is an intra-abdominal organ in retroperitoneal location chow trauma is uncommon. Degree classification helps in more effective treatment practice and in decrease of complications appeared s consequence of traumas or the surgical treatment, which may be simple or involves large resections. The case of a patient with closed abdominal trauma of 3 days course. Diagnostic and clinic and complementary examinations were carried out being necessary surgical treatment. The aim of present paper was to expose the clinical elements, complementary results and surgical findings in this patient, as well as to motivate the suspicion of this affection in abdominal trauma. (author)

  17. The "Unacknowledged" Rape Victim.

    Science.gov (United States)

    Koss, Mary P.; Oros, Cheryl J.

    Acknowledged rape victims are women who have experienced forced sexual intercourse and view their experience as rape. Unacknowledged rape victims have suffered the same experience but do not view it as rape. Acknowledged (N=39) and unacknowledged (N=29) rape victims completed a sexual experiences interview and a rape attitude survey to determine…

  18. An evaluation of the coping patterns of rape victims: integration with a schema-based information-processing model.

    Science.gov (United States)

    Littleton, Heather

    2007-08-01

    The current study sought to provide an expansion of Resick and Schnicke's information-processing model of interpersonal violence response. Their model posits that interpersonal violence threatens victims' schematic beliefs and that victims can resolve this threat through assimilation, accommodation, or overaccommodation. In addition, it is hypothesized that how victims resolve schematic threat affects their coping strategies. To test this hypothesis, a cluster analysis of rape victims' coping patterns was conducted. Victims' coping patterns were related to distress, self-worth, and rape label in ways consistent with predictions. Thus, future research should focus on the implications of how victims integrate trauma with schemas.

  19. A comparison of risk factors for various forms of trauma in the lives of lesbian, gay, bisexual and heterosexual homeless youth.

    Science.gov (United States)

    Tyler, Kimberly A; Schmitz, Rachel M

    2018-01-01

    Numerous homeless youth experience trauma prior to leaving home and while on the street. Bullying and trading sex (i.e. exchanging sexual favors for survival items such as food) are additional forms of trauma experienced by many homeless youth. Although lesbian, gay, and bisexual (LGB) homeless youth experience higher rates of child abuse compared to their heterosexual counterparts, there is a paucity of research comparing these two groups. As such, we compare whether difficulties finding items of necessity (e.g. food) and different forms of trauma including child sexual abuse, being bullied, trading sex, and street sexual victimization significantly differ for LGB and heterosexual homeless youth. Bivariate results reveal that LGB youth have more trouble finding shelter and are more likely to trade sex compared to heterosexual youth. Logistic regression results show that trading sex is correlated with street sexual victimization. In the second model, we find that being female, experiencing more child sexual abuse, and ever having traded sex are all positively linked with street sexual victimization. LGB youth are over-represented among homeless youth populations and are also more likely to trade sex; therefore, these young people need services that are widely accessible and specific to their needs.

  20. Sexual Abuse Trauma Among Chinese Survivors.

    Science.gov (United States)

    Luo, Tsun-yin Echo

    1998-01-01

    This study conducted interviews with 19 survivors of sexual abuse and three social workers in Taiwan. It found sexual stigmatization and feelings of disempowerment and betrayal as the most pervasive trauma complex among the abuse survivors. Effects of cultural attitudes toward sexual victimization of women and Chinese patriarchal familialism are…

  1. Childhood Gender Atypicality, Victimization, and PTSD among Lesbian, Gay, and Bisexual Youth

    Science.gov (United States)

    D'Augelli, Anthony R.; Grossman, Arnold H.; Starks, Michael T.

    2006-01-01

    This study examined childhood gender atypicality, lifetime victimization based on sexual orientation, and current mental health, including trauma symptoms and posttraumatic stress disorder (PTSD), among 528 lesbian, gay, and bisexual youth. Nearly 80% reported verbal victimization, 11% physical, and 9% sexual, with males reporting significantly…

  2. [The victim as object of the medico-legal intervention].

    Science.gov (United States)

    Magalhães, Teresa

    2005-01-01

    We present a reflection about the victim as the object of the medico-legal intervention, that opens perspectives not only to the evidence research (as a techno-scientific contribute to support Justice in what concerns bio-psycho-social questions), but also to the support of victims which, in a last analysis, is no more than another aspect of this the social contribution of this science to ensure the best interest of the victim. This reflection aims to contribute to a better knowledge of the victim in his/her various perspectives. Accordingly, during the exposition, we refer some contributes of Victimology towards the understanding of the victims' behaviour's. Afterwards, we focus on the problems related to the aetiologies (with a particular reference to trauma), levels and consequences (physical, psychological and socio-economical) of victimization, as well as the methodologies of victims approach, medico-legal evaluation and reparation. Considering victims as being not only those who suffer directly the consequences of the victimizing phenomena, but also those that suffer from it indirectly and even secondarily, we shall approach the topic regarding both perspectives. We highlight the importance of understanding the victim as a person, not just understanding him/her confined to the organic aspect (as it used to be until recently in certain fields of medico-legal intervention, and as it still happens due to some legal obligations, for instance in the Labour Law), but considering the person in a global way (body, capacities, life situations and subjectivity). In conclusion, we highlight the importance of this topic to the medico-legal mission, while taking part in various multidisciplinary interventions and being involved in strategies and measures which purpose is to prevent violence, promote safety, avoid secondary victimization and revictimization as well as guarantee the victims' protection and reintegration, in a work attitude that should happen, even more and

  3. "I Did What I Was Directed to Do but He Didn't Touch Me": The Impact of Being a Victim of Internet Offending

    Science.gov (United States)

    Leonard, Marcella Mary

    2010-01-01

    The trauma of being a victim of sexual abuse is very difficult to live with, but for victims of internet offending there are added complexities for him/her in trying to make sense of what has happened. They are often "directed" by the offender to perform sexual acts on themselves and/or others, which creates huge confusion for the victim in terms…

  4. Highlight: The need for victim support services in India's Criminal ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    2016-04-15

    Apr 15, 2016 ... Agnes emphasized the need to establish District Compensatory Boards that have efficient victim compensation mechanisms for all kinds of violence against women. There should also be District Trauma Teams with members drawn from police, hospitals, the judiciary, and non-governmental organizations to ...

  5. [The hospital care of victims of terrorist attacks].

    Science.gov (United States)

    Bouhaddou, Assena; Nion, Nathalie; Riou, Bruno; Blandeau, Fanny; Moreau, Pilar; Guemache, Sofia

    2017-04-01

    The treatment of victims of terrorist attacks in a trauma centre requires the putting in place of plans, training and simulation exercises. Previous experiences have highlighted the areas which require improvement. As exceptional health situations are unpredictable, it is essential to always be vigilant and prepared for an unforeseen event. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  6. Trauma Africa

    Directory of Open Access Journals (Sweden)

    Victor Y. Kong

    2013-11-01

    Full Text Available “Major Trauma. Dr. Kong, please come to the Trauma Unit immediately. Dr. Kong, please come to the Trauma Unit immediately.” Even though I have been working at Edendale Hospital as a trauma registrar for over a year, whenever I hear this announcement over the hospital intercom system, my heart beats just a little faster than normal. When I first arrived at Edendale my colleagues told me that the adrenaline rush I would experience after being called out to attend a new emergency would decrease over time, and indeed they were right. However, it is also true to say that on some occasions more than others, it is still felt more strongly than ever.

  7. Tailbone trauma

    Science.gov (United States)

    ... in snow or on ice. Alternative Names Coccyx injury Images Tailbone (coccyx) References Choi SB, Cwinn AA. Pelvic trauma. In: Marx JA, Hockberger RS, Walls RM, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 8th ed. Philadelphia, PA: Elsevier ...

  8. Medico-legal aspects of alleged rape victims in Lahore.

    Science.gov (United States)

    Manzoor, Iram; Hashmi, Noreen Rahat; Mukhtar, Fatima

    2010-12-01

    To describe the socio-demographic along with the medico-legal characteristics of rape victims reporting to a female police station of Lahore. Observational study. Female Police Station in Shadman, Lahore, from, June 1995 to January 2009. A total of 74 cases of alleged rape victims were identified while reviewing all available police files concerning reported rapes and attempted rapes from 1995 to 2008. The data was gathered on preformed questionnaires after conducting the pilot study. All information about victims and alleged offenders were extracted from the police files including socio-demographic profile of the accused and victim both. Use of weapon, evidence of physical and genital trauma, assailant identification and his relationship with the victim, number of accused persons and location of rape was noted in each case. Examination by doctor and obtaining the specimens were also identified and was related to the outcome of the court case. Chi-square test was applied to determine the association of rape with age and educational status of the victim and the accused. A total of 74 cases of alleged rape were reported in the study period at Shadman Female Police Station. Maximum number of victims was reported in the age group 10-19 years (n=46, 62.2%). Majority of the accused belonged to 20-39 years' age group constituting 64.8% of the total. Regarding educational status 45 (60.8%) of the victims and 51 (68.9%) of the accused were illiterate. Significant association was found between the educational status of rape victims and accused (p = 0.016) but not between their ages (p = 0.862). The maximum incidence of rape was reported in unmarried (n = 55, 74.3%) and unemployed (n =61, 82.4%) women. In 14 cases (19%) use of weapon was reported. Physical trauma was reported in 29 (39%) and genital trauma in 14 (19%) cases. The accused were identified as family friends (25%) and neighbours (23%) respectively. Only 21% of the victims were examined by doctor and specimens were

  9. ABDOMINAL TRAUMA

    Directory of Open Access Journals (Sweden)

    Alojz Pleskovič

    2003-12-01

    Full Text Available Background. The most common cause of abdominal trauma is blunt trauma, gunshot wounds and stab wounds are rare. Most commonly injured organs in abdominal cavity are the spleen and the liver.Conclusions. Early diagnosis is very important and include precise phisical examination and all available diagnostic methods. The final decission about the method of treatmet depends on patients clinical condition, surgeon’s experience and other local conditions.

  10. Secondary victims of rape

    DEFF Research Database (Denmark)

    Christiansen, Dorte Mølgaard; Bak, Rikke; Elklit, Ask

    2012-01-01

    secondary victims, including family members, partners, and friends of male and female rape victims. We found that many respondents found it difficult to support the PV and that their relationship with the PV was often affected by the assault. Furthermore, the sample showed significant levels...... of social support for the respondent, and feeling let down by others. The respondents were generally interested in friend-, family-, and partner-focused interventions, particularly in receiving education about how best to support a rape victim...

  11. Emergency Department Management of Trauma

    DEFF Research Database (Denmark)

    MacKenzie, Colin; Lippert, Freddy

    1999-01-01

    Initial assessment and management of severely injured patients may occur in a specialized area of an emergency department or in a specialized area of a trauma center. The time from injury until definitive management is of essence for survival of life-threatening trauma. The initial care delivered...... services (EMS) response times and advanced prehospital care increase the number of critically injured patients surviving sufficiently long to reach a hospital “in extremis.” Both scenarios provide challenges in the management of traumatized patients. This article addresses the management of severely...

  12. Prognosis for children in cardiac arrest shortly after blunt cranial trauma.

    Science.gov (United States)

    Widdel, Lars; Winston, Ken R

    2010-10-01

    The goal of this investigation is to determine the success rate of aggressive cardiorespiratory resuscitation in children who experience blunt cranial trauma of sufficient magnitude to quickly cause cardiac arrest. The records of all the children who, within a 6-year period, suffered cardiac arrest at the scene of injury, during transport or in the emergency department of a level one pediatric trauma center, as a consequence of blunt cranial trauma, form the basis of this study. One of the 40 children who met the inclusion criteria survived. Their ages ranged from 1 month to 16 years, and all had a Glasgow Coma Score of 3 at the scene of injury. Forty-two percent were passengers in motor vehicles, and 32% were victims of nonaccidental trauma. Eleven of the 17 children in the motor vehicle crash were not properly restrained. Eleven of the unrestrained children plus two who were properly restrained were ejected at the time of impact. The average cardiopulmonary resuscitation time was 36 (2-107) minutes. A sinus rhythm was established in 50% but was not sustained in most. The sole survivor was an 8-year-old boy who was ejected and had asystole at the scene. At discharge, he was walking well but had cranial nerve deficits and learning disability. Survival in 40 consecutive children with documented cardiac arrest caused by blunt cranial trauma was 2.5%. This series, when combined with other published reports, is supportive of the position that aggressive resuscitation is rarely successful after 10 minutes and futile after 20 minutes.

  13. Vicarious traumatization in the work with survivors of childhood trauma.

    Science.gov (United States)

    Crothers, D

    1995-04-01

    1. Persons working with victims of childhood trauma may experience traumatic countertransference and vicarious traumatization. After hearing a patient's trauma story, which is a necessary part of childhood trauma therapy, staff may experience post-traumatic stress disorder, imagery associated with the patient's story and the same disruptions in relationships as the patient. 2. During the first 6 months of working with survivors of childhood trauma, common behaviors of staff members were identified, including a lack of attention, poor work performance, medication errors, sick calls, treatment errors, irreverence, hypervigilance, and somatic complaints. 3. Staff working with victims of childhood trauma can obtain the necessary staff support through team support, in traumatic events, and in a leadership role.

  14. Predictors of assault among urban female trauma patients

    Directory of Open Access Journals (Sweden)

    Usha Periyanayagam

    2012-01-01

    Full Text Available Background: Assault is a common mechanism of injury among female trauma victims. This paper identifies risk factors for assault in female victims and explores the interplay between identified predictors of assault and their combined contribution to female violent victimization. Materials and Methods: A retrospective analysis of all female trauma patients was performed using the Illinois Department of Public Health Trauma Registry from 1999-2003. Patients with assault listed as their mechanism of injury were compared to patients with other mechanisms of injury. Bivariate and multivariate analyses were performed using STATA statistical software to identify independent risk factors for assault. Finally, interaction affects were studied among these identified risk factors. Results: Female victims of assault were more likely to be African American (OR 1.32, P < 0.001, lack insurance (OR 1.79, P < 0.001, and to have tested positive for drugs (OR 1.32, P < 0.001 than women with other mechanisms of injury. In addition to the independent effects of these variables, patient drug use and lack of insurance demonstrated interaction effects (OR 1.67, P = 0.02. Conclusion: In this study, women of color, the uninsured, and those using drugs were disproportionately represented among assault victims, highlighting further evidence of trauma disparities. Most significantly, this study demonstrates that predictors of assault in women frequently coexist and both independently and in combination may increase the risk for female violent victimization.

  15. Healing Trauma, Building Resilience: SITCAP in Action

    Science.gov (United States)

    Steele, William; Kuban, Caelan

    2014-01-01

    Childhood trauma is marked by an overwhelming sense of terror and powerlessness. Loss of loving relationships is yet another type of trauma that produces the pain of sadness and grief. The resulting symptoms only reflect the neurological, biological, and emotional coping systems mobilized in the struggle to survive. These young people need new…

  16. Geriatric trauma.

    Science.gov (United States)

    Adams, Sasha D; Holcomb, John B

    2015-12-01

    The landscape of trauma is changing due to an aging population. Geriatric patients represent an increasing number and proportion of trauma admissions and deaths. This review explores recent literature on geriatric trauma, including triage criteria, assessment of frailty, fall-related injury, treatment of head injury complicated by coagulopathy, goals of care, and the need for ongoing education of all surgeons in the care of the elderly. Early identification of high-risk geriatric patients is imperative to initiate early resuscitative efforts. Geriatric patients are typically undertriaged because of their baseline frailty being underappreciated; however, centers that see more geriatric patients do better. Rapid reversal of anticoagulation is important in preventing progression of brain injury. Anticipation of difficult disposition necessitates early involvement of physical therapy for rehabilitation and case management for appropriate placement. Optimal care of geriatric trauma patients will be based on the well established tenets of trauma resuscitation and injury repair, but with distinct elements that address the physiological and anatomical challenges presented by geriatric patients.

  17. Abdominal trauma

    International Nuclear Information System (INIS)

    Giordany, B.R.

    1985-01-01

    Abdominal injury is an important cause of morbidity and mortality in childhood. Ten percent of trauma-related deaths are due to abdominal injury. Thousands of children are involved in auto accidents annually; many suffer severe internal injury. Child abuse is a second less frequent but equally serious cause of internal abdominal injury. The descriptions of McCort and Eisenstein and their associates in the 1960s first brought to attention the frequency and severity of visceral injury as important manifestations of the child abuse syndrome. Blunt abdominal trauma often causes multiple injuries; in the past, many children have been subjected to exploratory surgery to evaluate the extent of possible hidden injury. Since the advent of noninvasive radiologic imaging techniques including radionuclide scans and ultrasound and, especially, computed tomography (CT), the radiologist has been better able to assess (accurately) the extent of abdominal injury and thus allow conservative therapy in many cases. Penetrating abdominal trauma occurs following gunshot wounds, stabbing, and other similar injury. This is fortunately, a relatively uncommon occurrence in most pediatric centers and will not be discussed specifically here, although many principles of blunt trauma diagnosis are valid for evaluation of penetrating abdominal trauma. If there is any question that a wound has extended intraperitonelly, a sinogram with water-soluble contrast material allows quick, accurate diagnosis. The presence of large amounts of free intraperitoneal gas suggests penetrating injury to the colon or other gas-containing viscus and is generally considered an indication for surgery

  18. Ballistic Trauma of Limbs

    Science.gov (United States)

    Lamah, Léopold; Keita, Damany; Marie Camara, Ibrahima; Lamine Bah, Mohamed; Sory, Sidimé; Diallo, Mamadou Moustapha

    2017-01-01

    The objective of our study was to report the management and follow-up of a particular case of ballistic trauma and to do the literature review. Observation: A 35-year-old patient, a trader who was the victim of a firearm accident under not very clear circumstances. He was admitted to the emergency department after 3 hours. Clinically, the patient had significant bleeding in the arm and was in a state of clouding of consciousness. We could notice on the right arm, a posterior large transfixing wound of 1 cm and a 6 cm one on the antero-internal side. The limb was cold with a small and thready pulse. Sensitivity was decreased in the radial nerve area. The radiograph showed bone comminution from the middle 1/3 to the superior 1/3 of the humeral diaphysis. The treatment was orthopedic (after debridement) by scapula-brachio-ante-brachiopalmar plaster splint with thoracic strap. The wound healed in 46 days and the patient resumed his activities after 11 months and 2 weeks. Conclusion: The authors presented the value of using the scapulo-brachio-palmar plaster splints with thoracic strap in some severe upper limb trauma in the absence of the external fixator. PMID:28567155

  19. Sudden death victims

    NARCIS (Netherlands)

    Ceelen, Manon; van der Werf, Christian; Hendrix, Anneke; Naujocks, Tatjana; Woonink, Frits; de Vries, Philip; van der Wal, Allard; Das, Kees

    2015-01-01

    The goal of this study was to ascertain accordance between cause of death established by the forensic physician and autopsy results in young sudden death victims in the Netherlands. Sudden death victims aged 1-45 years examined by forensic physicians operating in the participating regions which also

  20. Yoga and victims

    Directory of Open Access Journals (Sweden)

    Nikolić-Ristanović Vesna

    2014-01-01

    Full Text Available In this paper the findings of literature review and explorative empirical research of yoga application in the work with victims of various forms of sufferings is presented. The largest notion of victim is accepted, which encompasses victims of crime, victims of human rights violations (including convicted persons, as well as victims of war, natural disasters and other sufferings. After determination of the notion of victim and yoga, the review and analyses of research findings and direct experiences with the application of yoga in victim support and victimisation prevention worldwide and in Serbia, is done. The author’s research findings as well as personal experiences with the application of yoga in the work with prisoners in prison for women in Pozarevac (Serbia, within the workshops that Victimology Society of Serbia implemented during 2012/2013, are presented as well. In the conclusions, contribution of yoga to holistic approach to victim support as well as important role that yoga may have in prevention of victimisation and criminalisation, is stressed. The importance of yoga for support of prisoners as the part of preparation for re-entry and with the aim to prevent recidivism, as well as to enable their more successful reintegration into the society, is particularly emphasised. The paper is based on the research implemented by the author for the purpose of writing the final essey at the course for yoga instructors on International yoga academy, Yoga Allience of Serbia.

  1. Victimization of Obese Adolescents

    Science.gov (United States)

    Robinson, Sabrina

    2006-01-01

    Peer victimization of obese adolescents has been associated with low self-esteem, body dissatisfaction, social isolation, marginalization, poor psychosocial adjustment, depression, eating disorders, and suicidal ideation and attempts, not to mention poor academic performance. Weight-based peer victimization is defined as unsolicited bullying and…

  2. Victimization of Children.

    Science.gov (United States)

    Finkelhor, David; Dziuba-Leatherman, Jennifer

    1994-01-01

    Outlines a general theory of childhood victimology, with a typology that characterizes abuse as extraordinary, acute, or pandemic. Efforts to prevent childhood victimization must recognize its differential character and the importance of the child's stage of development in recognizing and dealing with victimization. (SLD)

  3. Radiologic findings of thoracic trauma

    Directory of Open Access Journals (Sweden)

    Akgul Ozmen C

    2017-08-01

    Full Text Available Cihan Akgul Ozmen,1 Serdar Onat,2 Delal Aycicek3 1Department of Radiology, 2Department of Chest Surgery, Dicle University School of Medicine, Diyarbakir, 3Radiology Unit, Siirt State Hospital, Siirt, Turkey Introduction: Chest trauma may be blunt or penetrating and the chest is the third most common trauma region. It is a significant cause of mortality. Multidetector computed tomography (MDCT has been an increasingly used method to evaluate chest trauma because of its high success in detecting tissue and organ injuries. Herein, we aimed to present MDCT findings in patients with blunt and penetrating chest trauma admitted to our department. Methods: A total of 240 patients admitted to the emergency department of our hospital between April 2012 and July 2013 with a diagnosis of chest trauma who underwent MDCT evaluations were included. Most of the patients were male (83.3% and victims of a blunt chest trauma. The images were analyzed with respect to the presence of fractures of bony structures, hemothorax, pneumothorax, mediastinal organ injury, and pulmonary and vascular injuries. Results: MDCT images of the 240 patients yielded a prevalence of 41.7% rib fractures, 11.2% scapular fractures, and 7.5% clavicle fractures. The prevalence of thoracic vertebral fracture was 13.8% and that of sternal fracture was 3.8%. The prevalence of hemothorax, pneumothorax, pneumomediastinum, and subcutaneous emphysema was 34.6%, 62.1%, 9.6%, and 35.4%, respectively. The prevalence of rib, clavicle, and thoracic vertebral fractures and pulmonary contusion was higher in the blunt trauma group, whereas the prevalence of hemothorax, subcutaneous emphysema, diaphragmatic injury, and other vascular lacerations was significantly higher in the penetrating trauma group than in the blunt trauma group (p<0.05. Conclusion: MDCT images may yield a high prevalence of fracture of bony structures, soft tissue lacerations, and vascular lesions, which should be well understood by

  4. Ballistic trauma

    Directory of Open Access Journals (Sweden)

    Parvathi Devi Munishwar

    2016-01-01

    Full Text Available Gunshot injuries are rather serious but uncommon type of trauma in India. Radiologists can contribute substantially in the evaluation and treatment of patients with gunshot wounds. Foreign bodies that enter a patient as a result of trauma are contaminated and produce a range of symptoms. Oral and maxillofacial gunshot injuries are usually fatal due to close proximity with vital structures. Here, we report a case in which radiographic evidence of foreign bodies in the right orofacial region exposed a history of a gunshot injury. The patient did not have any major complaints except for reduced mouth opening. These foreign bodies were clinically silent for approximately 12 years.

  5. Current status and future options for trauma and emergency surgery in Turkey.

    Science.gov (United States)

    Taviloğlu, Korhan; Ertekin, Cemalettin

    2008-01-01

    The number of trauma victims in Turkey is expected to increase as a consequence of the increasing vehicular traffic, potential for earthquakes, and risk of terrorist attacks. The Turkish Association for Trauma and Emergency Surgery monitors trauma cases, publishes a quarterly journal, organizes trauma courses and seminars for various health personnel nationwide. It is also extending efforts to improve in-hospital care by establishing trauma and emergency surgery fellowships and trauma and emergency surgery centers nationwide, which is run by General Surgeons currently. Turkey faces the same dilemma as the rest of the developed world regarding the future of trauma surgeons in the current era of nonoperative trauma management. We suggest that the field of trauma and emergency surgery be redefined to include emergency general surgery and cavitary trauma.

  6. Imaging in spinal trauma

    Energy Technology Data Exchange (ETDEWEB)

    Goethem, J.W.M. van [Universitair Ziekenhuis Antwerpen, University of Antwerp, Belgium, Department of Radiology, Edegem (Belgium); Algemeen Ziekenhuis Maria Middelares, Department of Radiology, Sint-Niklaas (Belgium); Maes, Menno; Oezsarlak, Oezkan; Hauwe, Luc van den; Parizel, Paul M. [Universitair Ziekenhuis Antwerpen, University of Antwerp, Belgium, Department of Radiology, Edegem (Belgium)

    2005-03-01

    Because it may cause paralysis, injury to the spine is one of the most feared traumas, and spinal cord injury is a major cause of disability. In the USA approximately 10,000 traumatic cervical spine fractures and 4000 traumatic thoracolumbar fractures are diagnosed each year. Although the number of individuals sustaining paralysis is far less than those with moderate or severe brain injury, the socioeconomic costs are significant. Since most of the spinal trauma patients survive their injuries, almost one out of 1000 inhabitants in the USA are currently being cared for partial or complete paralysis. Little controversy exists regarding the need for accurate and emergent imaging assessment of the traumatized spine in order to evaluate spinal stability and integrity of neural elements. Because clinicians fear missing occult spine injuries, they obtain radiographs for nearly all patients who present with blunt trauma. We are influenced on one side by fear of litigation and the possible devastating medical, psychologic and financial consequences of cervical spine injury, and on the other side by pressure to reduce health care costs. A set of clinical and/or anamnestic criteria, however, can be very useful in identifying patients who have an extremely low probability of injury and who consequently have no need for imaging studies. Multidetector (or multislice) computed tomography (MDCT) is the preferred primary imaging modality in blunt spinal trauma patients who do need imaging. Not only is CT more accurate in diagnosing spinal injury, it also reduces imaging time and patient manipulation. Evidence-based research has established that MDCT improves patient outcome and saves money in comparison to plain film. This review discusses the use, advantages and disadvantages of the different imaging techniques used in spinal trauma patients and the criteria used in selecting patients who do not need imaging. Finally an overview of different types of spinal injuries is given

  7. Imaging in spinal trauma

    International Nuclear Information System (INIS)

    Goethem, J.W.M. van; Maes, Menno; Oezsarlak, Oezkan; Hauwe, Luc van den; Parizel, Paul M.

    2005-01-01

    Because it may cause paralysis, injury to the spine is one of the most feared traumas, and spinal cord injury is a major cause of disability. In the USA approximately 10,000 traumatic cervical spine fractures and 4000 traumatic thoracolumbar fractures are diagnosed each year. Although the number of individuals sustaining paralysis is far less than those with moderate or severe brain injury, the socioeconomic costs are significant. Since most of the spinal trauma patients survive their injuries, almost one out of 1000 inhabitants in the USA are currently being cared for partial or complete paralysis. Little controversy exists regarding the need for accurate and emergent imaging assessment of the traumatized spine in order to evaluate spinal stability and integrity of neural elements. Because clinicians fear missing occult spine injuries, they obtain radiographs for nearly all patients who present with blunt trauma. We are influenced on one side by fear of litigation and the possible devastating medical, psychologic and financial consequences of cervical spine injury, and on the other side by pressure to reduce health care costs. A set of clinical and/or anamnestic criteria, however, can be very useful in identifying patients who have an extremely low probability of injury and who consequently have no need for imaging studies. Multidetector (or multislice) computed tomography (MDCT) is the preferred primary imaging modality in blunt spinal trauma patients who do need imaging. Not only is CT more accurate in diagnosing spinal injury, it also reduces imaging time and patient manipulation. Evidence-based research has established that MDCT improves patient outcome and saves money in comparison to plain film. This review discusses the use, advantages and disadvantages of the different imaging techniques used in spinal trauma patients and the criteria used in selecting patients who do not need imaging. Finally an overview of different types of spinal injuries is given

  8. The Impact of Specific and Complex Trauma on the Mental Health of Homeless Youth.

    Science.gov (United States)

    Wong, Carolyn F; Clark, Leslie F; Marlotte, Lauren

    2016-03-01

    This study investigates the relative impact of trauma experiences that occurred prior to and since becoming homeless on depressive symptoms, posttraumatic stress disorder (PTSD) symptoms, and self-injurious behaviors among a sample of homeless youth (N = 389). Youth (aged 13 to 25) who had been homeless or precariously housed in the past year completed a survey about housing history, experiences of violence and victimization, mental health, and service utilization. In addition to examining the impact associated with specific trauma types, we also considered the effect of "early-on" poly-victimization (i.e., cumulative number of reported traumas prior to homelessness) and the influence of a compound sexual trauma variable created to represent earlier complex trauma. This created-variable has values ranging from no reported trauma, single trauma, multiple non-sexual traumas, and multiple traumas that co-occurred with sexual abuse. Multivariate analyses revealed that specific traumatic experiences prior to homelessness, including sexual abuse, emotional abuse/neglect, and adverse home environment, predicted greater mental health symptoms. Poly-victimization did not add to the prediction of mental health symptoms after the inclusion of specific traumas. Results with early compound sexual trauma revealed significant differences between lower-order trauma exposures and multiple-trauma exposures. Specifically, experience of multiple traumas that co-occurred with sexual trauma was significantly more detrimental in predicting PTSD symptoms than multiple traumas of non-sexual nature. Findings support the utility of an alternate/novel conceptualization of complex trauma, and support the need to carefully evaluate complex traumatic experiences that occurred prior to homelessness, which can impact the design and implementation of mental health care and services for homeless youth. © The Author(s) 2014.

  9. Emergency Anaesthetic Management of Extensive Thoracic Trauma

    Directory of Open Access Journals (Sweden)

    H C Chandola

    2007-01-01

    Full Text Available High speed vehicles, drug abuse, alcohol and easy availability of handguns are the main reasons of increasing number of trauma especially thoracic trauma. Anaesthesiologist plays an important role in the management of extensive thoracic trauma. Thoracic trauma, penetrating or blunt, may cause damage to organs suspended in thorax viz. pleura, lungs, heart, great vessels, trachea and oesophagus. It may lead to pneumothorax, cardiac tamponade or life threatening haemorrhage. With aggressive care and management of these factors, majority of patients can survive and return to normal life.

  10. Trauma Ultrasound.

    Science.gov (United States)

    Wongwaisayawan, Sirote; Suwannanon, Ruedeekorn; Prachanukool, Thidathit; Sricharoen, Pungkava; Saksobhavivat, Nitima; Kaewlai, Rathachai

    2015-10-01

    Ultrasound plays a pivotal role in the evaluation of acute trauma patients through the use of multi-site scanning encompassing abdominal, cardiothoracic, vascular and skeletal scans. In a high-speed polytrauma setting, because exsanguinations are the primary cause of trauma morbidity and mortality, ultrasound is used for quick and accurate detection of hemorrhages in the pericardial, pleural, and peritoneal cavities during the primary Advanced Trauma Life Support (ATLS) survey. Volume status can be assessed non-invasively with ultrasound of the inferior vena cava (IVC), which is a useful tool in the initial phase and follow-up evaluations. Pneumothorax can also be quickly detected with ultrasound. During the secondary survey and in patients sustaining low-speed or localized trauma, ultrasound can be used to help detect abdominal organ injuries. This is particularly helpful in patients in whom hemoperitoneum is not identified on an initial scan because findings of organ injuries will expedite the next test, often computed tomography (CT). Moreover, ultrasound can assist in detection of fractures easily obscured on radiography, such as rib and sternal fractures. Copyright © 2015 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.

  11. Eye trauma

    African Journals Online (AJOL)

    2011-02-02

    Feb 2, 2011 ... 66. CME FEBRUARY 2011 Vol.29 No.2. Eye trauma. To a clinician without experience, a person with an eye injury presents a dilemma. This article should reassure you that methodical assessment and treatment of most injuries is simple and within the ambit of every doctor. JONatHaN PONs, MB ChB, Dip ...

  12. TRAUMA SURGERY

    African Journals Online (AJOL)

    and track this epidemic. A number of socio-political changes have continued, and these will impact on the trauma patterns seen in the country. Gun control legislation has been enforced since the turn of the millennium, and there have been ongoing attempts to demilitarise society by removing assault weapons. The ongoing ...

  13. Trauma Theory

    DEFF Research Database (Denmark)

    Pedersen, Bodil Maria

    There are two main trends in psychological approaches to human suffering related to what we term trauma. Although they have their respective limitations both approaches may help us explore and alleviate human suffering. One trend, primarily using concepts like traumatic events and traumatisation ...

  14. TRAUMA SURGERY

    African Journals Online (AJOL)

    deaths due to other trauma types (gunshot wounds, road traffic fatalities and assault) ... the axillary artery was ligated during surgery. Type of ... Left axillary artery. Ischaemic left upper limb. 3. Fifth intercostal space on the left. Bilateral pneumothorax and haemothorax still present at autopsy. (intercostal drain only inserted on ...

  15. The role of intelligence in posttraumatic stress disorder: does it vary by trauma severity?

    Directory of Open Access Journals (Sweden)

    Naomi Breslau

    Full Text Available Only a small minority of trauma victims develops post-traumatic stress disorder (PTSD, suggesting that victims vary in their predispositions to the PTSD response to stressors. It is assumed that the role of predispositions in PTSD varies by trauma severity: when stressors are less severe, predispositions play a bigger role. In this study, we test whether the role of intelligence in PTSD varies by trauma severity. Specifically, does low intelligence plays a bigger part among victims of lower magnitude stressors than among victims of extreme stressors?Data come from a longitudinal study of randomly selected sample in Southeast Michigan (n = 713. IQ was measured at age 6. PTSD was measured at age 17, using the NIMH-DIS for DSM-IV. Stressors were classified as extreme if they involved assaultive violence (e.g. rape, sexual assault, threatened with a weapon; other stressors in the list (e.g. disaster, accidents were classified as lower magnitude. Assaultive violence victims had experienced assaultive violence plus other event types or only assaultive violence. Victims of other stressors were participants who had never experienced assaultive violence. We compared the influence of age 6 IQ on PTSD among persons exposed to assaultive violence vs. other stressors, using multinomial logistic regression.Relative risk ratio (RRR for PTSD associated with a one point drop in age 6 IQ among victims of assaultive violence was 1.04 (95% CI 1.01, 1.06; among victims of other stressors, it was 1.03 (95% CI 0.99, 1.06. A comparison of the two RRRs indicates no significant difference between the two estimates (p = 0.652. IQ does not play a bigger role in PTSD among victims of other stressors than it does among victims of assaultive violence.Lower IQ exerts an adverse PTSD effect on trauma victims, with no evidence of variability by the severity of trauma they have experienced.

  16. Sexual harassment and PTSD: is sexual harassment diagnosable trauma?

    Science.gov (United States)

    Avina, Claudia; O'Donohue, William

    2002-02-01

    Sexual harassment has become a major social, legal, and mental health problem because of its high prevalence and its negative consequences for victims. These consequences can include decreased productivity, loss of job, decreased income, and impaired psychological and physical well-being. Despite evidence from empirical studies that victims often exhibit posttraumatic stress disorder (PTSD) symptoms, some have argued that sexual harassment does not constitute legitimate trauma. We argue that many forms of sexual harassment meet the diagnostic Criteria A1 and A2 of PTSD. Finally, the DSM-IV trauma criterion is explicated, and its relationship with sexual harassment and its effects are discussed.

  17. Cyber-Victimized Students

    Directory of Open Access Journals (Sweden)

    Kaitlyn N. Ryan

    2013-12-01

    Full Text Available Bullying is a common topic in the media and academic settings. Teachers are regularly expected to provide curriculum and intervene regarding all forms of bullying, including cyber-bullying. Altering the behaviors of those who bully is often the focus of interventions, with less attention being placed on victim impact. The purpose of this article was to provide educators with a review of evidence regarding the occurrence, impact, and interventions for victims of cyber-bullying. Evidence reveals that cyber-bullying can have emotional, social, and academic impacts but that there are very few documented, and even fewer evidence-based, programs for victims of cyber-bullying. We conclude by proposing that school-wide programs and support be developed and provided to victims.

  18. Damage control surgery and open abdomen in trauma patients with exsanguinating bleeding.

    Science.gov (United States)

    Mutafchiĭski, V; Popivanov, G

    2014-01-01

    Acute coagulopathy with exsanguinating bleeding occurs in 2-5% of all trauma cases carrying mortality rate near 100% after conventional management. In the last few decades, the development of damage control surgery (DCS) in combination with the technique of open abdomen led to significantly improved survival among these patients. A descriptive study based on a retrospective analysis of 12 consecutive blast victims with exsanguinating bleeding underwent DCS and open abdomen management. All patients were soldiers injured during their deployment in Iraq and Afghanistan during 2002-2007, treated by our deployed surgical teams. Vacuum Assisted Closure (V.A.C., KCI) and vacuum pack (VP) was used for a temporary closure of abdomen. A cumulative analysis of all relevant series used these methods during the period 2000-2013 was performed. DCS was applied in 12 of 114 consecutive blast victims (10.5%) with survival rate 66.7% (8/12). Eleven had open abdomen with temporary closure with V.A.C. in 6 and VP in 5. Four patients died before the definitive closure (36.4%). The survivors (n = 8) were with a mean age 28.5 years, suffered from a critical trauma with a mean Injury Severity Score 35.5. V.A.C was used in 4 of them, VP in 3. Primary closure of abdomen was achieved in 6 (85.7%) within 3.5 days and mean 1.3 dressing changes. Due to ACS, the abdomen was closed through skin suture only and a creation of planned ventral hernia in 1 patient treated with VP (1/7, 14.3%). Wound infection was observed in 1 case (14.3%). Despite the small sample size, our series clearly demonstrate the benefits of DCS and open abdomen in trauma patients with exsangiunating bleeding. The survival rate is highly dependent on the rapid implementation of DCS in properly selected patients. V.A.C. and VP provide a high rate of primary fascial closure in trauma.

  19. Secondary victims of rape.

    Science.gov (United States)

    Christiansen, Dorte; Bak, Rikke; Elklit, Ask

    2012-01-01

    Rape is often a very traumatic experience, which affects not only the primary victim (PV) but also his/her significant others. Studies on secondary victims of rape are few and have almost exclusively studied male partners of female rape victims. This study examined the impact of rape on 107 secondary victims, including family members, partners, and friends of male and female rape victims. We found that many respondents found it difficult to support the PV and that their relationship with the PV was often affected by the assault. Furthermore, the sample showed significant levels of traumatization, and it was estimated that approximately one quarter of the respondents suffered from posttraumatic stress syndrome (PTSD). Degree of traumatization was associated with a more recent assault, higher efforts to support the PV, recurrent thoughts about having been able to prevent the assault, a lack of social support for the respondent, and feeling let down by others. The respondents were generally interested in friend-, family-, and partner-focused interventions, particularly in receiving education about how best to support a rape victim.

  20. [False victimization syndrome].

    Science.gov (United States)

    Resch, Mária; Bella, Tamás

    2011-04-03

    Criminology and criminal-psychology are sciences dealing mostly with the personality of the criminals as well as the interconnections of crime and deviance. The other player of the crimes - the victim - has recently come into focus posing the question why and how somebody is becoming a victim, and what effect can the victim have when the crime is being committed. The first international publications appeared at the beginning of the third millennium on so-called victims who are convinced to suffer from material, moral or other damages and, accordingly, who would pursue "justice" at any rate. They often appeal against decisions. Considering these facts the procedures are rather thorough and circumspect. A significant part of the law-enforcement staff is heavily involved for long periods. On the other side there is the person considered criminal being actually the real victim. These people are getting alienated from the society because of their reckoned deeds and, because of the distorting influence of the media they are condemned morally. The present study describes the syndromes of fake-victim, their occurrence as well as psychiatric considerations, social appearance and impact. The authors are drawing attention to the existence and significance of this medical-legal problem.

