Darbo tikslas. Įvertinti asmens sveikatos priežiūros įstaigų (toliau ASPĮ), teikiančių ortopedijos traumatologijos ir/arba chirurgijos paslaugas, galimybes teikti kvalifikuotą pagalbą ir jų infrastruktūros atnaujinimo poreikius. Tyrimo metodika. Tyrimo objektas – ASPĮ, teikiančios pagalbą traumas patyrusiems pacientams bei GMP įstaigos. Tyrimo metodai: Mokslinės literatūros analizė, respondentų apklausa, statistinė duomenų analizė naudojant SPSS 13 versiją bei MS Excel, geografinės informacinės sistemos „Arc View 9.11” programinę įranga. Rezultatai. Esant vienam traumos centrui apskrityje (i��� viso 10 centrų), visiems Lietuvos gyventojams pagalba būtų prieinama per 1 val. Šiuo metu GMP per 15 minučių prieinama pusei LR teritorijos. Iš viso į 0 lygio traumos centrus kreipiasi beveik trečdalis visų traumą patyrusių pacientų, tačiau vienas šio lygio centras vidutiniškai aptarnauja 13,5 kartų mažiau pacientų, nei trečiojo lygio (p<0,005). Nulinio lygio centre vidutiniškai teikiama 9 kartų mažiau stacionarių paslaugų, lyginant su III lygio traumos centru (p<0,005). Nulinio lygio įstaigose traumos pacientų srautas yra nepakankamas lyginant su kitų lygių ASPĮ srautais. Dalis 0 lygio traumos centrų neturi pakankamo specialistų (ortopedų traumatologų, anesteziologų ir reanimatologų) skaičiaus, kurie užtikrintų nenutrūkstamą 24 valandų pagalbos teikimo ciklą. Didžiausias investicijų poreikis yra III lygio traumos centrų, tačiau investicijų poreikis 1 ligoniui šio lygio centre - 6,5... [toliau žr. visą tekstą] / The aim - to evaluate possibilities of the health care institutions which provides orthopaedic traumatology and/or surgery services, to provide qualified medical care and their infrastructure renewal needs. Methods. The object of the study is health care institutions which provide services for patients after trauma and also emergency service providers. Methods of the study: the analysis of the academic literature, respondents surveys, analysis of the statistical data using „SPPS“ 13th version, MS Excell program and geographical information system as well as Arc View 9.11 software program. Results. If there is one trauma centre in the area (there are 10 centres overall), all residents of Lithuania would have the access to the health care institutions in one hour. At this time emergency service is available in 15 minutes in the half of the Lithuanian territory. Overall, third part of the patients are maintained by zero level hospitals. Unfortunately, one of these centres (hospital) service 13.5 times less patients than third level canters (p < 0.005). On average, zero level centres provide service for the stationary care 9 times less compared to the third level hospitals (p<0.005). The demand for the zero level centres is insufficient compared to demand for university level care (hospitals). Part of the zero level trauma centres don‘t have sufficient number of specialists of anaesthesiology, reanimatology and traumatology disciplines that could provide continues 24 hour... [to full text]

Thesis (Dr. P.H.)--University of Texas Health Science Center at Houston, School of Public Health, 2007. / Source: Dissertation Abstracts International, Volume: 68-10, Section: B, page: 6620. Adviser: Charles E. Begley. Includes bibliographical references.

Background: Non-accidental Trauma (NAT) is a major cause of morbidity and mortality in children. Children less than 2 years old are at greater risk of NAT than older children. A skeletal survey is a series of X-rays of all the bones in the body, or at least the axial skeleton and the large cortical bones used to identify NAT in children. In this observational study, we examined the association between a child’s age, frequency of positive skeletal surveys, and the types of injuries discovered in pediatric patients undergoing a trauma work-up. Methods: The study sample consisted of all pediatric trauma patients ≤3 years old who had skeletal surveys performed at a single tertiary care center in Central Massachusetts between 2005 and 2015. Patients were divided into two age groups: ≤6months old (n=98) and >6months old (n=86). The utilization of a skeletal survey, frequency of confirmed NAT, and injuries were compared between these 2 age groups. Results: The average age of the sample was 8.4 months, 56.0% were boys, and 62.5% were Caucasian. A positive skeletal survey was found in 14.3% of patients ≤6months old and 18.6% of patients >6months old (p=0.43). The most common fractures identified were long bone (50.0%), torso (30.4%), and skull (13.0%). Similar frequencies of NAT were observed between those less than and older than 6 months (58.2% vs. 57.0%). Head computed tomography (CT) scans were performed in the majority (95.9%) of patients ≤6 months old while in only 66.3% of patients > 6 months old (p < 0.01). Conclusions: Skeletal surveys identify injuries at comparable rates in pediatric trauma patients regardless of age. Advanced imaging differs in younger and older pediatric trauma patients undergoing skeletal survey.