  1. Watercraft and watersport injuries in children: trauma mechanisms and proposed prevention strategies.

    Science.gov (United States)

    Keijzer, Richard; Smith, Geni F; Georgeson, Keith E; Muensterer, Oliver J

    2013-08-01

    Watercraft-associated trauma (WAT) in children has received little attention so far, despite the potentially severe and debilitating resulting injuries. The aim of this study was to evaluate all cases of major watercraft-associated trauma admitted to the Children's of Alabama during the past 10 years, identify patterns in mechanism and injury, and propose future prevention strategies. We reviewed our (prospective) database for children admitted through our trauma center after major WAT. Charts were abstracted for mechanism, epidemiologic data, injury type and injury severity scale (ISS), as well as outcome. We identified 15 children (6 males, 9 females, age range 7 to 15, mean 12 ± 2 years), involved in 14 accidents. Sharp trauma was inflicted by a propeller (n=4) or a rope (n=1). Towed tubing (riding an inflatable tube while being pulled by a boat) was the most prevalent mechanism (n=6). There was a trend towards higher ISS after towed tubing (24.8 ± 12.4) compared to all other mechanisms (15.1±7.7). Mean length of stay was longer after towed tubing accidents (14.2 ± 7.2 versus 4.9 ± 3.4 days). All patients survived and eventually were discharged home. In one of the incidences, involving 2 victims of this series, the driver of the boat was intoxicated with alcohol. Pediatric watercraft-related accidents are infrequent, but often result in major injuries. More awareness for safety measures to prevent these injuries is warranted. Alcohol is not a major factor in pediatric watercraft-associated trauma. Tubes towed by a boat seem to be particularly dangerous, perhaps because of the rider's limited maneuverability and the fact that centrifugal force lets the tube travel well outside the wake in curves. Limiting boat speed and the use of protective gear on towed tubes when children are involved may decrease the incidence and severity of pediatric WAT. Copyright © 2013 Elsevier Inc. All rights reserved.

  2. Organizational network in trauma management in Italy

    Directory of Open Access Journals (Sweden)

    Osvaldo Chiara

    2005-10-01

    Full Text Available In Italy, as in other western countries, trauma is a leading cause of death during the first four decades of life, with almost 18.000 of deaths per year. Since 80s organized systems for trauma care, including a pre-hospital emergency medical system and a network of hospitals designated as Trauma Centres, have been developed in north American countries. Effectiveness of trauma systems has been investigated comparing the post-system to the pre-system trauma care with the method of panel evaluation of preventable death rates and comparison of observed survival with expected probability of survival. In Italy, a pre-hospital emergency medical system has been implemented on a national scale, while a trauma network has not been developed. Nowadays, trauma patients are often admitted to the closest hospital, independently from local resources. The Superior Council of Ministry of Health has presented in 2004 a new trauma system model (SIAT based on the recognition in the field of patients with more serious injuries and the transportation to general hospitals with resources and multidisciplinary teams specialized in trauma care (trauma team. The designation of few trauma team hospitals, one highly specialized Centre (CTS and two area Centres (CTZ every two millions of inhabitants allows each Centre to treat at least 250 severe trauma patients per year to increase experience. Less severe injured patients may be treated in non-trauma team acute care facilities, according to the inclusive system model. The development of trauma team services in some Italian hospitals has demonstrated an increase in survival and a decrease in preventable death rate from 42% to 7,6%. Economic studies of Ministry of Health have established that the implementation of a trauma system model on a national scale with a 25% decrease of preventable trauma deaths and disabilities would save 7500 million of euros of public money. Therefore, in our country the concentration of severely

  3. Nurse-Led Trauma-Informed Correctional Care for Women.

    Science.gov (United States)

    Mollard, Elizabeth; Brage Hudson, Diane

    2016-07-01

    Incarcerated women are a vulnerable and unique population of special concern to nurses as they have high rates of mental illness. In this article, the authors discuss how trauma exposure contributes to mental illness in incarcerated women through abuse, socioeconomic factors, and the prison environment, how this trauma exposure manifests in the inmate survivor, and the related implications for practice. A history of trauma and victimization is related to complex mental health issues which affect the majority of justice-involved women. The correctional environment can exacerbate these issues. Nursing implications include discussion of the trauma-informed care model. The authors recommend a model of trauma-informed care named "the 4 Es" that can guide nurses in preparing a trauma-informed correctional environment and discuss the importance of nurse-led policy change in finding alternatives to incarceration for women with mental illness. © 2015 Wiley Periodicals, Inc.

  4. Adverse Childhood Experiences and School-Based Victimization and Perpetration.

    Science.gov (United States)

    Forster, Myriam; Gower, Amy L; McMorris, Barbara J; Borowsky, Iris W

    2017-01-01

    Retrospective studies using adult self-report data have demonstrated that adverse childhood experiences (ACEs) increase risk of violence perpetration and victimization. However, research examining the associations between adolescent reports of ACE and school violence involvement is sparse. The present study examines the relationship between adolescent reported ACE and multiple types of on-campus violence (bringing a weapon to campus, being threatened with a weapon, bullying, fighting, vandalism) for boys and girls as well as the risk of membership in victim, perpetrator, and victim-perpetrator groups. The analytic sample was comprised of ninth graders who participated in the 2013 Minnesota Student Survey ( n ~ 37,000). Multinomial logistic regression models calculated the risk of membership for victim only, perpetrator only, and victim-perpetrator subgroups, relative to no violence involvement, for students with ACE as compared with those with no ACE. Separate logistic regression models assessed the association between cumulative ACE and school-based violence, adjusting for age, ethnicity, family structure, poverty status, internalizing symptoms, and school district size. Nearly 30% of students were exposed to at least one ACE. Students with ACE represent 19% of no violence, 38% of victim only, 40% of perpetrator only, and 63% of victim-perpetrator groups. There was a strong, graded relationship between ACE and the probability of school-based victimization: physical bullying for boys but not girls, being threatened with a weapon, and theft or property destruction ( ps bullying and bringing a weapon to campus ( ps effects of cumulative ACE. We recommend that schools systematically screen for ACE, particularly among younger adolescents involved in victimization and perpetration, and develop the infrastructure to increase access to trauma-informed intervention services. Future research priorities and implications are discussed.

  5. Poly-victimization in a Norwegian adolescent population: Prevalence, social and psychological profile, and detrimental effects.

    Science.gov (United States)

    Mossige, Svein; Huang, Lihong

    2017-01-01

    This study focuses on poly-victimization, with the aim of providing a realistic estimation of the prevalence of lifetime victimization in a Norwegian adolescent population (ages 18-19 years). Based upon the concept from previous research, we applied measures of child poly-victimization on Norwegian data obtained from a national youth survey in 2015 (N = 4,531) to arrive at an estimation of its prevalence. We used variables that measure individual characteristics such as gender and educational aspiration and socio-economic factors such as parents' education level and home economic situation to derive a social and psychological profile of victimization and poly-victimization among young people. Finally, we estimated the effects of poly-victimization on mental health such as symptoms of depression, anxiety and trauma. Our study identified a poly-victimization prevalence of 8.6% among young people, i.e. they were exposed to three of all four forms of violence investigated by our study: non-physical violence, witnessing violence against parents, physical violence and sexual abuse. Adolescents of poly-victimization are six times more likely to report depression and anxiety and trauma when compared with those without victimization. Poly-victimization is a phenomenon that heavily burdens many young people across many national contexts. Poly-victims clearly tend to develop depression, anxiety, and posttraumatic stress symptoms. The early detection of sexual abuse, physical violence, and bullying victimization is of critical importance and preventive measures could consider addressing family factors through parental educational programs.

  6. Poly-victimization in a Norwegian adolescent population: Prevalence, social and psychological profile, and detrimental effects.

    Directory of Open Access Journals (Sweden)

    Svein Mossige

    Full Text Available This study focuses on poly-victimization, with the aim of providing a realistic estimation of the prevalence of lifetime victimization in a Norwegian adolescent population (ages 18-19 years.Based upon the concept from previous research, we applied measures of child poly-victimization on Norwegian data obtained from a national youth survey in 2015 (N = 4,531 to arrive at an estimation of its prevalence. We used variables that measure individual characteristics such as gender and educational aspiration and socio-economic factors such as parents' education level and home economic situation to derive a social and psychological profile of victimization and poly-victimization among young people. Finally, we estimated the effects of poly-victimization on mental health such as symptoms of depression, anxiety and trauma.Our study identified a poly-victimization prevalence of 8.6% among young people, i.e. they were exposed to three of all four forms of violence investigated by our study: non-physical violence, witnessing violence against parents, physical violence and sexual abuse. Adolescents of poly-victimization are six times more likely to report depression and anxiety and trauma when compared with those without victimization.Poly-victimization is a phenomenon that heavily burdens many young people across many national contexts. Poly-victims clearly tend to develop depression, anxiety, and posttraumatic stress symptoms. The early detection of sexual abuse, physical violence, and bullying victimization is of critical importance and preventive measures could consider addressing family factors through parental educational programs.

  7. Sexual abuse trauma among Chinese survivors.

    Science.gov (United States)

    Tsun-Yin, E L

    1998-10-01

    As an initial effort to examine Chinese sexual abuse trauma in relation to the cultural construction of sexual victimization of women, this study applies Finkelhor and Browne's (1985) traumagenic dynamics model to examine post-abuse trauma among Chinese child and adolescent survivors in Taiwan. In analyzing sexual abuse trauma in the context of Chinese patriarchal familialism and cultural fetish for female chastity, this study attempts to explore cultural constructional process of sexual abuse in Chinese society. This study conducted in-depth interviews with 19 survivors of, and three social workers on, sexual abuse in Taiwan. These interviews were guided by a semi-structured questionnaire on sexual abuse incidents and post-abuse responses/concerns, and had generated a total of 84 pages of written reports, which serve as the text-data for the analysis. This study identifies sexual stigmatization and senses of disempowerment and betrayal as the most pervasive trauma complex among Chinese sexual abuse survivors in Taiwan. This study found that, in addition to lowering self-esteem, sexual stigmatization results in polarized sexuality among adolescent survivors, as manifested in aversion to and preoccupation with sexuality. The abuse-induced disempowerment is manifested in the survivors' fear for personal safety and heightened sense of vulnerability to re-victimization. The sense of betrayal results in interpersonal difficulties as manifested in self-imposed isolation from others and/or suspicious attitudes toward others, which further impair the survivor's efficacy in meeting her abuse-induced clinging need. Overall, this study observes similar traumatic symptoms between Chinese survivors and their American counterparts as documented in the literature. Nevertheless, this study observes the sexual stigmatization represents the most prevailing post-abuse trauma among Chinese sexual abuse survivors, and reflects the patriarchal fetish for female chastity in the Chinese

  8. Gênero e trauma Gender and trauma

    Directory of Open Access Journals (Sweden)

    Gláucio Ary Dillon Soares

    2005-04-01

    Full Text Available As conseqüências sociais e psicológicas da violência urbana sobre os parentes e amigos de pessoas vitimadas por mortes violentas (homicídio, suicídio ou acidentes são analisadas à luz das diferenças de gênero. A literatura especializada nesta área propõe que mulheres e homens vivenciam experiências traumáticas de forma peculiar. Porém, os traumas típicos são diferentes em cada gênero, deixando em aberto a questão sobre quanto das diferenças entre as respostas se devem a gênero e quanto se devem ao tipo de trauma. Testamos a hipótese de que as mulheres são mais suscetíveis à desordem de estresse pós-trauma (DEPT numa situação traumática comum, usando dados qualitativos e quantitativos. Comparamos os sintomas do trauma e as percepções sobre o significado da perda de seus entes queridos. A amostra, de 425 mulheres (62% e 265 homens (38%, foi retirada de uma lista de parentes de pessoas que sofreram morte violenta na cidade do Rio de Janeiro. Incluímos trinta relatos de parentes e amigos próximos das vítimas diretas. Os resultados revelaram que 54% das mulheres e 41% dos homens tiveram o cotidiano alterado depois da morte de um parente/amigo. Há diferenças estatisticamente significativas nos problemas de saúde e na diversão. Essa área foi a mais afetada, atingindo metade dos entrevistados. Uma variável intimamente correlacionada com os sintomas da DEPT é o contato com o corpo: controlando a extensão do contato (fez o reconhecimento do corpo; viu, mas não reconheceu e nem viu nem reconheceu. Em cada uma dessas categorias, as mulheres foram mais afetadas do que os homens. O artigo conclui que as mulheres sentem mais as perdas do que os homens, mas que parte das diferenças não são internas aos gêneros, mas externas a eles, dependendo das interações e dos contatos pessoais.The social and psychological consequences endured by friends and relatives of people victimized by violent death (homicide, suicide or

  9. Salivary cortisol and dehydroepiandrosterone sulfate in adolescent rape victims with post traumatic stress disorder.

    Science.gov (United States)

    Bicanic, Iva A E; Postma, Riemke M; Sinnema, Gerben; De Roos, Carlijn; Olff, Miranda; Van Wesel, Floryt; Van de Putte, Elise M

    2013-03-01

    In chronic sexual abuse victims with post traumatic stress disorder (PTSD), the hypothalamic pituitary adrenal (HPA) axis can be dysregulated. In single rape victims, PTSD symptoms are hypothesized to function as a chronic stressor leading to similar HPA-axis dysregulation. The objective of the current study was to assess HPA-axis functioning in female adolescents with rape-related PTSD, but no prior sexual trauma, in comparison to non-victimized controls. Salivary cortisol and dehydroepiandrosterone sulfate (DHEAS) were measured in 52 female adolescent rape victims with PTSD and 37 healthy adolescents at 0, 15, 30, 45 and 60 min after awakening, both under basal conditions and after 0.5 mg dexamethasone administration. Compared to age-matched controls, adolescent rape victims with PTSD showed significantly reduced cortisol and DHEAS levels. No group differences for the effect of dexamethasone suppression were found. Both the event of rape and PTSD diagnosis, and not factors such as sleep duration, smoking, education or oral contraceptives, accounted for the neuroendocrine differences between rape victims and controls. The results show evidence for a dysregulated HPA-axis in female adolescent victims of single sexual trauma with PTSD. The finding of hypocortisolism is consistent with endocrine dysfunctioning in chronic sexual abuse victims and may have clinical implications with regard to treatment possibilities. Copyright © 2012 Elsevier Ltd. All rights reserved.

  10. Factors Influencing the Relationship between Sexual Trauma and Risky Sexual Behavior in College Students

    Science.gov (United States)

    Johnson, Nicole L.; Johnson, Dawn M.

    2013-01-01

    While the relationship between sexual trauma and risky sexual behavior (RSB) has received much attention, only a handful of studies have investigated the factors that protect victims of sexual trauma from developing this maladaptive pattern of behavior. The current study investigated the protective role of social support, quality and quantity, in…

  11. Well-Being and Trauma in Adults Displaced by Political Violence

    Directory of Open Access Journals (Sweden)

    Raymundo Abello-Llanos

    2009-06-01

    Full Text Available This study studied Subjective and Objective Psychological Well-being, andFatalism, Trauma and Irrational Posttraumatic Cognitions, in adults displacedby socio-political violence, living in Barranquilla, Colombia. Outcomessuggest that people who have been victims of forced displacement exhibitundeniable symptoms of psychosocial trauma, and that they also have elementsassociated to Mental Health.

  12. Date Rape: Its Relationship to Trauma Symptoms and Sexual Self-Esteem.

    Science.gov (United States)

    Shapiro, Brenda L.; Schwarz, J. Conrad

    1997-01-01

    Extends previous research on date rape by assessing trauma symptoms and sexual self-esteem among college women who had, or who had not, been raped. Results indicate that rape victims had significantly more trauma symptoms and lower sexual self-esteem compared to other women, thus suggesting date rape's significant consequences. (RJM)

  13. [Treatment strategies for mass casualty incidents and terrorist attacks in trauma and vascular surgery : Presentation of a treatment concept].

    Science.gov (United States)

    Friemert, B; Franke, A; Bieler, D; Achatz, A; Hinck, D; Engelhardt, M

    2017-10-01

    The treatment of patients in the context of mass casualty incidents (MCI) represents a great challenge for the participating rescue workers and clinics. Due to the increase in terrorist activities it is necessary to become familiar with this new kind of threat to civilization with respect to the medical treatment of victims of terrorist attacks. There are substantial differences between a "normal" MCI and a terrorist MCI with respect to injury patterns (blunt trauma vs. penetrating/perforating trauma), the type and form of the incident (MCI=static situation vs. terrorist attack MCI= dynamic situation) and the different security positions (rescue services vs. police services). This article is concerned with question of which changes in the surgical treatment of patients are made necessary by these new challenges. In this case it is necessary that physicians are familiar with the different injury patterns, whereby priority must be given to gunshot and explosion (blast) injuries. Furthermore, altered strategic and tactical approaches (damage control surgery vs. tactical abbreviated surgical care) are necessary to ensure survival for as many victims of terrorist attacks as possible and also to achieve the best possible functional results. It is only possible to successfully counter these new challenges by changing the mindset in the treatment of terrorist MCI compared to MCI incidents. An essential component of this mindset is the acquisition of a maximum of flexibility. This article would like to make a contribution to this problem.

  14. The emotional challenges faced by Sexual Assault Nurse Examiners: "ER nursing is stressful on a good day without rape victims".

    Science.gov (United States)

    Maier, Shana L

    2011-12-01

    Although research has indicated that counselors, advocates and social workers who assist rape victims experience vicarious trauma or psychological consequences as a result of their exposure to victims' traumatic experiences, little is known about Sexual Assault Nurse Examiners' (SANEs') experiences. This qualitative research explores SANEs' experiences of vicarious trauma and burnout as a result of treating rape victims, and the coping strategies they implement to reduce both. Data from interviews with 39 SANEs reveal that when asked about their difficulties as a SANE and the hardest part of their job, the majority (67%) discussed vicarious trauma, the emotional demands associated with the job, worrying about victims after they leave the hospital, and burnout. More than half (51%) of SANEs interviewed specifically indicated that they have experienced vicarious trauma as a result of treating rape victims, and 46% indicated they have experienced burnout at least to some degree. All SANEs, regardless of whether they believe they have experienced vicarious trauma or burnout, have ways to cope after hard cases. These coping mechanisms include talking to family members, calling or reaching out to other SANEs, program coordinators or rape victim advocates and detectives, participating in meetings with other SANEs where the focus is on problems after difficult cases, and finding relaxing activities. © 2011 International Association of Forensic Nurses.

  15. Urethral trauma

    International Nuclear Information System (INIS)

    Carrington, B.M.; Hricak, H.; Dixon, C.; McAninch, J.W.

    1990-01-01

    This paper evaluates the role of MR imaging in posterior urethral trauma. Fifteen patients with posttraumatic membranous urethral strictures underwent prospective MR imaging with a 1.5-T unit before open urethroplasty. All patients had transaxial T1-weighted (500/20) and T2-weighted (2,500/70) spin-echo images and T2-weighted sagittal and coronal images (matrix, 192 x 256; section thickness, 4 mm with 20% gap). Conventional retrograde and cystourethrography were performed preoperatively. Compared with conventional studies, MR imaging defined the length and location of the urethral injury and provided additional information regarding the direction and degree of prostatic and urethral dislocation

  16. Symptoms of PTSD in a sample of female victims of sexual violence in post-earthquake Haiti.

    Science.gov (United States)

    Rahill, Guitele J; Joshi, Manisha; Lescano, Celia; Holbert, Dezeray

    2015-03-01

    Globally, sexual violence (SV) impacts 25-33% of women, is often perpetrated by intimate partners and occurs even post-disasters. The 2010 Haiti earthquake occasioned a SV epidemic in Cité Soleil, where over 50% of females are reportedly victims of SV via non-intimate partners/strangers (NPSV). Little is known about the psychological effects of SV perpetrated by NPSV; even less in known about the biopsychosocial consequences of NPSV on women in Haiti. Yet, the World Health Organization recently called for research on NPSV, particularly in poor and disaster-affected countries. As a first step in categorizing the consequences of NPSV on female victims in Haiti, we conducted 2 focus groups of 16 female residents of Cité Soleil who survived the earthquake and its aftershocks, along with ensuing hurricanes and cholera. Participants reported rapes by strangers who intentionally "crush the uterus." All endorsed criteria for PTSD, including enduring physiological, neurological and psychological symptoms: significant intrusive, avoidance, arousal, cognitive, mood changes, as well as significant distress/impairment in various areas of functioning; and all but one became pregnant from the experience. All denied substance use and other illness that is not associated with the sexual violence. Our study was exploratory, targeting a small sample of women in one specific neighborhood and cannot be generalized to all SV victims in Haiti. Following earthquakes, there should be vigilance by public health officials and rescue teams for prevention of SV against women. Women who survive SV in Haiti should be provided access to trauma-informed care that addresses biological consequences of the SV, as well as biological, neurological and psychological sequelae. Copyright © 2014 Elsevier B.V. All rights reserved.

  17. Images in kidney trauma

    International Nuclear Information System (INIS)

    Rodriguez, Jose Luis; Rodriguez, Sonia Pilar; Manzano, Ana Cristina

    2007-01-01

    A case of a 3 years old female patient, who suffered blunt lumbar trauma (horse kick) with secondary kidney trauma, is reported. Imaging findings are described. Renal trauma classification and imaging findings are reviewed

  18. Violación y trauma desde una perspectiva histórica

    OpenAIRE

    Bourke, Joanna

    2010-01-01

    Trauma is not a universal way of speaking about the effects of “bad events” but is socially constructed. In the case of rape, psychological trauma is a relatively recent way of conceptualising the aftermath of violence. This article examines the development within psychiatric, legal, and forensic textbooks of the notion of “trauma” in reference to rape victims, and investigates the reasons for its relatively recent application.

    El trauma no constituye una forma universal de...

  19. Perpetrator or victim?

    DEFF Research Database (Denmark)

    Hansen, Helle Rabøl

    Paper 3: HAN091384 Victim, Perpetrator and Pupil - Teacher Perspectives on Peer Bullying Helle Rabøl Hansen, University of Aarhus This paper investigates the approaches and strategies taken up by two crucial actors in relation to bullying in schools: 1. documents indicating school policies...... and identifies a legally informed matrix, which points out unequivocal positions of perpetrators and victims. The policy document mixes the definition practices, which derive from the Olweus tradition on bullying research, into a law informed kind of discourse. Subsequently the policy document iterates...

  20. Psychosocial Factors Influencing Competency of Children's Statements on Sexual Trauma

    Science.gov (United States)

    Kim, Tae Kyung; Choi, Soul; Shin, Yee Jin

    2011-01-01

    Objectives: The objectives of this study are to assess children's competence to state their traumatic experience and to determine psychosocial factors influencing the competency of children's statements, such as emotional factors of children and parents and trauma-related variables, in Korean child sex abuse victims. Methods: We enrolled 214…

  1. The Secondary Traumatic Stress Scale: Confirmatory Factor Analyses With a National Sample of Victim Advocates.

    Science.gov (United States)

    Benuto, Lorraine T; Yang, Yueran; Ahrendt, Andrew; Cummings, Caroline

    2018-03-01

    Secondary traumatic stress (STS) is a pattern of psychological symptoms that approximates the symptoms of posttraumatic stress disorder (PTSD) and occurs in professionals who are exposed to individuals who have experienced trauma. While victim advocates are frontline health professionals who are trained to support victims of crime and interpersonal violence and are at risk for developing STS, they have been largely neglected in the extant literature on STS. The STS Scale (STSS) is a 17-item self-report questionnaire utilized to assess frequency of symptoms of intrusion, avoidance, and arousal, specifically related to providing services to victims of trauma. The purpose of this study was to investigate the psychometric properties of the STSS with a sample of victim advocates ( N = 135) using confirmatory factor analysis (CFA). Results indicated that both a single-factor model and three-factor model were equivalent. This study represents a first attempt to validate a measure of STS among victim advocates, a unique and understudied population who are at risk for developing STS given their work with individuals who have experienced interpersonal violence. Establishing effective, easy to administer, and efficient measures of STS is important given that this population encounters secondary trauma on a regular basis in the context of their job. While additional theoretical work regarding the construct of STS is needed, the STSS did demonstrate high reliability with this population and thus can be used as part of the assessment of STS among victim advocates.

  2. Counseling Torture Victims.

    Science.gov (United States)

    Whittaker, Shaun R.

    1988-01-01

    Addresses the psychological effects of torture (including solitary confinement) and the implications of torture for counseling and the counseling psychology profession. Discusses counseling issues related to diagnosis of torture victims, treatment, special considerations for counselors, use of testimony as counseling technique, and prognosis.…

  3. Between "Victims" and "Criminals"

    DEFF Research Database (Denmark)

    Plambech, Sine

    2014-01-01

    This article is about the lives of Nigerian sex workers after deportation from Europe, as well as the institutions that intervene in their migration trajectories. In Europe, some of these women's situations fit the legal definitions of trafficking, and they were categorized as “victims of human...

  4. Adolescent sexual victimization

    DEFF Research Database (Denmark)

    Bramsen, Rikke Holm; Lasgaard, Mathias; Koss, Mary P

    2012-01-01

    The present study set out to investigate predictors of first time adolescent peer-on-peer sexual victimization (APSV) among 238 female Grade 9 students from 30 schools in Denmark. A prospective research design was utilized to examine the relationship among five potential predictors as measured...

  5. The mediating role of shame in the relationship between childhood bullying victimization and adult psychosocial adjustment

    Science.gov (United States)

    Strøm, Ida Frugård; Aakvaag, Helene Flood; Birkeland, Marianne Skogbrott; Felix, Erika; Thoresen, Siri

    2018-01-01

    ABSTRACT Background: Psychological distress following experiencing bullying victimization in childhood has been well documented. Less is known about the impact of bullying victimization on psychosocial adjustment problems in young adulthood and about potential pathways, such as shame. Moreover, bullying victimization is often studied in isolation from other forms of victimization. Objective: This study investigated (1) whether childhood experiences of bullying victimization and violence were associated with psychosocial adjustment (distress, impaired functioning, social support barriers) in young adulthood; (2) the unique effect of bullying victimization on psychosocial adjustment; and (3) whether shame mediated the relationship between bullying victimization and these outcomes in young adulthood. Method: The sample included 681 respondents (aged 19–37 years) from a follow-up study (2017) conducted via phone interviews derived from a community telephone survey collected in 2013. Results: The regression analyses showed that both bullying victimization and severe violence were significantly and independently associated with psychological distress, impaired functioning, and increased barriers to social support in young adulthood. Moreover, causal mediation analyses indicated that when childhood physical violence, sexual abuse, and sociodemographic factors were controlled, shame mediated 70% of the association between bullying victimization and psychological distress, 55% of the association between bullying victimization and impaired functioning, and 40% of the association between bullying victimization and social support barriers. Conclusions: Our findings support the growing literature acknowledging bullying victimization as a trauma with severe and long-lasting consequences and indicate that shame may be an important pathway to continue to explore. The unique effect of bullying victimization, over and above the effect of violence, supports the call to integrate

  6. Trauma in the elderly caused by traffic accident: integrative review

    Directory of Open Access Journals (Sweden)

    Ana Maria Ribeiro dos Santos

    2015-02-01

    Full Text Available OBJECTIVE To describe the scientific knowledge produced about trauma in the elderly caused by traffic accidents in healthcare area studies. METHODS Integrative review of studies from 2003 to 2013 searched in LILACS, SciELO, PubMed and CINHAL databases. We used combination of the descriptors injuries, wounds and accidents, in English, Portuguese and Spanish languages. RESULTS 32 studies were selected. In the thematic analysis, three categories emerged: epidemiological data from traffic accidents involving elderly; traffic accidents with elderly pedestrians; and trauma care in the elderly. We observed increased incidence of trauma in most countries and pedestrians represented a large part of the victims. Among these, the elderly are the most vulnerable group. CONCLUSION Studies showed that trauma care in the elderly need protocols and professionals with training in gerontology specialized in trauma care services.

  7. Trauma and homelessness in youth: Psychopathology and intervention.

    Science.gov (United States)

    Davies, Benjamin R; Allen, Nicholas B

    2017-06-01

    Youth runaway behavior and homelessness (RHY) in the U.S. is increasingly common, with prevalence estimated at 1-1.7 million youth. RHY have multiple, overlapping problems often including poor physical and mental health, frequent street victimization, and histories of physical and sexual abuse. Further, current street victimization interacts with childhood abuse to produce complex, unique presentations of traumatic symptoms and related disorders in runaway and homeless youth. This review paper explores (1) the role of childhood trauma in the genesis of runaway and homeless behavior, and (2) how childhood trauma interacts with street victimization to create vulnerability to psychopathology. In response to the trauma needs of RHY, we conducted a systematic review of the state of the current literature on trauma-informed interventions for RHY. We conclude that the field currently lacks empirically validated trauma interventions in RHY. However, theoretically plausible frameworks do exist and could be the basis for future research and intervention development. Copyright © 2017 Elsevier Ltd. All rights reserved.

  8. A Danish model for treating victims of rape and sexual assault: The multidisciplinary public approach

    DEFF Research Database (Denmark)

    Bramsen, Rikke Holm; Elklit, Ask; Nielsen, Louise Hjort

    2009-01-01

    Most centers for rape and sexual assault victims today build on the original principles proposed in Boston by Burgess and Holmstrom in the 1970s (Burgess & Holmstrom, 1973; Burgess, 2006). In line with technological advances, scientific developments, and societal changes, the standards...... of and the framework behind these centers must be assessed and developed further to accommodate the growing need for rape trauma services in Europe and worldwide. This paper describes the experiences of a public Danish center for rape victims and proposes a management model for current and future rape victim centers....

  9. Sobrevivência após acidentes de trânsito: impacto das variáveis clínicas e pré-hospitalares Sobrevida después de accidentes de tránsito: impacto de las variables clínicas y pre hospitalarias Survival after motor vehicle crash: impact of clinical and prehospital variables

    Directory of Open Access Journals (Sweden)

    Marisa Aparecida Amaro Malvestio

    2008-08-01

    Full Text Available OBJETIVO: Analisar as variáveis clínicas e pré-hospitalares associadas à sobrevivência de vítimas de acidente de trânsito. MÉTODOS: Estudo realizado no município de São Paulo, SP, de 1999 a 2003. Foram analisados dados de 175 pacientes, entre 12 e 65 anos, vitimados por acidente de trânsito. A Análise de Sobrevivência de Kaplan-Meier foi utilizada na abordagem dos resultados na cena do acidente com as vítimas de escore OBJETIVO: Analizar las variables clínicas y pre hospitalarias asociadas a la sobrevida de víctimas de accidentes del tránsito. MÉTODOS: Estudio realizado en el municipio de São Paulo (Sudeste de Brasil, de 1999 a 2003. Fueron analizados datos de 175 pacientes, entre 12 y 65 años, victimas de accidentes de tránsito. El análisis de Sobrevida de Kaplan-Meier fue utilizado en el abordaje de los resultados en la escena del accidente con las víctimas de score OBJECTIVE: To assess clinical and prehospital variables associated with survival of motor vehicle crash victims. METHODS: Study carried out in the city of São Paulo (Southeastern Brazil, from 1999 to 2003. Data from 175 patients, who were aged between 12 and 65 years and had been motor vehicle crash victims, were analyzed. Kaplan-Meier Survival Analysis was used to approach the results at the accident scene with victims scoring <11, according to the Revised Trauma Score. Variables analyzed were: sex, age, injury mechanisms, basic and advanced support procedures, Revised Trauma Score parameters and fluctuations, time elapsed in the prehospital phase and trauma severity according to the Injury Severity Score and Maximum Abbreviated Injury Scale. RESULTS: Analysis revealed that victims who were less likely to survive during the hospitalization period showed serious lesions in the abdomen, thorax, or lower limbs, with negative fluctuation of respiratory frequency and Revised Trauma Score in the prehospital phase. In addition, they needed specialized

  10. Thoracic trauma: analysis of 100 consecutive cases

    Directory of Open Access Journals (Sweden)

    Maíra Benito Scapolan

    2010-09-01

    Full Text Available Objective: To analyze thoracic trauma assisted by the EmergencyService of Hospital da Irmandade da Santa Casa de Misericórdia deSão Paulo. Methods: One hundred patients with thoracic trauma wereassisted throughout six months in 2006. Data from their records werecollected and a protocol of thoracic trauma was fulfilled. The RevisedTrauma Score was used to evaluate gravity of injury and to calculatethe survival index. Results: Prevalence of trauma injury in male from20 to 29 years old was observed. Out of all patients, 44 had blunttrauma and 56 penetrating trauma (78.6% presented stab woundsand 21.4% gun shots. Up to the settings of injuries, 23% were in thethoracoabdominal transition, 7% in the precordium and 70% in theremainder thoracic area. In those with the thoracoabdominal transitioninjury, 22.7% were hemodynamically unstable and 77.3% stable.Thoracoabdominal injury patients presented 40.9% of diaphragmwound and all were stable. Of those with precordium wound, 37.5%presented cardiac injury. In cardiac onset, 66.7% presented stableand 33.3% unstable. Thoracic drainage was the most accomplishedsurgical procedure (71%. Conclusions: The thoracic trauma patientis most prevalently young male with stab wound penetrating injury,without associated injuries, hemodynamically stable, presentinghemothorax, with high probability of survival.

  11. Unmet needs and service satisfaction of victim support for the direct and indirect victims of serious violence: Results from a cross-sectional survey in Taiwan.

    Directory of Open Access Journals (Sweden)

    Lanying Huang

    Full Text Available Victim support services, in mature societies, aim to help victims recover after suffering a traumatic event. The effectiveness of victim support has traditionally been evaluated through rates of service utilization and incidence of psychopathology such as posttraumatic stress disorder. The current study, instead, inquires into service users' unmet needs and satisfaction, and identifies factors that mediate such subjective measures, using data from a national cross-sectional survey on victims and surviving families of violent crime in Taiwan in 2011. The results reveal: 1 a gap between available and expected services, and 2 a correlation between service utilization and satisfaction, both consistent with previous studies. In addition, the current study identifies unsatisfied service users: They are homicidally bereaved, live with their spouse, suffer from post-crime financial distress and are still waiting for a court verdict on the incident. Victim support that helps victims heal through tailored services incorporating relationship counseling is proposed.

  12. Trauma Symptoms in Abused Children

    Directory of Open Access Journals (Sweden)

    Parvaneh Mohammadkhani

    2003-07-01

    Full Text Available Objective: There are many traumatic events (including natural disasters, physical, psychological and sexual abuse that may befall children and there is clear evidence that such experiences can produce a plethora of negative psychological effects. Children’s exposure to such traumas has been associated with a wide variety of negative mental health outcomes, including anxiety and depression, post-traumatic stress and dissociation and anger and aggression. It seems that the impacts of traumatic events are significantly related to type and intensity of trauma. Materials & Method: Through a systematized clustral sampling 3042 male and female students from junior high school who were participated in a survey study for investigating point prevalence of child abuse, completed Trauma Symptoms Checklist for Children-Alternate Version (TSCC-A and Child Abuse Self-report Scale (CASRS. After recognition of abused children, they were compared based on trauma symptoms. TSCC-A is a self-report measure of post-traumatic distress and related psychological symptomatology in male and female children aged 8-16 years. It is useful in the evaluation of children who have experienced traumatic events, including physical and sexual assault, victimization by peers, major losses, the witnessing of violence done to others and natural disasters. TSCC-A makes no reference to sexual issues. CASRS is a self-report scale to assess child abuse and neglect with 38 items and four subscales (psychological abuse, neglect, physical and sexual abuse. Results: Considering the type of traumatic experiences, the results showed that abused children significantly received higher scores in scales and subscales of TSCC-A than nonabused group. They specially reported more symptoms (depression, anxiety, post-traumatic stress, anger and dissociation comparing normal children. Conclusion: It is concluded that the type and rate of traumatic event is related to intensity of symptomatology.

  13. Predictors of trauma in bank employee robbery victims

    OpenAIRE

    Mucci, Nicola; Giorgi, Gabriele; Perez, Javier Fiz; Iavicoli, Ivo; Arcangeli, Giulio

    2015-01-01

    Nicola Mucci,1 Gabriele Giorgi,2 Javier Fiz Perez,2 Ivo Iavicoli,1 Giulio Arcangeli3 1Institute of Public Health, Catholic University of Sacred Heart, Rome, Italy; 2Department of Psychology, European University of Rome, Rome, Italy; 3Department of Clinical and Experimental Medicine, University of Florence, Florence, Italy Abstract: In the literature, there are many studies that have investigated the psychological reactions resulting from traumatic events of varying degrees, such as wars, na...

  14. Sexual Violence, Bodily Pain, and Trauma: A History

    Science.gov (United States)

    Bourke, Joanna

    2014-01-01

    Psychological trauma is a favoured trope of modernity. It has become commonplace to assume that all ‘bad events’ – and particularly those which involve violence – have a pathological effect on the sufferer’s psyche, as well as that of the perpetrators. This essay explores the ways victims of rape and sexual assault were understood in psychiatric, psychological, forensic, and legal texts in Britain and America from the 19th to the late 20th century. It argues that, unlike most other ‘bad events’, which were incorporated within trauma narratives from the 1860s, the ascription of psychological trauma was only applied to rape victims a century later. Why and what were the consequences? PMID:24790284

  15. The Role of Troponin in Blunt Cardiac Injury After Multiple Trauma in Humans.

    Science.gov (United States)

    Kalbitz, Miriam; Pressmar, Jochen; Stecher, Johanna; Weber, Birte; Weiss, Manfred; Schwarz, Stephan; Miltner, Erich; Gebhard, Florian; Huber-Lang, Markus

    2017-01-01

    The incidence of cardiac injury in immediate fatalities after blunt trauma remains underestimated, and reliable diagnostic strategies are still missing. Furthermore, clinical data concerning heart-specific troponin serum levels, injury severity score (ISS), catecholamine treatment and survival of patients on admission to the hospital have rarely been interrelated so far. Therefore, the object of the present study was to identify predictive parameters for mortality in the context of blunt cardiac injury. This retrospective observational study included 173 severely injured patients with an ISS ≥25 admitted to the University Hospital of Ulm, a level 1 trauma center, during 2009-2013 . Furthermore, 83 blunt trauma victims who died before hospital admission were subjected to postmortem examination at the Institute of Legal Medicine, University of Ulm, during 2009-2014. ISS, cardiac injury and associated thoracic injuries were determined in both groups. Furthermore, in the hospitalized patients, serum troponin and IL-6 levels were measured. Macroscopic heart injury was observed in 18 % of the patients who died at the scene and only in 1 % of the patients admitted to the hospital, indicating that macroscopic heart injury is associated with an immediate life-threatening condition. Troponin levels were elevated in 43 % of the patients after admission to the hospital. Moreover, troponin serum concentrations were significantly higher in patients treated with norepinephrine (26.4 ± 4 ng/l) and in non-survivors (84.9 ± 22.8 ng/l) compared to patients without catecholamines and survivors, respectively. Macroscopic heart injury was 20 times more frequent in non-survivors than in survivors. Serum troponin levels correlated with mortality after multiple injury and therefore may represent a valuable prognostic marker in trauma patients.

  16. Attitudes toward victim and victimization in the light of the just world theory

    Directory of Open Access Journals (Sweden)

    Simeunović-Patić Biljana

    2017-01-01

    Full Text Available The present paper discusses current empirical status of the Just world theory introduced several decades ago by Melvin Lerner, the content and functions of a just world belief as its central construct, and particularly, the relation between a just world belief and victim blaming and victim derogation phenomena. In the light of existing research evidence, a just world belief and a need to re-establish a “justice” when this belief is threatened, is considered to be an adaptive mechanism that protect a belief that a world is secure and the future is predictable, as well as a confidence in the purposefulness of selfdiscipline, long-term personal investments and social rules respecting. As proposed By the just world theory, when a person faces injustice, i.e. others’ (innocent victims’ suffering, his/her belief in a just world is threatened. Possible reactions to that threat comprise various rational victim helping activities, but also specific cognitive defensive strategies, including cognitive distortion, rationalization and reinterpretation of an event in order to minimize injustice or deny injustice happened at all. In the course of reinterpretation of injustice, victims are often blamed for their former actions, or derogated for their character, in order to indicate them responsible for their own fate and suffering. The findings of research studies suggest that the likelihood of employing cognitive defensive strategies rises if formal responses to crime and victimization lack or fail. This further suggests that an efficient and effective formal social response in terms of both sanctioning of offenders and reparation of victims should be considered highly important in reducing the risk of stigmatization and rejection of victims. Finally, the paper discusses the role of victim’s just world beliefs in post-trauma adaptation and coping processes. In virtue of findings from the existing research literature it may be concluded that victim

  17. A Civilian/Military Trauma Institute: National Trauma Coordinating Center

    Science.gov (United States)

    2012-10-01

    maxillofacial Trauma, Trauma Mental Health, Neurosurgery, Craniofacial, Anesthesiology, and Burn Surgery . Page | 5 A. National Coordinating...research information to the trauma community 3. Breakouts included; Trauma/Critical Care, Orthopedic Trauma, Emergency Care, Trauma Nursing, Oral ...was presented at the 2012 Annual American Association for the Surgery of Trauma (AAST) meeting in September 2012, in Kauai, Hawaii (Appendix A

  18. Aggression Using a Knife or Other Sharp Instruments and Oral-Maxillofacial Traumas: Incidence, Risk Factors, and Epidemiologic Trends.