This article discusses early childhood trauma and the negative long-term consequences that can cause life-long medical and psychological deficiencies. Early childhood trauma, especially complex trauma, can cause neurobiological changes that impact human development and cause significant changes in brain function. These changes in brain structures are responsible for cognitive and physical functioning. Empirical evidence suggests that childhood trauma is associated with physical, mental, and emotional symptoms that can persist into adulthood. This article examines the impact of trauma exposure; neurologically, physiologically, and psychologically. The long-term consequences of trauma exposure, such as substance abuse, incarceration, and co-occurring psychiatric problems are discussed along with the importance of recognizing protective factors, examining resiliency, and identifying empirically based treatment modalities to help alleviate symptoms of trauma survivors.

Social workers are susceptible to the potential negative impacts of vicarious trauma. Perspectives of trauma social workers on the responsiveness of rural social work agencies to vicarious trauma have not been explored even though the trauma-informed care model has been available since 2006 and outlines best practice in all settings of trauma social work. Considering the risk factors and negative effects vicarious trauma has on social workers, an increased understanding of the perspectives of social workers on how rural social work agencies are responding to vicarious trauma was needed. The purpose of this study was to explore this response through consideration of the trauma-informed care principles of safety, trustworthiness, choice, collaboration, and empowerment. The guiding research question was, what are the perspectives of social workers on the response of rural social work agencies on vicarious trauma and self-care. For this narrative study, storytelling was used as a way to understand and answer the research question. Data were collected using purposeful sampling from 10 trauma social workers through face-to-face interviews and analyzed using a coding and theming process. Organizational culture was identified as a suppressive force that has the potential to be a source of support to therapists. The findings support the need for change in organizational practice standards and furthers knowledge about the potential effects of vicarious trauma on clients, agencies, and therapists and how to mitigate those effects. The awareness this study provided to organizational leaders and policy makers has the potential to be the catalyst for positive practice and policy change.

Professionals who work with victims of sexual trauma frequently experience emotional and psychological stressors that affect their everyday life. Vicarious traumatization is an occupational risk among helping professionals, but it is not known how this phenomenon can be identified and minimized among professionals who work with victims of sexual trauma. The purpose of this qualitative narrative study was to explore the personal experiences of licensed and nonlicensed professionals who work with female victims of sexual trauma. Constructivist self-development theory and the traumagenic dynamics model provided the framework for the study. The research questions focused on the evidence of vicarious trauma among participants, the skills and techniques used to minimize the risk of vicarious trauma, and the influence of vicarious traumatization on helping professionals. Data were collected through semistructured interviews with 8 helping professionals in the Southern United States. Findings from data coding and theme analysis indicated that (a) professionals experience psychological and emotional risks in trauma work, (b) establishing boundaries and implementing self-care techniques can minimize vicarious trauma, and (c) consistent training and ongoing discussions about vicarious trauma are essential to professionals who commit their lives to helping sexual trauma victims. Findings may be used to increase awareness and education about vicarious trauma among professionals who work with victims of sexual trauma, and to develop techniques to minimize the risk of vicarious trauma.

In considering the Israel-Palestine conflict, focus has remained on conventional major issues: borders, settlements, Jerusalem, Palestinian refugee rights and water. Should there be one binational state, or two states for two peoples? Yet this is a conflict that is sustained by factors more profound than the dispute over limited resources or competing nationalisms. The parties’ narratives, continually rehearsed, speak of a cataclysmic event or chain of events, a collective trauma, which has created such deep suffering and disruption that the rehearsers remain ‘frozen’ amid the overarching context of political violence. This study offers a critical analysis of the concept of collective trauma together with the role of commemorative practices, including core contemporary canonical days of memory, and asks to what extent they may hinder progress in the resolution of an intractable conflict, such as the Israel/Palestine conflict. Without addressing the powerful traumatic current that underpins a chronic conflict, no amount of top-down formal peace-making is likely to be sustainable.

Exposure of employees to traumatic experiences in the workplace is a reality that many organisations face. Although not every person exposed to a traumatic experience will necessarily develop post-traumatic stress, the workplace still has a responsibility to assist individuals to deal with psychological reactions after a traumatic experience. The South African Police Service (SAPS) is one such organisation, where employees run a particularly high risk of being exposed to traumatic experiences while performing their tasks. In order to help employees of the SAPS to debrief their trauma, trauma counsellors are necessary. Within the SAPS, trauma counsellors are trained in an adapted version of Mitchell’s Critical Incident Stress Management (CISM) model, with the underlying focus to establish a sense of safety for the police official. The trauma counsellors in the SAPS are trained by means of an experiential learning experience, where journaling is utilised to capture personal experiences during the training. The objective of the study was therefore to explore the experience of counsellors during a trauma counselling training programme. A qualitative research design was utilised following a phenomenology approach. The social constructivism paradigm was also utilised in this research study. Trauma counsellors (N=12) in the SAPS were used as case study for this research, where a purposive homogeneous non-probability sampling technique was implemented. The journal entries made by the participants during the nine day training programme were used as a data collection method. Four categories were extracted from the data, namely, thoughts regarding trauma counsellor’s experiences, emotion experiences of counsellors, the impact of daily experiences on counsellors and the participants’ view on how their competence of efficiency would change in the future. The results showed that the training programme was an effective strategy to train the counsellors. The counsellors showed increased self-awareness and self-insight after the training. The participants gained insight and understanding of how police officials experience trauma. The findings showed that the participants felt empowered and more confident to assist police officials with their trauma recovery. In relation to their training, counsellors made recommendations for the future training of trauma counsellors within the SAPS. Finally, recommendations were made for future research as well as the implications of the study for the industrial psychology practise. / MCom (Industrial Psychology), North-West University, Potchefstroom Campus, 2015

Exposure of employees to traumatic experiences in the workplace is a reality that many organisations face. Although not every person exposed to a traumatic experience will necessarily develop post-traumatic stress, the workplace still has a responsibility to assist individuals to deal with psychological reactions after a traumatic experience. The South African Police Service (SAPS) is one such organisation, where employees run a particularly high risk of being exposed to traumatic experiences while performing their tasks. In order to help employees of the SAPS to debrief their trauma, trauma counsellors are necessary. Within the SAPS, trauma counsellors are trained in an adapted version of Mitchell’s Critical Incident Stress Management (CISM) model, with the underlying focus to establish a sense of safety for the police official. The trauma counsellors in the SAPS are trained by means of an experiential learning experience, where journaling is utilised to capture personal experiences during the training. The objective of the study was therefore to explore the experience of counsellors during a trauma counselling training programme. A qualitative research design was utilised following a phenomenology approach. The social constructivism paradigm was also utilised in this research study. Trauma counsellors (N=12) in the SAPS were used as case study for this research, where a purposive homogeneous non-probability sampling technique was implemented. The journal entries made by the participants during the nine day training programme were used as a data collection method. Four categories were extracted from the data, namely, thoughts regarding trauma counsellor’s experiences, emotion experiences of counsellors, the impact of daily experiences on counsellors and the participants’ view on how their competence of efficiency would change in the future. The results showed that the training programme was an effective strategy to train the counsellors. The counsellors showed increased self-awareness and self-insight after the training. The participants gained insight and understanding of how police officials experience trauma. The findings showed that the participants felt empowered and more confident to assist police officials with their trauma recovery. In relation to their training, counsellors made recommendations for the future training of trauma counsellors within the SAPS. Finally, recommendations were made for future research as well as the implications of the study for the industrial psychology practise. / MCom (Industrial Psychology), North-West University, Potchefstroom Campus, 2015

The research on pastoral counseling of persons struggling with complex trauma was undertaken with the aim of designing a practice-orientated model for pastoral counseling in order to guide such persons to emotional healing, stability and spiritual growth. An exegetical study throws light on the role of prayer and trust in God. One can entrust to God one's problems and one's supplication for help in the firm belief that He will provide a way out. An investigation into counseling perspectives in the Scriptures and in the literature on Christian counseling brought to light that pastoral counseling, which is a mandate given to believers, affords a unique opportunity for lovingly encouraging and consoling people with complex trauma. Contributions by psychiatry and psychology emphasise the phase approach. They stress security and stability, the processing of the traumatic memory and mourning, as well as a renewed commitment to new relationships. The core of the findings is that persons with complex trauma - which is an intricate syndrome relating to a spectrum of post-traumatic disturbances following intense, protracted and repeated trauma - can be guided by pastoral counseling to emotional healing, stability and spiritual growth. Specific reference is made to victims of prolonged family violence and/or physical and/or emotional and/or sexual abuse and/or protracted physical and/or emotional neglect in family context. The empirical research confirmed that the children of the Abraham Krielkinderhuis, Potchefstroom, who were subjected to these traumatic experiences in their parental homes exhibit the typical symptomatology of complex trauma. These entail emotional disturbances like anger and self-injury, disturbances of consciousness like dissociation, disturbances of self-image like stigma, guilt and shame, disturbances in the image of the perpetrator, like unrealistic expectations and finally disturbances in relationships like distrust and loss of faith. The principles and outcome of the empirical research are eventually applicable to all persons struggling with complex trauma. A practice-orientated counseling model was designed which focuses on stabilisation and security, the processing of the traumatic memory and mourning, as well as a renewed commitment to life in abundance and new relationships. In this therapeutic relationship of faith the distress narrative and the narrative of the past are central. God allows everything to turn out for the best for those who trust in Him. In Christ people are more than victors through God's will for their lives. / Thesis (Ph.D. (Pastoral))--North-West University, Potchefstroom Campus, 2006.