    Science.gov (United States)

    Santos, Luzia Michelle; Bernardino, Italo M; Ferreira Porto, Alysson Vinicius; Nórbrega Barbosa, Kevan Guilherme; Marques da Nóbrega, Lorena; d'Avila, Sérgio

    2018-01-31

    The aim of the present study was to characterize the profile of victims of interpersonal physical violence (IPV) caused by a knife or other sharp instrument, identify the factors associated with maxillofacial trauma, and examine the incidence of maxillofacial trauma over time. In a retrospective cohort study, we evaluated 569 medicolegal and social records of IPV victims by knife or other sharp instruments treated at a forensic medicine and dentistry center in Brazil during a 4-year consecutive period. The variables investigated were related to the sociodemographic characteristics of the victims, circumstances of the aggression, and trauma patterns. Descriptive and multivariate statistics through Poisson regression and trend analysis with the creation of polynomial regression models were used. The cumulative incidence of oral-maxillofacial trauma was 19.3%. The mean age of the victims was 31.29 ± 13.82 years. Cases of trauma affecting more than one region of the face prevailed (45.5%). Based on the final Poisson regression model, unemployed people were more likely to exhibit maxillofacial trauma (relative risk [RR] 1.86; 95% confidence interval [CI] 1.03-3.35; P = .039). In addition, individuals were more likely to experience maxillofacial trauma on Wednesdays (RR 1.85; 95% CI 1.01-3.37; P = .045). The trend analysis revealed a significant increase in oral-maxillofacial injuries over time (P maxillofacial trauma was high, and the main factors associated with trauma were the victim's employment status and day of occurrence. Future studies will focus on assessing the effect of maxillofacial trauma on the quality of life and well-being of violence victims. Copyright © 2018. Published by Elsevier Inc.

  19. Victimes d'inceste en maternité. État des lieux de la connaissance et des pratiques des sages-femmes

    OpenAIRE

    Ambroise, Adélaide

    2013-01-01

    Incest victims in maternity: knowledge and practices of midwives. Up to 3% of the French population are victims of incest. This trauma can lead to serious consequences for women, especially during pregnancy and motherhood. Our objective is to evaluate the knowledge, the professional practice and the feeling of midwives regarding incest. It has been done to define their training needs so that female victims can benefit from suitable follow up. The study is qualitative; 93 midwives, working in ...

  20. Sexual violation and trauma in historical perspective

    Directory of Open Access Journals (Sweden)

    Bourke, Joanna

    2010-06-01

    Full Text Available Trauma is not a universal way of speaking about the effects of “bad events” but is socially constructed. In the case of rape, psychological trauma is a relatively recent way of conceptualising the aftermath of violence. This article examines the development within psychiatric, legal, and forensic textbooks of the notion of “trauma” in reference to rape victims, and investigates the reasons for its relatively recent application.

    El trauma no constituye una forma universal de expresión de los efectos de un “suceso desagradable” sino que es construido socialmente. En el caso de la violación, el trauma psicológico es una forma relativamente reciente de conceptualizar las consecuencias de la agresión. En este artículo se examina el desarrollo de la noción de trauma en manuales psiquiátricos, legales y forenses, a propósito de las víctimas de violación, y se investigan las razones para su relativamente reciente puesta en práctica.

  1. Violent and Fatal Youth Trauma: Is There a Missed Opportunity?

    Directory of Open Access Journals (Sweden)

    Robert Madlinger, DO

    2012-05-01

    Full Text Available Introduction: Accidents and assaults (homicides are the leading causes of death among the youth of the United States, accounting for 53.3% of deaths among children aged 1 to19 years. Victim recidivism,defined as repeated visits to the emergency department (ED as a victim of violent trauma, is a significantly growing public health problem. As 5-year mortality rates for recidivism are as high as 20%,it is important to determine whether victims with a history of violent trauma are at increased risk for fatal outcome with their next trauma. We hypothesized that victims of violent trauma who have had 1 prior ED visit for violent trauma will have increased odds of fatal outcome.Methods: A retrospective chart review was conducted for patients presenting with penetrating trauma to the ED from January 1, 1999 to December 31, 2009. All patients between the ages of 15 to 25 years who presented to the ED for any penetrating trauma were included. Patients with prior presentations for penetrating trauma were compared to those patients who were first-time presenters to determine the odds ratio of fatal outcome.Results: Overall, 15,395 patients were treated for traumatic presentations. Of these, 1,044 met inclusion criteria. Demographically, 79.4% were Hispanic, 19.4% were African American, and 0.96% were Caucasian. The average age was 21 years, and 98% of the population was male. One hundred and forty-seven (14% had prior presentations, and 897 (86% did not. Forty of the 147 patients (27%with prior presentations had a fatal outcome as compared to 29 patients of the 868 (3% without prior presentations, with odds ratio of 10.8 (95% confidence interval, 6.4–18.1; Pearson v2, P , 0.001. The 5-year mortality rate for those patients with fatal outcomes was calculated at 16.5%.Conclusion: Patients who had prior ED visits for penetrating trauma were at greater risk for fatal outcomes compared to those with no prior visits. Therefore, trauma-related ED visits might

  2. Contratransferência e trauma psíquico Countertransference and psychic trauma

    Directory of Open Access Journals (Sweden)

    Mariana Eizirik

    2006-12-01

    Full Text Available O objetivo deste artigo é revisar aspectos importantes da relação entre a contratransferência e o atendimento de pacientes vítimas de trauma psíquico. O tratamento de pessoas traumatizadas é potencialmente uma fonte de sofrimento psíquico também para os terapeutas, devido à grande carga emocional envolvida, bem como pelas chances de evocar fortes reações contratransferenciais. Um maior entendimento acerca deste processo poderá contribuir decisivamente para os resultados dos tratamentos, além de possibilitar a proteção e a prevenção da saúde mental dos terapeutas. Inicialmente, aborda-se o trauma a partir de seu conceito e definições, incluindo considerações sobre o transtorno de estresse pós-traumático, estendendo-se para a conceitualização de contratransferência e seu significado no contexto das situações traumáticas. O impacto de tratar pacientes vítimas de trauma será também exposto através da relevância do fenômeno de traumatização vicária, cuja compreensão vem sendo destacada como indispensável para um melhor atendimento de vítimas de traumas psicológicos.This article aims at reviewing important aspects of the relationship between countertransference and care of patients who were victims of psychic trauma. The treatment of traumatized patients is a potential source of psychic suffering to their therapists as well, due to the emotional burden involved and to the chances of evoking strong countertransferential reactions. A better understanding of this process could be a valuable contribution to treatment outcome, besides promoting mental health protection and prevention for therapists. Firstly, psychic trauma will be approached from its concept and definitions, including considerations on posttraumatic stress disorder and extending to countertransference reactions and their meaning in the context of traumatic situations. The impact of treating trauma victims will also be discussed through the

  3. Trauma, attentional biases, and revictimization among young adults.

    Science.gov (United States)

    Reichert, Elizabeth; Segal, Caroline; Flannery-Schroeder, Ellen

    2015-01-01

    Individuals with previous histories of trauma are at increased risk for subsequent victimization and the development of posttraumatic stress disorder, depression, and anxiety disorders. Attentional biases to threat-related stimuli are thought to impact one's ability to recognize future risk in his or her environment and may explain high rates of revictimization. Although the literature has identified three possible types of attentional biases among victims of trauma (i.e., interference, facilitation, and avoidance), findings are mixed. The current study examined attentional biases to threats among a sample of men and women with no, some, and multiple incident interpersonal and non-interpersonal trauma histories. It was hypothesized that those with multiple incident interpersonal trauma histories would demonstrate an interference effect (i.e., slower response times to threat-related words). Participants (N = 309) were 18- to 29-year-old college students. Self-report measures assessed trauma history, posttraumatic stress, and other psychological sequelae. Attentional biases were assessed using a dot probe computer task. Contrary to hypotheses, no significant differences in response times in the presence of threat-related words or neutral words were found among groups. Results suggest that multiple traumatized individuals do not exhibit attentional bias to threats compared to individuals with some or no trauma.

  4. Betrayal trauma among homeless adults: associations with revictimization, psychological well-being, and health.

    Science.gov (United States)

    Mackelprang, Jessica L; Klest, Bridget; Najmabadi, Shadae J; Valley-Gray, Sarah; Gonzalez, Efrain A; Cash, Ralph E Gene

    2014-04-01

    Betrayal trauma theory postulates that traumas perpetrated by a caregiver or close other are more detrimental to mental health functioning than are traumatic experiences in which the victim is not affiliated closely with the perpetrator. This study is the first to examine the concept of betrayal among a sample of individuals with a history of homelessness. A total of 95 homeless or formerly homeless adults completed the Brief Betrayal Trauma Survey, the Posttraumatic Stress Disorder Checklist-Civilian Version, the Center for Epidemiologic Studies Depression Scale the Perceived Stress Scale, and a demographics questionnaire assessing participants' histories of homelessness, health, and relationships with their families. Regression analyses were conducted to explore the associations between high betrayal (HB) and low betrayal (LB) trauma exposure, relationship with family, and physical and mental health symptoms. Exposure to HB traumas in childhood and poor family relationships predicted earlier age at first episode of homelessness, and participants who had been exposed to a greater number of traumas during childhood were more likely to be revictimized during adulthood. Trauma exposure as an adult and earlier age of first homeless episode predicted symptoms of posttraumatic stress disorder, while trauma exposure alone predicted symptoms of depression and perceived stress. Number of medical diagnoses was associated with trauma exposure and becoming homeless at an older age. These findings emphasize that even among the most marginalized and multiply victimized individuals in our society, traumas that are characterized by a higher degree of betrayal are associated with more adverse outcomes.

  5. Patterns of injury seen in road crash victims in a South African ...

    African Journals Online (AJOL)

    Patterns of injury seen in road crash victims in a South African trauma centre. F Parkinson, S Kent, C Aldous, G Oosthuizen, DL Clarke. Abstract. Background. Road traffic crashes (RTCs) account for a significant burden of disease in South Africa. This prospective study reviews basic demographic and outcome data of ...

  6. Alcohol consumption in victims of violence : A trend study for the period 1970-1998

    NARCIS (Netherlands)

    Kingma, J

    2000-01-01

    This 29-yr. retrospective study is about alcohol consumption by victims of violence intentionally injured (N = 13,048) and general patients unintentionally injured (N=296,544) who were treated for their injuries at the Trauma Center of the University Hospital Groningen (The Netherlands) during the

  7. The Child Welfare Response to Serious Nonaccidental Head Trauma

    Science.gov (United States)

    Jaudes, Paula Kienberger; Bilaver, Lucy A.

    2004-01-01

    Serious nonaccidental head trauma (NHT) can leave permanent neurological damage in children who survive abuse. This study reports on child welfare's handling of NHT cases compared with cases of physical abuse and head trauma due to neglect with regard to placement in foster care, reunification with family, and safety issues. The results show that…

  8. Nature and Outcome of Prehospital Care in an Informal Trauma ...

    African Journals Online (AJOL)

    Objective: Our aim was to describe the features of prehospital management in our region with no formal trauma system, and measure its effectiveness using survival and complication as outcome parameters. Patients and Methods: This is a prospective analysis of prehospital management of the injured in an informal trauma

  9. Is sexual victimization gender specific?

    DEFF Research Database (Denmark)

    Sundaram, Vanita; Laursen, Bjarne; Helweg-Larsen, Karin

    2008-01-01

    The present study investigates the prevalence of sexual victimization and correlations between sexual victimization and indicators of poor health in two representative samples of men and women in Denmark. Specifically, the authors explore the prevalence of self-reported victimization among...... adolescents (N = 5,829) and adults (N = 3,932) and analyze differences in self-reported health outcomes between male and female victims and corresponding controls. Gender differences are found in the reported prevalence of sexual victimization. Significantly more females than males reported forced sexual...... experiences in both samples. Associations between sexual victimization and poor health outcomes are found for both genders. Comparable patterns of association for men and women are found on a number of variables, particularly those pertaining to risk behavior....

  10. The Relationship between Trauma, Arrest, and Incarceration History among Black Americans: Findings from the National Survey of American Life.

    Science.gov (United States)

    Jäggi, Lena J; Mezuk, Briana; Watkins, Daphne C; Jackson, James S

    2016-11-01

    Prior research indicates an association between exposure to trauma (e.g., being victimized) and perpetration of crime, especially in the context of chronic victimization. This study examines the relationship between trauma exposure, posttraumatic stress disorder (PTSD), and history of arrest and incarceration among a representative sample of black Americans from the National Survey of American Life (N = 5,189). One-third had a history of arrest, and 18 percent had a history of incarceration. Frequency of trauma exposure was associated with involvement with the criminal justice system. Relative to never experiencing trauma, experiencing ≥4 traumas was associated with elevated odds of arrest (odds ratio [OR] = 4.03), being jailed (OR = 5.15), and being imprisoned (OR = 4.41), all p history of trauma (OR = 2.18, p Americans.

  11. Road rage victimization among adolescents.

    Science.gov (United States)

    Smart, Reginald G; Stoduto, Gina; Adlaf, Edward M; Mann, Robert E; Sharpley, Justin M

    2007-09-01

    Although much has been learned about road rage among adults, data on road rage experiences among adolescents has not been available previously. We examine the prevalence and demographic correlates of road rage victimization based on a population survey of Ontario students. Based on the 2005 Ontario Student Drug Use Survey, a self-administered survey of Ontario students in grades 7-12 (n = 7726), the contribution of demographic factors (gender, region, driver's license status, grade, overall marks) to three road rage victimization measures was examined with logistic regression analysis. Just over half of students (53.2%) had been victims of shouts, curses and rude gestures in the past year, 8.9% were threatened with damage to their vehicle or personal injury and 6.2% experienced an attempt or actual damage to their vehicle or personal injury. Logistic regression analyses revealed that being a victim of shouting was significantly related to region, driver's license status, and grade. Victimization by threats was significantly related to gender, driver's license, grade, and marks. Being a victim of attempts or actual vehicle damage or injury was significantly related to region, driver's license, and marks. This study provides the first indication of prevalence of road rage victimization among adolescents. Road rage victimization in its milder form is common, involving just over half of Ontario students in grades 7-12. About 1 in 10 students were threatened with vehicle damage or personal injury, and about 1 in 20 were victims of attempts or actual damage or injury.

  12. Transfusion therapy in paediatric trauma patients

    DEFF Research Database (Denmark)

    Nystrup, Kristin Brønnum; Stensballe, Jakob; Bøttger, Morten

    2015-01-01

    Haemorrhage is a leading cause of death in paediatric trauma patients. Predefined massive transfusion protocols (MTP) have the potential to significantly reduce mortality by treating haemorrhagic shock and coagulopathy, in adhering to the principles of haemostatic resuscitation with rapid...... administration of balanced ratios of packed red blood cells (RBC), fresh frozen plasma (FFP) and platelets (PLT).Because of their substantial physiological reserve, initial vital signs may not be good predictors of early haemorrhage in paediatric patients. Determining the triggers for MTP activation...... in paediatric trauma patients is challenging, and the optimal blood product ratio that will increase survival in massively bleeding paediatric trauma patients has yet to be determined. To date, only a few small descriptive studies and case reports have investigated the use of predefined MTP in paediatric trauma...

  13. Korean atomic bomb victims.

    Science.gov (United States)

    Sasamoto, Yukuo

    2009-01-01

    After colonizing Korea, Japan invaded China, and subsequently initiated the Pacific War against the United States, Britain, and their allies. Towards the end of the war, U.S. warplanes dropped atomic bombs on Hiroshima and Nagasaki, which resulted in a large number of Koreans who lived in Hiroshima and Nagasaki suffering from the effects of the bombs. The objective of this paper is to examine the history of Korea atomic bomb victims who were caught in between the U.S., Japan, the Republic of Korea (South Korea) and the Democratic People's Republic of Korea (North Korea).

  14. Drug abuse in hospitalized trauma patients in a university trauma care center: an explorative study

    Directory of Open Access Journals (Sweden)

    A.R. Soroush

    2006-08-01

    Full Text Available Background: Drug abuse has been known as a growing contributing factor to all types of trauma in the world. The goal of this article is to provide insight into demographic and substance use factors associated with trauma and to determine the prevalence of drug abuse in trauma patients. Methods: Evidence of substance abuse was assessed in trauma patients presenting to Sina trauma hospital over a 3-month period. They were interviewed and provided urine samples to detect the presence of drug/metabolites of opium, morphine, cannabis and heroin by “Morphine Check” kits. Demographic data, mechanisms of injury, history of smoking and drug abuse were recorded. Results: A total of 358 patients with a mean age of 28.4 years were studied. The Patients were predominantly male (94.7%. There was a history of smoking in 136 cases (38%. 58 cases (16.2% reported to abuse drugs (91.5% opium. The commonest route of administration was smoke inhalation (37.2%. Screening by Morphine Check test revealed 95 samples to be positive (26.5%. The preponderance of test-positive cases was among young people (of 20-30 years of age with a history of smoking. Victims of violence and those with penetrating injuries also showed a higher percentage of positive screens (P=0.038 and P<0.001, respectively. Conclusion: These results suggest that drug abuse is a contributing factor to trauma especially in violent injuries and among the young. Regarding the considerable prevalence of drug abuse among trauma patients, it’s highly recommended that all trauma patients be screened for illicit drugs

  15. Family Presence During Resuscitation After Trauma.

    Science.gov (United States)

    Leske, Jane S; McAndrew, Natalie S; Brasel, Karen J; Feetham, Suzanne

    The purpose of this study was to examine the effects of family presence during resuscitation (FPDR) in patients who survived trauma from motor vehicle crashes (MVC) and gunshot wounds (GSW). A convenience sample of family members participated within three days of admission to critical care. Family members of 140 trauma patients (MVC n = 110, 79%; GSW n = 30, 21%) participated. Family members ranged in age from 20-84 years (M = 46, SD = 15, Mdn = 47). The majority were female (n = 112, 80%) and related to the patient as spouse (n = 46, 33%). Participating in the FPDR option reduced anxiety (t = -2.43, p =.04), reduced stress (t = -2.86, p = .005), and fostered well-being (t = 3.46, p = .001). Results demonstrate the positive initial effects of FPDR on family members of patients surviving trauma injury.

  16. Facial trauma as physical violence markers against elderly Brazilians: A comparative analysis between genders.

    Science.gov (United States)

    de Sousa, Rayanne Izabel Maciel; de Macedo Bernardino, Ítalo; Castro, Ricardo Dias; Cavalcanti, Alessandro Leite; Bento, Patricia Meira; d'Ávila, Sérgio

    2016-01-01

    The aim of this study was to characterize the profile of elderly Brazilians with injuries resulting from physical violence and identify victimization differences. A descriptive and exploratory study was conducted involving the analysis of medico-legal and social records of 259 elderly victims of physical violence treated at an Institute of Forensic Medicine and Dentistry over four years (from January 2008 to December 2011). The forensic service database was evaluated by researchers properly trained and calibrated to perform this function between January and March 2013. Socio-demographic variables of victims, aggression characteristics, aggressor's profile and types of lesions were evaluated. Descriptive and multivariate statistics using Multiple Correspondence Analysis (MCA) were performed. The prevalence of facial trauma was 42.9%. Based on the MCA results, two groups with different victimization profiles were identified: married men aged 70-79 years, victims of community violence at night, suffering facial injuries; and single, widowed or separated women aged 60-69 years, victims of domestic violence during the day, suffering trauma in other areas of the body. The results suggest that there is a high prevalence of facial injuries among elderly Brazilians victims of physical violence and there are important differences related to victimization characteristics according to gender. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  17. Suspension Trauma / Orthostatic Intolerance

    Science.gov (United States)

    ... Technology Assessment Printer Friendly Version Suspension Trauma/Orthostatic Intolerance Safety and Health Information Bulletin SHIB 03-24- ... with important information about the hazards of orthostatic intolerance and suspension trauma when using fall arrest systems. ...

  18. Acute coagulopathy of trauma

    DEFF Research Database (Denmark)

    Johansson, P I; Ostrowski, S R

    2010-01-01

    Acute coagulopathy of trauma predicts a poor clinical outcome. Tissue trauma activates the sympathoadrenal system resulting in high circulating levels of catecholamines that influence hemostasis dose-dependently through immediate effects on the two major compartments of hemostasis, i...

  19. Attitudes About Human Trafficking: Individual Differences Related to Belief and Victim Blame.

    Science.gov (United States)

    Cunningham, Katherine C; Cromer, Lisa DeMarni

    2016-01-01

    Human trafficking is believed to oppress millions of people worldwide. Despite increased media attention and public awareness campaigns in recent years, no empirical research has examined public attitudes about human trafficking. The present study examined gender, sexual trauma history, and attitudes about human trafficking as they related to belief of a sex-trafficking scenario and willingness to blame the victim for the situation. Undergraduate students (N = 409) at a large private university in the Northeastern United States completed measures in which they responded to a vignette portraying sex trafficking in the United States. Participants also reported their personal trauma history and completed a Human Trafficking Myths Scale. Results indicated that gender and human trafficking myth acceptance, but not sexual trauma history, were significantly related to participants' belief of the sex-trafficking scenario and their perception of the victim's responsibility. Potential implications and directions for future research are discussed. © The Author(s) 2014.

  20. Predictive factors for somatization in a trauma sample

    DEFF Research Database (Denmark)

    Elklit, Ask; Christiansen, Dorte M

    2009-01-01

    ABSTRACT: BACKGROUND: Unexplained somatic symptoms are common among trauma survivors. The relationship between trauma and somatization appears to be mediated by posttraumatic stress disorder (PTSD). However, only few studies have focused on what other psychological risk factors may predispose...... a trauma victim towards developing somatoform symptoms. METHODS: The present paper examines the predictive value of PTSD severity, dissociation, negative affectivity, depression, anxiety, and feeling incompetent on somatization in a Danish sample of 169 adult men and women who were affected by a series...... of incompetence significantly predicted somatization in the trauma sample whereas dissociation, depression, and anxiety were not associated with degree of somatization. PTSD as a risk factor was mediated by negative affectivity....

  1. Trauma in elderly people: access to the health system through pre-hospital care1

    Science.gov (United States)

    da Silva, Hilderjane Carla; Pessoa, Renata de Lima; de Menezes, Rejane Maria Paiva

    2016-01-01

    Objective: to identify the prevalence of trauma in elderly people and how they accessed the health system through pre-hospital care. Method: documentary and retrospective study at a mobile emergency care service, using a sample of 400 elderly trauma victims selected through systematic random sampling. A form validated by experts was used to collect the data. Descriptive statistical analysis was applied. The chi-square test was used to analyze the association between the variables. Results: Trauma was predominant among women (52.25%) and in the age range between 60 and 69 years (38.25%), average age 74.19 years (standard deviation±10.25). Among the mechanisms, falls (56.75%) and traffic accidents (31.25%) stood out, showing a significant relation with the pre-hospital care services (p<0.001). Circulation, airway opening, cervical control and immobilization actions were the most frequent and Basic Life Support Services (87.8%) were the most used, with trauma referral hospitals as the main destination (56.7%). Conclusion: trauma prevailed among women, victims of falls, who received pre-hospital care through basic life support services and actions and were transported to the trauma referral hospital. It is important to reorganize pre-hospital care, avoiding overcrowded hospitals and delivering better care to elderly trauma victims. PMID:27143543

  2. Outcome of major cardiac injuries at a Canadian trauma center

    Directory of Open Access Journals (Sweden)

    Lamy Andre

    2002-06-01

    Full Text Available Abstract Background Canadian trauma units have relatively little experience with major cardiac trauma (disruption of a cardiac chamber so injury outcome may not be comparable to that reported from other countries. We compared our outcomes to those of other centers. Methods Records of patients suffering major cardiac trauma over a nine-year period were reviewed. Factors predictive of outcome were analyzed. Results Twenty-seven patients (11 blunt and 16 penetrating with major cardiac trauma were evaluated. Injury severity scores (ISS were similar for blunt (49.6 ± 16.6 and penetrating (39.5 ± 21.6, p = 0.20 injuries. Five of 11 blunt trauma patients, and 9 of 16 penetrating trauma patients, had detectable vital signs on hospital arrival (p = 0.43. Ten patients underwent emergency department thoracotomy and 11 patients had cardiac repair in the operating theatre. Eleven patients survived and 16 died. Survivors had a lower ISS (33.7 ± 15.4 than non-survivors (50.4 ± 20.4; p = 0.03. Two of 11 blunt trauma patients and 9 of 16 penetrating trauma patients survived (p = 0.06. Eleven of 14 patients with detectable vital signs survived; all 13 without detectable vital signs died (p = 0.00003. Ten of eleven patients treated in the operating theatre survived, while only one of the other 16 patients survived (p = 0.00002. Conclusions Patients with major cardiac injuries and detectable vital signs on hospital arrival can be salvaged by prompt surgical intervention in the operating theatre. Major cardiac injuries are infrequently encountered at our center but patient survival is comparable to that reported from trauma units in other countries.

  3. Trauma Facts for Educators

    Science.gov (United States)

    National Child Traumatic Stress Network, 2008

    2008-01-01

    This paper offers facts which can help educators deal with children undergoing trauma. These include: (1) One out of every 4 children attending school has been exposed to a traumatic event that can affect learning and/or behavior; (2) Trauma can impact school performance; (3) Trauma can impair learning; (4) Traumatized children may experience…

  4. Anaesthesia for trauma patients

    African Journals Online (AJOL)

    in trauma patients can be used. However, some modifications have been made to adapt it to unstable trauma patients, where reawakening the patient is not an option because of the need for emergency airway control (Figure 3).4. Anaesthetists working in high-volume trauma centers should determine their own algorithm, ...

  5. Trauma resuscitation time.

    NARCIS (Netherlands)

    Olden, G.D.J. van; Vugt, A.B. van; Biert, J.; Goris, R.J.A.

    2003-01-01

    Documenting the timing and organisation of trauma resuscitation can be utilised to assess performance standards, and to ensure a high quality of trauma resuscitation procedures. Since there is no European literature available on trauma resuscitation time (TRT) in the emergency room, the aim of this

  6. Development of statewide geriatric patients trauma triage criteria.

    Science.gov (United States)

    Werman, Howard A; Erskine, Timothy; Caterino, Jeffrey; Riebe, Jane F; Valasek, Tricia

    2011-06-01

    The geriatric population is unique in the type of traumatic injuries sustained, physiological responses to those injuries, and an overall higher mortality when compared to younger adults. No published, evidence-based, geriatric-specific field destination criteria exist as part of a statewide trauma system. The Trauma Committee of the Ohio Emergency Medical Services (EMS) Board sought to develop specific criteria for geriatric trauma victims. A literature search was conducted for all relevant literature to determine potential, geriatric-specific, field-destination criteria. Data from the Ohio Trauma Registry were used to compare elderly patients, defined as age >70 years, to all patients between the ages of 16 to 69 years with regards to mortality risk in the following areas: (1) Glasgow Coma Scale (GCS) score; (2) systolic blood pressure (SBP); (3) falls associated with head, chest, abdominal or spinal injury; (4) mechanism of injury; (5) involvement of more than one body system as defined in the Barell matrix; and (6) co-morbidities and motor vehicle collision with one or more long bone fracture. For GCS score and SBP, those cut-off points with equal or greater risk of mortality as compared to current values were chosen as proposed triage criteria. For other measures, any criterion demonstrating a statistically significant increase in mortality risk was included in the proposed criteria. The following criteria were identified as geriatric-specific criteria: (1) GCS score trauma; (2) SBP trauma. In addition, these data suggested that elderly patients with specific co-morbidities be given strong consideration for evaluation in a trauma center. The state of Ohio is the first state to develop evidence-based geriatric-specific field-destination criteria using data from its state-mandated trauma registry. Further analysis of these criteria will help determine their effects on over-triage and under-triage of geriatric victims of traumatic injuries and the impact on the

  7. Victim ranking among sex offenders

    NARCIS (Netherlands)

    Buschman, J.; Wilcox, D.; Spreen, M.; Marshall, B.; Bogaerts, S.

    2008-01-01

    A previous exploratory study of the Child Molester Empathy Measure (CMEM) focused on the difference between offenders' normal level of general empathy and the way in which a sample of Dutch offenders viewed their own victims. The authors found that, regardless of their level of general victim

  8. Victims of Bullying in Schools

    Science.gov (United States)

    Graham, Sandra

    2016-01-01

    This article provides an overview of current research on bullying (peer victimization, peer harassment) in school, with a focus on victims of such bullying. The 1st section provides a working definition of bullying and its many forms. The 2nd section describes some of the known consequences of being bullied for mental health, physical health, and…

  9. The dilemmas of victim positioning

    DEFF Research Database (Denmark)

    Søndergaard, Dorte Marie

    2015-01-01

    Based on a conceptualization of bullying and relational aggression in groups as an effect of social dynamics rather than individual deficits – this article reflects upon some of the intricate mechanisms and dilemmas involved in victim positioning. Victims of bullying and relational aggression often...

  10. The dilemmas of victim positioning

    Directory of Open Access Journals (Sweden)

    Dorte Marie Søndergaard

    2015-08-01

    Full Text Available This article centres on some of the dilemmas contained within victim positioning. Such dilemmas are often overlooked by the authorities involved with people subjected to relational aggression. 2 For example, when teachers rule out cases of bullying because the victim has 'participated in' or 'laughed at' some of the bullies' initiatives, or when a rape victim's status as a victim is questioned because, in the lead up to the assault, she was supposedly friendly to the rapist. In these cases, it could be useful to explore the reason for the bullying victim's apparent collusion or to better understand the premises for the rape victim's positioning options in relation to the perpetrator. In other words, it could be fruitful to explore the dynamics and dilemmas of the victim position. In this article, I aim to reflect on the motivational conditions of the victim phenomenon. These reflections are based on an analysis of qualitative data produced through interviews with school children as well as on relevant secondary literature.

  11. Distribution of Laboratory Parameters in Trauma Population

    Directory of Open Access Journals (Sweden)

    Prashant Bhandarkar

    2018-01-01

    Full Text Available Background: Biochemical laboratory investigations help plan optimum management and communication in short- as well as long-term outcome to trauma victims. Objective: To assess the status of real-time values of biochemical laboratory investigations of different trauma patients and their association with overall mortality. Materials and Methods: Data based on prospective, observational registry of “Towards Improved Trauma Care Outcomes” (TITCO from four Indian city hospitals. Hemoglobin, hematocrit, random blood sugar, blood urea nitrogen (BUN, and serum creatinine of patients on admission were recorded. Logistic regression was applied with all biochemical investigation as independent variable and overall mortality as dependent variable. Results: Among 17047 trauma patients, 3456 with available laboratory result details were considered for this study. Overall mortality was 20% (range 14%–21%. For the higher laboratory results, value mortality was 21%–70%, with highest death (70% for higher hemoglobin patients, followed by hematocrit (44% and then creatinine (43%. Odds of high hemoglobin compared to normal were 15.20; odds of higher and lower of normal creatinine were 3.80 and 1.65 and for BUN were 2.17 and 1.92, respectively. Gender-wise significant difference was in overall female mortality (29%% compared males (18%. Similar differences were replicated with results of each laboratory tests. Conclusion: The study ascertained the composite additional explanatory values of laboratory parameters in predicting outcome among injured patients in our population from Indian settings.

  12. Cyberbullying victimization in adolescents’ population

    Directory of Open Access Journals (Sweden)

    Nešić Marija

    2016-01-01

    Full Text Available With the rapid development of communication technology and its wide use by the adolescents, cyberspace became a new risky environment for bullying manifestation and victimization. The significance of the problem lies in the fact that, unlike the traditional bullying, the cyberbullying victimization occurs also out of the school surroundings, it’s characterized by the possible anonymity of the bully, it’s harder to discover it and it could have a much bigger audience. Results of numerous studies show that the prevalence of cyberbullying victimization is 10% to 40% during one school year and that it is related to different negative outcomes - from problems of lower self-esteem to severe psychological and behavioral problems. The aim of the paper is to present basic characteristics and negative outcomes of cyberbullying victimization and also to summarize possible factors which are associated with this form of bullying. Lastly, possible ways of preventive action and coping with cyberbullying victimization will be reviewed.

  13. Identification and Management of Human Trafficking Victims in the Emergency Department.

    Science.gov (United States)

    Hachey, Lisa M; Phillippi, Julia C

    Health care practitioners serve an important role in identification and assistance of human trafficking victims. Advanced practice registered nurses, including certified nurse midwives, clinical nurse specialists, and nurse practitioners, are in a unique position to interact with persons trafficked and seen in the clinical setting, yet they require knowledge to identify the signs of human trafficking. Lack of training and education has been identified as a barrier for health care professionals to recognize human trafficking victims and implement needed health care services (; ). Barriers to identification and management include gap in knowledge about the process to screen for trafficking, to assist victims, and to make referrals. A patient-centered, trauma-informed approach can provide a safe environment to sensitively screen patients for human trafficking. Advanced practice registered nurses should be able to assess for trafficking indicators, collaborate with multidisciplinary service providers, and ensure understanding and availability of federal, state, and local resources to manage the care of victims of trafficking.

  14. [Advanced life support: care provided to motor vehicle crash victims].

    Science.gov (United States)

    Malvestio, Marisa Aparecida Amaro; de Sousa, Regina Márcia Cardoso

    2002-10-01

    To analyze the performance of Advanced Life Support care mode (ALS) applied to car crash victims using indicators by means of the Revised Trauma Score (RTS) in prehospital phase. It were analyzed 643 reports of car crash victims cared by public ALS services that occurred in highways of the city of São Paulo, from April 1999 to April 2000. Time intervals assessed were: response time, on-scene time, transport time, and total time. Correct screening decision analysis considered RTStransport time were higher in RTS transported to tertiary hospitals. Screening decision misjudgments were identified. Maintenance or improvement of RTS values occurred in 98.8% of the cases. Respiratory rate was the parameter that showed better improvement followed by systolic blood pressure.

  15. Building blocks toward contemporary trauma theory: Ferenczi 's paradigm shift.

    Science.gov (United States)

    Mészáros, Judit

    2010-12-01

    In laying down the building blocks of contemporary trauma theory, Ferenczi asserted that trauma is founded on real events and that it occurs in the interpersonal and intersubjective dynamics of object relations. He stressed the significance of the presence or lack of a trusted person in the post-traumatic situation. After the trauma, the loneliness and later the isolation of the victim represent a serious pathogenic source. In the traumatic situation, the victim and the persecutor/aggressor operate differing ego defense mechanisms. Ferenczi was the first to describe the ego defense mechanism of identification with the aggressor. Ferenczi pointed out the characteristic features of the role of analyst/therapist with which (s)he may assist the patient in working through the trauma, among them being the development of a therapeutic atmosphere based on trust, so that the traumatic experiences can be relived, without which effective therapeutic change cannot be achieved. For the analyst, countertransference, as part of authentic communication, is incorporated into the therapeutic process. These are the key building blocks that are laid down by Ferenczi in his writings and appear in later works on trauma theory.

  16. [Trauma and emergency thoracoscopy].

    Science.gov (United States)

    Ochmann, J; Vrastyák, J; Svoboda, P; Kantorová, I; Zelnícek, P; Cierny, M

    1996-08-01

    Authors present their first experience with urgent videothoracoscopy in polytraumatism and in isolated thoracic trauma patients. During the prospective study in 1993-1995 thoracoscopically was treated 41 (18%) from 229 multiple trauma patients including thorax trauma, hospitalised in our Institute. Thoracoscopy underwent 62 (4%) from 1452 patients with simple thoracic trauma. Thoracoscopy has been indicated above all for continued bleeding into peritoneal cavity, for suspected diafragmatic injury and for the diagnosis and treatment of posttraumatic complications. Authors suggest that thoracoscopy is in experienced hands and adequatelly equipped workplaces an accurate and safe method for the diagnosis and in some cases also for therapy of hemodynamic stabile patients with thoracic trauma.

  17. La mujer como víctima de trauma sexual Women as victims of sexual trauma

    Directory of Open Access Journals (Sweden)

    Emilio Alberto Restrepo Baena

    1996-03-01

    Full Text Available Se revisa el tema de las consecuencias físicas que la práctica sexual puede acarrear sobre las diferentes estructuras genitales y anorrectales de la mujer. Physical consequences of different modalities of sexual practice on female genital and anorectal structures are reviewed.

  18. First Person Victim

    DEFF Research Database (Denmark)

    Schoenau-Fog, Henrik; Bruni, Luis Emilio; Khalil, Faysal Fuad

    2010-01-01

    Interactive Drama in 3D worlds has great potential for communicating serious themes, however it can become challenging to organize the content in such a way that the theme is communicated clearly while maintaining the feeling of free spatial navigation in the 3D world. In order to address...... this problem, and to propose a way to structure content, we have developed the Interactive Dramatic Experience Model, which attempts to organize narrative events in a 3D world while keeping the freedom of spatial interactivity. In order to exemplify this model, we have chosen to oppose the classic genre...... of violent interactive shooter experiences by allowing the participants to experience the feeling of being a victim of war. An evaluation of the implementation indicated that participants experienced free spatial interaction, while still being able to acquire an understanding of the theme being mediated....

  19. Victims and Heroes

    DEFF Research Database (Denmark)

    Højbjerg, Christian K.

    2010-01-01

    Victimization, autochthony and citizenship, power and nation-building constitute recurrent, interrelated themes in post-war Manding historical memory in the border area between Liberia and Guinea. While the perceived history of the Manding diverges from academic, historical knowledge as well...... as from neighbouring peoples’ recollection of the past, it informs about the position and role of the marginalized, but at the same time military victorious Manding in a reshuffled Liberian political culture. The chapter suggests that contemporary Mande memory work serves a double purpose. On the one hand......, Manding historical imagination gives expression to political ambitions and conveys claims to a number of basic civic rights, including citizenship. On the other, there is a moral value to heroic memories of the past as a means to recreate communal life and to come to terms with the experience of prolonged...

  20. [Cardiorespiratory arrest in children with trauma].

    Science.gov (United States)

    López-Herce Cid, J; Domínguez Sampedro, P; Rodríguez Núñez, A; García Sanz, C; Carrillo Alvarez, A; Calvo Macías, C; Bellón Cano, J M

    2006-11-01

    To analyze the characteristics and outcome of cardiorespiratory arrest secondary to trauma in children. We performed a secondary analysis of data from a prospective, multicenter study of cardiorespiratory arrest in children. Data were recorded according to the Utstein style. Twenty-eight children (age range: 7 days to 16 years) with cardiorespiratory arrest secondary to trauma were evaluated. The outcome variables were return of spontaneous circulation, sustained (more than 20 minutes) return of spontaneous circulation (initial survival), and survival at hospital discharge (final survival) in relation to the characteristics of the cardiorespiratory arrest and cardiopulmonary resuscitation. Neurological and general performance outcome was assessed by means of the Pediatric Cerebral Performance Category scale and the Pediatric Overall Performance Category scale. Return of spontaneous circulation was obtained in 18 patients (64.2 %), initial survival was achieved in 14 (50 %) and final survival was achieved in three (10.7 %) (two without neurological sequelae and one with vegetative status). Final survival was significantly higher in patients with respiratory arrest (33.3 %) than in those with cardiac arrest (4.5 %), p = 0.04. Final survival was also higher in patients with a duration of cardiopulmonary resuscitation shorter than 20 minutes (27.2 %) than in the remaining patients (0 %), p =0.05. The two survivors without neurologic sequelae had respiratory arrest. Survival until hospital discharge in children with cardiorespiratory arrest secondary to trauma is lower than that in children with cardiorespiratory arrest. Patients with respiratory arrest when resuscitation is started and those with a duration of cardiopulmonary resuscitation of less than 20 minutes showed better survival than the remaining patients.

  1. Pattern of oral-maxillofacial trauma from violence against women and its associated factors.

    Science.gov (United States)

    da Nóbrega, Lorena Marques; Bernardino, Ítalo de Macedo; Barbosa, Kevan Guilherme Nóbrega; E Silva, Jéssica Antoniana Lira; Massoni, Andreza Cristina de Lima Targino; d'Avila, Sérgio

    2017-06-01

    Violence against women is a global public health problem. The aim of this study was to characterize the profile of women victims of violence and identify factors associated with maxillofacial injuries. A cross-sectional study was performed based on an evaluation of 884 medico-legal and social records of women victims of physical aggression treated at the Center of Forensic Medicine and Dentistry in Brazil. The variables investigated were related to the sociodemographic characteristics of victims, circumstances of aggressions, and patterns of trauma. Descriptive and multivariate statistics using decision tree analysis by the Chi-squared automatic interaction detector (CHAID) algorithm, as well as univariate and multivariate Poisson regression analyses were performed. The occurrence of maxillofacial trauma was 46.4%. The mean age of victims was 29.38 (SD=12.55 years). Based on decision tree, the profile of violence against women can be explained by the aggressor's gender (Pmaxillofacial trauma (PR=1.752; CI 95%=1.153-2.662; P=.009) compared to those living in rural areas. Moreover, aggression using a weapon resulted in a lower occurrence of maxillofacial trauma (PR=0.476; CI 95%=0.284-0.799; P=.005) compared to cases of aggression using physical force. The prevalence of oral-maxillofacial trauma was high, and the main associated factors were place of residence and mechanism of aggression. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  2. Hurricane Sandy: Shared Trauma and Therapist Self-Disclosure.

    Science.gov (United States)

    Rao, Nyapati; Mehra, Ashwin

    2015-01-01

    Hurricane Sandy was one of the most devastating storms to hit the United States in history. The impact of the hurricane included power outages, flooding in the New York City subway system and East River tunnels, disrupted communications, acute shortages of gasoline and food, and a death toll of 113 people. In addition, thousands of residences and businesses in New Jersey and New York were destroyed. This article chronicles the first author's personal and professional experiences as a survivor of the hurricane, more specifically in the dual roles of provider and trauma victim, involving informed self-disclosure with a patient who was also a victim of the hurricane. The general analytic framework of therapy is evaluated in the context of the shared trauma faced by patient and provider alike in the face of the hurricane, leading to important implications for future work on resilience and recovery for both the therapist and patient.

  3. The Hidden Rape Victim: Personality, Attitudinal, and Situational Characteristics.

    Science.gov (United States)

    Koss, Mary P.

    1985-01-01

    Describes victimization experienced by rape victims and determines whether any psychological variables were related to victimization status. Psychological variables examined included personality, attitudinal, and situational characteristics relevant to the three major models of rape victimization: social control, victim precipitation, and…

  4. Isolated right atrial appendage (RAA) rupture in blunt trauma--a case report and an anatomic study comparing RAA and right atrium (RA) wall thickness.

    Science.gov (United States)

    Figueiredo, Adoniram M; Poggetti, Renato S; Quintavalle, Fabio G; Fontes, Belchor; Dalva, Moise; Younes, Riad N; Jatene, Fabio B; Birolini, Dario

    2007-02-15

    Heart chambers rupture in blunt trauma is uncommon and is associated with a high mortality. The determinant factors, and the incidence of isolated heart chambers rupture remains undetermined. Isolated rupture of the right atrium appendage (RAA) is very rare, with 8 cases reported in the reviewed literature. The thin wall of the RAA has been presumed to render this chamber more prone to rupture in blunt trauma. To report a case of isolated RAA rupture in blunt trauma, and to compare right atrium (RA) and RAA wall thickness in a necropsy study. The thickness of RA and RAA wall of hearts from cadavers of fatal penetrating head trauma victims was measured. Our case of isolated RAA rupture is presented. The main findings of the 8 cases reported in the literature, and the findings of our case, were organized in a table. The comparison of the data showed that wall thickness of the RAA (0.53 +/- 0.33 mm) was significantly thinner than that of RA (1.11 +/- 0.42 mm) (p < 0.05). In all these 9 cases of isolated RAA rupture, cardiac tamponade occurred, RAA rupture was diagnosed intraoperatively and sutured, and the patients survived. Main mechanisms hypothesized for heart chamber rupture include mechanical compression coincident with phases of cardiac cycle, leading to high hydrostatic pressure inside the chamber. Published series include numerous cases of RA rupture, and only a few cases of RAA rupture. Thus, our data suggests that wall thickness is not a determinant factor for RA or RAA rupture in blunt trauma.

  5. Isolated right atrial appendage (RAA rupture in blunt trauma – a case report and an anatomic study comparing RAA and right atrium (RA wall thickness

    Directory of Open Access Journals (Sweden)

    Jatene Fabio B

    2007-02-01

    Full Text Available Abstract Background Heart chambers rupture in blunt trauma is uncommon and is associated with a high mortality. The determinant factors, and the incidence of isolated heart chambers rupture remains undetermined. Isolated rupture of the right atrium appendage (RAA is very rare, with 8 cases reported in the reviewed literature. The thin wall of the RAA has been presumed to render this chamber more prone to rupture in blunt trauma. Objective To report a case of isolated RAA rupture in blunt trauma, and to compare right atrium (RA and RAA wall thickness in a necropsy study. Methods The thickness of RA and RAA wall of hearts from cadavers of fatal penetrating head trauma victims was measured. Our case of isolated RAA rupture is presented. The main findings of the 8 cases reported in the literature, and the findings of our case, were organized in a table. Result The comparison of the data showed that wall thickness of the RAA (0.53 ± 0.33 mm was significantly thinner than that of RA (1.11 ± 0.42 mm (p Comments In all these 9 cases of isolated RAA rupture, cardiac tamponade occurred, RAA rupture was diagnosed intraoperatively and sutured, and the patients survived. Main mechanisms hypothesized for heart chamber rupture include mechanical compression coincident with phases of cardiac cycle, leading to high hydrostatic pressure inside the chamber. Published series include numerous cases of RA rupture, and only a few cases of RAA rupture. Conclusion Thus, our data suggests that wall thickness is not a determinant factor for RA or RAA rupture in blunt trauma.

  6. Isolated right atrial appendage (RAA) rupture in blunt trauma – a case report and an anatomic study comparing RAA and right atrium (RA) wall thickness

    Science.gov (United States)

    Figueiredo, Adoniram M; Poggetti, Renato S; Quintavalle, Fabio G; Fontes, Belchor; Dalva, Moise; Younes, Riad N; Jatene, Fabio B; Birolini, Dario

    2007-01-01

    Background Heart chambers rupture in blunt trauma is uncommon and is associated with a high mortality. The determinant factors, and the incidence of isolated heart chambers rupture remains undetermined. Isolated rupture of the right atrium appendage (RAA) is very rare, with 8 cases reported in the reviewed literature. The thin wall of the RAA has been presumed to render this chamber more prone to rupture in blunt trauma. Objective To report a case of isolated RAA rupture in blunt trauma, and to compare right atrium (RA) and RAA wall thickness in a necropsy study. Methods The thickness of RA and RAA wall of hearts from cadavers of fatal penetrating head trauma victims was measured. Our case of isolated RAA rupture is presented. The main findings of the 8 cases reported in the literature, and the findings of our case, were organized in a table. Result The comparison of the data showed that wall thickness of the RAA (0.53 ± 0.33 mm) was significantly thinner than that of RA (1.11 ± 0.42 mm) (p < 0.05). Comments In all these 9 cases of isolated RAA rupture, cardiac tamponade occurred, RAA rupture was diagnosed intraoperatively and sutured, and the patients survived. Main mechanisms hypothesized for heart chamber rupture include mechanical compression coincident with phases of cardiac cycle, leading to high hydrostatic pressure inside the chamber. Published series include numerous cases of RA rupture, and only a few cases of RAA rupture. Conclusion Thus, our data suggests that wall thickness is not a determinant factor for RA or RAA rupture in blunt trauma. PMID:17302990

  7. Victims of cyberstalking in Serbia

    Directory of Open Access Journals (Sweden)

    Kovačević-Lepojević Marina

    2009-01-01

    Full Text Available The aim of this paper is to present research findings on prevalence and characteristics of cyberstalking in Serbia. A web-based questionnaire was used to collect data from a group of respondents who were recruited by snowball sampling via e-mail. A total of 237 respondents completed the online questionnaire. The aim of the first part of this paper is to determine the notion of cyberstalking as well as, to review research about the prevalence and the nature of stalking. The main results are the following: 39,6 % of respondents reported stalking; every fourth stalking victim is a victims of cyberstalking; mostly, cyberstalking victims were female and perpetrators were male. Victims were stalked by: persistent sending of unwanted e-mails and telephone calls, spreading rumors, abusive and negative comments and threats, encouraged other users to harass, threaten or insult, manipulating with victim's personal data, sending malicious programs and files, etc. In Serbia, cyberstalking is not criminalized yet and there are no organizations to whom victims may appeal and ask for help. We are hoping that this research will raise the awareness on cyberstalking and serve as a base for further research and legal reforms regarding cyberstalking victimization in Serbia.

  8. Pathways to poly-victimization.

    Science.gov (United States)

    Finkelhor, David; Ormrod, Richard; Turner, Heather; Holt, Melissa

    2009-11-01

    Some children, whom we have labeled poly-victims, experience very high levels of victimizations of different types. This article finds support for a conceptual model suggesting that there may be four distinct pathways to becoming such a poly-victim: (a) residing in a dangerous community, (b) living in a dangerous family, (c) having a chaotic, multiproblem family environment, or (d) having emotional problems that increase risk behavior, engender antagonism, and compromise the capacity to protect oneself. It uses three waves of the Developmental Victimization Survey, a nationally representative sample of children aged 2-17 years. All four hypothesized pathways showed significant independent association with poly-victim onset. For the younger children, the symptom score representing emotional problems was the only significant predictor. For the older children, the other three pathway variables were significant predictors--dangerous communities, dangerous families, and problem families--but not symptom score. Poly-victimization onset was also disproportionately likely to occur in the year prior to children's 7th and 15th birthday, corresponding roughly to the entry into elementary school and high school. The identification of such pathways and the ages of high onset should help practitioners design programs for preventing vulnerable children from becoming poly-victims.

  9. Survival, neurological recovery and morbidity after spinal cord injuries following road accidents in Israel.

    Science.gov (United States)

    Tchvaloon, E; Front, L; Gelernter, I; Ronen, J; Bluvshtein, V; Catz, A

    2008-02-01

    A retrospective cohort study. Assess outcomes in patients with spinal cord injuries (SCI) following road accidents, and factors that affect them. Loewenstein Rehabilitation Hospital, Raanana, Israel. A total of 143 patients admitted for rehabilitation between 1962 and 2004. Survival rates were estimated using the product limit (Kaplan-Meyer) method and their association with risk factors was analyzed with the Cox model. Neurological recovery was determined by comparing the Frankel grade at admission to rehabilitation and at discharge. The relation between recovery and various factors was tested with logistic regression. The risk of SCI in road accidents is higher among car drivers and motorcycle or bicycle riders. Median survival was 43 years. Survival was negatively associated with age at injury (PNeurological recovery was negatively associated with the severity of neurological deficit (P<0.001) and with thoracic injuries (P=0.046). The most common complications were pressure sores and those of the urinary and respiratory systems. In SCI following road accidents, survival rates were higher and recovery rates lower than in mixed types of trauma. This may be related to better compensation followed by better nursing for road accident victims in Israel, which may prevent life-shortening complications, and to more severe injuries caused by road accidents.

  10. Sex, timing, and depression among suicide victims with schizophrenia.

    Science.gov (United States)

    Karvonen, Kaisa; Sammela, Hanna-Lena; Rahikkala, Heidi; Hakko, Helinä; Särkioja, Terttu; Meyer-Rochow, V Benno; Räsänen, Pirkko; Timonen, Markku

    2007-01-01

    Schizophrenia and depression by themselves and especially in combination with each other are known to be important risk factors of suicide. An increased risk of suicide has also been reported for the period immediately after a psychiatric patient's discharge from the hospital. However, to the best of our knowledge, it remains unknown whether survival times differ between suicide victims with schizophrenia concomitantly with and those without depression. This study aimed to examine survival times from the discharge of last hospital treatment (irrespective of the kind of illness) to the day of death in suicide victims with schizophrenia with or without concomitant depression. A 16-year database of all suicides (1535 males, 342 females) committed during the years 1988-2003 in the province of Oulu in northern Finland, and information available from the national hospital discharge registers formed the basis of this study. In male suicide victims with schizophrenia, the median survival time after final hospitalization was approximately 1 day in those with a history of depression and 90 days in those without depression (P = .005). The corresponding times for females were 50 and 24 days, respectively (P = .396). Using Cox regression analysis after adjusting for confounders, we noticed a statistically significant difference in survival times from last hospitalization to suicide between depressive and nondepressive male patients with schizophrenia (hazard ratio, 1.80; 95% confidence interval, 1.04-3.11), but not females (hazard ratio, 0.72; 95% confidence interval, 0.34-1.53). Concomitant depression was markedly linked with shorter survival time in male suicide victims with schizophrenia after last hospitalization. Psychiatric inpatient facilities appear to be in a key position to establish suicide prevention programs for patients with schizophrenia, especially those with depression.

  11. Link between sexual abuse trauma coping and mother complex in adolescent girls

    OpenAIRE

    Grigutytė, Neringa

    2010-01-01

    The number of victims of sexual abuse is increasing thus making scholars and practicioners get into the subject. Sexual abuse trauma causes immediate and long-term consequences. Ways of managing posttraumatic difficulties are of great importance. There is no one answer which coping strategies are most effective for sexual abuse trauma coping in adolescence. The aim of the study is to explore the coping of sexual abuse (the connection between the consequences and coping strategies of sexual ab...

  12. [Trauma management under military conditions. A German field hospital in Afghanistan in comparison with the National Trauma Registry].

    Science.gov (United States)

    Helm, M; Kulla, M; Birkenmaier, H; Lefering, R; Lampl, L

    2007-12-01

    The German armed forces run a role-III field hospital in Kabul, Afghanistan. Emergency room (ER) management is of utmost importance as a link between pre- and in-hospital treatment. Prospective data were acquired of all patients admitted to the ER over a 3-month period. The quality of ER management was tested using established audit filters and comparing the results with those of the National Trauma Registry. A total of 353 patients were admitted to the ER (48.4% trauma cases). Fifty-nine patients were major trauma cases, and the proportion of combat-related injury was 33.2%. In comparison to the National Trauma Registry, significant differences were observed regarding age (25.2 vs 41.7 years, Pquality of ER management have increased. Using the audit filters of the National Trauma Registry, significant differences were observed regarding ER management. In a military setting, medical treatment of major trauma victims is influenced by multiple adverse factors significantly affecting the quality of trauma management.

  13. Wide Spectrum of Traumatic Rhabdomyolysis in Earthquake Victims

    Directory of Open Access Journals (Sweden)

    Shahnaz Atabak

    2009-12-01

    Full Text Available In the natural disasters such as earthquake, based on severity of trauma, time under the rubble and quality/quantity of hydratation we will confront with a spectrum of traumatic rhabdomyolysis. In present study we evaluate victims of Bam earthquake to show different stage of muscle trauma, from minor trauma with almost normal level of muscle enzyme to those with moderate trauma leading to crush injury and finally to advanced crush syndrome. Questionnaire consisted of clinical, biochemical and demographic items was designed and completed by our research team retrospectively. We divided the patients to crush and non-crush and also crush injury and crush syndrome, and then compared aforementioned items between them. Clinical and laboratory data of 2962 hospitalized victims, with an average age of 28.4(SD14.2 years (range 1-90 were collected (40% female. 611 patients were affected with crush injury (20%. These were entrapped 2.2 hours longer than the others (P<0.001. Mean IV intake in first 5 days was 3.6(SD2.6 liters for these patients in compare with 2.5(SD1.4 liters for others (P<0.001. 200 cases showed complete feature of crush syndrome. Electrolyte imbalance and systemic complications were drastically increased in the worst patients with crush syndrome. In approach to crushed patients of natural disasters by attention to the wide spectrum of muscle damage and systemic problems, the stepwise management protocol based on severity of traumatic rhabdomyolysis is inevitable and warranted.

  14. Mulheres vítimas de estrupo: contexto e enfrentamento dessa realidade Women rape victims: experiences and confrontation of this reality

    Directory of Open Access Journals (Sweden)

    Sandra Sudário

    2005-12-01

    Full Text Available Este artigo, parte da dissertação de mestrado da autora, analisa o contexto do estupro e seu enfrentamento pelas mulheres vitimadas e descreve o comportamento do estuprador com base na percepção da vítima. Cinco mulheres atendidas em um hospital de referência em HIV/AIDS responderam a entrevistas semi-estruturadas submetidas à técnica de análise de conteúdo. Os resultados evidenciaram a vulnerabilidade da mulher, não somente em lugares ermos e vias públicas, mas também no trabalho e residência. Diante da frieza e crueldade do estuprador, que manifesta oscilações comportamentais variáveis, desde ameaças de morte até choro após a violência, a mulher lança mão de estratégias de libertação e sobrevivência. A busca pelo atendimento configura-se em uma verdadeira via-crucis. Entretanto, a despeito dos traumas adquiridos, as mulheres mostraram profunda resiliência.This article, as part of the authors' dissertation for her Masters degree, analyzes the experience of rape and the way victims face the problem. It also describes the behavior of the rapist based on the victims' view. Five women, who were being attended in a HIV/AIDS reference hospital, answered semi-structured interviews that were submitted to the technique of content analysis. The results show the vulnerability of woman, not only in deserted places and public ways but also at work and at home. The victims use strategies of liberation and survival at the moment of rape, in face of the rapist who reveals himself as being cruel and cold, with emotional oscillations that may vary from death threats to crying after the rape. Reaching out for assistance constitutes a real via cruxes for the victims. However, despite the traumas, they have demonstrated a profound capacity of resilience.

  15. Trauma abdominal em grávidas Abdominal trauma in pregnant women

    Directory of Open Access Journals (Sweden)

    Gustavo Pereira Fraga

    2005-09-01

    Full Text Available OBJETIVOS: avaliar os fatores indicativos (parâmetros clínicos e índices de gravidade fisiológicos e anatômicos da evolução materna e fetal entre gestantes vítimas de trauma abdominal submetidas à laparotomia e discutir as particularidades do atendimento nesta situação. MÉTODOS: análise retrospectiva dos prontuários de 245 mulheres com trauma abdominal e tratamento operatório, atendidas entre 1990 e 2002. Foram identificadas 13 gestantes com lesão abdominal submetidas à laparotomia. Para registro e análise estatística dos dados foram utilizados o protocolo Epi-Info 6.04 e o teste exato de Fisher, com intervalo de confiança de 95%. Foram relacionados com a mortalidade fetal: escore na escala de coma de Glasgow, pressão arterial sistólica, índices de trauma (RTS, ATI, ISS e lesão uterina. RESULTADOS: a idade variou de 13 a 34 anos (média de 22,5. Seis mulheres (46,2% estavam no terceiro trimestre de gestação. O trauma penetrante correspondeu a 53,8% das lesões e em seis dessas pacientes o mecanismo de trauma foi ferimento por projétil de arma de fogo. Três pacientes tiveram lesões uterinas, associadas com óbito fetal. Não houve óbito materno e a mortalidade fetal foi de 30,7%. Não houve associação entre os índices de trauma e a mortalidade materna e fetal. A lesão uterina foi o único fator preditivo de risco para perda fetal (p=0,014. CONCLUSÕES: apesar da casuística pequena e de se tratar de estudo retrospectivo de gestantes com trauma grave, os achados deste estudo mostram que não há indicadores com boa acurácia para indicação da evolução materna e fetal.PURPOSE: to evaluate the predictors (clinical findings and physiological and anatomical scores of the maternal and fetal outcomes among pregnant women victims of abdominal trauma who were submitted to laparotomy and to discuss particularities of assessment in this situation. METHODS: retrospective analysis of the medical records of 245 women with

  16. Trauma as common denominator of sexual violence and victimisation

    Directory of Open Access Journals (Sweden)

    Veselinović Nataša I.

    2003-01-01

    Full Text Available Results of researches on biological, psychological and sociological characteristics of sexual offenders show etiological and phenomenological differences, while, on the other side, treatment programs show tendency toward unification. Unification that works contains behavioural learning victim empathy work and work on one’s own trauma. In this paper the author looks for an answer to the question who is the sexual offender and how he became that. In theory rapists and paedophiles are similar as much as their victims are, and they are often victims of some traumatic experience which seeks for satisfaction in inappropriate but well-known way. Sexual violence can be stopped by breaking the circle of its beginning and development by helping sexual perpetrator to find the way out from sexual violence circle and healthier behavioural patterns.

  17. 78 FR 52877 - VOCA Victim Assistance Program

    Science.gov (United States)

    2013-08-27

    ... criminal justice process, support for human trafficking victims with a myriad of complicated issues... particularly important for human trafficking victims, but also for victims of domestic abuse, identity theft, and other crimes as well. OVC has funded programs providing services for human trafficking victims for...

  18. Predicting Rape Victim Empathy Based on Rape Victimization and Acknowledgment Labeling.

    Science.gov (United States)

    Osman, Suzanne L

    2016-06-01

    Two studies examined rape victim empathy based on personal rape victimization and acknowledgment labeling. Female undergraduates (Study 1, n = 267; Study 2, n = 381) from a Northeast U.S. midsize public university completed the Rape-Victim Empathy Scale and Sexual Experiences Survey. As predicted, both studies found that acknowledged "rape" victims reported greater empathy than unacknowledged victims and nonvictims. Unexpectedly, these latter two groups did not differ. Study 1 also found that acknowledged "rape" victims reported greater empathy than victims who acknowledged being "sexually victimized." Findings suggest that being raped and acknowledging "rape" together may facilitate rape victim empathy. © The Author(s) 2015.

  19. Association of autistic traits in adulthood with childhood abuse, interpersonal victimization, and posttraumatic stress.

    Science.gov (United States)

    Roberts, Andrea L; Koenen, Karestan C; Lyall, Kristen; Robinson, Elise B; Weisskopf, Marc G

    2015-07-01

    Persons with autistic traits may be at elevated risk for interpersonal victimization across the life course. Children with high levels of autistic traits may be targeted for abuse, and deficits in social awareness may increase risk of interpersonal victimization. Additionally, persons with autistic traits may be at elevated risk of posttraumatic stress disorder (PTSD) symptoms subsequent to trauma. We examined retrospectively reported prevalence of childhood abuse, trauma victimization and PTSD symptoms by autistic traits among adult women in a population-based longitudinal cohort, the Nurses' Health Study II (N=1,077). Autistic traits were measured by the 65-item Social Responsiveness Scale. We estimated odds ratios (OR) for childhood sexual and physical/emotional abuse and PTSD symptoms by quintiles of autistic traits. We examined possible mediation of PTSD risk by abuse and trauma type. Women in the highest versus lowest quintile of autistic traits were more likely to have been sexually abused (40.1% versus 26.7%), physically/emotionally abused (23.9% versus 14.3%), mugged (17.1% versus 10.1%), pressured into sexual contact (25.4% versus 15.6%) and have high PTSD symptoms (10.7% versus 4.5%). Odds of PTSD were elevated in women in the top three quintiles of autistic traits compared with the reference group (OR range=1.4 to 1.9). Childhood abuse exposure partly accounted for elevated risk of PTSD in women with autistic traits. We identify for the first time an association between autistic traits, childhood abuse, trauma victimization, and PTSD. Levels of autistic traits that are highly prevalent in the general population are associated with abuse, trauma and PTSD. Copyright © 2015 Elsevier Ltd. All rights reserved.

  20. Prior Sexual Trauma and Adjustment Following the Virginia Tech Campus Shootings: Examination of the Mediating Role of Schemas.

    Science.gov (United States)

    Littleton, Heather L; Grills-Taquechel, Amie E; Axsom, Danny; Bye, Kimberly; Buck, Katherine S

    2012-11-01

    A sizable body of research supports trauma's cumulative nature. However, few studies have evaluated potential mechanisms through which the experience of multiple traumas leads to elevated distress. The current study sought to evaluate differences between sexual trauma victims and women who had not experienced sexual trauma in their adjustment following a mass trauma (college women exposed to the 2007 Virginia Tech campus shooting). In addition, the study examined whether maladaptive schema change (lower self-worth and less belief in benevolence) and social support mediated the relationship between experiencing multiple traumas (sexual trauma and the campus shooting) and distress. The sample consisted of 215 college women who were assessed preshooting as well as two months and one year following the campus shooting. Women who had experienced sexual trauma (either contact sexual abuse or sexual assault) were compared to those who had not on their one-year postshooting PTSD and depressive symptoms. Results supported that sexual trauma victims reported significantly more depressive symptoms and shooting-related PTSD as well as less belief in benevolence and lower family support. Family support and benevolence beliefs at the two month postshooting assessment were significant medi-ators of the association between sexual trauma history and depression and PTSD. Implications of the findings for future research evaluating the cumulative impact of multiple traumatic experiences are discussed.

  1. Ultrasonography in trauma

    DEFF Research Database (Denmark)

    Weile, Jesper; Nielsen, Klaus; Primdahl, Stine C

    2017-01-01

    .9%) facilities. CONCLUSION: Ultrasonography was used in a non-uniform fashion by multiple specialties in Danish trauma facilities. Very few images from FAST examinations were stored and documentation was scanty. National guidelines on application and documentation of ultrasonography in trauma are called for.......BACKGROUND: The Focused Assessment with Sonography in Trauma (FAST) protocol is considered beneficial in emergent evaluation of trauma patients with blunt or penetrating injury and has become integrated into the Advanced Trauma Life Support (ATLS) protocol. No guidelines exist as to the use....... Twenty-one (95.5%) of the guidelines included and recommended FAST as part of trauma assessment. The recommended person to perform the examination was the radiologist in n = 11 (50.0%), the surgeon in n = 6 (27.3%), the anesthesiologist in n = 1 (4.5%), and unspecified in n = 3 (13.6%) facilities. FAST...

  2. Management of duodenal trauma

    Directory of Open Access Journals (Sweden)

    CHEN Guo-qing

    2011-02-01

    Full Text Available 【Abstract】Duodenal trauma is uncommon but nowadays seen more and more frequently due to the increased automobile accidents and violent events. The management of duodenal trauma can be complicated, especially when massive injury to the pancreatic-duodenal-biliary complex occurs simultaneously. Even the patients receive surgeries in time, multiple postoperative complications and high mortality are common. To know and manage duodenal trauma better, we searched the recent related literature in PubMed by the keywords of duodenal trauma, therapy, diagnosis and abdomen. It shows that because the diagnosis and management are complicated and the mortality is high, duodenal trauma should be treated in time and tactfully. And application of new technology can help improve the management. In this review, we discussed the incidence, diagnosis, management, and complications as well as mortality of duodenal trauma. Key words: Duodenum; Wounds and injuries; Diagnosis; Therapeutics

  3. Victims of fraud: comparing victims of white collar and violent crime.

    Science.gov (United States)

    Ganzini, L; McFarland, B; Bloom, J

    1990-01-01

    Mental health professionals have focused attention on the psychiatric sequelae of criminal victimization. This article compares the experience of white collar and violent crime victims on several parameters including statistical risk of victimization and psychiatric outcome after victimization. Emphasis is given to data obtained from interviewing 77 victims of a fraudulent financial scheme.

  4. The victims of unethical human experiments and coerced research under National Socialism.

    Science.gov (United States)

    Weindling, Paul; von Villiez, Anna; Loewenau, Aleksandra; Farron, Nichola

    2016-03-01

    There has been no full evaluation of the numbers of victims of Nazi research, who the victims were, and of the frequency and types of experiments and research. This paper gives the first results of a comprehensive evidence-based evaluation of the different categories of victims. Human experiments were more extensive than often assumed with a minimum of 15,754 documented victims. Experiments rapidly increased from 1942, reaching a high point in 1943. The experiments remained at a high level of intensity despite imminent German defeat in 1945. There were more victims who survived than were killed as part of or as a result of the experiments, and the survivors often had severe injuries. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

  5. Cyberbullying victimization in adolescents’ population

    OpenAIRE

    Nešić Marija

    2016-01-01

    With the rapid development of communication technology and its wide use by the adolescents, cyberspace became a new risky environment for bullying manifestation and victimization. The significance of the problem lies in the fact that, unlike the traditional bullying, the cyberbullying victimization occurs also out of the school surroundings, it’s characterized by the possible anonymity of the bully, it’s harder to discover it and it could have a much bigger...

  6. The performance and assessment of hospital trauma teams

    Directory of Open Access Journals (Sweden)

    Lockey David J

    2010-12-01

    Full Text Available Abstract The purpose of the trauma team is to provide advanced simultaneous care from relevant specialists to the seriously injured trauma patient. When functioning well, the outcome of the trauma team performance should be greater than the sum of its parts. Trauma teams have been shown to reduce the time taken for resuscitation, as well as time to CT scan, to emergency department discharge and to the operating room. These benefits are demonstrated by improved survival rates, particularly for the most severely injured patients, both within and outside of dedicated trauma centres. In order to ensure the best possible performance of the team, the leadership skills of the trauma team leader are essential and their non-technical skills have been shown to be particularly important. Team performance can be enhanced through a process of audit and assessment of the workings of the team and the evidence currently available suggests that this is best facilitated through the process of video review of the trauma resuscitation. The use of human patient simulators to train and assess trauma teams is becoming more commonplace and this technique offers a safe environment for the future education of trauma team staff. Trauma teams are a key component of most programmes which set out to improve trauma care. This article reviews the background of trauma teams, the evidence for benefit and potential techniques of performance assessment. The review was written after a PubMed, Ovid, Athens, Cochrane and guideline literature review of English language articles on trauma teams and their performance and hand searching of references from the relevant searched articles.

  7. The association between childhood maltreatment, psychopathology, and adult sexual victimization in men and women: results from three independent samples

    Science.gov (United States)

    Werner, K. B.; McCutcheon, V. V.; Challa, M.; Agrawal, A.; Lynskey, M. T.; Conroy, E.; Statham, D. J.; Madden, P. A. F.; Henders, A. K.; Todorov, A. A.; Heath, A. C.; Degenhardt, L.; Martin, N. G.; Bucholz, K. K.; Nelson, E. C.

    2016-01-01

    Background Childhood maltreatment (CM) has consistently been linked with adverse outcomes including substance use disorders and adult sexual revictimization. Adult sexual victimization itself has been linked with psychopathology but has predominately been studied in women. The current investigation examines the impact of CM and co-occurring psychopathology on adult sexual victimization in men and women, replicating findings in three distinct samples. Method We investigated the association between continuous CM factor scores and adult sexual victimization in the Childhood Trauma Study (CTS) sample (N = 2564). We also examined the unique relationship between childhood sexual abuse (CSA) and adult sexual victimization while adjusting for co-occurring substance dependence and psychopathology. We replicated these analyses in two additional samples: the Comorbidity and Trauma Study (CATS; N = 1981) and the Australian Twin-Family Study of Alcohol Use Disorders (OZ-ALC; N = 1537). Results Analyses revealed a significant association with CM factor scores and adult sexual victimization for both men and women across all three samples. The CSA factor score was strongly associated with adult sexual victimization after adjusting for substance dependence and psychopathology; higher odds ratios were observed in men (than women) consistently across the three samples. Conclusions A continuous measure of CSA is independently associated with adult sexual trauma risk across samples in models that included commonly associated substance dependence and psychopathology as covariates. The strength of the association between this CSA measure and adult sexual victimization is higher in magnitude for men than women, pointing to the need for further investigation of sexual victimization in male community samples. PMID:26688007

  8. Estudo preliminar das relações entre duração da parada cardiorrespiratória e suas consequências nas vítimas de trauma Preliminary study of the relationship between the cardiopulmonary arrest time and its consequences in patients who underwent trauma

    Directory of Open Access Journals (Sweden)

    Andréia Bertelli

    1999-06-01

    Full Text Available Foi proposta desta pesquisa obter subsídios para iniciar ou manter manobras de reanimação cardiopulmonar (RCP especificamente em vítimas de trauma. A duração da parada e reanimação cardiopulmonar de sobreviventes foi descrita, assim como, o desempenho cerebral e mortalidade dessas vítimas 24, 48 e 72 horas após tais eventos terem ocorrido. Com os resultados dessa caracterização estudou-se a relação entre tempo de parada e reanimação cardiorrespiratória, e, mortalidade. Os dados foram obtidos em plantões no Pronto Socorro do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo. Grande parte das vítimas (93,4% apresentaram trauma grave e a principal "causa mortis" foi trauma crânio-encefálico. A sobrevivência ao período de 72 horas foi de 10%. A avaliação de 72 horas, das vítimas sobreviventes a parada cardiorrespiratória (PCR de causa traumática mostrou mau desempenho cerebral dessas vítimas no período. A sobrevida após o primeiro episódio de PCR relacionou-se mais consistentemente com o tempo de PCR das vítimas de trauma do que o tempo de RCP. O tempo de PCR The proposal of this research was to obtain parameters to start or maintain cardiopulmonary resuscitation (CPR in victims of trauma. The duration of the cardiac arrest and the CPR of the survivors was described, as well as the cerebral performance and the mortality of these victims 24, 48 and 72 hours after these events had happened. With the results of this caracterization the relation between duration of cardiac arrest time, CPR and mortality were described. Data for this report were coleted in Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo emergency departament. A big amount of the victims (93, 4% presents severe trauma and main cause of death was brain injury. Survival at 72 hours after CPR was 10%. The assessment, during the 72 hour period, of the survivors from cardiac arrest of traumatic cause has

  9. About Military Sexual Trauma

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  11. [Trauma registry and injury].

    Science.gov (United States)

    Shapira, S C

    2001-10-01

    The trauma registry network constitutes an essential database in every injury prevention system. In order to rationally estimate the extent of injury in general, and injuries from traffic accidents in particular, the trauma registry systems should contain the most comprehensive and broad database possible, in line with the operational definitions. Ideally, the base of the injury pyramid should also include mild injuries and even "near-misses". The Israeli National Trauma Registry has come a long way in the last few years. The eventual inclusion of all trauma centers in Israel will enable the establishment of a firm base for the allocation of resources by decision-makers.

  12. About Military Sexual Trauma

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  15. Abusive head trauma: Differentiation between impact and non-impact cases based on neuroimaging findings and skeletal surveys

    Energy Technology Data Exchange (ETDEWEB)

    Sieswerda-Hoogendoorn, T., E-mail: t.sieswerda@amc.nl [Department of Forensic Medicine, Netherlands Forensic Institute, The Hague (Netherlands); Department of Radiology, Academic Medical Center/Emma Children' s Hospital, Meibergdreef 9, 1105 AZ Amsterdam (Netherlands); Robben, S.G.F., E-mail: s.robben@maastrichtuniversity.nl [Maastricht University Medical Center, P.O. Box 5800, 6202 AZ Maastricht (Netherlands); Karst, W.A., E-mail: w.karst@nfi.minvenj.nl [Department of Forensic Medicine, Netherlands Forensic Institute, P.O. Box 24044, 2490 AA The Hague (Netherlands); Moesker, F.M., E-mail: f.moesker@erasmusmc.nl [Faculty of Medicine, Academic Medical Center, Amsterdam (Netherlands); Aalderen, W.M. van, E-mail: w.m.vanaalderen@amc.nl [Department of Paediatrics, Academic Medical Center/Emma Children' s Hospital, Meibergdreef 9, 1105 AZ Amsterdam (Netherlands); Laméris, J.S., E-mail: j.s.lameris@amc.nl [Department of Radiology, Academic Medical Center, Meibergdreef 9, 1105 AZ Amsterdam (Netherlands); Rijn, R.R. van, E-mail: r.r.vanrijn@amc.nl [Department of Forensic Medicine, Netherlands Forensic Institute, The Hague (Netherlands); Department of Radiology, Academic Medical Center/Emma Children' s Hospital, Meibergdreef 9, 1105 AZ Amsterdam (Netherlands)

    2014-03-15

    Objectives: To determine whether imaging findings can be used to differentiate between impact and non-impact head trauma in a group of fatal and non-fatal abusive head trauma (AHT) victims. Methods: We included all AHT cases in the Netherlands in the period 2005–2012 for which a forensic report was written for a court of law, and for which imaging was available for reassessment. Neuroradiological and musculoskeletal findings were scored by an experienced paediatric radiologist. Results: We identified 124 AHT cases; data for 104 cases (84%) were available for radiological reassessment. The AHT victims with a skull fracture had fewer hypoxic ischaemic injuries than AHT victims without a skull fracture (p = 0.03), but the relative difference was small (33% vs. 57%). There were no significant differences in neuroradiological and musculoskeletal findings between impact and non-impact head trauma cases if the distinction between impact and non-impact head trauma was based on visible head injuries, as determined by clinical examination, as well as on the presence of skull fractures. Conclusions: Neuroradiological and skeletal findings cannot discriminate between impact and non-impact head trauma in abusive head trauma victims.

  16. Abusive head trauma: Differentiation between impact and non-impact cases based on neuroimaging findings and skeletal surveys

    International Nuclear Information System (INIS)

    Sieswerda-Hoogendoorn, T.; Robben, S.G.F.; Karst, W.A.; Moesker, F.M.; Aalderen, W.M. van; Laméris, J.S.; Rijn, R.R. van

    2014-01-01

    Objectives: To determine whether imaging findings can be used to differentiate between impact and non-impact head trauma in a group of fatal and non-fatal abusive head trauma (AHT) victims. Methods: We included all AHT cases in the Netherlands in the period 2005–2012 for which a forensic report was written for a court of law, and for which imaging was available for reassessment. Neuroradiological and musculoskeletal findings were scored by an experienced paediatric radiologist. Results: We identified 124 AHT cases; data for 104 cases (84%) were available for radiological reassessment. The AHT victims with a skull fracture had fewer hypoxic ischaemic injuries than AHT victims without a skull fracture (p = 0.03), but the relative difference was small (33% vs. 57%). There were no significant differences in neuroradiological and musculoskeletal findings between impact and non-impact head trauma cases if the distinction between impact and non-impact head trauma was based on visible head injuries, as determined by clinical examination, as well as on the presence of skull fractures. Conclusions: Neuroradiological and skeletal findings cannot discriminate between impact and non-impact head trauma in abusive head trauma victims

  17. Examining cultural, social, and self-related aspects of stigma in relation to sexual assault and trauma symptoms.

    Science.gov (United States)

    Deitz, Mandi F; Williams, Stacey L; Rife, Sean C; Cantrell, Peggy

    2015-05-01

    The current study investigated a model explaining sexual assault victims' severity of trauma symptoms that incorporated multiple stigma constructs. Integrating the sexual assault literature with the stigma literature, this study sought to better understand trauma-related outcomes of sexual assault by examining three levels of stigma-cultural, social, and self. Results showed self-stigma was significantly and positively related to trauma symptom severity. Thus, results revealed that the internalized aspect of stigma served as a mechanism in the relation between sexual assault severity and increased levels of trauma symptom severity, highlighting the importance of assessing self-stigma in women reporting sexual assault experiences. © The Author(s) 2015.

  18. Genitourinary injuries after traffic accidents: Analysis of a registry of 162,690 victims.

    Science.gov (United States)

    Terrier, Jean-Etienne; Paparel, Philippe; Gadegbeku, Blandine; Ruffion, Alain; Jenkins, Lawrence C; N'Diaye, Amina

    2017-06-01

    Traffic accidents are the most frequent cause of genitourinary injuries (GUI). Kidney injuries after trauma have been well described. However, there exists a paucity of data on other traumatic GUI after traffic accidents. The objective of this study was to analyze the frequency and type of all GUI, by user category, after traffic accidents. Patient cases were extracted from the trauma registry of the French department of Rhone from 1996 to 2013. We assessed the urogenital injuries presented by each of road user's categories. Severity injuries were coded with the Abbreviated Injury Scale and the Injury Severity Score. Kidney trauma was mapped with the classification of the American Association for the Surgery of Trauma. Multivariate prediction models were used for analysis of data. Of 162,690 victims, 963 presented with GUI (0.59%). 47% were motorcyclists, 22% were in a car, 18% on bicycles, and 9% were pedestrians. The most common organ injury was kidney (41%) followed by testicular (23%). Among the 208 motorists with a GUI, kidney (70%), bladder (10%), and adrenal gland (9%) were the most frequent lesions. Among the 453 motorcyclist victims with GUI, kidney (35%) and testicular (38%) traumas were the most frequent and 62% of injuries involved external genitalia. There were 175 cyclists with GUI, 70% of injuries involved external genitalia; penile traumas (23%) were the most frequent. In total, there were 395 kidney injuries, most being low grade. According to the American Association for the Surgery of Trauma kidney injuries were grade I, 59%; grade II, 11%; grade III, 16%; grade IV, 9%; grade V, 3%; and indeterminate, 2%. GUI is an infrequent trauma after traffic accidents, with kidneys being the most commonly injured. Physicians must maintain a high awareness for external genitalia injuries in motorcyclists and cyclists. Prognostic and epidemiologic study, level III.

  19. Are routine pelvic radiographs in major pediatric blunt trauma necessary?

    Energy Technology Data Exchange (ETDEWEB)

    Lagisetty, Jyothi [Memorial Hermann Medical Center, Emergency Medicine Department, Houston, TX (United States); Slovis, Thomas [Wayne State University School of Medicine, Department of Radiology, Pediatric Imaging, Children' s Hospital of Michigan, Detroit, MI (United States); Thomas, Ronald [Children' s Hospital of Michigan, Wayne State University of Medicine, Department of Pediatrics, Detroit, MI (United States); Knazik, Stephen; Stankovic, Curt [Wayne State University of Medicine, Division of Emergency Medicine, Children' s Hospital of Michigan, Detroit, MI (United States)

    2012-07-15

    Screening pelvic radiographs to rule out pelvic fractures are routinely used for the initial evaluation of pediatric blunt trauma. Recently, the utility of routine pelvic radiographs in certain subsets of patients with blunt trauma has been questioned. There is a growing amount of evidence that shows the clinical exam is reliable enough to obviate the need for routine screening pelvic radiographs in children. To identify variables that help predict the presence or absence of pelvic fractures in pediatric blunt trauma. We conducted a retrospective study from January 2005 to January 2010 using the trauma registry at a level 1 pediatric trauma center. We analyzed all level 1 and level 2 trauma victims, evaluating history, exam and mechanism of injury for association with the presence or absence of a pelvic fracture. Of 553 level 1 and 2 trauma patients who presented during the study period, 504 were included in the study. Most of these children, 486/504 (96.4%), showed no evidence of a pelvic fracture while 18/504 (3.6%) had a pelvic fracture. No factors were found to be predictive of a pelvic fracture. However, we developed a pelvic fracture screening tool that accurately rules out the presence of a pelvic fracture P = 0.008, NPV 99, sensitivity 96, 8.98 (1.52-52.8). This screening tool combines eight high-risk clinical findings (pelvic tenderness, laceration, ecchymosis, abrasion, GCS <14, positive urinalysis, abdominal pain/tenderness, femur fracture) and five high-risk mechanisms of injury (unrestrained motor vehicle collision [MVC], MVC with ejection, MVC rollover, auto vs. pedestrian, auto vs. bicycle). Pelvic fractures in pediatric major blunt trauma can reliably be ruled out by using our pelvic trauma screening tool. Although no findings accurately identified the presence of a pelvic fracture, the screening tool accurately identified the absence of a fracture, suggesting that pelvic radiographs are not warranted in this subset of patients. (orig.)

  20. Maxillofacial intervention in trauma patients aged 60 years and older

    Directory of Open Access Journals (Sweden)

    Subhashraj K

    2008-01-01

    Full Text Available The purpose of this study was to evaluate the incidence of trauma victims of age 60 years and older who required maxillofacial intervention. The study analyses the pattern of injuries and the various factors that predict the treatment plan of these patients. A retrospective study was carried out in 1820 trauma patients who reported to the Sri. Ramachandra Dental College and Hospital and required maxillofacial intervention, over a period of 5 years (October 2000 and September 2005. Of the total trauma victims, 185 patients were found to be aged 60 years more. In the majority of the patients, the injury was due to road traffic accidents (79.4%. Males (72.4% sustained more injuries than females (27.6%. Soft tissue injuries were seen in 49.1% of the patients, while 14% had mandibular fractures. People in their early 60s were injured more often than their older counterparts. The findings of this study highlight the present situation with regard to maxillofacial trauma in patients aged 60 years and older and its management in this part of the country.

  1. Coagulation studies in patients with orthopedic trauma

    Directory of Open Access Journals (Sweden)

    Rangarajan Kanchana

    2010-01-01

    Full Text Available Background : Head injury, severe acidosis, hypothermia, massive transfusion and hypoxia often complicate traumatic coagulopathy. First line investigations such as prothrombin time, activated partial thromboplastin time, thrombin time, fibrinogen level, platelet count and D-dimer levels help in the initial assessment of coagulopathy in a trauma victim. Aim : To study the coagulation profile in patients of orthopedic trauma. Settings and Design : Prospective study. Patients and Methods : Patients with head injury, severe acidosis, massive transfusion and severe hypoxia were excluded from the study. Coagulation parameters were evaluated at three intervals, at the time of admission, intra operatively and in the postoperative period. Statistical Analysis : Chi-square test was used for analysis of categorical variables. For comparison between groups, two- way ANOVA was used. Results and Conclusions : Of the 48 patients studied, 38 (80% had normal DIC scores upon admission and only 10 (20% had mild DIC scores at the time of admission. The median Injury Severity Score was 34 and they did not correlate with DIC scores. Fibrinogen levels alone were significantly different, increased progressively (mean pre op, intra op and post op levels 518 ± 31,582 ± 35 and 643 ± 27 respectively; P ≤ 0.02 since the time of admission in these patients. All the other parameters remained unchanged. Further large scale prospective studies would be required to correlate elevated fibrinogen levels with the type of trauma or surgery.

  2. The sequential trauma score - a new instrument for the sequential mortality prediction in major trauma*

    Directory of Open Access Journals (Sweden)

    Huber-Wagner S

    2010-05-01

    Full Text Available Abstract Background There are several well established scores for the assessment of the prognosis of major trauma patients that all have in common that they can be calculated at the earliest during intensive care unit stay. We intended to develop a sequential trauma score (STS that allows prognosis at several early stages based on the information that is available at a particular time. Study design In a retrospective, multicenter study using data derived from the Trauma Registry of the German Trauma Society (2002-2006, we identified the most relevant prognostic factors from the patients basic data (P, prehospital phase (A, early (B1, and late (B2 trauma room phase. Univariate and logistic regression models as well as score quality criteria and the explanatory power have been calculated. Results A total of 2,354 patients with complete data were identified. From the patients basic data (P, logistic regression showed that age was a significant predictor of survival (AUCmodel p, area under the curve = 0.63. Logistic regression of the prehospital data (A showed that blood pressure, pulse rate, Glasgow coma scale (GCS, and anisocoria were significant predictors (AUCmodel A = 0.76; AUCmodel P + A = 0.82. Logistic regression of the early trauma room phase (B1 showed that peripheral oxygen saturation, GCS, anisocoria, base excess, and thromboplastin time to be significant predictors of survival (AUCmodel B1 = 0.78; AUCmodel P +A + B1 = 0.85. Multivariate analysis of the late trauma room phase (B2 detected cardiac massage, abbreviated injury score (AIS of the head ≥ 3, the maximum AIS, the need for transfusion or massive blood transfusion, to be the most important predictors (AUCmodel B2 = 0.84; AUCfinal model P + A + B1 + B2 = 0.90. The explanatory power - a tool for the assessment of the relative impact of each segment to mortality - is 25% for P, 7% for A, 17% for B1 and 51% for B2. A spreadsheet for the easy calculation of the sequential trauma

  3. Associations between youth homelessness, sexual offenses, sexual victimization, and sexual risk behaviors: a systematic literature review.

    Science.gov (United States)

    Heerde, Jessica A; Scholes-Balog, Kirsty E; Hemphill, Sheryl A

    2015-01-01

    Homeless youth commonly report engaging in sexual risk behaviors. These vulnerable young people also frequently report being sexually victimized. This systematic review collates, summarizes, and appraises published studies of youth investigating relationships between homelessness, perpetration of sexual offenses, experience of sexual victimization, and engagement in sexual risk behavior. A systematic search of seventeen psychology, health, and social science electronic databases was conducted. Search terms included "homeless*," "youth," "offend*," "victimization," "crime," "rape," "victim*," and "sex crimes." Thirty-eight studies were identified that met the inclusion criteria. Findings showed homeless youth commonly report being raped and sexually assaulted, fear being sexually victimized, and engage in street prostitution and survival sex. Rates of victimization and sexual risk behavior were generally higher for females. Given the paucity of longitudinal studies and limitations of current studies, it is unclear whether homelessness is prospectively associated with sexual victimization or engagement in sexual risk behavior, and whether such associations vary cross nationally and as a function of time and place. Future prospective research examining the influence of the situational context of homelessness is necessary to develop a better understanding of how homelessness influences the perpetration of sexual offenses, experience of sexual victimization, and engagement in sexual risk behavior among homeless youth.

  4. Trauma and the truth

    NARCIS (Netherlands)

    Meeter, Martijn

    2016-01-01

    Witnessing horrible things may leave a person scarred for life — an effect usually referred to as psychological trauma. We do not know exactly what it does or how it worms its way into our psyche, but psychological trauma has been linked to a wide range of fear- and depression-related symptoms

  5. Trauma - the malignant epidemic

    African Journals Online (AJOL)

    murdered by the time he is aged 35 years.5 Trauma is respon- sible for the deaths of ISO000 Americans each ... people than malignant disease, hean disease and AIDS com- bined.7. South Mrica. South Africa has no ... away trauma patients, the IeU has also to refuse care for those patients who.require intensive monitoring ...

  6. Platelet aggregation following trauma

    DEFF Research Database (Denmark)

    Windeløv, Nis A; Sørensen, Anne M; Perner, Anders

    2014-01-01

    We aimed to elucidate platelet function in trauma patients, as it is pivotal for hemostasis yet remains scarcely investigated in this population. We conducted a prospective observational study of platelet aggregation capacity in 213 adult trauma patients on admission to an emergency department (ED...

  7. Haemostatic resuscitation in trauma

    DEFF Research Database (Denmark)

    Stensballe, Jakob; Ostrowski, Sisse Rye; Johansson, Par I.

    2016-01-01

    PURPOSE OF REVIEW: To discuss the recent developments in and evolvement of next generation haemostatic resuscitation in bleeding trauma. RECENT FINDINGS: Mortality from major trauma is a worldwide problem, and massive haemorrhage remains a major cause of potentially preventable deaths. Developmen...

  8. Randomized clinical trial comparing affect regulation and supportive group therapies for victimization-related PTSD with incarcerated women.

    Science.gov (United States)

    Ford, Julian D; Chang, Rocío; Levine, Joan; Zhang, Wanli

    2013-06-01

    Traumatic victimization and associated problems with posttraumatic stress disorder (PTSD) and affect dysregulation are prevalent among incarcerated women, but there is limited evidence to support psychotherapeutic interventions for these problems in this underserved population. A group psychotherapy designed to enhance affect regulation without trauma memory processing-Trauma Affect Regulation: Guide for Education and Therapy (TARGET)-was compared to a supportive group therapy (SGT) in a randomized clinical trial with 72 incarcerated women with full or partial PTSD. Both interventions achieved statistically significant reductions in PTSD and associated symptom severity and increased self-efficacy. Dropout rates for both interventions were low (women's ability to achieve affective resolution (forgiveness) while also reducing their victimization-related PTSD and associated symptoms. Experiential-focused supportive group therapy also may reduce victimization-related PTSD and associated symptoms. Both group therapy approaches warrant further study with this vulnerable population. Copyright © 2012. Published by Elsevier Ltd.

  9. The dependence of the nature of the crime to the type of trauma the perpetrator (for example, minors convicted of violent crimes

    Directory of Open Access Journals (Sweden)

    Khachaturyan S. Dzh.

    2017-07-01

    Full Text Available The article is devoted to psychological correction of juvenile offenders for violent crimes. The authors, based on the fundamentals polygeneration system of traumatology, hypothesize about the presence of a family history of juvenile offenders system traumas. The study was conducted in PKU Nakhodka educational colony GUFSIN Russia for the Primorye territory in January-February 2017. The study involved 23 minors convicted of violent crimes. All system traumas are divided into four types: existential trauma, trauma of losses, trauma of relationship and trauma family system. Conclusions about what the nature of the offence depends on the depth and type of traumatization of the perpetrator and his family system. All examined juvenile offenders are themselves victims of traumatic events in their own families. The main types of trauma from sex offenders are trauma of losses and trauma of relationship. Family convicted of murder filled with existential trauma, trauma of relationship and trauma family system. Convicted of intentional infliction of grievous bodily harm had an average degree of trauma. There are all kinds of trauma in their experience, with a predominance of existential trauma. Offered the main directions of psychological adjustment to each category of prisoners.

  10. Mediational Significance of PTSD in the Relationship of Sexual Trauma and Eating Disorders

    Science.gov (United States)

    Holzer, Sarah R.; Uppala, Saritha; Wonderlich, Stephen A.; Crosby, Ross D.; Simonich, Heather

    2008-01-01

    Objective: To examine the mediational significance of posttraumatic stress disorder (PTSD) and the development of eating disorder symptomatology following sexually traumatic experiences. Method: Seventy-one victims of sexual trauma and 25 control subjects completed interviews and questionnaires assessing eating disorder psychopathology and…

  11. Analysis of personality traits as a risk factor in crash related trauma.

    African Journals Online (AJOL)

    Conclusion: Majority of CRT victims attending orthopedic emergency unit at trauma center had impulsive and histrionic per- ... cite as: Kumar V, Goyal R, Singh A, Sharma V, Srivastava RN,Kumar S, Kumar A. Analysis of personality traits as a risk factor in crash .... namely International Personality Disorder Examination.

  12. Justice And Legal Certainty For Child Victims

    Directory of Open Access Journals (Sweden)

    Edi Setiadi

    2016-12-01

    Full Text Available Focus of attention in the criminal justice system so far has always been to the perpetrator, whereas parties related to a process of criminal justice encompasses the perpetrator, the victim, and the community. A crime victim, in particular, would suffer more since he/she could experience secondary victimization in the criminal justice system. The law concerning victim and witness protection only states the limitation for the criminal victim to ask for compensation to criminal justice system, either as a victim of direct criminal or a victim of abuse power done by law enforcement officers. Child victims are treated the same way as to adult victims, whilst they have a greater dimension of the problem and effects to be dealt with Mechanism and procedures to be followed are ius constituendum (intended/desirable law, as they only share expectation of indemnity, compensation, and rehabilitation which have not been empirically tested in a real situation.

  13. Gangguan Stres Pasca Trauma Pada Korban Pelecehan Seksual dan Pemerkosaan

    Directory of Open Access Journals (Sweden)

    Aries Dirgayunita

    2016-12-01

    Full Text Available Sexual abuse and rape is one of the worst things that can be experienced and toughest human beings, both women and men. In addition to physical injury also brought emotional pain or psychological needs time to heal. According to WHO data in 2006 found that women abused, raped and was beaten every day around the world. At least half of the world's population who are women has experienced both physical and psychological of violence. in cases of sexual abuse and rape, mostly victims of sexual abuse and rape are women, but in some cases, men can also be victims generally performed by men as well. Perpetrators is the people around them, sometimes they know well. While most other cases, performed by people who are just been known that originally as a good man who offered to help. Sexual harassment and rapes will trigger a deep trauma to victims. Victims of rape and sexual abuse can experience stress as a result of traumatic experiences that have happened. Stress disorder endured by the victims of sexual abuse and rapes is often referred to Post Traumatic Stress Disorder (Post Traumatic Stress Disorder or PTSD.

  14. Exploring the Characteristics of Personal Victims Using the National Crime Victimization Survey

    National Research Council Canada - National Science Library

    Jairam, Shashi

    1998-01-01

    .... Two statistical methods were used to investigate these hypotheses, logistical regression for victimization prevalence, and negative binomial regression for victimization incidence and concentration...

  15. Combined Therapy of Pegylated G-CSF and Alxn4100TPO Improves Survival and Mitigates Acute Radiation Syndrome after Whole-Body Ionizing Irradiation Alone and Followed by Wound Trauma.

    Science.gov (United States)

    Kiang, Juliann G; Zhai, Min; Bolduc, David L; Smith, Joan T; Anderson, Marsha N; Ho, Connie; Lin, Bin; Jiang, Suping

    2017-11-01

    Exposure to ionizing radiation alone or combined with traumatic tissue injury is a crucial life-threatening factor in nuclear and radiological incidents. Radiation injuries occur at the molecular, cellular, tissue and systemic levels; their mechanisms, however, remain largely unclear. Exposure to radiation combined with skin wounding, bacterial infection or burns results in greater mortality than radiation exposure alone in dogs, pigs, rats, guinea pigs and mice. In the current study we observed that B6D2F1/J female mice exposed to 60 Co gamma-photon radiation followed by 15% total-body-surface-area skin wounds experienced an increment of 25% higher mortality over a 30-day observation period compared to those subjected to radiation alone. Radiation exposure delayed wound healing by approximately 14 days. On day 30 post-injury, bone marrow and ileum in animals from both groups (radiation alone or combined injury) still displayed low cellularity and structural damage. White blood cell counts, e.g., neutrophils, lymphocytes, monocytes, eosinophils, basophils and platelets, still remained very low in surviving irradiated alone animals, whereas only the lymphocyte count was low in surviving combined injury animals. Likewise, in surviving animals from radiation alone and combined injury groups, the RBCs, hemoglobin, hematocrit and platelets remained low. We observed, that animals treated with both pegylated G-CSF (a cytokine for neutrophil maturation and mobilization) and Alxn4100TPO (a thrombopoietin receptor agonist) at 4 h postirradiation, a 95% survival (vehicle: 60%) over the 30-day period, along with mitigated body-weight loss and significantly reduced acute radiation syndrome. In animals that received combined treatment of radiation and injury that received pegylated G-CSF and Alxn4100TPO, survival was increased from 35% to 55%, but did not accelerate wound healing. Hematopoiesis and ileum showed significant improvement in animals from both groups (irradiation

  16. Lived experiences of male intimate partners of female rape victims in Cape Town, South Africa

    Directory of Open Access Journals (Sweden)

    Evalina van Wijk

    2014-09-01

    Objectives: The study aimed to explore the lived experiences of MIPs of female rape victims and the meaning of these experiences in the six months following the partner’s rape. Method: We conducted a longitudinal hermeneutic phenomenological study. Nine purposively sampled adult MIPs were interviewed over a period of six months. The participants were in an intimate relationship with a female rape victim prior to and immediately after the rape; their partners had been treated at a specialised centre for victims of rape and sexual assault. Four interviews were conducted with each of the nine intimate partners of female rape victims: (1 within 14 days of, (2 a month after, (3 three months after, and (4 six months after the rape. Results: Two major themes emerged: being-in-the-world as a secondary victim of rape, and living in multiple worlds, those of their female partners, family, friends, society, employers or colleagues, professionals and the justice system. The participant’s familiar world became strange and even threatening, and his relationship with his partner became uncertain. Conclusion: Early supportive intervention for intimate partners of female rape victims is required to prevent on-going emotional trauma and alleviate the effects of chronic post-traumatic stress disorder and suffering at intra- and interpersonal levels.

  17. Bullying and Victimization Among Children

    Science.gov (United States)

    Shetgiri, Rashmi

    2013-01-01

    Bullying among children is a significant public health problem world-wide. Bullying is most commonly defined as repeated, intentional aggression, perpetrated by a more powerful individual or group against a less powerful victim. Trends in victimization and moderate to frequent bullying may be decreasing slightly in the United States, but over 20% of children continue to be involved in bullying. Direct bullying consists of physical and verbal aggression, whereas indirect bullying involves relational aggression. Cyber bullying is an emerging problem which may be more difficult to identify and intervene with than traditional bullying. Bullies, victims, and bully-victims are at risk for negative short and long-term consequences such as depression, anxiety, low self-esteem, and delinquency. Various individual, parental, and peer factors increase the risk for involvement in bullying. Anti-bullying interventions are predominantly school-based and demonstrate variable results. Healthcare providers can intervene in bullying by identifying potential bullies or victims, screening them for co-morbidities, providing counseling and resources, and advocating for bullying prevention. PMID:24007839

  18. Victimization and the general theory of crime.

    Science.gov (United States)

    Nofziger, Stacey

    2009-01-01

    Theories of victimization developed independently of theories of offending, in spite of consistent findings of similarities between offenders and victims of crime. This study examines whether Gottfredson and Hirschi's (1990) general theory of crime, typically used to predict offending, also has relevance in understanding juvenile victimization. The data for this project are drawn from a sample of over 1,200 middle and high school students. Using structural equation models, the findings suggest that higher self-control does directly decrease victimization and that self-control also affects victimization indirectly though opportunities (peer deviance). Implications for the studies of victimization as well as the general theory of crime are discussed.

  19. Child homicide victims in forensic autopsy in Taiwan: A 10-year retrospective study.

    Science.gov (United States)

    Hwa, Hsiao-Lin; Pan, Chih-Hsin; Shu, Guang-Ming; Chang, Chin-Hao; Lee, Tsui-Ting; Lee, James Chun-I

    2015-12-01

    Child homicides are critical medico-legal issues worldwide. Data on the characteristics of these cases in Asia are limited. This study aimed to describe the characteristics of child homicides in Taiwan. A retrospective analysis of forensic autopsy records of child homicide victims (aged 0-17 years) in Taiwan, during a 10-year period between 2001 and 2010, was carried out. The age, sex, relationship with the perpetrator(s), injury patterns of the victims, and causes of death were analyzed. In all, 193 child homicide autopsies were identified. There were 38 (19.7%), 82 (42.5%), 25 (13.0%), and 48 (24.9%) homicide victims aged under 1, 1-5, 6-12, and 13-17 years, respectively. One-hundred boys (mean age: 8.4±7.0) and 93 girls (mean age: 3.7±4.3) were included. A female predominance was noted among the victims aged 0-5. Blunt force (53.4%) was the most frequent method of injury, followed by suffocation/strangulation (20.2%) and sharp force (13.0%). Bruise (64.8%) and brain injury (45.1%) were the most common types of injuries. The cranium (62.2%) and face (60.6%) were the most frequently injured body regions. The distribution of fatal injuries varied among victims in different age groups. Neurogenic shock, asphyxia, and hemorrhagic shocks were most common in victims aged 0-5, 6-12, and 13-17, respectively. The most frequent causes of death included blunt force head injury (40.4%), suffocation/strangulation (20.2%), and sharp force lung trauma (7.3%). The type of offenders, injury methods, types of injuries, distribution of injuries, mechanism of death, and causes of death were significantly different among victims of different age groups. Eighteen (9.33%) victims displayed no external evidence of trauma. The patterns of injuries, mechanism of death, and causes of death were different among victims of different age groups. A female predominance was noted among the victims aged 0-5. Complete forensic autopsy is necessary to identify child homicide. This report will

  20. Sexual Aggression Experiences Among Male Victims of Physical Partner Violence: Prevalence, Severity, and Health Correlates for Male Victims and Their Children.

    Science.gov (United States)

    Hines, Denise A; Douglas, Emily M

    2016-07-01

    Although research has documented the prevalence and health correlates of sexual aggression among women who have experienced severe partner violence (PV), no research has documented the parallel issues among male victims of severe PV. Research also suggests that children of female victims of both physical and sexual PV have worse mental health than children of female victims of physical PV only, but no research has assessed the mental health of children whose fathers experienced both physical and sexual PV. We surveyed 611 men who experienced physical PV from their female partners and sought help. We assessed the types and extent of various forms of PV, the men's mental and physical health, and the mental health of their oldest child. Results showed that almost half of the men experienced sexual aggression in their relationship, and 28 % severe sexual aggression. Increasing levels of severity of sexual aggression victimization was associated with greater prevalence and types of other forms of PV. In addition, greater levels of severity of sexual aggression victimization among the men was significantly associated with depression symptoms, post-traumatic stress disorder symptoms, physical health symptoms, and poor health, and attention deficit and affective symptoms among their children. These associations held after controlling for demographics and other violence and trauma exposure. Discussion focused on the importance of broadening our conceptualization of PV against men by women to include sexual aggression as well.

  1. The Violent Victimization of Children, Adolescents, Adults, and the Elderly: Situational Characteristics and Victim Injury.

    Science.gov (United States)

    Kelsay, James D; Tillyer, Marie Skubak; Tillyer, Rob; Ward, Jeffrey T

    2017-04-01

    This study explores the nature and outcome of violent incidents experienced by child, adolescent, adult, and elderly victims. Data from the National Incident-Based Reporting System (NIBRS) are used to determine whether there are differences in the situational characteristics-including location, time of day, weapons, and the victim-offender relationship-of violent victimization experiences across the 4 age groups, including whether situational characteristics influence the likelihood of victim injury. Results indicate that victim injury is most prevalent among adult victims and that the situational characteristics of violent incidents vary by victim age, as do the correlates of victim injury. These findings suggest that of the nature of violent victimization should be examined within the context of victim age, and supports research by scholars who have proposed a model of developmental victimology to identify age-specific victimization patterns.

  2. Is extracorporeal rewarming indicated in avalanche victims with unwitnessed hypothermic cardiorespiratory arrest?

    Science.gov (United States)

    Mair, Peter; Brugger, Hermann; Mair, Birgit; Moroder, Luca; Ruttmann, Elfriede

    2014-12-01

    International guidelines recommend using extracorporeal rewarming in all hypothermic avalanche victims with prolonged cardiac arrest if they have patent airways and a plasma potassium level≤12 mmol/L. The aim of this study was to evaluate outcome data to determine if available experience with extracorporeal rewarming of avalanche victims supports this recommendation. At Innsbruck Medical University Hospital, 28 patients with hypothermic cardiac arrest following an avalanche accident were resuscitated using extracorporeal circulation. Of these patients, 25 were extricated from the snow masses with no vital signs and did not survive to hospital discharge. Three patients had witnessed cardiac arrest after extrication and a core temperature of 21.7°C, 22°C, and 24.0°C, two of whom survived long-term with full neurological recovery. A search of the literature revealed only one asystolic avalanche victim with unwitnessed hypothermic cardiac arrest (core temperature 19°C) surviving long-term. All other avalanche victims in the medical literature surviving prolonged hypothermic cardiac arrest suffered witnessed arrest after extrication with a core temperature below 24°C. Our results suggest that prognosis of hypothermic avalanche victims with unwitnessed asystolic cardiac arrest and a core temperature>24°C is extremely poor. Available outcome data do not support the use of extracorporeal rewarming in these patients.

  3. Sexual Coercion, Trauma, and Sex Work in Justice-Involved Women with Substance Use Disorders.

    Science.gov (United States)

    Salina, Doreen D; Ram, Daphna; Jason, Leonard A

    Sexual victimization is strongly associated with mental health problems, traumatic responses, earlier onset of substance use and criminal justice involvement. It is well known that multiple forms of sexual victimization and aggression have been experienced by most incarcerated women. Two hundred women with a substance use disorder and involvement with the criminal justice system within the previous two years (parole, probation, arrest, or incarceration) were recruited from multiple sites in metropolitan Chicago. We examined whether empowerment moderates the relationship between trauma symptoms, trading sex and the experience of being forced or coerced to have sex. There was a significant three-way interaction between sexual coercion, trading, and empowerment scores on trauma symptoms. For individuals who have not traded sex, lower levels of empowerment were associated with a larger difference in trauma symptomatology between individuals who have been coerced and those who have not been coerced. For individuals who had been coerced to engage in sexual activity, lower levels of empowerment were associated with a larger difference in trauma symptomatology between those who have traded and those who have not traded. The promotion of empowerment beliefs and attitudes in women disproportionately impacted by violence and sexual trauma may reduce the harm that results from being victimized. Furthermore, providing specific interventions that educate women regarding gender roles and cultural values may help women avoid situations that result in exploitation and coercion.

  4. The pattern of thoracic trauma after suicide terrorist bombing attacks.

    Science.gov (United States)

    Bala, Miklosh; Shussman, Noam; Rivkind, Avraham I; Izhar, Uzi; Almogy, Gidon

    2010-11-01

    The worldwide escalation in the volume of suicide terrorist bombing attacks warrants special attention to the specific pattern of injury associated with such attacks. The goal of this study was to characterize thoracic injuries inflicted by terrorist-related explosions and compare pattern of injury to penetrating and blunt thoracic trauma. Prospectively collected database of patients with chest injury who were admitted to Hadassah Hospital Level I trauma centre, in Jerusalem, Israel, from October 2000 to December 2005. Patients were divided into three groups according to the mechanism of injury: terrorist explosions (n = 55), gunshot wounds (GSW; n = 78), and blunt trauma (n = 747). There were many female victims after suicide bombing attacks (49.1%) compared with GSW (21.8%) and blunt trauma (24.6%; p = 0.009). The number of body regions injured was significantly higher in the terror group compared with the GSW and blunt groups (median, 4, 2, and 3, respectively, p attacks was caused by a unique combination of the effects of the blast wave and penetrating shrapnel. More than half (52.7%) of the terror victims suffered from lung contusion and 25 (45.5%) required tube thoracostomy. Five patients (9.1%) underwent thoracotomy for lung lacerations (n = 3), injury to great vessels (n = 2), cardiac lacerations (n = 1), and esophageal injury (n = 1). Penetrating shrapnel was the mechanism of injury in all these cases. Injury inflicted by terrorist bombings causes a unique pattern of thoracic wounds. Victims are exposed to a combination of lung injury caused by the blast wave and penetrating injury caused by metallic objects.

  5. Outcome from paediatric cardiac arrest associated with trauma.

    Science.gov (United States)

    Crewdson, K; Lockey, D; Davies, G

    2007-10-01

    To examine survival rates for paediatric trauma patients requiring cardiopulmonary resuscitation (CPR) in the pre-hospital setting, and to identify characteristics that may be associated with survival. Ten-year retrospective trauma database review. An urban physician-led pre-hospital trauma service serving a population of approximately 7.5 million, in the United Kingdom. Eighty paediatric trauma patients (15 years or less) who received pre-hospital resuscitation following cardiorespiratory arrest between July 1994 and June 2004. Pre-hospital cardiopulmonary resuscitation. Survival to hospital discharge. Eighty children met inclusion criteria for the study. Nineteen (23.8%) were discharged alive from the emergency department and seven children (8.75%) survived to hospital discharge. Of the seven survivors, one had spinal cord injury. Two suffered asphyxial injury associated with blunt trauma and three sustained hypoxic insults following drowning or burns/smoke inhalation. In one patient with known congenital cardiac disease the cause of cardiac arrest was likely to have been medical. This study confirms the poor outcome for children requiring pre-hospital CPR following trauma. However, the results are better in this physician-attended group than in other studies where physicians were not present. They also suggest that cardiac arrest associated with trauma in children has a better outcome than in adults. In common with adults treated in this system, those patients with hypovolaemic cardiac arrest did not survive (Ann Emerg Med 2006;48:240-4). A large proportion of the survivors suffered hypoxic or asphyxial injuries. Targeted aggressive out-of-hospital resuscitation in certain patient groups can produce good outcomes.

  6. Pediatric trauma mortality by type of designated hospital in a mature inclusive trauma system

    Directory of Open Access Journals (Sweden)

    Amini Rachid

    2011-01-01

    Full Text Available Background : Previous studies have shown divergent results regarding the survival of injured children treated at pediatric trauma centers (PTC and adult trauma centers (ATC. Aims : (1 To document, in a regionalized inclusive trauma system, at which level of trauma centers were the injured children treated and (2 to compare the in-hospital mortality over five levels of trauma care, ranging from pediatric level I trauma centers (PTC to designated local trauma hospitals (level IV for the whole study sample and for subgroups of severely injured children and head trauma. Materials and Methods : A retrospective analysis included data on 11,053 injured children (age ≤16 years treated between April 1998 and March 2005 in 58 designated trauma hospitals in the province of Quebec, Canada. Multiple imputation was used to handle missing physiological data and multivariate logistic regression was used to compare mortality over levels of care. Results : PTC treated 52.2% of the children. Children treated at PTC were more often transferred from another hospital (73% and were more severely injured. ATC level I, II, III and IV centers treated, respectively, 3.0%, 16.2%, 24.3% and 4.3% of children. Compared with children treated at a PTC, the risk of mortality was higher for children treated at each other ATC, i.e. level I (adjusted odds ratio [OR] = 3.1; 95% confidence interval [CI]: 1.3-7.5, level II (OR = 2.5; 95% CI: 1.3-5.0, level III (OR = 5.2; 95% CI: 2.1-13.1 and level IV (OR = 9.9; 95% CI: 2.4-41.3. Similar findings were observed among the subsamples of children who were more severely injured (Injury Severity Score >15 and who sustained head injuries. Conclusions : In our trauma system, PTC cared for more than half of the injured children and patients treated there have better survival than those treated at all other levels of ATC.

  7. Sexual Assault, Sexual Harassment, and Physical Victimization during Military Service across Age Cohorts of Women Veterans.

    Science.gov (United States)

    Gibson, Carolyn J; Gray, Kristen E; Katon, Jodie G; Simpson, Tracy L; Lehavot, Keren

    2016-01-01

    Exposure to sexual and physical trauma during military service is associated with adverse mental and physical health outcomes. Little is known about their prevalence and impact in women veterans across age cohorts. Data from a 2013 national online survey of women veterans was used to examine associations between age and trauma during military service, including sexual assault, sexual harassment, and physical victimization. Analyses were conducted using logistic regression, adjusting for service duration and demographic factors. In secondary analyses, the moderating role of age in the relationship between trauma and self-reported health was examined. The sample included 781 women veterans. Compared with the oldest age group (≥ 65), all except the youngest age group had consistently higher odds of reporting trauma during military service. These differences were most pronounced in women aged 45 to 54 years (sexual assault odds ratio [OR], 3.81 [95% CI, 2.77-6.71]; sexual harassment, OR, 3.99 [95% CI, 2.25-7.08]; and physical victimization, OR, 5.72 [95% CI, 3.32-9.85]). The association between trauma during military service and self-reported health status also varied by age group, with the strongest negative impact observed among women aged 45 to 54 and 55 to 64. Compared with other age groups, women in midlife were the most likely to report trauma during military service, and these experiences were associated with greater negative impact on their self-reported health. Providers should be aware that trauma during military service may be particularly problematic for the cohort of women currently in midlife, who represent the largest proportion of women who use Department of Veterans Affairs health care. Published by Elsevier Inc.

  8. Internet-based prevention of posttraumatic stress symptoms in injured trauma patients: design of a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Joanne Mouthaan

    2011-11-01

    Full Text Available Background: Injured trauma victims are at risk of developing Posttraumatic Stress Disorder (PTSD and other post-trauma psychopathology. So far, interventions using cognitive behavioral techniques (CBT have proven most efficacious in treating early PTSD in highly symptomatic individuals. No early intervention for the prevention of PTSD for all victims has yet proven effective. In the acute psychosocial care for trauma victims, there is a clear need for easily applicable, accessible, cost-efficient early interventions. Objective: To describe the design of a randomized controlled trial (RCT evaluating the effectiveness of a brief Internet-based early intervention that incorporates CBT techniques with the aim of reducing acute psychological distress and preventing long-term PTSD symptoms in injured trauma victims. Method: In a two armed RCT, 300 injured trauma victims from two Level-1 trauma centers in Amsterdam, the Netherlands, will be assigned to an intervention or a control group. Inclusion criteria are: being 18 years of age or older, having experienced a traumatic event according to the diagnostic criteria of the DSM-IV and understanding the Dutch language. The intervention group will be given access to the intervention's website (www.traumatips.nl, and are specifically requested to login within the first month postinjury. The primary clinical study outcome is PTSD symptom severity. Secondary outcomes include symptoms of depression and anxiety, quality of life, and social support. In addition, a cost-effectiveness analysis of the intervention will be performed. Data are collected at one week post-injury, prior to first login (baseline, and at 1, 3, 6 and 12 months. Analyses will be on an intention-to-treat basis. Discussion: The results will provide more insight into the effects of preventive interventions in general, and Internet-based early interventions specifically, on acute stress reactions and PTSD, in an injured population, during the

  9. Trauma, protection, and distress in late adolescence: a multi-determinant approach.

    Science.gov (United States)

    Rosenthal, Beth Spenciner; Wilson, W Cody; Futch, Valerie A

    2009-01-01

    This empirical study investigated the multivariable relationship between psychological distress and the combination of a set of four trauma events (victim of violence, witness of violence, victim of accidents, and interpersonal loss) and a set of four protective factors (emotional social support, sense of personal efficacy, easygoing temperament, and gender) among a sample of 1,066 graduating high school seniors in a large urban community. Each of the eight independent variables had a statistically significant zero-order correlation with psychological distress. The set of eight variables (four trauma and four protective) had a multiple correlation of R = .61 with psychological distress accounting for 38% of the variance (considered a very large effect size by Cohen (1988)). The protective factors had a larger effect on psychological distress than did the trauma variables. The study demonstrates the desirability of using a multi-determinant approach rather than a single-determinant approach in the study of psychological distress.

  10. The trauma concept: the role of MDCT in the diagnosis and management of visceral injuries

    Energy Technology Data Exchange (ETDEWEB)

    Becker, C.D.; Poletti, P.A. [Diagnostic and Interventional Radiology, Geneva Univ. Hospital (Switzerland)

    2005-11-15

    The imaging concept in the acute trauma victim includes abdominal ultrasonography during initial triage, and contrast-enhanced computed tomography (CT) for further assessment of visceral organ injuries and active bleeding sites if haemodynamic stability can be established during initial resuscitation. Integration of modern multidetector CT (MDCT) scanners in the emergency admission area greatly facilitates initial assessment of the extent of injuries in all body regions, and is therefore the emerging standard in all major centresinvolved in acute trauma care. Initial assessment of visceral injuries by means of CT not only allows determining the presence and extent of organ injuries and detecting active bleeding sources that may require transarterial embolisation for haemostasis, but also serves as a baseline for monitoring of conservative treatment. Specific indications for CT monitoring of conservative treatment exist in each individual organ. This concept enables the vast majority of blunt injuries of the parenchymal abdominal organs in the haemodynamically stable trauma victim to be managed without surgery. (orig.)

  11. The trauma concept: the role of MDCT in the diagnosis and management of visceral injuries

    International Nuclear Information System (INIS)

    Becker, C.D.; Poletti, P.A.

    2005-01-01

    The imaging concept in the acute trauma victim includes abdominal ultrasonography during initial triage, and contrast-enhanced computed tomography (CT) for further assessment of visceral organ injuries and active bleeding sites if haemodynamic stability can be established during initial resuscitation. Integration of modern multidetector CT (MDCT) scanners in the emergency admission area greatly facilitates initial assessment of the extent of injuries in all body regions, and is therefore the emerging standard in all major centresinvolved in acute trauma care. Initial assessment of visceral injuries by means of CT not only allows determining the presence and extent of organ injuries and detecting active bleeding sources that may require transarterial embolisation for haemostasis, but also serves as a baseline for monitoring of conservative treatment. Specific indications for CT monitoring of conservative treatment exist in each individual organ. This concept enables the vast majority of blunt injuries of the parenchymal abdominal organs in the haemodynamically stable trauma victim to be managed without surgery. (orig.)

  12. Could spirituality and religion promote stress resilience in survivors of childhood trauma?

    Science.gov (United States)

    Brewer-Smyth, Kathleen; Koenig, Harold G

    2014-04-01

    Trauma is a precursor to many mental health conditions that greatly impact victims, their loved ones, and society. Studies indicate that neurobiological associations with adverse childhood experiences are mediated by interpersonal relationships and play a role in adult behavior, often leading to cycles of intergenerational trauma. There is a critical need to identify cost effective community resources that optimize stress resilience. Faith-based communities may promote forgiveness rather than retaliation, opportunities for cathartic emotional release, and social support, all of which have been related to neurobiology, behavior, and health outcomes. While spirituality and religion can be related to guilt, neurotic, and psychotic disorders, they also can be powerful sources of hope, meaning, peace, comfort, and forgiveness for the self and others. This article provides an overview of religion and spirituality as they relate to the neurobiology of resilience in victims of childhood trauma.

  13. Dental Trauma Guide

    DEFF Research Database (Denmark)

    Andreasen, Jens Ove; Lauridsen, Eva; Gerds, Thomas Alexander

    2012-01-01

    Diagnosis and treatment for traumatic dental injuries are very complex owing to the multiple trauma entities represented by six luxation types and nine fracture types affecting both the primary and the permanent dentition. When it is further considered that fracture and luxation injuries are often...... problems in selecting proper treatment for some of these trauma types. To remedy this situation, an Internet-based knowledge base consisting of 4000 dental trauma cases with long-term follow up is now available to the public and the professions on the Internet using the address http://www.Dental...

  14. Victims of cybercrime in Europe : a review of victim surveys

    NARCIS (Netherlands)

    Reep-van den Bergh, Carin M.M.; Junger, Marianne

    2018-01-01

    Objectives: Review the evidence provided by victim surveys in order to provide a rough estimate of the personal crime prevalence of the main types of cybercrime. Methods: We performed a search in databases, searched online, and contacted several Offices for National Statistics in Europe and selected

  15. Men as Victims: "Victim" Identities, Gay Identities, and Masculinities

    Science.gov (United States)

    Dunn, Peter

    2012-01-01

    The impact and meanings of homophobic violence on gay men's identities are explored with a particular focus on their identities as men and as gay men. Homosexuality can pose a challenge to conventional masculinities, and for some gay men, being victimized on account of sexual orientation reawakens conflicts about their masculinity that they…

  16. Transformational change in parenting practices after child interpersonal trauma: A grounded theory examination of parental response.

    Science.gov (United States)

    Cummings, Jorden A

    2018-02-01

    Child interpersonal trauma is associated with a host of negative outcomes, both concurrently and in adulthood. Parental responses following trauma can play an important role in modulating child responses, symptoms, and post-trauma functioning. However, parents themselves are also impacted after their child experiences trauma, reporting distress, psychopathology, concerns about the child's safety, changes in discipline and protectiveness, and feelings of blame. Most of this previous research, however, suffers from methodological limitations such as focusing on description and correlations, providing static "one shot" assessments of parenting after trauma, and relying mainly on results related to child sexual abuse. This project developed a comprehensive, explanatory theory of the dynamic process by which parenting changes in response to a range of child trauma, using a sample of parents whose children had experienced a range of interpersonal trauma types. Grounded theory analyses revealed a three-phase dynamic model of discontinuous transformation, in which parents experienced destabilization, recalibration, and re-stabilization of parenting practices in response to child trauma. Parents were focused on Protecting and Healing the child victim, often at the expense of their own needs. Most parents reached a phase of posttraumatic growth, labelled Thriving Recovery, but processes that hindered this recovery are also discussed. This study provides the first evidence that dynamic systems of change as well as vicarious posttraumatic growth can apply to parents of child trauma victims. Generating an explanatory theory provides important avenues for future research as well as interventions and services aimed at families who have experienced child trauma. Copyright © 2017 The Author. Published by Elsevier Ltd.. All rights reserved.

  17. Risk for traumatization among violent crime victims in an urban community sample in South Africa

    Directory of Open Access Journals (Sweden)

    K Peltzer

    2000-09-01

    Full Text Available This study intended to investigate risk factors for the development of trauma symptoms as a consequence of violent crime in an urban South African community. The sample included 128 adult victims of violent crime chosen by snowball sampling. The adults were 36 (28.1% males and 92 females (71.9% in the age range of 18 to 52 years (M age 36.6 yr., SD -8.9. Results indicate that the most common violent crimes experienced among the participants were rape (attempted rape, followed by physical assault, armed robbery, attempted murder and threat in that order. The majority of the victims scored high on the Kolner Risk Index (for traumatization - several case examples are given. Analysis of Variance indicated that almost all factors of the Kolner Risk Index seem to be significantly correlated with PTSD outcome measures (PTSS- 10, IES-R, Peritraumatic Dissociation and Trauma Belief. It is concluded that the Kolner Risk Index can be a useful tool for identifying crime victims at risk for the development of trauma symptoms, especially in (mental health care settings.

  18. Measurement of S-100B for risk classification of victims sustaining minor head injury: first pilot study in Brazil Medida da proteína S-100B sérica para classificação de risco no trauma craniano leve: estudo piloto no Brasil

    Directory of Open Access Journals (Sweden)

    Luiz F Poli-de-Figueiredo

    2006-02-01

    Full Text Available BACKGROUND: Release of the neuronal protein S-100B into the circulation has been suggested as a specific indication of neuronal damage. The hypothesis that S-100B is a useful and cost-effective screening tool for the management of minor head injuries was tested. METHODS: Fifty consecutive patients sustaining isolated minor head injury were prospectively evaluated in the emergency room of a Brazilian hospital by routine cranial computed tomography scan. Venous blood samples (processed to serum were assssayed for S-100B using a newly developed immunoassay test kit. Twenty-one normal healthy individuals served as negative controls. Data are presented as median and 25 to 75 percentiles. RESULTS: Patients reached the emergency room an average of 45 minutes (range: 30-62 minutes after minor head injury. Six of 50 patients (12% showed relevant posttraumatic lesions in the initial cranial computed tomography scan and were counted as positive. The median systemic concentration of S-100B in those patients was 0.75 µg/L (range: 0.66-6.5 µg/L, which was significantly different (U-test, P INTRODUÇÃO: A liberação da proteína neuronal S-100B na circulação tem sido sugerida como indicadora de dano neuronal. Foi testada a hipótese de que a S-100B é um marcador útil e custo efetivo para a triagem de pacientes com trauma craniano leve. MÉTODO: Cinqüenta pacientes consecutivos com trauma craniano isolado foram prospectivamente avaliados na sala de emergência de um Centro de Trauma brasileiro pela tomografia computadorizada de crânio e por amostras de sangue venoso, para a medida no soro da proteína S-100B utilizando um teste recentemente desenvolvido; 21 pessoas normais foram utilizadas como controles negativos. Os resultados são apresentados como mediana e percentis 25-75. RESULTADOS: Os pacientes chegaram ao Centro de Trauma em média 45 min (30-62 após o trauma craniano leve. Seis dos 50 pacientes tiveram lesões pós-traumáticas relevantes

  19. Characteristics of Brazilian Offenders and Victims of Interpersonal Violence: An Exploratory Study.

    Science.gov (United States)

    d'Avila, Sérgio; Campos, Ana Cristina; Bernardino, Ítalo de Macedo; Cavalcante, Gigliana Maria Sobral; Nóbrega, Lorena Marques da; Ferreira, Efigênia Ferreira E

    2016-10-01

    The aim of this study was to characterize the profile of Brazilian offenders and victims of interpersonal violence, following a medicolegal and forensic perspective. A cross-sectional and exploratory study was performed in a Center of Forensic Medicine and Dentistry. The sample was made up of 1,704 victims of nonlethal interpersonal violence with some type of trauma. The victims were subject to forensic examinations by a criminal investigative team that identified and recorded the extent of the injuries. For data collection, a specific form was designed consisting of four parts according to the information provided in the medicolegal and social records: sociodemographic data of the victims, offender's characteristics, aggression characteristics, and types of injuries. Descriptive and multivariate statistics using cluster analysis (CA) were performed. The two-step cluster method was used to characterize the profile of the victims and offenders. Most of the events occurred during the nighttime (50.9%) and on weekdays (66.3%). Soft tissue injuries were the most prevalent type (94.6%). Based on the CA results, two clusters for the victims and two for the offenders were identified. Victims: Cluster 1 was formed typically by women, aged 30 to 59 years, and married; Cluster 2 was composed of men, aged 20 to 29 years, and unmarried. Offenders: Cluster 1 was characterized by men, who perpetrated violence in a community environment. Cluster 2 was formed by men, who perpetrated violence in the familiar environment. These findings revealed different risk groups with distinct characteristics for both victims and offenders, allowing the planning of targeted measures of care, prevention, and health promotion. This study assesses the profile of violence through morbidity data and significantly contributes to building an integrated system of health surveillance in Brazil, as well as linking police stations, forensic services, and emergency hospitals.

  20. Coagulation management in trauma-associated coagulopathy: allogenic blood products versus coagulation factor concentrates in trauma care.

    Science.gov (United States)

    Klages, Matthias; Zacharowski, Kai; Weber, Christian Friedrich

    2016-04-01

    Coagulation management by transfusion of allogenic blood products and coagulation factors are competing concepts in current trauma care. Rapid and adequate therapy of trauma-associated coagulopathy is crucial to survival of severely injured patients. Standard coagulation tests such as prothrombin time and activated partial thromboplastin time are commonly used, but these tests are inappropriate for monitoring and guiding therapy in trauma patients. Coagulation factor-based treatment showed promising results, but randomized trials have not yet been performed. In addition, viscoelastic tests are needed to guide therapy, although there is in fact limited evidence for these in tests in trauma care. Regarding transfusion therapy with allogenic blood products, plasma transfusion has been associated with improved survival in trauma patients following massive transfusion. In contrast, patients not requiring massive transfusion seem to be at risk for suffering complications with increasing volumes of plasma transfused. The collective of trauma patients is heterogeneous. Despite the lack of evidence, there are strong arguments for individualized patient treatment with coagulation factors for some indications and to abstain from the use of fresh frozen plasma. In patients with severe trauma and major bleeding, plasma, platelets, and red blood cells should be considered to be administered at a ratio of 1 : 1 : 1.

  1. Suffering in Silence: The Male Incest Victim.

    Science.gov (United States)

    Nasjleti, Maria

    1980-01-01

    The reasons why boys who are victims of incest remain silent are explored in terms of the special meaning of victimization to males. Males' inability to express helplessness and vulnerability is identified as a major contributing factor. (CM)

  2. Diverting victims of commercial sexual exploitation from juvenile detention: development of the InterCSECt screening protocol.

    Science.gov (United States)

    Salisbury, Emily J; Dabney, Jonathan D; Russell, Kelli

    2015-04-01

    Identifying victims of commercial sexual exploitation in the juvenile justice system is a challenging complexity requiring concerted organizational commitment. Using a three-tiered, trauma-informed screening process, a 3½-month pilot intervention was implemented in Clark County Juvenile Court (Washington) to identify victims in an effort to connect them to community youth advocates and sexual assault resources. A total of 535 boys and girls ages 9 to 19 were screened during intake; 47 of these youth reported risk factors associated with commercial sexual exploitation of children (CSEC) and were subsequently referred to community advocates. Six youth (all girls) were confirmed CSEC victims and were successfully diverted from juvenile detention. Study results suggest that despite the lack of reliable data surrounding the prevalence of CSEC, juvenile justice agencies need to become educated on the risk factors to triage victims to services. © The Author(s) 2014.

  3. Victim Emotional Response: Effects on Social Reaction to Victims of Rape.

    Science.gov (United States)

    Calhoun, Lawrence G.; And Others

    The effects of the victim's emotional style on social reactions to the rape victim are examined. Of specific interest were perceptions of victim credibility, degree to which she would later be socially accepted and the degree to which the observers believed the victim found the rape unpleasant. Subjects (N=55) viewed two videotapes depicting a…

  4. Development of a model to quantify the accessibility of a Canadian trauma system.

    Science.gov (United States)

    Tansley, Gavin; Schuurman, Nadine; Erdogan, Mete; Bowes, Matthew; Green, Robert; Asbridge, Mark; Yanchar, Natalie

    2017-07-01

    Trauma systems have been widely implemented across Canada, but access to trauma care remains a challenge for much of the population. This study aims to develop and validate a model to quantify the accessibility of definitive care within one provincial trauma system and identify populations with poor access to trauma care. A geographic information system (GIS) was used to generate models of pre-scene and post-scene intervals, respectively. Models were validated using a population-based trauma registry containing data on prehospital time intervals and injury locations for Nova Scotia (NS). Validated models were then applied to describe the population-level accessibility of trauma care for the NS population as well as a cohort of patients injured in motor vehicle collisions (MVCs). Predicted post-scene intervals were found to be highly correlated with documented post-scene intervals (β 1.05, paccess to Level III and Level I trauma care within 60 minutes of prehospital time from their residence, respectively. Access for victims of MVCs was lower, with 84.3% and 29.7% of the cohort having access to Level III and Level I trauma care within 60 minutes of the location of injury, respectively. GIS models can be used to identify populations with poor access to care and inform service planning in Canada. Although only 43% of the provincial population has access to Level I care within 60 minutes, the majority of the population of NS has access to Level III trauma care.

  5. The Question of “Solidarity” in Postcolonial Trauma Fiction: Beyond the Recognition Principle

    Directory of Open Access Journals (Sweden)

    Hamish Dalley

    2015-09-01

    Full Text Available Dominant theorizations of cultural trauma often appeal to the twinned notions of “recognition” and “solidarity”, suggesting that by inviting readers to recognize distant suffering, trauma narratives enable forms of cross-cultural solidarity to emerge. This paper explores and critiques that argument with reference to postcolonial literature. It surveys four areas of postcolonial trauma, examining works that narrate traumatic experiences of the colonized, colonizers, perpetrators and proletarians. It explores how novelists locate traumatic affects in the body, and suggests that Frantz Fanon’s model of racial trauma in Black Skin, White Masks and The Wretched of the Earth remains essential for the interpretation of postcolonial texts, including those to which it is not usually applied. The analysis further reveals tensions between different texts’ appeals for recognition, and suggests that these tensions problematize the claim that solidarity will emerge from sympathetic engagement with trauma victims. As such, the paper makes three key arguments: first, that trauma offers a productive ground for comparing postcolonial fiction; second, that comparison uncovers problems for theorists attempting to “decolonize” trauma studies; and third, that trauma theory needs to be supplemented with systemic material analyses of particular contexts if it is not to obfuscate what makes postcolonial traumas distinct.

  6. About Military Sexual Trauma

    Medline Plus

    Full Text Available ... it free Find out why Close About Military Sexual Trauma Veterans Health Administration Loading... Unsubscribe from Veterans ... is Cognitive Processing Therapy (CPT) [for posttraumatic stress disorder]? - Duration: 2:01. Veterans Health Administration 27,844 ...

  7. About Military Sexual Trauma

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    Full Text Available ... Try it free Find out why Close About Military Sexual Trauma Veterans Health Administration Loading... Unsubscribe from ... Veterans Health Administration 2,027 views 25:30 Language: English Location: United States Restricted Mode: Off History ...

  8. About Military Sexual Trauma

    Science.gov (United States)

    ... Try it free Find out why Close About Military Sexual Trauma Veterans Health Administration Loading... Unsubscribe from ... Veterans Health Administration 2,027 views 25:30 Language: English Location: United States Restricted Mode: Off History ...

  9. Pediatric Ocular Trauma

    Science.gov (United States)

    ... What are the most common causes of eye injuries in children? Pediatric eye trauma most often occurs at school ... should happen when a child gets an eye injury? A child that sustains an eye injury should seek immediate ...

  10. About Military Sexual Trauma

    Medline Plus

    Full Text Available ... it free Find out why Close About Military Sexual Trauma Veterans Health Administration Loading... Unsubscribe from Veterans ... MST. http://www.mentalhealth.va.gov/msthom... Category Education License Standard YouTube License Show more Show less ...

  11. Paediatric trauma care

    African Journals Online (AJOL)

    . The injury prevention ... for even more injuries than motor vehicle accidents, accounting for almost as many trauma admissions, as is also seen .... IS Secondly, seat-belt legislation and enforcement have only recently come into effect, despite ...

  12. The Psychological Impact of Rape Victims

    Science.gov (United States)

    Campbell, Rebecca

    2008-01-01

    This review article examines rape victims' experiences seeking postassault assistance from the legal, medical, and mental health systems and how those interactions impact their psychological well-being. This literature suggests that although some rape victims have positive, helpful experiences with social system personnel, for many victims,…

  13. Emotional Problems in Traditional and Cyber Victimization

    Science.gov (United States)

    Sjursø, Ida Risanger; Fandrem, Hildegunn; Roland, Erling

    2016-01-01

    Previous studies show an association between traditional and cyber victimization. However, there seem to be differences in how these forms of being bullied relates to emotional problems in the victims. Few studies focus on symptoms of general anxiety and depression as separate variables when comparing traditional and cyber victimization.…

  14. Prevention of victimization following sexual assaults

    DEFF Research Database (Denmark)

    Pedersen, Bodil Maria; Sidenius, Katrine

    2004-01-01

    Centre for Victims of Sexual Assault in Copenhagen is a centre for interdisciplinary research and practice. Goals of the centre are to contribute to the documentation of victimization and to prevent further victimization. Research at the centre aims at the examination of the diversity of conditio...... of women exposed to sexualized coercion and the diversity of perspectives on the events....

  15. Sexual victimization, partner aggression and alcohol consumption ...

    African Journals Online (AJOL)

    This paper examines the relationship sexual victimization (both childhood sexual victimization and adult sexual victimization), aggression and alcohol consumption. The data for this research is from the Gender, Alcohol and Culture: an International Study (GENACIS). A random sample of 2070 adults (53.8% males and ...

  16. Thromboembolic Complications Following Trauma

    Science.gov (United States)

    2009-12-01

    these physiologic derangements, it is estimated that hypercoagulable disorders, such as factor V Leiden and hyperhomocysteinemia, may be present in...risk factors of venous thrombosis. Hum Genet 2001;109:369-84. 3. Knudson MM, Ikossi DG. Venous thromboembolism after trauma. Curr Opin Crit Care...R E V I E W A R T I C L E Thromboembolic complications following trauma Daniel F. McLaughlin, Charles E. Wade, Howard R. Champion, Jose Salinas, and

  17. Quality of trauma care and trauma registries.

    Science.gov (United States)

    Pino Sánchez, F I; Ballesteros Sanz, M A; Cordero Lorenzana, L; Guerrero López, F

    2015-03-01

    Traumatic disease is a major public health concern. Monitoring the quality of services provided is essential for the maintenance and improvement thereof. Assessing and monitoring the quality of care in trauma patient through quality indicators would allow identifying opportunities for improvement whose implementation would improve outcomes in hospital mortality, functional outcomes and quality of life of survivors. Many quality indicators have been used in this condition, although very few ones have a solid level of scientific evidence to recommend their routine use. The information contained in the trauma registries, spread around the world in recent decades, is essential to know the current health care reality, identify opportunities for improvement and contribute to the clinical and epidemiological research. Copyright © 2014 Elsevier España, S.L.U. and SEMICYUC. All rights reserved.

  18. Impact of the Worst School Experiences in Students: A Retrospective Study on Trauma

    Directory of Open Access Journals (Sweden)

    Paloma Pegolo de Albuquerque

    2015-12-01

    Full Text Available AbstractThe literature indicates damage to students' mental health in cases of school violence. The aim of this retrospective study was to evaluate the psychological impact of school victimization in university students, and to analyze the association between PTSD symptoms and variables related to school victimization. 691 University students responded to the Portuguese version of the Student Alienation and Trauma Survey (SATS. Clinically significant scores in the subscales ranged from 4.7% (somatic symptoms to 20% (hypervigilance, with frequent symptoms described in the literature resulting from school victimization, such as depression, hopelessness, cognitive difficulties, and traumatic event recollection. Additionally, 7.8% of participants presented PTSD symptoms after suffering their "worst school experience". Associations were found between PTSD symptoms and the level of distress after the experience, as well as the perceived benefits after the event, and duration. The results confirm the potential detrimental effects of school victimization, and may be useful to further investigations on this topic.

  19. Earthquakes and trauma: review of triage and injury-specific, immediate care.

    Science.gov (United States)

    Gautschi, Oliver P; Cadosch, Dieter; Rajan, Gunesh; Zellweger, René

    2008-01-01

    Earthquakes present a major threat to mankind. Increasing knowledge about geophysical interactions, progressing architectural technology, and improved disaster management algorithms have rendered modern populations less susceptible to earthquakes. Nevertheless, the mass casualties resulting from earthquakes in Great Kanto (Japan), Ancash (Peru), Tangshan (China), Guatemala, Armenia, and Izmit (Turkey) or the recent earthquakes in Bhuj (India), Bam (Iran), Sumatra (Indonesia) and Kashmir (Pakistan) indicate the devastating effect earthquakes can have on both individual and population health. Appropriate preparation and implementation of crisis management algorithms are of utmost importance to ensure a large-scale medical-aid response is readily available following a devastating event. In particular, efficient triage is vital to optimize the use of limited medical resources and to effectively mobilize these resources so as to maximize patient salvage. However, the main priorities of disaster rescue teams are the rescue and provision of emergency care for physical trauma. Furthermore, the establishment of transport evacuation corridors, a feature often neglected, is essential in order to provide the casualties with a chance for survival. The optimal management of victims under such settings is discussed, addressing injuries of the body and psyche by means of simple diagnostic and therapeutic procedures globally applicable and available.

  20. Head trauma in China.

    Science.gov (United States)

    Jiang, Ji-Yao

    2013-11-01

    The Chinese Head Trauma Data Bank (CHTDB) has been established, which includes 7,145 hospitalised cases with acute head trauma patients in 47 hospitals. We explored factors that might affect the outcome of acute traumatic brain injury. There was no statistical difference in the mortality rate between male (7.5%) and female (7.2%) patients (P>0.05). The mortality rate in children (65 years) was 7.3%, 7.2% and 9.0%, respectively (P>0.05). The mortality rate of patients with mild (2.7%), moderate (5.0%) and severe (21.8%) head trauma was significantly different (P40 mm Hg was 6.3%, 21.4% and 93.1%, respectively (Phead trauma data bank in China, has one of the largest numbers of cases of any head trauma data bank in the world. Our major findings on mortality may be helpful to neurosurgeons for predicting the outcome of acute head trauma patients. Copyright © 2012 Elsevier Ltd. All rights reserved.

  1. Airway management in trauma.

    Science.gov (United States)

    Langeron, O; Birenbaum, A; Amour, J

    2009-05-01

    Maintenance of a patent and prevention of aspiration are essential for the management of the trauma patient, that requires experienced physicians in airway control techniques. Difficulties of the airway control in the trauma setting are increased by the vital failures, the risk of aspiration, the potential cervical spine injury, the combative patient, and the obvious risk of difficult tracheal intubation related to specific injury related to the trauma. Endotracheal intubation remains the gold standard in trauma patient airway management and should be performed via the oral route with a rapid sequence induction and a manual in-line stabilization maneuver, to decrease the risks previously mentioned. Different techniques to control the airway in trauma patients are presented: improvement of the laryngoscopic vision, lighted stylet tracheal intubation, retrograde technique for orotracheal intubation, the laryngeal mask and the intubating laryngeal mask airways, the combitube and cricothyroidotomy. Management of the airway in trauma patients requires regular training in these techniques and the knowledge of complementary techniques allowing tracheal intubation or oxygenation to overcome difficult intubation and to prevent major complications as hypoxemia and aspiration.

  2. Effect of a brief intervention for alcohol and illicit drug use on trauma recidivism in a cohort of trauma patients.

    Directory of Open Access Journals (Sweden)

    Sergio Cordovilla-Guardia

    Full Text Available Estimate the effectiveness of brief interventions in reducing trauma recidivism in hospitalized trauma patients who screened positive for alcohol and/or illicit drug use.Dynamic cohort study based on registry data from 1818 patients included in a screening and brief intervention program for alcohol and illicit drug use for hospitalized trauma patients. Three subcohorts emerged from the data analysis: patients who screened negative, those who screened positive and were offered brief intervention, and those who screened positive and were not offered brief intervention. Follow-up lasted from 10 to 52 months. Trauma-free survival, adjusted hazard rate ratios (aHRR and adjusted incidence rate ratios (aIRR were calculated, and complier average causal effect (CACE analysis was used.We found a higher cumulative risk of trauma recidivism in the subcohort who screened positive. In this subcohort, an aHRR of 0.63 (95% CI: 0.41-0.95 was obtained for the group offered brief intervention compared to the group not offered intervention. CACE analysis yielded an estimated 52% reduction in trauma recidivism associated with the brief intervention.The brief intervention offered during hospitalization in trauma patients positive for alcohol and/or illicit drug use can halve the incidence of trauma recidivism.

  3. Bruising characteristics discriminating physical child abuse from accidental trauma.

    Science.gov (United States)

    Pierce, Mary Clyde; Kaczor, Kim; Aldridge, Sara; O'Flynn, Justine; Lorenz, Douglas J

    2010-01-01

    Our objective was to conduct a pilot study to identify discriminating bruising characteristics and to model those findings into a decision tool for screening children at high risk for abuse. A case-control study of children 0 to 48 months of age who were admitted to a PICU because of trauma was performed. Case subjects (N = 42) were victims of physical abuse, and control subjects (N = 53) were children admitted because of accidental trauma during the same time period. Bruising characteristics (total number and body region) and patient age were compared for children with abusive versus accidental trauma. The development of a decision rule for predicting abusive trauma was accomplished with the fitting of a classification and regression tree through binary recursive partitioning. Ninety-five patients were studied. Seventy-one (33 of 42 patients in the abuse group and 38 of 53 in the accident group) were found to have bruising, and the characteristics were modeled. Characteristics predictive of abuse were bruising on the torso, ear, or neck for a child abuse. Discriminating differences exist in bruising characteristics for abusive versus accidental trauma. The body region- and age-based bruising clinical decision rule model functions as a clinically sensible screening tool to identify young children who require further evaluation for abuse.

  4. Trauma-Informed Approach to Survivors of Intimate Partner Violence.

    Science.gov (United States)

    Anyikwa, Victoria A

    2016-01-01

    Trauma leads to deleterious effects on individuals and families causing many to seek treatment from social work practitioners across systems of care. Trauma comes in all forms, from community violence to domestic violence, including physical and sexual abuse of children and violence among intimate partners that leaves its victims devastatingly impacted. Women make up the majority of survivors of intimate partner violence (IPV) with studies revealing significant associated mental health problems. Social workers are bound to work with survivors of IPV and must be prepared to deliver effective trauma-informed services. While trauma-specific services exist for specific populations, researchers are finding that negative events in childhood and in family functioning can impact individuals' lives in negative ways thus having implications for treatment across systems. For women survivors of IPV, the traumatic stress may be cumulative with varied emotional and mental health impacts that may force them to seek services across systems, not just domestic violence specific systems. As such it is imperative that social workers increase awareness of trauma, its impact on women, and the importance of the approach and environment in which they provide services. In this article the author aims to broaden social workers knowledge of the use of a TIC approach developed by the Substance Abuse and Mental Health Services Administration that's applicable across systems of care, particularly when working with women survivors of IPV.

  5. Survival analysis

    International Nuclear Information System (INIS)

    Badwe, R.A.

    1999-01-01

    The primary endpoint in the majority of the studies has been either disease recurrence or death. This kind of analysis requires a special method since all patients in the study experience the endpoint. The standard method for estimating such survival distribution is Kaplan Meier method. The survival function is defined as the proportion of individuals who survive beyond certain time. Multi-variate comparison for survival has been carried out with Cox's proportional hazard model

  6. Cyanide poisoning is a possible cause of cardiac arrest among fire victims, and empiric antidote treatment may improve outcomes.

    Science.gov (United States)

    Kaita, Yasuhiko; Tarui, Takehiko; Shoji, Takahiro; Miyauchi, Hiroshi; Yamaguchi, Yoshihiro

    2018-01-22

    Carbon monoxide and cyanide poisoning are important causes of death due to fire. Carbon monoxide is more regularly assessed than cyanide at the site of burn or smoke inhalation treatment due to its ease in assessment and simplicity to treat. Although several forensic studies have demonstrated the significance of cyanide poisoning in fire victims using blood cyanide levels, the association between the cause of cardiac arrest and the concentration of cyanide among fire victims has not been sufficiently investigated. This study aimed to investigate the frequency of cyanide-induced cardiac arrest in fire victims and to assess the necessity of early empiric treatment for cyanide poisoning. This study was a retrospective analysis of fire victims with cardiac arrest at the scene who were transported to a trauma and critical care center, Kyorin University Hospital, from January 2014 to June 2017. Patients whose concentration of cyanide was measured were included. Five patients were included in the study; all died despite cardiopulmonary resuscitation. Three of these victims were later found to have lethal cyanide levels (>3 μg/ml). Two of the patients had non-lethal carboxyhemoglobin levels under 50% and might have been saved if hydroxocobalamin had been administered during resuscitation. According to our results, cyanide-induced cardiac arrest may be more frequently present among fire victims than previously believed, and early empiric treatment with hydroxocobalamin may improve outcomes for these victims in cases where cardiac arrest is of short duration. Copyright © 2018 Elsevier Inc. All rights reserved.

  7. Imaging abusive head trauma: why use both computed tomography and magnetic resonance imaging?

    Energy Technology Data Exchange (ETDEWEB)

    Vazquez, Elida; Delgado, Ignacio; Sanchez-Montanez, Angel [Hospital Universitario Vall d' Hebron, UAB, Pediatric Radiology Department, Barcelona (Spain); Fabrega, Anna [Hospital Universitario Vall d' Hebron, UAB, Department of Pediatrics, Barcelona (Spain); Cano, Paola [Hospital Universitario Vall d' Hebron, UAB, Pediatric Neurosurgery, Barcelona (Spain); Martin, Nieves [Hospital Universitario Vall d' Hebron, UAB, Pediatric Ophthalmology, Barcelona (Spain)

    2014-12-15

    Abusive head trauma is the leading cause of death in child abuse cases. The majority of victims are infants younger than 1 year old, with the average age between 3 and 8 months, although these injuries can be seen in children up to 5 years old. Many victims have a history of previous abuse and the diagnosis is frequently delayed. Neuroimaging is often crucial for establishing the diagnosis of abusive head trauma as it detects occult injury in 37% of cases. Several imaging patterns are considered to be particularly associated with abusive head trauma. The presence of subdural hematoma, especially in multiple locations, such as the interhemispheric region, over the convexity and in the posterior fossa, is significantly associated with abusive head trauma. Although CT is the recommended first-line imaging modality for suspected abusive head trauma, early MRI is increasingly used alongside CT because it provides a better estimation of shear injuries, hypoxic-ischemic insult and the timing of lesions. This article presents a review of the use and clinical indications of the most pertinent neuroimaging modalities for the diagnosis of abusive head trauma, emphasizing the newer and more sensitive techniques that may be useful to better characterize the nature and evolution of the injury. (orig.)

  8. Imaging abusive head trauma: why use both computed tomography and magnetic resonance imaging?

    International Nuclear Information System (INIS)

    Vazquez, Elida; Delgado, Ignacio; Sanchez-Montanez, Angel; Fabrega, Anna; Cano, Paola; Martin, Nieves

    2014-01-01

    Abusive head trauma is the leading cause of death in child abuse cases. The majority of victims are infants younger than 1 year old, with the average age between 3 and 8 months, although these injuries can be seen in children up to 5 years old. Many victims have a history of previous abuse and the diagnosis is frequently delayed. Neuroimaging is often crucial for establishing the diagnosis of abusive head trauma as it detects occult injury in 37% of cases. Several imaging patterns are considered to be particularly associated with abusive head trauma. The presence of subdural hematoma, especially in multiple locations, such as the interhemispheric region, over the convexity and in the posterior fossa, is significantly associated with abusive head trauma. Although CT is the recommended first-line imaging modality for suspected abusive head trauma, early MRI is increasingly used alongside CT because it provides a better estimation of shear injuries, hypoxic-ischemic insult and the timing of lesions. This article presents a review of the use and clinical indications of the most pertinent neuroimaging modalities for the diagnosis of abusive head trauma, emphasizing the newer and more sensitive techniques that may be useful to better characterize the nature and evolution of the injury. (orig.)

  9. Cyberbullying: who are the victims? A comparison of victimization in internet chatrooms and victimization in school

    NARCIS (Netherlands)

    Katzer, C.; Fetchenhauer, D.; Belschak, F.

    2009-01-01

    Bullying is not a phenomenon exclusive to the school environment. Pupils also become victims of verbal aggression (teasing, threats, insults, or harassment) in the context of internet chatrooms. The present study addresses the following questions: (1) How often does bullying occur in internet

  10. Patterns of ocular trauma

    International Nuclear Information System (INIS)

    Babar, T.F.; Khan, M.T.; Marwat, M.; Shah, A.; Murad, Y.; Khan, M.D.

    2007-01-01

    To describe the patterns of ocular trauma, cause of injury and its effects on eye. A retrospective case series. Medical records of 1105 patients admitted with ocular trauma were reviewed. The details of patients regarding age, gender, literacy, cause of injury and its effects on eye were entered into specially-designed performa. Sample selection consisted of all patients with history of ocular trauma and who were admitted to hospital. Population details consisted patients who were referred to the hospital from all parts of N.W.F.P. Thus, the frequency of trauma in the hospital admissions was analysed. Ophthalmic trauma comprised 6.78% of the hospital admission. One thousand one hundred and five patients presented with eye injuries. Out of them, 21 patients suffered from trauma to both eyes. Almost 80% patients were male and 69% patients were below 30 years of age. Delayed presentation was more common and 63.61% patients presented after one week. Open globe injuries were more common (520 eyes (46.18%)) than closed globe injuries (484 eyes (42.98%)). 23.26% of open globe injuries were associated with intraocular and intra-orbital foreign bodies. Superficial non-perforating, eyelid and adnexal and burns were seen in 122 eyes (10.83%). Among the complications, lens damage and hyphema was seen in more than 50% of the patients, 16.60% eyes were infected at the time of admission and 4.88% of eyes needed enucleation or evisceration. The common causes of injury were violence in 37.37%, occupational in 24.43% and domestic accidents in 19.18%. Ophthalmic trauma is a major public health problem. Majority of the involved are male and under 30 years of age. Delayed presentation is more common. Open globe injuries are more frequent. Violence and occupational injuries are the major causes. (author)

  11. Essential trauma management training: addressing service delivery needs in active conflict zones in eastern Myanmar

    Directory of Open Access Journals (Sweden)

    Richard Matthew G

    2009-03-01

    Full Text Available Abstract Introduction Access to governmental and international nongovernmental sources of health care within eastern Myanmar's conflict regions is virtually nonexistent. Historically, under these circumstances effective care for the victims of trauma, particularly landmine injuries, has been severely deficient. Recognizing this, community-based organizations (CBOs providing health care in these regions sought to scale up the capacity of indigenous health workers to provide trauma care. Case description The Trauma Management Program (TMP was developed by CBOs in cooperation with a United States-based health care NGO. The goal of the TMP is to improve the capacity of local health workers to deliver effective trauma care. From 2000 to the present, international and local health care educators have conducted regular workshops to train indigenous health workers in the management of landmine injuries, penetrating and blunt trauma, shock, wound and infection care, and orthopedics. Health workers have been regularly resupplied with the surgical instruments, supplies and medications needed to provide the care learnt through TMP training workshops. Discussion and Evaluation Since 2000, approximately 300 health workers have received training through the TMP, as part of a CBO-run health system providing care for approximately 250 000 internally displaced persons (IDPs and war-affected residents. Based on interviews with health workers, trauma registry inputs and photo/video documentation, protocols and procedures taught during training workshops have been implemented effectively in the field. Between June 2005 and June 2007, more than 200 patients were recorded in the trauma patient registry. The majority were victims of weapons-related trauma. Conclusion This report illustrates a method to increase the capacity of indigenous health workers to manage traumatic injuries. These health workers are able to provide trauma care for otherwise inaccessible

  12. Information Processing of Trauma.

    Science.gov (United States)

    Hartman, Carol R.; Burgess, Ann W.

    1993-01-01

    This paper presents a neuropsychosocial model of information processing to explain a victimization experience, specifically child sexual abuse. It surveys the relation of sensation, perception, and cognition as a systematic way to provide a framework for studying human behavior and describing human response to traumatic events. (Author/JDD)

  13. Epidemiological study of ocular trauma in an urban slum population in Delhi, India

    Science.gov (United States)

    Vats, S; Chandra, M; Gupta, S K; Vashist, P; Gogoi, M

    2008-01-01

    Purpose: To study the epidemiology and clinical profile of victims of ocular trauma in an urban slum population. Materials and Methods: This cross-sectional study, conducted on 500 families each in three randomly selected urban slums in Delhi, collected demographic data for all members of these families, and clinical data for all those who suffered ocular trauma at any time, that required medical attention. Data was managed on SPSS 11.0. Results: Of 6704 participants interviewed, 163 episodes of ocular trauma were reported by 158 participants (prevalence = 2.4%, confidence interval = 2.0 to 2.7) Mean age at trauma was 24.2 years. The association between the age of participants and the history of ocular trauma was significant (P < 0.001), when adjusted for sex, education and occupation. Males were significantly more affected. Blunt trauma was the commonest mode of injury (41.7%). Blindness resulted in 11.4% of injured eyes ( P = 0.028). Of 6704 participants, 1567 (23.4%) were illiterate, and no association was seen between education status and trauma, when adjusted for sex and age at injury. A significant association was noted between ocular trauma and workplace (Chi-square = 43.80, P < 0.001), and between blindness and place (Chi-square = 9.98, P = 0.041) and source (Chi-square = 10.88, P = 0.028) of ocular trauma. No association was found between visual outcome and the time interval between trauma and first consultation (Chi-square = 0.50, P = 0.78), between receiving treatment and the best corrected visual acuity (Chi-square = 0.81, P = 0.81), and between the person consulted and blinding ocular trauma (Chi-square = 1.88, P = 0.170). Conclusion: A significant burden of ocular trauma in the community requires that its prevention and early management be a public health priority. PMID:18579991

  14. Epidemiological study of ocular trauma in an urban slum population in Delhi, India

    Directory of Open Access Journals (Sweden)

    Vats S

    2008-01-01

    Full Text Available Purpose: To study the epidemiology and clinical profile of victims of ocular trauma in an urban slum population. Materials and Methods: This cross-sectional study, conducted on 500 families each in three randomly selected urban slums in Delhi, collected demographic data for all members of these families, and clinical data for all those who suffered ocular trauma at any time, that required medical attention. Data was managed on SPSS 11.0. Results: Of 6704 participants interviewed, 163 episodes of ocular trauma were reported by 158 participants (prevalence = 2.4%, confidence interval = 2.0 to 2.7 Mean age at trauma was 24.2 years. The association between the age of participants and the history of ocular trauma was significant ( P < 0.001, when adjusted for sex, education and occupation. Males were significantly more affected. Blunt trauma was the commonest mode of injury (41.7%. Blindness resulted in 11.4% of injured eyes ( P = 0.028. Of 6704 participants, 1567 (23.4% were illiterate, and no association was seen between education status and trauma, when adjusted for sex and age at injury. A significant association was noted between ocular trauma and workplace (Chi-square = 43.80, P < 0.001, and between blindness and place (Chi-square = 9.98, P = 0.041 and source (Chi-square = 10.88, P = 0.028 of ocular trauma. No association was found between visual outcome and the time interval between trauma and first consultation (Chi-square = 0.50, P = 0.78, between receiving treatment and the best corrected visual acuity (Chi-square = 0.81, P = 0.81, and between the person consulted and blinding ocular trauma (Chi-square = 1.88, P = 0.170. Conclusion: A significant burden of ocular trauma in the community requires that its prevention and early management be a public health priority.

  15. Patient Safety Culture and the Second Victim Phenomenon: Connecting Culture to Staff Distress in Nurses

    Science.gov (United States)

    Quillivan, Rebecca R.; Burlison, Jonathan D.; Browne, Emily K.; Scott, Susan D.; Hoffman, James M.

    2017-01-01

    Background Second victim experiences can affect the well-being of healthcare providers and compromise patient safety. Many factors associated with improved coping afer patient safety event involvement are also components of a strong patient safety culture, so that supportive patient safety cultures may reduce second victim–related trauma. A cross-sectional survey study was conducted to assess the influence of patient safety culture on second victim–related distress, in which associations among patient safety culture dimensions, organizational support, and second victim distress were investigated. Methods The Agency for Healthcare Research and Quality (AHRQ) Hospital Survey on Patient Safety Culture (HSOPSC) and the Second Victim Experience and Support Tool (SVEST), which was developed to assess organizational support and personal and professional distress after involvement in a patient safety event, were administered to nurses involved in direct patient care. Results Of 358 nurses, 155 (41%) responded, of whom 144 completed both surveys. Hierarchical linear regression demonstrated that the patient safety culture survey dimension nonpunitive response to errors was significantly associated with reductions in the second victim survey dimensions psychological, physical, and professional distress (p patient safety event by encouraging supportive interactions. Also, perceptions of second victim–related distress may be less severe when hospital cultures are characterized by nonpunitive response to errors. Reducing punitive response to error and encouraging supportive coworker, supervisor, and institutional interactions may be useful strategies to manage the severity of second victim experiences. PMID:27456420

  16. Rates of Exposure to Victimizing Events and Use of Substances Among California's Middle and High School Students.

    Science.gov (United States)

    Larson, Satu; Brindis, Claire D; Chapman, Susan A; Spetz, Joanne

    2018-01-01

    Nearly half of 5- to 17-year-olds have experienced trauma in the form of at-school victimization. Exposure to trauma increases students' risk for mental health disorders and school failure. This study reviews at-school victimization in middle and high school students and associated health outcomes that may negatively impact academic outcomes. Analyzing the California Healthy Kids Survey 2010, we examine rates of victimization on school grounds, substance use, and symptoms of depression and eating disorders among a sample of 6th to 12th graders ( N = 639,925). Between 20% and 50% of students had experienced at least one type of victimizing event on school grounds, with the highest incidence in middle schools. A significantly higher share of victimized students reported using substances, symptoms of depression and eating disorders when compared to nonvictimized students. School district investment in school nurses, social workers, and school-based health centers could increase preventive interventions to improve school climate, student well-being, and academic success.

  17. Fracture dislocation of the capitate following major trauma: A case report and literature review

    Directory of Open Access Journals (Sweden)

    Michael James Grant

    2017-12-01

    Conclusion: More patients are surviving major trauma events and have multiple complex limb injuries. We underscore the importance of having a high index of suspicion for complex injuries in high energy trauma and also the importance of appropriate and prompt management of such cases at specialized institutions. [Hand Microsurg 2017; 6(3.000: 146-149

  18. How does extracerebral trauma affect the clinical value of S100B measurements?

    DEFF Research Database (Denmark)

    Ohrt-Nissen, Søren; Friis-Hansen, Lennart; Dahl, Benny

    2011-01-01

    trauma and then stored at -80°C until analysed. Variables included Abbreviated Injury Scale (AIS) for head trauma, Injury Severity Score (ISS) and 30-day survival. Results Two patients could not be classified. IHI occurred in 28, MTHI in 102 and NHI was found in 101. The median S100B concentrations...

  19. Epidemiology of severe trauma.

    Science.gov (United States)

    Alberdi, F; García, I; Atutxa, L; Zabarte, M

    2014-12-01

    Major injury is the sixth leading cause of death worldwide. Among those under 35 years of age, it is the leading cause of death and disability. Traffic accidents alone are the main cause, fundamentally in low- and middle-income countries. Patients over 65 years of age are an increasingly affected group. For similar levels of injury, these patients have twice the mortality rate of young individuals, due to the existence of important comorbidities and associated treatments, and are more likely to die of medical complications late during hospital admission. No worldwide, standardized definitions exist for documenting, reporting and comparing data on severely injured trauma patients. The most common trauma scores are the Abbreviated Injury Scale (AIS), the Injury Severity Score (ISS) and the Trauma and Injury severity Score (TRISS). Documenting the burden of injury also requires evaluation of the impact of post-trauma impairments, disabilities and handicaps. Trauma epidemiology helps define health service and research priorities, contributes to identify disadvantaged groups, and also facilitates the elaboration of comparable measures for outcome predictions. Copyright © 2014 Elsevier España, S.L.U. y SEMICYUC. All rights reserved.

  20. Male genital trauma

    International Nuclear Information System (INIS)

    Jordan, G.H.; Gilbert, D.A.

    1988-01-01

    We have attempted to discuss genital trauma in relatively broad terms. In most cases, patients present with relatively minimal trauma. However, because of the complexity of the structures involved, minimal trauma can lead to significant disability later on. The process of erection requires correct functioning of the arterial, neurologic, and venous systems coupled with intact erectile bodies. The penis is composed of structures that are compliant and distensible to the limits of their compliance. These structures therefore tumesce in equal proportion to each other, allowing for straight erection. Relatively minimal trauma can upset this balance of elasticity, leading to disabling chordee. Likewise, relatively minimal injuries to the vascular erectile structures can lead to significantly disabling spongiofibrosis. The urethra is a conduit of paramount importance. Whereas the development of stricture is generally related to the nature of the trauma, the extent of stricture and of attendant complications is clearly a function of the immediate management. Overzealous debridement can greatly complicate subsequent reconstruction. A delicate balance between aggressive initial management and maximal preservation of viable structures must be achieved. 38 references

  1. Maternofetal Trauma in Craniosynostosis.

    Science.gov (United States)

    Swanson, Jordan; Oppenheimer, Adam; Al-Mufarrej, Faisal; Pet, Mitchell; Arakawa, Chris; Cunningham, Michael; Gruss, Joseph; Hopper, Richard; Birgfeld, Craig

    2015-08-01

    Premature cranial suture fusion may prevent neonatal skull malleability during birth, increasing the risk of unplanned cesarean delivery and neonatal birth trauma caused by cephalopelvic disproportion. We sought to determine the incidence of perinatal maternofetal complications in cases of craniosynostosis. Records of children presenting with nonsyndromic craniosynostosis to a tertiary pediatric hospital from 1996 to 2012 were reviewed retrospectively with focus on birth history and birth-related complications. Six hundred eighteen births were reviewed. Rates of cesarean delivery among mothers of children with craniosynostosis [n = 201 (32.5 percent)] exceeded the overall regional rate of 24.5 percent (OR, 1.50; p delivery occurred in 19.7 percent of births, and were most associated with nulliparous mothers, breech fetal presentations, and lambdoid or multisuture synostosis patterns. Eleven neonates (1.8 percent) exhibited cranial birth trauma, including cephalohematoma and subgaleal hematoma. Neonates with sagittal or multisuture synostosis patterns were more likely to suffer birth trauma and had a higher mean head circumference than those who did not (81st versus 66th percentile, p birth trauma is increased-for mothers in the form of increased cesarean delivery risk, and for fetuses in the form of subgaleal and subperiosteal perinatal bleeding. Difficult maternal labor may be mediated especially by multisuture or lambdoid synostosis, whereas fetal birth trauma may be mediated to a greater extent by large head size. Prenatal diagnosis of craniosynostosis could influence decision-making in the management of labor. Risk, IV.

  2. Poisoning, envenomation, and trauma from marine creatures.

    Science.gov (United States)

    Perkins, R Allen; Morgan, Shannon S

    2004-02-15

    In the course of their clinical work or during leisure activity, family physicians occasionally may encounter patients with injuries from marine creatures. Poisoning, envenomation, and direct trauma are all possible in the marine environment. Ciguatera poisoning can result from ingestion of predatory fish that have accumulated biotoxins. Symptoms can be gastrointestinal or neurologic, or mixed. Management is mostly symptomatic. Scombroid poisoning results from ingestion of fish in which histamine-like substances have developed because of improper refrigeration. Gastrointestinal and systemic symptoms occur. Treatment is based on antihistamines. Envenomations from jellyfish in U.S. waters and the Caribbean are painful but rarely deadly. Household vinegar deactivates the nematocysts, and manual removal of tentacles is important. Treatment is symptomatic. Heat immersion may help with the pain. Stingrays cause localized damage and a typically severe envenomation. The venom is deactivated by heat. The stingray spine, including the venom gland, typically is difficult to remove from the victim, and radiographs may be necessary to localize the spine or fragment. Surgical débridement occasionally is needed. Direct trauma can result from contact with marine creatures. Hemorrhage and tissue damage occasionally are severe. Infections with organisms unique to the marine environment are possible; antibiotic choices are based on location and type of injury. Shark attacks, although rare, require immediate attention.

  3. The Influence of Direct and Indirect Juvenile Victimization Experiences on Adult Victimization and Fear of Crime.

    Science.gov (United States)

    Grubb, Jonathan A; Bouffard, Leana A

    2015-11-01

    Research has identified that juvenile victimization can play a detrimental role for individuals later in life. While this literature has focused on direct and indirect forms of victimization at different stages of life, the influence of juvenile victimization on fear of crime and violent victimization as an adult has been limited. To expand this body of literature, the present research examines the effects of direct (sexual victimization) and indirect (witnessing parental intimate partner violence) juvenile victimization on fear of crime as well as the prevalence of victimization as an adult. Using telephone survey data collected from randomly selected Texas adults, this study demonstrates that both juvenile sexual victimization and indirect victimization increase the likelihood of adult victimization, whereas juvenile sexual victimization increases the likelihood of adult sexual victimization. In contrast, fear of crime as an adult was not significantly influenced by either juvenile sexual victimization or indirect victimization. A discussion of how these findings relate to previous research, limitations, and implications are also provided. © The Author(s) 2014.

  4. Childhood victimization, poly-victimization, and adjustment to college in women.

    Science.gov (United States)

    Elliott, Ann N; Alexander, Apryl A; Pierce, Thomas W; Aspelmeier, Jeffery E; Richmond, Jessica M

    2009-11-01

    This study examines the relationships among poly-victimization (i.e., high cumulative levels of victimization), six aggregate categories of childhood victimization (property crime, physical assault, peer and sibling, witnessed and indirect, sexual, child maltreatment), and college adjustment in females. This study first examines the relative contributions of poly-victimization and individual categories of childhood victimization in predicting college adjustment. The study then examines whether poly-victimization contributes any unique variance, beyond that accounted for by the combination of all six aggregate categories. Regression analyses reveal that a) poly-victimization accounts for a significant proportion of variability in scores for college adjustment, beyond that accounted for by any of the six categories of childhood victimization alone, and b) the categories of childhood victimization contribute little to no variability beyond that accounted for by poly-victimization. Furthermore, poly-victimization accounts for a significant proportion of variability in college adjustment, beyond that already accounted for by the simultaneous entry of all six categories as predictor variables. Finally, although victimization does not predict GPA, it predicts other domains of college adjustment. Results suggest that counselors working with college students should a) assess multiple categories of victimization and poly-victimization, and b) evaluate clients' adjustment to college across multiple domains (e.g., academic, social, interpersonal).

  5. Lived experiences of male intimate partners of female rape victims in Cape Town, South Africa

    Directory of Open Access Journals (Sweden)

    Evalina van Wijk

    2014-02-01

    Full Text Available Background: Sexual violence in South Africa is a major public health and social problem. Sexual assault or rape is a traumatic event which disrupts not only the life of the female rape victim, but also that of her male intimate partner (MIP, irrespective of whether he witnessed or was informed of the incident.Objectives: The study aimed to explore the lived experiences of MIPs of female rape victims and the meaning of these experiences in the six months following the partner’s rape.Method: We conducted a longitudinal hermeneutic phenomenological study. Nine purposively sampled adult MIPs were interviewed over a period of six months. The participants were in an intimate relationship with a female rape victim prior to and immediately after the rape; their partners had been treated at a specialised centre for victims of rape and sexual assault. Four interviews were conducted with each of the nine intimate partners of female rape victims: (1 within 14 days of, (2 a month after, (3 three months after, and (4 six months after the rape.Results: Two major themes emerged: being-in-the-world as a secondary victim of rape, and living in multiple worlds, those of their female partners, family, friends, society, employers or colleagues, professionals and the justice system. The participant’s familiar world became strange and even threatening, and his relationship with his partner became uncertain.Conclusion: Early supportive intervention for intimate partners of female rape victims is required to prevent on-going emotional trauma and alleviate the effects of chronic post-traumatic stress disorder and suffering at intra- and interpersonal levels.

  6. Lived experiences of male intimate partners of female rape victims in Cape Town, South Africa.

    Science.gov (United States)

    van Wijk, Evalina; Duma, Sinegugu E; Mayers, Pat M

    2014-09-23

    Sexual violence in South Africa is a major public health and social problem. Sexual assault or rape is a traumatic event which disrupts not only the life of the female rape victim, but also that of her male intimate partner (MIP), irrespective of whether he witnessed or was informed of the incident. The study aimed to explore the lived experiences of MIPs of female rape victims and the meaning of these experiences in the six months following the partner's rape. We conducted a longitudinal hermeneutic phenomenological study. Nine purposively sampled adult MIPs were interviewed over a period of six months. The participants were in an intimate relationship with a female rape victim prior to and immediately after the rape; their partners had been treated at a specialised centre for victims of rape and sexual assault. Four interviews were conducted with each of the nine intimate partners of female rape victims: (1) within 14 days of, (2) a month after, (3) three months after, and (4) six months after the rape. Two major themes emerged: being-in-the-world as a secondary victim of rape, and living in multiple worlds, those of their female partners, family, friends, society, employers or colleagues, professionals and the justice system. The participant's familiar world became strange and even threatening, and his relationship with his partner became uncertain. Early supportive intervention for intimate partners of female rape victims is required to prevent on-going emotional trauma and alleviate the effects of chronic post-traumatic stress disorder and suffering at intra- and interpersonal levels.

  7. Decreased dehydroepiandrosterone sulphate levels in adolescents with post-traumatic stress disorder after single sexual trauma.

    Science.gov (United States)

    Usta, Mirac Baris; Tuncel, Ozgur Korhan; Akbas, Seher; Aydin, Berna; Say, Gokce Nur

    2016-01-01

    Recent evidence shows that the hypothalamic-pituitary-adrenal (HPA) axis can be dysregulated in chronic sexual abuse victims with post-traumatic stress disorder (PTSD). We hypothesized that PTSD in adolescents exposed to a single sexual trauma may function as a chronic stressor leading to HPA-axis dysregulation. The objective of this study was to assess dehydroepiandrosterone sulphate (DHEA-S) and cortisol levels in female adolescents |with single sexual trauma-related PTSD compared to healthy controls. We assessed 20 female adolescent (age 12-18) single sexual trauma victims with PTSD from the Ondokuz Mayis University Department of Child and Adolescent Psychiatry between December 2013 and December 2014. PTSD symptoms were assessed using the Child Depression Inventory (CDI) and Child Posttraumatic Stress Reaction Index (CPSRI). Blood cortisol and DHEA-S were measured in 20 female adolescent sexual abuse victims with PTSD and 20 healthy adolescents after 12-h fasting using the chemiluminescence method. Compared to age-matched controls, female adolescent sexual abuse victims with PTSD had significantly lower DHEA-S levels (U = 70.00, Z = - 3.517, p = 0.01, r = 0.55). There was also a significant negative correlation between DHEA-S and CDI scores (Spearman r = - 0.522, p < 0.01). Decreased DHEA-S levels and correlation with depressive symptoms are evidence for a dysregulated HPA-axis in female adolescent single sexual trauma victims with PTSD. Further research is now recommended with large patient groups in order to maximize generalizations.

  8. Trauma Induced Coagulopathy

    DEFF Research Database (Denmark)

    Genét, Gustav Folmer; Johansson, Per; Meyer, Martin Abild Stengaard

    2013-01-01

    It remains debated whether traumatic brain injury (TBI) induces a different coagulopathy compared to non-TBI. This study investigated traditional coagulation tests, biomarkers of coagulopathy and endothelial damage in trauma patients with and without TBI. Blood from 80 adult trauma patients were...... sampled (median of 68 min (IQR 48-88) post-injury) upon admission to our trauma centre. Plasma/serum were retrospectively analysed for biomarkers reflecting sympathoadrenal activation (adrenaline, noradrenaline), coagulation activation/inhibition and fibrinolysis (protein C, activated protein C, tissue......+other had significantly higher plasma levels of adrenaline, noradrenaline, annexinV, d-dimer, IL6, syndecan-1, solubel thrombomodulin, and reduced protein C and factor XIII levels (all p...

  9. Resuscitative goals and new strategies in severe trauma patient resuscitation.

    Science.gov (United States)

    Egea-Guerrero, J J; Freire-Aragón, M D; Serrano-Lázaro, A; Quintana-Díaz, M

    2014-11-01

    Traumatic injuries represent a major health problem all over the world. In recent years we have witnessed profound changes in the paradigm of severe trauma patient resuscitation, new concepts regarding acute coagulopathy in trauma have been proposed, and there has been an expansion of specific commercial products related to hemostasis, among other aspects. New strategies in severe trauma management include the early identification of those injuries that are life threatening and require surgical hemostasis, tolerance of moderate hypotension, rational intravascular volume replacement, prevention of hypothermia, correction of acidosis, optimization of oxygen carriers, and identification of those factors required by the patient (fresh frozen plasma, platelets, tranexamic acid, fibrinogen, cryoprecipitates and prothrombin complex). However, despite such advances, further evidence is required to improve survival rates in severe trauma patients. Copyright © 2014 Elsevier España, S.L.U. y SEMICYUC. All rights reserved.

  10. Understanding trauma as a men's health issue: sex differences in traumatic injury presentations at a level 1 trauma center in Australia.

    Science.gov (United States)

    Mitchell, Rebecca; Curtis, Kate; Fisher, Murray

    2012-01-01

    Predominantly, males have a higher risk of injury mortality and morbidity than females. However, less is known about gender differences for injury and trauma outcome at a regional level. The aim of this study was to examine the epidemiologic profile and trauma outcomes of males and females at a level 1 trauma center to inform local injury prevention efforts. A retrospective review was conducted of injuries identified from the trauma registry of the New South Wales St George Public Hospital during January 1, 2004, to December 31, 2008. There were 6763 major trauma presentations, and 65.1% of these were of males. Males had a higher proportion of trauma presentations in each age group, except for those younger than 15 years, 45 to 54 years, and older than 65 years. Almost all presentations were as a result of unintentional injuries. However, 8% of males were victims of assault compared with 2% of females. Males were more likely to be injured while working and during leisure or sports activities and at sporting, farming, home, trade, and industrial locations than females. Males were more likely to be more severely injured than females and generally had a longer hospital length of stay. There was no significant difference in the rate of mortality between the genders. There are distinct differences between the sexes regarding the mechanism and severity of injury and trauma outcomes. Local injury prevention initiatives should be targeted to address gender differences. Future social research should examine the interplay of the construction of masculinities with male injury.

  11. The complexity of victim-questioning attitudes by rape victim advocates: exploring some gray areas.

    Science.gov (United States)

    Maier, Shana L

    2012-12-01

    Despite efforts to educate and create community awareness, rape myths and victim-blaming attitudes persist in society. This research explores whether advocates express victim-questioning attitudes or questions, negative judgment, or frustration regarding victims' behavior or choices. Data from interviews with 58 advocates reveal that the majority (76%) of advocates never expressed any victim-questioning attitudes during the interview. However, responses from 14 advocates (24%) show that victim-questioning has evolved into a much more complex, subtle form than historical victim blaming or acceptance of rape myths.

  12. Coping with the Murder of a Loved One: Counseling Survivors of Murder Victims in Groups

    Science.gov (United States)

    Miranda, Alexis O.; Molina, Bogusia; MacVane, Sandi L.

    2003-01-01

    The survival of the murder of a loved one is a psychologically taxing process. Survivors of murder victims experience stressors that originate from the exigencies of the interpersonal, situational, and the criminal justice system domains. Group facilitators must be aware of the experiences and the mental health dynamics common to survivors, the…

  13. Heroes and Victims: The Stereotyping of Animal Characters in Children's Realistic Animal Fiction.

    Science.gov (United States)

    Oswald, Lori Jo

    1995-01-01

    Discusses portrayals of animals in children's realistic animal fiction over the course of the 20th century. Shows how the definition of animal hero generally changed from wild animals that were heroic for surviving against all odds to domesticated animals that were heroic for rescuing humans from wild beasts. Discusses animals as victims. (SR)

  14. Pre-hospital triage performance after standardized trauma courses.

    Science.gov (United States)

    Lampi, Maria; Junker, Johan; Berggren, Peter; Jonson, Carl-Oscar; Vikström, Tore

    2017-05-19

    The pre-hospital triage process aims at identifying and prioritizing patients in the need of prompt intervention and/or evacuation. The objective of the present study was to evaluate triage decision skills in a Mass Casualty Incident drill. The study compares two groups of participants in Advanced Trauma Life Support and Pre-Hospital Trauma Life Support courses. A questionnaire was used to deal with three components of triage of victims in a Mass Casualty Incident: decision-making; prioritization of 15 hypothetical casualties involved in a bus crash; and prioritization for evacuation. Swedish Advanced Trauma Life Support and Pre-Hospital Trauma Life Support course participants filled in the same triage skills questionnaire just before and after their respective course. One hundred fifty-three advanced Trauma Life Support course participants were compared to 175 Pre-Hospital Trauma Life Support course participants. The response rates were 90% and 95%, respectively. A significant improvement was found between pre-test and post-test for the Pre-Hospital Trauma Life Support group in regards to decision-making. This difference was only noticeable among the participants who had previously participated in Mass Casualty Incident drills or had experience of a real event (pre-test mean ± standard deviation 2.4 ± 0.68, post-test mean ± standard deviation 2.60 ± 0.59, P = 0.04). No improvement was found between pre-test and post-test for either group regarding prioritization of the bus crash casualties or the correct identification of the most injured patients for immediate evacuation. Neither Advanced Trauma Life Support nor Pre-Hospital Trauma Life Support participants showed general improvement in their tested triage skills. However, participation in Mass Casualty Incident drills or experience of real events prior to the test performed here, were shown to be advantageous for Pre-Hospital Trauma Life Support participants. These courses should be

  15. Big Five Personality Traits of Cybercrime Victims.

    Science.gov (United States)

    van de Weijer, Steve G A; Leukfeldt, E Rutger

    2017-07-01

    The prevalence of cybercrime has increased rapidly over the last decades and has become part of the everyday life of citizens. It is, therefore, of great importance to gain more knowledge on the factors related to an increased or decreased likelihood of becoming a cybercrime victim. The current study adds to the existing body of knowledge using a large representative sample of Dutch individuals (N = 3,648) to study the relationship between cybercrime victimization and the key traits from the Big Five model of personality (i.e., extraversion, agreeableness, conscientiousness, emotional stability, and openness to experience). First, multinomial logistic regression analyses were used to examine the associations between the personality traits and three victim groups, that is, cybercrime victims versus nonvictims, traditional crime victims versus nonvictims, and cybercrime victims versus traditional crime victims. Next, logistic regression analyses were performed to predict victimization of cyber-dependent crimes (i.e., hacking and virus infection) and cyber-enabled crimes (i.e., online intimidation, online consumer fraud, and theft from bank account). The analyses show that personality traits are not specifically associated with cybercrime victimization, but rather with victimization in general. Only those with higher scores on emotional stability were less likely to become a victim of cybercrime than traditional crime. Furthermore, the results indicate that there are little differences between personality traits related to victimization of cyber-enabled and cyber-dependent crimes. Only individuals with higher scores on openness to experience have higher odds of becoming a victim of cyber-enabled crimes.

  16. Trauma cardiaco cerrado

    OpenAIRE

    Alvarado, Camilo; Vargas, Fernando; Guzmán, Fernando; Zárate, Alejandro; Correa, José L.; Ramírez, Alejandro; Quintero, Diana M.; Ramírez, Erika M.

    2016-01-01

    El trauma cardiaco constituye una de las primeras causas de mortalidad en la población general. Requiere alto índice de sospecha en trauma cerrado severo, mecanismo de desaceleración y en presencia de signos indirectos como: equimosis, huella del volante o del cinturón en el tórax anterior. Las lesiones incluyen: conmoción cardiaca, ruptura cardiaca, lesión cardiaca indirecta como la trombosis coronaria aguda, lesión aórtica, lesión del pericardio y herniación cardiaca. Entre las manifestacio...

  17. Sonography of scrotal trauma

    Directory of Open Access Journals (Sweden)

    Meka Srinivasa Rao

    2012-01-01

    Full Text Available The purpose of this article is to depict the spectrum of scrotal injuries in blunt trauma. Scrotal injuries are not very common and are mostly due to blunt trauma from direct injury, sports injuries or motor vehicle accidents. To minimize complications and ensure testicular salvage, rapid and accurate diagnosis is necessary. High-resolution USG is the investigation of choice, as it is readily available, accurate and has been seen to improve outcomes. An understanding of and familiarity with the sonographic appearance of scrotal injuries on the part of the radiologist/sonographer is therefore of key importance.

  18. Cognitive-Behavioral Therapy for PTSD and Depression Symptoms Reduces Risk for Future Intimate Partner Violence among Interpersonal Trauma Survivors

    Science.gov (United States)

    Iverson, Katherine M.; Gradus, Jaimie L.; Resick, Patricia A.; Suvak, Michael K.; Smith, Kamala F.; Monson, Candice M.

    2011-01-01

    Objective: Women who develop symptoms of posttraumatic stress disorder (PTSD) and depression subsequent to interpersonal trauma are at heightened risk for future intimate partner violence (IPV) victimization. Cognitive-behavioral therapy (CBT) is effective in reducing PTSD and depression symptoms, yet limited research has investigated the…

  19. Profile Of Burn Victims Attended By An Emergency Unit

    Directory of Open Access Journals (Sweden)

    Lidiane Souza Lima

    2017-02-01

    Full Text Available Objectives: to identify the sociodemographic and health profile of burn victims, knowing the characteristics of the events and detecting the major analgesics prescribed in the emergency department. Methods: descriptive, exploratory and quantitative study with 16 burn victims treated at a Burn Treatment Unit from October 2015 to May 2016. Results: the average age of participants was 31.8 years (± 14.1. Mostly, the subjects were male (62.5%, single (43.8%, brown (68.8%, economically active (75.0% and coming from Aracaju and its surroundings (62.5%. Injuries from burns were mostly of second degree (93.8% and reached the lower limbs (68.8%. The average burned body surface was 15.8% (± 11.5. The circumstances surrounding burns occurred mainly at home (50.0%, on Sundays (25.0% and in the shifts morning (37.5% and night (37.5%. The main etiological agent was alcohol (31.3%. All patients received analgesia in the emergency department, but the minority had pain documented (18.8%. The physician was the only professional who reported pain in their records, but did incompletely (18.8%. Conclusion: due to the negative effects of burns, it is crucial to adopt educational and preventive measures to change the current scenario of epidemiology of such trauma. Keywords: Burns; Epidemiology; Analgesia; Emergency.

  20. CERN’s firefighters hone their trauma response skills

    CERN Document Server

    Anaïs Schaeffer

    2016-01-01

    Seven CERN firefighters have been trained in how to treat trauma victims. This training forms part of the Fire Brigade’s efforts to acquire specialist knowledge.   The fifteen trainees who took the PHTLS course at CERN, with the instructor team. On 23 and 24 May, the CERN Fire Brigade welcomed five instructors from Life Support France, an association that offers training in pre-hospital emergency treatment, to provide a course on Pre-Hospital Trauma Life Support (PHTLS). Fifteen “trainees” – seven CERN firefighters and eight rescue and healthcare professionals from outside the Organization (nurses, paramedics and firefighters) – took part in the course, at the end of which they were awarded an official PHTLS certificate, valid for four years. Of course, the whole PHTLS programme cannot be covered in just two days, so several months of additional work were required in advance of the course, particularly to acquire the necessary theoretical knowledg...

  1. Man impaled on crowbar saved by hospital trauma team | Bateman ...

    African Journals Online (AJOL)

    A cool-as-a-cucumber Carltonville mine engineer walked out of hospital 19days after being impaled from groin to upper back by a 2-metre, 2 cm-thick industrial crowbar, his survival and recovery due to his presence of mind, and world-class trauma surgery. The crowbar pierced three of his body cavities – his pelvis, ...

  2. Non-trauma related paediatric abdominal surgical emergencies in ...

    African Journals Online (AJOL)

    Background: Pediatric surgical emergencies are associated with higher morbidity and mortality. The aim of this study is to describe the epidemiology of non-trauma related pediatric abdominal surgical emergencies in our centre and determine the indicators for survival in a cohort of patients. Patients and Methods: A ...

  3. Man impaled on crowbar saved by hospital trauma team

    African Journals Online (AJOL)

    A cool-as-a-cucumber Carl- ton ville mine engineer walked out of hospital 19 days after being impaled from groin to upper back by a 2-metre, 2 cm-thick industrial crowbar, his survival and recovery due to his presence of mind, and world-class trauma surgery. The crowbar pierced three of his body cavities – his pelvis ...

  4. The culture of a trauma team in relation to human factors.

    Science.gov (United States)

    Cole, Elaine; Crichton, Nicola

    2006-10-01

    The aim of this ethnographic study was to explore the culture of a trauma team in relation to human factors. Traumatic injury is the leading cause of death in the first four decades of life in the western world. Evidence suggests that the initial assessment and resuscitation of trauma victims is most successfully carried out by an organized trauma team. Most trauma teams use Advanced Trauma Life Support principles which focus on rapid assessment and management of the patient's injuries. Similarly, most trauma education focuses on Advanced Trauma Life Support principles, concentrating firmly on the patient's physical status. Nevertheless, contemporary literature about emergency teams suggests that human factors, such as communication and interprofessional relationships, can affect the team's performance regardless of how clinically skilled the team members are. Focused ethnography was used to explore the culture of a trauma team in one teaching hospital. Six periods of observation were undertaken followed by 11 semi-structured interviews with purposively chosen key personnel. Data from transcripts of the observation field notes and interviews were analysed using open coding, followed by formation of categories resulting in the emergence of six central categories. Findings suggest that leadership, role competence, conflict, communication, the environment and the status of the patient all influence the culture of the trauma team. Interpretation of these categories suggests that trauma team education should include human factor considerations such as leadership skills, team management, interprofessional teamwork, conflict resolution and communication strategies. The findings suggest that support systems for role development of junior team leaders should be formalized. The proven airline industry techniques of Crew Resource Management, focusing on teamwork and effective communication, could be implemented into continuing professional development for trauma teams to

  5. Victim's Rights - Comparative Approach within EU Legislation

    Directory of Open Access Journals (Sweden)

    Monica Pocora

    2015-12-01

    Full Text Available Usually is talking about offender rights and rarely about victim's rights. This study aims to analyse victim's rights especially in Romanian legislation from all points of view. Having involuntary fallen victim to crime, the person is often unaware of what information is available. It is therefore important that the onus is not put on the victim to request a certain piece of information. Victims of crimes need to have their important role in the criminal proceedings and he or she has to know about the extension of them rights. Not least, the study is focus on the right of the victim to receive information, not to be made responsible for the practicalities surrounding its delivery.

  6. Assessment of cardiopulmonary resuscitation practices in emergency departments for out-of-hospital cardiac arrest victims in Lebanon

    Directory of Open Access Journals (Sweden)

    Samar Noureddine

    2016-01-01

    Full Text Available Background: The survival rate of out-of-hospital cardiac arrest (OHCA victims in Lebanon is low. A national policy on resuscitation practice is lacking. This survey explored the practices of emergency physicians related to the resuscitation of OHCA victims in Lebanon. Methods: A sample of 705 physicians working in emergency departments (EDs was recruited and surveyed using the LimeSurvey software (Carsten Schmitz, Germany. Seventy-five participants responded, yielding 10.64% response rate. Results: The most important factors in the participants' decision to initiate or continue resuscitation were presence of pulse on arrival (93.2%, underlying cardiac rhythm (93.1%, the physician's ethical duty to resuscitate (93.2%, transport time to the ED (89%, and down time (84.9%. The participants were optimistic regarding the survival of OHCA victims (58.1% reporting > 10% survival and reported frequent resuscitation attempts in medically futile situations. The most frequently reported challenges during resuscitation decisions were related to pressure or presence of victim's family (38.8% and lack of policy (30%. Conclusion: In our setting, physicians often rely on well-established criteria for initiating/continuing resuscitation; however, their decisions are also influenced by cultural factors such as victim's family wishes. The findings support the need for a national policy on resuscitation of OHCA victims.

  7. Association of perpetrator relationship to abusive head trauma clinical outcomes.

    Science.gov (United States)

    Scribano, Philip V; Makoroff, Kathi L; Feldman, Kenneth W; Berger, Rachel P

    2013-10-01

    The diagnosis of abusive head trauma (AHT) remains a significant public health problem with limited prevention success. Providing protection from further harm is often challenged by the difficulty in identifying the alleged perpetrator (AP) responsible for this pediatric trauma. The objective of this study was to evaluate demographic and clinical characteristics of children with AHT and the relationship between APs and their victims in a large, multi-site sample. Understanding the AHT risks from various caregivers may help to inform current prevention strategies. A retrospective review of all cases of AHT diagnosed by child protection teams (CPT) from 1/1/04 to 6/30/09 at four children's hospitals was conducted. Clinical characteristics of children with AHT injured by non-parental perpetrators (NPP) were compared to parental perpetrators (PP). There were 459 children with AHT; 313 (68%) had an identified AP. The majority of the 313 children were <1 year of age (76%), Caucasian (63%), male (58%), receiving public assistance (80%), and presented without a history of trauma (62%); mortality was 19%. Overall, APs were: father (53%), parent partner (22%), mother (8%), babysitter (8%), other adult caregiver (5%); NPP accounted for 39% of APs. NPPs were more likely to cause AHT in children ≥ 1 year (77% vs. 23%, p<0.001) compared to PP. Independent associations to NPP included: older child, absence of a history of trauma, retinal hemorrhages, and male perpetrator gender. While fathers were the most common AP in AHT victims, there is a significant association for increased risk of AHT by NPPs in the older child, who presents with retinal hemorrhages, in the hands of a male AP. Further enhancement of current prevention strategies to address AHT risks of non-parental adults who provide care to children, especially in the post-infancy age seems warranted. Copyright © 2013 Elsevier Ltd. All rights reserved.

  8. Cranial birth trauma

    International Nuclear Information System (INIS)

    Papanagiotou, P.; Roth, C.; Politi, M.; Zimmer, A.; Reith, W.; Rohrer, T.

    2009-01-01

    Injuries to an infant that result during the birth process are categorized as birth trauma. Cranial injuries due to mechanical forces such as compression or traction include caput succedaneum, cephalhematoma, subgaleal hematoma and intracranial hemorrhaging. Hypoxic ischemic encephalopathy is the consequence of systemic asphyxia occurring during birth. (orig.) [de

  9. About Military Sexual Trauma

    Medline Plus

    Full Text Available ... count__/__total__ Find out why Close About Military Sexual Trauma Veterans Health Administration Loading... Unsubscribe from Veterans ... views 4:50 Prolonged Exposure for PTSD - Duration: 2:45. Veterans Health Administration 53,436 views 2: ...

  10. Trauma Aware & Safety Ready

    Science.gov (United States)

    Paterson, Jim

    2017-01-01

    The interwoven issues of trauma and safety have swept through college campuses over the last decade, and they've arrived at doors of admission offices, encouraging officials to think more carefully about those concerns and take a closer look at how they handle them. Experts recommend in this atmosphere that admission offices discuss these topics…

  11. Dental Trauma Guide

    DEFF Research Database (Denmark)

    Andreasen, Jens Ove; Lauridsen, Eva Fejerskov; Christensen, Søren Steno Ahrensburg

    2012-01-01

    Diagnose and treatment of traumatic dental injuries is very complex due to the multiple trauma entities represented by 6 lunation types and 9 fracture types affecting both the primary and the permanent dentition. When it is further considered that fracture and lunation injuries are often combined...

  12. Imaging of vertebral trauma

    International Nuclear Information System (INIS)

    Daffner, R.H.

    1999-01-01

    This translation of the toolbook published in the 'US-ART' series, offers invaluable help to medical radiologists in the diagnostic imaging and evaluation of complex vertebral traumas which are on the rise, inter alia due to increasingly dangerous leisure sports. (orig./CB) [de

  13. Laparoscopy in abdominal trauma

    African Journals Online (AJOL)

    distal pancreatectomy has been advised. Laparoscopy has been successfully used both in acute and delayed distal pancreatectomies following trauma. It has been reported that magnification obtained through laparoscopic camera allows excellent identification of vessels and dissection of pancreas from splenic artery and ...

  14. Obesity in pediatric trauma.

    Science.gov (United States)

    Witt, Cordelie E; Arbabi, Saman; Nathens, Avery B; Vavilala, Monica S; Rivara, Frederick P

    2017-04-01

    The implications of childhood obesity on pediatric trauma outcomes are not clearly established. Anthropomorphic data were recently added to the National Trauma Data Bank (NTDB) Research Datasets, enabling a large, multicenter evaluation of the effect of obesity on pediatric trauma patients. Children ages 2 to 19years who required hospitalization for traumatic injury were identified in the 2013-2014 NTDB Research Datasets. Age and gender-specific body mass indices (BMI) were calculated. Outcomes included injury patterns, operative procedures, complications, and hospital utilization parameters. Data from 149,817 pediatric patients were analyzed; higher BMI percentiles were associated with significantly more extremity injuries, and fewer injuries to the head, abdomen, thorax and spine (p values Obese children also had significantly longer lengths of stay and more frequent ventilator requirement. Among children admitted after trauma, increased BMI percentile is associated with increased risk of death and potentially preventable complications. These findings suggest that obese children may require different management than nonobese counterparts to prevent complications. Level III; prognosis study. Copyright © 2017 Elsevier Inc. All rights reserved.

  15. When Trauma Hinders Learning

    Science.gov (United States)

    Barr, Donald A.

    2018-01-01

    Many kindergarten teachers have encountered children who enter school lacking the ability to control their behavior, but they may not understand the social and biological processes behind these children's disruptive behavior. The author reviews research into early childhood brain development to explain how trauma and chronic stress can make it…

  16. Early Childhood Trauma

    Science.gov (United States)

    National Child Traumatic Stress Network, 2010

    2010-01-01

    Early childhood trauma generally refers to the traumatic experiences that occur to children aged 0-6. Because infants' and young children's reactions may be different from older children's, and because they may not be able to verbalize their reactions to threatening or dangerous events, many people assume that young age protects children from the…

  17. About Military Sexual Trauma

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    Full Text Available ... count__/__total__ Find out why Close About Military Sexual Trauma Veterans Health Administration Loading... Unsubscribe from Veterans ... MST. http://www.mentalhealth.va.gov/msthom... Category Education License Standard YouTube License Show more Show less ...

  18. Neurological Surgery of Trauma,

    Science.gov (United States)

    1965-01-01

    Neurosurgical aspects of Neurogenic Bladder , Urological aspects of Neurogenic Bladder , Sympathetic Blockade, An Acute Cervical Cord Syndrome, Autonomic Hyperreflexia, Physical and Vocational Rehabilitation....Hematomas Associated with Penetrating Wounds, Infection Complicating Penetrating Craniocerebral trauma, Tangential Wounds of Scalp and Skull, Through and

  19. Scintigraphy In skeletal trauma

    African Journals Online (AJOL)

    1989-08-05

    Aug 5, 1989 ... sustained during the trauma. Fig. 2. Case 2. Bone scan of the pelvis (anterior view) showing a fracture through the sacro-iliac joint. Case 3. A 67-year-old woman had a Moore prosthesis in the left hip. She presented 2 weeks after having injured her right hip in a fall. Examination revealed pain on movemen~ ...

  20. Molecular autopsy in victims of inherited arrhythmias

    Directory of Open Access Journals (Sweden)

    Christopher Semsarian, MBBS, PhD, MPH

    2016-10-01

    Full Text Available Sudden cardiac death (SCD is a rare but devastating complication of a number of underlying cardiovascular diseases. While coronary artery disease and acute myocardial infarction are the most common causes of SCD in older populations, inherited cardiac disorders comprise a substantial proportion of SCD cases aged less than 40 years. Inherited cardiac disorders include primary inherited arrhythmogenic disorders such as familial long QT syndrome (LQTS, Brugada syndrome (BrS, catecholaminergic polymorphic ventricular tachycardia (CPVT, and inherited cardiomyopathies, most commonly hypertrophic cardiomyopathy (HCM. In up to 40% of young SCD victims (defined as 1–40 years old, excluding sudden unexplained death in infancy from 0 to 1 years, referred to as SIDS, no cause of death is identified at postmortem [so-called “autopsy negative” or “sudden arrhythmic death syndrome” (SADS]. Management of families following a SCD includes the identification of the cause of death, based either on premorbid clinical details or the pathological findings at the postmortem. When no cause of death is identified, genetic testing of DNA extracted from postmortem tissue (the molecular autopsy may identify a cause of death in up to 30% of SADS cases. Targeted clinical testing in a specialized multidisciplinary clinic in surviving family members combined with the results from genetic testing, provide the optimal setting for the identification of relatives who may be at risk of having the same inherited heart disease and are therefore also predisposed to an increased risk of SCD.

  1. Skeleton scintigraphy in trauma

    International Nuclear Information System (INIS)

    Ansari, M.

    2002-01-01

    Skeletal trauma is common and presents both an opportunity and a problem in skeletal scintigraphy. The opportunity arises in the ability of skeletal scintigraphy to demonstrate abnormalities early after direct trauma. It is well recognized that the early detection of fractures in some sites cannot be reliably achieved by standard radiography, especially in the femoral neck and scaphoid bone. The problem comes in recognizing the effects of skeletal trauma when using skeletal scintigraphy for another purpose, such as the detection of metastatic disease. iatrogenic trauma to either the skeleton or soft tissues may be manifest scintigraphic ally. For example Craniotomy typically leaves a rim pattern at the surgical margin. Rib Retraction during thoracotomy can elicit periosteal reaction. Areas of the skeletal receiving curative levels of ionizing radiation (typically 4000 rads or greater) characteristically demonstrate decreased uptake within 6 months to 1 year after therapy. The generally high sensitivity of the skeletal scintigraphy seems to make it an ideal survey test in cases of suspected child abuse especially in which radiographs are unrevealing. Because of difficulties in obtaining a history of trauma from a preschool child or even eliciting a satisfactory description of the location and nature of the pain, skeletal scintigraphy provides a simple and reliable investigation in these children. Subtle trauma, such as that from stress fractures is often difficult to visualize on a plain radiograph. Skeletal scintigraphy is frequently positive at the time of clinical presentation. Skeletal scintigraphy is exquisitely sensitive to the remodeling process and typically shows abnormalities 1 to 2 weeks or more before the appearance of radiographic changes in stress fractures. The periosteal reaction can be visualized within hours of the injury. Insufficiency and fatigue fractures such as vertebral compression fracture, which is probably the most common consequence of

  2. Training in Trauma Surgery

    Science.gov (United States)

    Reilly, Patrick M.; Schwab, C William; Haut, Elliott R.; Gracias, Vicente H.; Dabrowski, G Paul; Gupta, Rajan; Pryor, John P.; Kauder, Donald R.

    2003-01-01

    Objective: To describe outcomes from a clinical trauma surgical education program that places the board-eligible/board-certified fellow in the role of the attending surgeon (fellow-in-exception [FIE]) during the latter half of a 2-year trauma/surgical critical care fellowship. Summary Background Data: National discussions have begun to explore the question of optimal methods for postresidency training in surgery. Few objective studies are available to evaluate current training models. Methods: We analyzed provider-specific data from both our trauma registry and performance improvement (PI) databases. In addition, we performed TRISS analysis when all data were available. Registry and PI data were analyzed as 2 groups (faculty trauma surgeons and FIEs) to determine experience, safety, and trends in errors. We also surveyed graduate fellows using a questionnaire that evaluated perceptions of training and experience on a 6-point Likert scale. Results: During a 4-year period 7,769 trauma patients were evaluated, of which 46.3% met criteria to be submitted to the PA Trauma Outcome Study (PTOS, ie, more severe injury). The faculty group saw 5,885 patients (2,720 PTOS); the FIE group saw 1,884 patients (879 PTOS). The groups were similar in respect to mechanism of injury (74% blunt; 26% penetrating both groups) and injury severity (mean ISS faculty 10.0; FIEs 9.5). When indexed to patient contacts, FIEs did more operations than the faculty group (28.4% versus 25.6%; P FIEs 10.0%). Analysis of deaths using PI and TRISS data failed to demonstrate differences between the groups. Analysis of provider-specific errors demonstrated a slightly higher rate for FIEs when compared with faculty when indexed to PTOS cases (4.1% versus 2.1%; P FIE year; P FIE educational experience “great -5” or “exceptional– 6.” Eighty-five percent consider the current structure of the fellowship (with FIE year) as ideal. Ninety percent would repeat the fellowship. Conclusion: The educational

  3. Traumatismos oculares Ocular traumas

    Directory of Open Access Journals (Sweden)

    Gelen Welch Ruiz

    2007-12-01

    Full Text Available Se realizó un estudio descriptivo de tipo retrospectivo longitudinal cuyo universo estuvo constituido por 72 ojos de 72 pacientes con traumatismos oculares mecánicos que fueron hospitalizados en el Hospital Militar Central “Dr. Carlos J. Finlay” desde enero de 1999 hasta enero de 2005. Para el análisis estadístico de la información se utilizó el programa automatizado SPSS versión 11.5 en el cual también se conformó la base de datos y se realizaron los cálculos de acuerdo con el tipo de variable analizada. Se utilizaron medidas de resumen, tendencia central y asociación estadística con un nivel de significación de p A retrospective longitudinal and descriptive study was carried out in 72 eyes from 72 patients with mechanical occular traumas, who had been hospitalized in “Dr. Carlos J. Finlay” Military Hospital from December 1999 to January 2005. For the statistical data analysis, an automated program (SPSS 11.5 version was used to create the database and estimations were made according to the variable types. Summary measures, central tendency measures and statistical association with significance level equal to p < 0.05 were employed. Males prevailed (95.8%, the average age was 30.26 years with a minimum rate of 17 years and maximum rate of 82 years. The most frequent mechanisms of trauma were aggressions (23. 6% and injures from secondary projectiles (13.9%. The anterior segment traumas were more frequent (61, 1% than posterior segment traumas (6.94%. Both segments of the eyeball were affected in 39, 1% of eyes which evinced the worst visual acuity. The most common associated injures were hyphema (54, 2% and vitreous hemorrhage (16.6%. Closed trauma (contusions were more common and most of the eyes had better final visual acuity (45, 2% with vision range of 0.6-1.0 and 26.2% with vision range of 0.59-0.1. On the other hand, eyes affected by open trauma (simple wound, contusion-wound, wound with intraocular foreign body and

  4. Links between sisters' sexual and dating victimization: the roles of neighborhood crime and parental controls.

    Science.gov (United States)

    East, Patricia L; Chien, Nina C; Adams, Joyce A; Hokoda, Audrey; Maier, Ashley

    2010-12-01

    This study examined the extent to which a sister's prior sexual and dating victimization is a risk factor for young women being similarly victimized and the possible factors underlying a co-occurrence. The sample involved 122 young adult Latina or African American sister pairs (244 women; ages 16-25) who resided in low-income, urban neighborhoods. Results indicated that women whose sisters had been victimized had increased risk of victimization even after controlling for neighborhood crime, parental controls, age and race-ethnicity (odds ratios were 4.0 for unwanted touching, 6.2 for a forced sex act, and 16.7 for dating violence). In high-crime neighborhoods, the presence of two adult parent figures in the home was associated with women's reduced likelihood of unwanted touching, and mothers' high monitoring during adolescence was associated with women's lower risk of dating aggression. Survival analysis results showed that the risk period of a second sister being victimized lasts between 7 and 10 years after a first sister's victimization. The prevention implications of study findings are discussed.

  5. Childhood trauma and metabolic syndrome in men and women.

    Science.gov (United States)

    Lee, Chioun; Tsenkova, Vera; Carr, Deborah

    2014-03-01

    The long-term effects of childhood trauma on health are well-documented, but few population-based studies have explored how childhood trauma affects the risk of developing metabolic syndrome (MetS) in adulthood. Using data from 1234 adults in the second wave of Midlife in the United States (MIDUS), we investigate (1) the extent to which childhood abuse affects the risk of developing MetS in adulthood; (2) how the severity of different types of abuse (emotional, physical, sexual, or cumulative abuse) affects this risk; and (3) the extent to which adult socioeconomic status (SES), maladaptive stress responses, and unhealthy behaviors mediate the association. We also test whether these associations differ significantly by sex. We find that emotional and physical abuse increase the risk of developing MetS for both sexes, whereas sexual abuse is a predictor for women only. For both sexes, individuals who experienced more cumulative abuse have a greater risk of developing MetS. Adult SES partially explains the association between childhood abuse and MetS. Maladaptive stress responses and unhealthy behaviors further explain the association. Among the potential mediators, poor sleep quality was a significant pathway for men and women, while stress-induced eating was a significant pathway for women only. Our findings suggest that the well-documented health consequences of early life trauma may vary by the nature of the trauma, the victim's sex, and the coping mechanisms that he or she employs. Copyright © 2014 Elsevier Ltd. All rights reserved.

  6. Resistensi dalam Psikoterapi Terhadap Trauma KDRT Pada Anak (Perspektif Psikoanalisa

    Directory of Open Access Journals (Sweden)

    Evita Yuliatul Wahidah

    2017-01-01

    Full Text Available Abstract: Psychological resistance is a phenomenon that is often encountered in clinical practice where the patient either directly or indirectly change their behavior oppose or refuse to discuss, remember, or think about the experience may be clinically relevant. Resistance could impinge on child trauma of domestic violence. And it is important to understand that domestic violence exposure in children can cause various problems in both the short and long term. In the short term such as: threats to the safety of life of children, damaging the structure of the family, the emergence of various mental disorders; whereas in the long term raises the potential of children engaged in violent behavior and abuse in the future, either as perpetrators or victims. Psychoanalytic theory gives a resolution deals Trauma Psychotherapy Against Domestic Violence on Children In include: Free Association, Interpretation (Interpretation, and the analysis of dreams. For this paper to begin discussion of the notion of resistance, understanding and concepts of psychotherapy for the child trauma of domestic violence within the perspective of psychoanalysis. Keywords: Resistensi, Psikoterapi, Trauma KDRT, Psikoanalisa.

  7. Supporting Young Crime Victims: Discursive Environments and Formula Narratives

    Science.gov (United States)

    Lofstrand, Cecilia Hansen

    2009-01-01

    Within the crime victim movement and discourse on victimization, a novel victim category has been introduced: the young crime victim. This article analyses the professional discourse formed around the new notion, focusing on the needs of the young crime victim along with the practices, tools, and techniques used to deal with resistance at a…

  8. Substance use and intimate partner violence victimization among White, African American, and Latina women.

    Science.gov (United States)

    Nowotny, Kathryn M; Graves, Jennifer L

    2013-11-01

    The existing literature on intimate partner violence (IPV) does not paint a consistent portrait of the impact of race/ethnicity. In addition, although research has clearly demonstrated that there is a relationship between substance use and IPV, the temporal ordering of these variables is not clearly established. This article seeks to examine the temporal ordering of IPV victimization and drug use using longitudinal data with a nationally representative racially and ethnically diverse sample. Data from Wave III (2001-2002) and Wave IV (2007-2008) of the National Longitudinal Study of Adolescent Health (Add Health) will serve as Time 1 and Time 2, respectively, to answer three research questions. First, does substance use during early young adulthood (Time 1) predict IPV victimization during young adulthood (Time 2) among women? Second, does IPV victimization during early young adulthood predict substance use during young adulthood for women? Finally, do these bidirectional relationships vary by race/ethnicity (i.e., White, African American, and Latina)? Four different forms of IPV (minor violence, major violence, rape/sexual coercion, and injury) are investigated along with binge drinking, marijuana use, and other drug use. Understanding not only the temporal relationship between substance use, trauma, and IPV but also the racial and ethnic differences in these relationships is critical to developing and refining culturally sensitive trauma-informed prevention and treatment services for women.

  9. Investigation of telomere length and psychological stress in rape victims.

    Science.gov (United States)

    Malan, Stefanie; Hemmings, Sian; Kidd, Martin; Martin, Lindi; Seedat, Soraya

    2011-12-21

    Women are at an increased risk of depression and other mental health problems following rape. Various etiological factors for depression, including predisposing genetic factors, have been identified. Telomeres are repetitive nucleoprotein structures located at chromosomal ends that protect them from premature degradation. Telomeres reduce in length with each cell division, resulting in cellular senescence and apoptosis. Relative quantification of telomeric repeats using qPCR was performed to investigate whether shorter relative leukocyte telomere length (LTL) in a cohort of 64 rape victims was associated with resilience, the development of rape trauma-related major depressive disorder (MDD) or the development of posttraumatic stress disorder (PTSD) after 3 months. Out of the 64 participants, 23 participants were diagnosed with MDD at baseline and 31 after 3 months. Nine participants were diagnosed with PTSD (MDD and PTSD specifically related to the trauma). No significant associations were observed between relative LTL and resilience or the development of MDD at either baseline or after 3 months in this cohort. However, a marginally significant association was evident between relative LTL and PTSD status. The significant association between relative LTL and PTSD suggests that shorter relative LTL might have acted as a predisposing factor in the development of PTSD after a severely traumatic event. The results of this study indicate that telomere shortening may be an important marker of PTSD risk, with implications for early intervention and timely treatment, and as such warrant replication in a larger cohort. © 2011 Wiley Periodicals, Inc.

  10. Assessment and treatment of torture victims: a critical review.

    Science.gov (United States)

    Allodi, F A

    1991-01-01

    This paper presents the main issues in the diagnosis and treatment of psychiatric sequelae in torture victims. The concept of post traumatic stress disorder is used to organize literature on psychiatric casualties resulting from massive psychic trauma, e.g., the Nazi Holocaust, the Vietnam and Israeli wars, and the current world epidemic of torture. Torture is a unique human made stressor resulting in category-specific diagnostic symptoms. Medical assessment can be complemented with photographs, x-rays, electroencephalograms, and sleep studies. Individual psychotherapy and group techniques focus on the issues of denial and trust, loss, survivor guilt, and reparation. Programs of psychological and social rehabilitation and treatment with benzodiazepines, tricyclic antidepressants, and other compounds are reviewed. Future research needs include the conceptualization of the trauma of torture and its sequelae in broader terms, the application of standardized measurements to facilitate international comparisons, and the testing of various approaches to intervention in an experimental design. An ethical physician must resist the pressures of totalitarian governments to assume neutrality in the presence of human rights violations affecting his/her patients.

  11. Preventable trauma deaths: from panel review to population based-studies

    Directory of Open Access Journals (Sweden)

    Vesconi Sergio

    2006-04-01

    Full Text Available Abstract Preventable trauma deaths are defined as deaths which could be avoided if optimal care has been delivered. Studies on preventable trauma deaths have been accomplished initially with panel reviews of pre-hospital and hospital charts. However, several investigators questioned the reliability and validity of this method because of low reproducibility of implicit judgments when they are made by different experts. Nevertheless, number of studies were published all around the world and ultimately gained some credibility, particularly in regions where comparisons were made before and after trauma system implementation with a resultant fall in mortality. During the last decade of century the method of comparing observed survival with probability of survival calculated from large trauma registries has obtained popularity. Preventable trauma deaths were identified as deaths occurred notwithstanding a high calculated probability of survival. In recent years, preventable trauma deaths studies have been replaced by population-based studies, which use databases representative of overall population, therefore with high epidemiologic value. These databases contain readily available information which carry out the advantage of objectivity and large numbers. Nowadays, population-based researches provide the strongest evidence regarding the effectiveness of trauma systems and trauma centers on patient outcomes.

  12. Bullies and Victims: A Phenomenological Study

    Science.gov (United States)

    Omizo, Michael M.; Omizo, Sharon A.; Baxa, Gari-Vic C. O.; Miyose, Ross J.

    2006-01-01

    This study presents the results of a phenomenological study with sixteen elementary school children identified as bullies or victims. Implications for school counselors and educators are also discussed.

  13. Victimization and suicidality among female college students.

    Science.gov (United States)

    Leone, Janel M; Carroll, James M

    2016-01-01

    To investigate the predictive role of victimization in suicidality among college women. Female respondents to the American College Health Association National College Health Assessment II (N = 258). Multivariate logistic regression analyses examined the relationship between victimization and suicidality. Emotional victimization (odds ratio [OR] = 11.79, 95% confidence interval [CI] = 2.43, 57.19, p college women. Controlling for relevant psychological health-related variables, college women who reported any of the 3 types of victimization had more than 8 times the odds of suicidality compared with nonvictims.

  14. Juvenile offender as a crime victim

    Directory of Open Access Journals (Sweden)

    Vasiljević-Prodanović Danica

    2017-01-01

    Full Text Available There is a stereotype of an ideal victim that deserves attention and sympathy of the public because it is helpless and has not done anything to cause harm or damage inflicted on her. In real life, a victim can often have quite the opposite attributes and identities. Recent studies deal with the phenomenon of victim-offender overlap, or the circumstance in which an individual is the victim and the offender at the same time. Numerous authors state that offenders are more likely to become crime victims than non-offenders, while on the other hand, crime victims are more likely to become offenders than non-victims. This article provides an overview of some of the characteristics of the victim-offender overlap phenomenon in the context of adolescents, aiming to point out the theoretical determinants and practical implications of the relationship between offending and victimization of juveniles. Studying this relationship is a current topic in criminology and victimology, which also has applicative importance for making various decisions in juvenile justice system.

  15. Implementation of a trauma registry in a brazilian public hospital: the first 1,000 patients

    Directory of Open Access Journals (Sweden)

    Paulo Roberto Lima Carreiro

    Full Text Available OBJECTIVE: Show the steps of a Trauma Registry (TR implementation in a Brazilian public hospital and evaluate the initial data from the database.METHODS: Descriptive study of the a TR implementation in João XXIII Hospital (Hospital Foundation of the state of Minas Gerais and analysis of the initial results of the first 1,000 patients.RESULTS: The project was initiated in 2011 and from January 2013 we began collecting data for the TR. In January 2014 the registration of the first 1000 patients was completed. The greatest difficulties in the TR implementation were obtaining funds to finance the project and the lack of information within the medical records. The variables with the lowest completion percentage on the physiological conditions were: pulse, blood pressure, respiratory rate and Glasgow coma scale. Consequently, the Revised Trauma Score (RTS could be calculated in only 31% of cases and the TRISS methodology applied to 30.3% of patients. The main epidemiological characteristics showed a predominance of young male victims (84.7% and the importance of aggression as a cause of injuries in our environment (47.5%, surpassing traffic accidents. The average length of stay was 6 days, and mortality 13.7%.CONCLUSION: Trauma registries are invaluable tools in improving the care of trauma victims. It is necessary to improve the quality of data recorded in medical records. The involvement of public authorities is critical for the successful implementation and maintenance of trauma registries in Brazilian hospitals.

  16. [Cranio-cerebral trauma in publications by the Central hospital in the city of Aden].

    Science.gov (United States)

    Bersnev, V P; Shukri, A A

    2008-01-01

    An analysis of cranio-cerebral traumas in the Republic Yemen in 1998 has shown that the organization of medical care is unsatisfactory. Such situation led to address to the government of the Republic Yemen with a number of organizational suggestions. It is necessary to improve the material and technical basis of the city hospital of Aden and provide necessary diagnostic medical equipment, CT and MRT in particular. The neurosurgical department should be enlarged to 30 beds with a special department of resuscitation and correspondingly increased service personnel. It was proposed to consider the question of organization of emergency medical care (State or private) as well as medical units in distant regions with a full staff of specialists; to provide a calculation and registration of victims and dead of cranio-cerebral traumas at the State level; to organize a permanent preparing of all physician of the region to provide emergency aid to victims with cranio-cerebral traumas. Of great significance is not only the severity of the cranio-cerebral trauma, but also the time of admission to hospital, timely adequate therapy. As a rule most of such patients (75%) are admitted to hospital in a long time after trauma from several hours to several days. It is due to the absence of the service of emergency medical aid in the Republic, distant places of living in the region, highlands included.

  17. Implementation of a trauma registry in a Brazilian public hospital: the first 1,000 patients.

    Science.gov (United States)

    Carreiro, Paulo Roberto Lima; Drumond, Domingos André Fernandes; Starling, Sizenando Vieira; Moritz, Mônica; Ladeira, Roberto Marini

    2014-01-01

    Show the steps of a Trauma Registry (TR) implementation in a Brazilian public hospital and evaluate the initial data from the database. Descriptive study of the a TR implementation in João XXIII Hospital (Hospital Foundation of the state of Minas Gerais) and analysis of the initial results of the first 1,000 patients. The project was initiated in 2011 and from January 2013 we began collecting data for the TR. In January 2014 the registration of the first 1000 patients was completed. The greatest difficulties in the TR implementation were obtaining funds to finance the project and the lack of information within the medical records. The variables with the lowest completion percentage on the physiological conditions were: pulse, blood pressure, respiratory rate and Glasgow coma scale. Consequently, the Revised Trauma Score (RTS) could be calculated in only 31% of cases and the TRISS methodology applied to 30.3% of patients. The main epidemiological characteristics showed a predominance of young male victims (84.7%) and the importance of aggression as a cause of injuries in our environment (47.5%), surpassing traffic accidents. The average length of stay was 6 days, and mortality 13.7%. Trauma registries are invaluable tools in improving the care of trauma victims. It is necessary to improve the quality of data recorded in medical records. The involvement of public authorities is critical for the successful implementation and maintenance of trauma registries in Brazilian hospitals.

  18. Investigating Trauma in Narrating World War I: A Psychoanalytical Reading of Pat Barker’s Regeneration

    Directory of Open Access Journals (Sweden)

    Bakhtiar Sadjadi

    2016-12-01

    Full Text Available The present paper seeks to critically read Pat Barker’s Regeneration in terms of Cathy Caruth’s psychoanalytic study of trauma. This analysis attempts to trace the concepts of latency, post-traumatic stress disorders, traumatic memory, and trauma in Barker’s novel in order to explore how trauma and history are interrelated in the narrative of past history and, particularly, in the history of World War I. The present paper also demonstrates how Barker’s novel Regeneration acts as the narrative of trauma that vocalizes the silenced history of shell-shocked soldiers of World War I to represent British society, the history that has been concealed due to social and individual factors. The study thus investigates the dissociative disorders which are experienced by traumatized survivors of World War I as the aftermath of traumatic experiences of wartime. In addition, it argues how time moves for the traumatized victim and how the notion of latency in terms of Caruth’s theory is traceable in Barker’s novel. In Regeneration, the traumatized survivors are haunted with traumatic memory of past history; furthermore, past history constantly disrupts their present and the victims are in continuous shift from present time to past time. Time thus loses its linearity in the narrative of traumatized survivors. Keywords: Latency, post-traumatic stress disorders, traumatic memory, trauma

  19. Girlhood Betrayals of Women Childhood Trauma Survivors in Treatment for Addiction.

    Science.gov (United States)

    Grabbe, Linda; Ball, Janell; Hall, Joanne M

    2016-05-01

    This research explored the understanding of trauma from the perspective of women who had experienced abuse and neglect in childhood. The goal was to better conceptualize potential avenues or interventions for prevention and treatment. Qualitative description of the accounts of eight women who were childhood trauma survivors and in treatment for addiction. Open-ended interviews focused on key events or experiences during childhood and adolescence and the use of drugs and alcohol. Four levels of betrayal fit the accounts the participants gave as the dominant theme in their narratives. "Primary betrayal" referred to the direct victimization by a perpetrator; "secondary betrayal" referred to the complicity, denial, or indifference of another adult to the child's victimization; "tertiary betrayal" referred to failures of responsible individuals in community settings to protect the child; and "quaternary betrayal" represented self-betrayals. Substance misuse was an adolescent self-betrayal that provided initial solace yet ultimately threatened the integrity of the girls. We found an almost complete lack of support in family and community settings for the participants. These findings on betrayal inform health care for trauma survivors and can be a framework for preventing violence against children. Interventions for child and adolescent trauma survivors are critical to prevent the life-long health sequelae of childhood trauma. Pivotal times to engage these survivors include periods when they may be accessed in school and healthcare settings. © 2016 Sigma Theta Tau International.

  20. Characterizing Drug-Facilitated Sexual Assault Subtypes and Treatment Engagement of Victims at a Hospital-Based Rape Treatment Center.

    Science.gov (United States)

    Richer, Laurie A; Fields, Laurie; Bell, Shannon; Heppner, Jennifer; Dodge, Jessica; Boccellari, Alicia; Shumway, Martha

    2015-06-10

    Variation among existing studies in labeling, defining, identifying, and subtyping cases of suspected drug-facilitated sexual assault (DFSA) poses challenges to integrating research findings for public health purposes. This descriptive study addressed methodological issues of nomenclature and DFSA operational definitions to improve case identification and was designed to distinguish assault subtypes. We studied a 2-year ethnically diverse cohort of 390 patients who presented acutely to an urban rape treatment center (RTC). We abstracted data from RTC medical and mental health records via chart review. Assault incidence rates; engagement into medical, forensic, and mental health services; injury sustained; and weapon use were calculated separately for assault subtypes and compared. DFSA accounted for over half of the total sexual assault (SA) cases. Involuntary DFSA (in which an incapacitating substance was administered to victims without their knowledge or against their will) increased from 25% to 33% of cases over the 2-year period. DFSA victims presented sooner, and more often attended medical follow-up and psychotherapy than non-DFSA victims. Incidence rates indicated increasing risk for young males. These findings indicate that DFSA continues to be a growing and complex phenomenon and suggest that DFSA victims have greater service needs. The field would benefit from innovations to address symptomatology arising from this novel type of trauma and the unique risks and needs of male victims, as well as underscoring the ongoing need for DFSA-specific prevention efforts for both victims and perpetrators. © The Author(s) 2015.

  1. Multiple victimizations before and after leaving home associated with PTSD, depression, and substance use disorder among homeless youth.

    Science.gov (United States)

    Bender, Kimberly; Brown, Samantha M; Thompson, Sanna J; Ferguson, Kristin M; Langenderfer, Lisa

    2015-05-01

    Exposure to multiple forms of maltreatment during childhood is associated with serious mental health consequences among youth in the general population, but limited empirical attention has focused on homeless youth-a population with markedly high rates of childhood maltreatment followed by elevated rates of street victimization. This study investigated the rates of multiple childhood abuses (physical, sexual, and emotional abuse) and multiple street victimizations (robbery, physical assault, and sexual assault) and examined their relative relationships to mental health outcomes (meeting Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision, criteria for post-traumatic stress disorder [PTSD], depression, and substance use disorder) among a large (N = 601) multisite sample of homeless youth. Approximately 79% of youth retrospectively reported multiple childhood abuses (two or more types) and 28% reported multiple street victimizations (two or more types). Each additional type of street victimization nearly doubled youths' odds for meeting criteria for substance use disorder. Furthermore, each additional type of childhood abuse experienced more than doubled youths' odds for meeting criteria for PTSD. Both multiple abuses and multiple street victimizations were associated with an approximate twofold increase in meeting depression criteria. Findings suggest the need for screening, assessment, and trauma-informed services for homeless youth who consider multiple types of abuse and victimization experiences. © The Author(s) 2014.

  2. Surviving relatives after suicide

    DEFF Research Database (Denmark)

    Nørrelykke, Helle; Cohrt, Pernille

    We would like to focus on the surviving relatives after suicides, because it is generally accepted that it is especially difficult to recover after the loss from suicide and because we know as a fact that one suicide affects five persons on average. Every year approximately 700 people commit...... suicide in Denmark. This means that at least 400 people undergo the trauma it is when one of their near relatives commits suicide. We also know that the loss from suicide involves a lot of conflicting feelings - like anger, shame, guilt and loss and that the lack of therapy/treatment of these difficult...... for treatment for the relatives. In the wake of this policy document a national organization for relatives after suicide and a national network for those who attempt suicide occurred. Both organizations are formed by voluntary subscription and both organizations offer acute emergency relief, conversation groups...

  3. Terrorism-related injuries versus road traffic accident-related trauma: 5 years of experience in Israel.

    Science.gov (United States)

    Peleg, Kobi; Savitsky, Bella

    2009-12-01

    Terrorism victims comprise the minority among trauma injured people, but this small population imposes a burden on the health care system. Thirty percent of the population injured in terrorist activities experienced severe trauma (injury severity score > or =16), more than half of them need a surgical procedure, and 25% of the population affected by terrorism had been admitted to intensive care. Furthermore, compared with patients with non-terrorism-related trauma, victims of terrorism often arrive in bulk, as part of a mass casualty event. This poses a sudden load on hospital resources and requires special organization and preparedness. The present study compared terrorism-related and road accident-related injuries and examined clinical characteristics of both groups of patients. This study is a retrospective study of all patients injured through terrorist acts and road traffic accidents from September 29, 2000 to December 31, 2005, and recorded in the Israel Trauma Registry. Data on the nature of injuries, treatment, and outcome were obtained from the registry. Medical diagnoses were extracted from the registry and classified based on International Classification of Diseases coding. Diagnoses were grouped to body regions, based on the Barell Injury Diagnosis Matrix. The study includes 2197 patients with terrorism-related injuries and 30,176 patients injured in road traffic accidents. All in all, 27% of terrorism-related casualties suffered severe to critical injuries, comparing to 17% among road traffic accident-related victims. Glasgow Coma Scale scores terrorism victims, in contrast with 7.4% among people injured on the roads. The terrorism victims had a significantly higher rate of use of intensive care facilities (24.2% vs 12.4%). The overall inpatient death rate was 6.0% among terrorism victims and 2.4% among those injured in road traffic accidents. Casualties from terrorist events are more severely injured and require more resources relative to casualties

  4. Reactions to Rape Victims: Effects of Rape Circumstances, Victim's Emotional Response, and Sex of Helper.

    Science.gov (United States)

    Krulewitz, Judith E.

    1982-01-01

    Female and male undergraduates judged impact of the rape experience on victims' psychological adjustment and indicated their likely counseling goals. Results are discussed in terms of popular assumptions about rape victims and sex differences in identification with and empathy for female rape victims. Implications for training are noted. (Author)

  5. Perceived Characteristics of Victims according to their Victimized and Nonvictimized Peers

    Science.gov (United States)

    Almeida, Ana; Caurcel, Maria-Jesus; Machado, Jose-Cunha

    2006-01-01

    This study investigates perceived characteristics of victims of peer bullying in a sample of 1237 adolescents (mean age is 13.3 years-old) in two southern European countries. Focusing upon perceived characteristics of victimized peers, the main goal was to inspect how descriptions of the victims varied according to country, age, gender,…

  6. Differences between Sexually Victimized and Nonsexually Victimized Male Adolescent Sexual Abusers: Developmental Antecedents and Behavioral Comparisons

    Science.gov (United States)

    Burton, David L.; Duty, Kerry Jo; Leibowitz, George S.

    2011-01-01

    This study compares sexually victimized and nonsexually victimized male adolescent sexual abusers on a number of variables. Self-report measures were administered to 325 male sexually abusive youth (average age 16) in six residential facilities in the Midwest, 55% of whom reported sexual victimization. The results indicate that the sexually…

  7. The Violent and Sexual Victimization of College Women: Is Repeat Victimization a Problem?

    Science.gov (United States)

    Daigle, Leah E.; Fisher, Bonnie S.; Cullen, Francis T.

    2008-01-01

    Little attention has been given to repeat violent and sexual victimization among college women. Using two national-level data sets, the authors find that a small proportion of college women experience a large proportion of violent and sexual victimizations. Women are more likely to experience repeat sexual victimization than repeat violence…

  8. Contribution of forensic anthropology to identification process in Croatia: examples of victims recovered in wells.

    Science.gov (United States)

    Slaus, Mario; Strinović, Davor; Petrovecki, Vedrana; Vyroubal, Vlasta

    2007-08-01

    To describe the contribution of forensic anthropology to the recovery, analysis, and identification of victims from the 1991-1995 war in Croatia recovered in wells. From 1996 to the present, human remains of a total of 61 individuals have been recovered from 13 wells. Six wells contained the remains of a single individual, one well contained the remains of 2 individuals, and 6 wells contained the remains 3 or more individuals. The majority of wells, containing 90.2% (55/61) of recovered individuals, were located within a 4 km radius of the Croatian-Serbian border. Forensic anthropologists re-individualized 26/61 (42.6%) individuals out of skeletonized and commingled remains, provided basic biological data on sex, age-at-death, and stature in all identifications (n=37), as well as established positive identification by recognizing unique skeletal features (antemortem fractures and skeletal evidence of antemortem surgical interventions) in 3/37 (8.1%) cases. Trauma analyses carried out by forensic anthropologists contributed to the determination of the cause of death in 38/61 (62.3%) individuals and to the probable cause of death in an additional 18/61 (29.5%) individuals. The most frequent (27/38, 71.0%) type of trauma causing death in individuals recovered from wells was a single gunshot wound. Forensic anthropologists, collaborating closely with forensic pathologists, forensic odontologists, forensic radiologists, criminologists, and molecular biologists contributed significantly to trauma analysis and identification of war victims recovered from wells.

  9. Collecting core data in severely injured patients using a consensus trauma template: an international multicentre study

    DEFF Research Database (Denmark)

    Ringdal, Kjetil G; Lossius, Hans Morten; Jones, J Mary

    2011-01-01

    ABSTRACT: INTRODUCTION: No worldwide, standardised definitions exist for documenting, reporting, and comparing data from severely injured trauma patients. This study evaluated the feasibility of collecting the data variables of the international consensus-derived Utstein Trauma Template. METHODS......: Trauma centres from three different continents were invited to submit Utstein Trauma Template core data during a defined period, for up to 50 consecutive trauma patients. Directly admitted patients with a New Injury Severity Score (NISS) equal to or above 16 were included. Main outcome variables were...... was 27 (IQR 20-38), and blunt trauma predominated (91.1%). Of the 36 Utstein variables, 13 (36%) were collected by all participating centres. Eleven (46%) centres applied definitions of the survival outcome variable that were different from those of the template. Seventeen (71%) centres used...

  10. Racial Differences in Children's Trauma Symptoms Following Complex Trauma Exposure.

    Science.gov (United States)

    Wamser-Nanney, Rachel; Cherry, Kathryn E; Campbell, Claudia; Trombetta, Elise

    2018-03-01

    Complex trauma exposure has been defined as multiple or chronic interpersonal trauma that begins early in life, which leads to widespread dysregulation. Previous studies have reported that minorities may be at greater risk for trauma exposure and symptoms; yet, racial differences have not been investigated in the context of complex trauma. The aim of the present study was to determine if there are racial disparities in children's trauma exposure and outcomes among 167 child survivors of complex trauma (3-18 years, M = 9.90, SD = 3.92; 61.67% female; 62.2% Black). Black children endorsed a greater number of trauma types and were more likely to have experienced community violence and have been placed in child protective custody than White children. Caregivers of White children endorsed higher levels of select internalizing symptoms and social concerns whereas Black children reported higher levels of sexual concerns than White children. White children who experience complex trauma may be at higher risk for some trauma-related difficulties. Alternatively, caregivers of White children may perceive them to have, or be more willing to acknowledge, higher levels of symptoms than Black children. Future work is needed to further investigate the role of race in disclosure of trauma exposure and related symptoms.

  11. Trauma Tactics: Rethinking Trauma Education for Professional Nurses.

    Science.gov (United States)

    Garvey, Paula; Liddil, Jessica; Eley, Scott; Winfield, Scott

    2016-01-01

    According to the National Trauma Institute (2015), trauma accounts for more than 180,000 deaths each year in the United States. Nurses play a significant role in the care of trauma patients and therefore need appropriate education and training (L. ). Although several courses exist for trauma education, many nurses have not received adequate education in trauma management (B. ; L. ). Trauma Tactics, a 2-day course that focuses on high-fidelity human patient simulation, was created to meet this educational need. This descriptive study was conducted retrospectively to assess the effectiveness of the Trauma Tactics course. Pre- and postsurveys, tests, and simulation performance were used to evaluate professional nurses who participated in Trauma Tactics over a 10-month period. Fifty-five nurses were included in the study. Pre- and postsurveys revealed an increase in overall confidence, test scores increased by an average of 2.5 points, and simulation performance scores increased by an average of 16 points. Trauma Tactics is a high-quality course that provides a valuable and impactful educational experience for nurses. Further research is needed to evaluate the long-term effects of Trauma Tactics and its impacts on quality of care and patient outcomes.

  12. Reporting Crime Victimizations to the Police and the Incidence of Future Victimizations: A Longitudinal Study.

    Science.gov (United States)

    Ranapurwala, Shabbar I; Berg, Mark T; Casteel, Carri

    2016-01-01

    Law enforcement depends on cooperation from the public and crime victims to protect citizens and maintain public safety; however, many crimes are not reported to police because of fear of repercussions or because the crime is considered trivial. It is unclear how police reporting affects the incidence of future victimization. To evaluate the association between reporting victimization to police and incident future victimization. We conducted a retrospective cohort study using National Crime Victimization Survey 2008-2012 data. Participants were 12+ years old household members who may or may not be victimized, were followed biannually for 3 years, and who completed at least one follow-up survey after their first reported victimization between 2008 and 2012. Crude and adjusted generalized linear mixed regression for survey data with Poisson link were used to compare rates of future victimization. Out of 18,657 eligible participants, 41% participants reported to their initial victimization to police and had a future victimization rate of 42.8/100 person-years (PY) (95% CI: 40.7, 44.8). The future victimization rate of those who did not report to the police (59%) was 55.0/100 PY (95% CI: 53.0, 57.0). The adjusted rate ratio comparing police reporting to not reporting was 0.78 (95%CI: 0.72, 0.84) for all future victimizations, 0.80 (95% CI: 0.72, 0.90) for interpersonal violence, 0.73 (95% CI: 0.68, 0.78) for thefts, and 0.95 (95% CI: 0.84, 1.07) for burglaries. Reporting victimization to police is associated with fewer future victimization, underscoring the importance of police reporting in crime prevention. This association may be attributed to police action and victim services provisions resulting from reporting.

  13. Psychiatric outcomes of bullying victimization: a study of discordant monozygotic twins.

    Science.gov (United States)

    Silberg, J L; Copeland, W; Linker, J; Moore, A A; Roberson-Nay, R; York, T P

    2016-07-01

    Bullying victimization in childhood is associated with a broad array of serious mental health disturbances, including anxiety, depression, and suicidal ideation and behavior. The key goal of this study was to evaluate whether bullying victimization is a true environmental risk factor for psychiatric disturbance using data from 145 bully-discordant monozygotic (MZ) juvenile twin pairs from the Virginia Twin Study of Adolescent Behavioral Development (VTSABD) and their follow-up into young adulthood. Since MZ twins share an identical genotype and familial environment, a higher rate of psychiatric disturbance in a bullied MZ twin compared to their non-bullied MZ co-twin would be evidence of an environmental impact of bullying victimization. Environmental correlations between being bullied and the different psychiatric traits were estimated by fitting structural equation models to the full sample of MZ and DZ twins (N = 2824). Environmental associations were further explored using the longitudinal data on the bullying-discordant MZ twins. Being bullied was associated with a wide range of psychiatric disorders in both children and young adults. The analysis of data on the MZ-discordant twins supports a genuine environmental impact of bullying victimization on childhood social anxiety [odds ratio (OR) 1.7], separation anxiety (OR 1.9), and young adult suicidal ideation (OR 1.3). There was a shared genetic influence on social anxiety and bullying victimization, consistent with social anxiety being both an antecedent and consequence of being bullied. Bullying victimization in childhood is a significant environmental trauma and should be included in any mental health assessment of children and young adults.

  14. Pelvic floor muscle problems mediate sexual problems in young adult rape victims.

    Science.gov (United States)

    Postma, Riemke; Bicanic, Iva; van der Vaart, Huub; Laan, Ellen

    2013-08-01

    Prior studies have addressed sexual abuse and sexual function in adult women. No studies have focused on the effect of adolescence rape on sexual functioning. To investigate the effect of rape on sexual problems and on pelvic floor problems, as well as the mediating role of pelvic floor problems on sexual problems, in a homogenous group of victims of adolescence rape without a history of childhood sexual, physical, and/or emotional abuse. Sexual functioning and pelvic floor functioning were assessed using self-report questionnaires. In this cross-sectional study, a group of 89 young women aged 18-25 years who were victimized by rape in adolescence was compared with a group of 114 nonvictimized controls. The rape victims were treated for posttraumatic stress disorder (PTSD) 3 years prior to participation in the study. Three years posttreatment, rape victims were 2.4 times more likely to have a sexual dysfunction (lubrication problems and pain) and 2.7 times more likely to have pelvic floor dysfunction (symptoms of provoked vulvodynia, general stress, lower urinary tract, and irritable bowel syndrome) than nonvictimized controls. The relationship between rape and sexual problems was partially mediated by the presence of pelvic floor problems. Rape victims and controls did not differ with regard to sexual activities. Rape victims suffer significantly more from sexual dysfunction and pelvic floor dysfunction when compared with nontraumatized controls, despite the provision of treatment for PTSD. Possibly, physical manifestations of PTSD have been left unaddressed in treatment. Future treatment protocols should consider incorporating (physical or psychological) treatment strategies for sexual dysfunction and/or pelvic floor dysfunction into trauma exposure treatments. © 2013 International Society for Sexual Medicine.

  15. Bullying and victimization in elementary schools: a comparison of bullies, victims, bully/victims, and uninvolved preadolescents.

    Science.gov (United States)

    Veenstra, René; Lindenberg, Siegwart; Oldehinkel, Albertine J; De Winter, Andrea F; Verhulst, Frank C; Ormel, Johan

    2005-07-01

    Research on bullying and victimization largely rests on univariate analyses and on reports from a single informant. Researchers may thus know too little about the simultaneous effects of various independent and dependent variables, and their research may be biased by shared method variance. The database for this Dutch study was large (N = 1,065) and rich enough to allow multivariate analysis and multi-source information. In addition, the effect of familial vulnerability for internalizing and externalizing disorders was studied. Gender, aggressiveness, isolation, and dislikability were most strongly related to bullying and victimization. Among the many findings that deviated from or enhanced the univariate knowledge base were that not only victims and bully/victims but bullies as well were disliked and that parenting was unrelated to bullying and victimization once other factors were controlled.

  16. Women from different ethnic groups and their experiences with victimization and seeking help.

    Science.gov (United States)

    Postmus, Judy L

    2015-03-01

    For women who experience abuse in childhood or adulthood, the assumptions are that surviving includes seeking help. This article presents an exploratory study on the prevalence of victimization in the lives of Caucasian, African American, and Latina women, if and to whom they disclosed their victimization, and where they turned for services and support. The results indicate Caucasian women turn more to traditional, therapeutic sources compared with African American women, who tend to use tangible supports. However, when controlling for a number of key variables, the ethnic differences disappear. Implications for further research and practice conclude this article. © The Author(s) 2015.

  17. Trauma care - a participant observer study of trauma centers at Delhi, Lucknow and Mumbai.

    Science.gov (United States)

    Kumar, Sandeep; Chaudhary, Sushant; Kumar, Akshay; Agarwal, Arpit Kumar; Misra, M C

    2009-06-01

    trained accident and emergency (AandE) personnel were not available at any of the centers. Expert management of cardiac peri-arrest arrhythmias, peripheral and microvascular repair were occasionally available. Maxillo-facial, dental and prosthodontic facilities, evenomation grading and treatment of poisoning - anti venom were not integrated. Ventilators, anesthetist, neuro and plastic surgeons were available on call for emergency care at all the 4 centers. Emergency diagnostic radiology (X-ray, CT scan, and ultrasound) and pathology were available at all the 4 centers. On the spot blood bank and component blood therapy was available only at the Delhi centers. Pre-hospital care, though envisioned by the officials, was lacking. Comprehensively trained senior A and E personnel as first responders were unavailable. Double barrier nursing for burn victims was not witnessed. Laparoscopic and fibreoptic endoscopic emergency procedures were also available only at Delhi. Delay in treatment on account of incomplete medico-legal formalities was not seen. Social and legal assistance, bereavement service and cold room for dead body were universally absent. Free treatment at Delhi and partial financial support at Lucknow were available for poor and destitute. Though a late start, evolution of trauma services was observed and huge infrastructure for trauma have come up at Delhi and Lucknow. Postgraduate accreditation in Trauma and EMS and creation of National Injury Control Program must be mandated to improve trauma care in India. Integration of medical, non traumatic surgical and pediatric emergency along with pre-hospital care is recommended.

  18. Pre-migration Trauma Exposure and Psychological Distress for Asian American Immigrants: Linking the Pre- and Post-migration Contexts.

    Science.gov (United States)

    Li, Miao; Anderson, James G

    2016-08-01

    Drawing on the life course perspective and the assumptive world theory, this paper examines whether pre-migration trauma exposure is associated with psychological distress through post-migration perceived discrimination for Asian American immigrants. The study is based on cross-sectional data from the National Latino and Asian American Study (N = 1639). Structural equation model is used to estimate the relationship between pre-migration trauma, post-migration perceived discrimination, and psychological distress. Additional models are estimated to explore possible variations across ethnic groups as well as across different types of pre-migration trauma experience. Pre-migration trauma exposure is associated with higher levels of psychological distress, both directly and indirectly through higher level of perceived discrimination, even after controlling for demographic/acculturative factors and post-migration trauma exposure. This pattern holds for the following sub-types of pre-migration trauma: political trauma, crime victimization, physical violence, accidental trauma, and relational trauma. Multi-group analyses show that this pattern holds for all Asian immigrant subgroups except the Vietnamese. Studies of immigrant mental health primarily focus on post-migration stressors. Few studies have considered the link between pre- and post-migration contexts in assessing mental health outcomes. The study illustrates the usefulness of bridging the pre- and post-migration context in identifying the mental health risks along the immigrant life course.

  19. Maxillofacial trauma scoring systems.

    Science.gov (United States)

    Sahni, Vaibhav

    2016-07-01

    The changing complexity of maxillofacial fractures in recent years has created a situation where classical systems of classification of maxillofacial injuries fall short of defining trauma particularly that observed with high-velocity collisions where more than one region of the maxillofacial skeleton is affected. Trauma scoring systems designed specifically for the maxillofacial region are aimed to provide a more accurate assessment of the injury, its prognosis, the possible treatment outcomes, economics, length of hospital stay, and triage. The evolution and logic of such systems along with their merits and demerits are discussed. The author also proposes a new system to aid users in quickly and methodically choosing the system best suited to their needs without having to study a plethora of literature available in order to isolate their choice. Copyright © 2016 Elsevier Ltd. All rights reserved.

  20. Videolaparoscopia no trauma abdominal

    Directory of Open Access Journals (Sweden)

    Átila Varela Velho

    Full Text Available A videolaparoscopia (VL vem contribuindo de forma crescente, para diagnóstico e terapêutica de várias afecções cirúrgicas abdominais, introduzindo profundas mudanças na cirurgia contemporânea. Esse avanço incorporou-se também às urgências traumáticas, fazendo parte da avaliação diagnóstica e, às vezes, da terapêutica do trauma abdominal. Os autores apresentam uma revisão concisa da literatura sobre a VL no trauma, atualizando o tema e discutindo os aspectos mais relevantes das indicações, limitações e complicações do método.