<p><font face="Times New Roman"> <p align="left">Limitations of the study include the issue of counsellor variables and the fact that the participants varied between receiving a debriefing on a group or individual basis. The experience of the trauma debriefings were explored but more specific information relating to debriefing could have been elicited. Therefore, these findings cannot be generalised and further research could<font face="Times New Roman"> explore the utility and efficacy of trauma debriefing.</font></p> </font></p>

Two of Don DeLillo’s recently published novels, The Body Artist (2001) and Falling Man (2007), feature performance artists performing trauma. Through the bodies of these performers, DeLillo restates the central concern of trauma studies: if trauma is that which denies mediation, how may we speak about traumatic experience? DeLillo’s stagings of traumatic (re)iterations illustrate how the missed originary moment of trauma precludes directly referential content in traumatic representation. But I propose that performed trauma – the knowledge of forgetting addressed to another – recapitulates the structure of traumatic experience itself, thereby revealing trauma to be wholly constituted in repetition, and providing a means of speaking about the unspeakable. I hope to illustrate how restoring trauma to language revives the ethical and political efficacy of traumatic representation.

<p><font face="Times New Roman"> <p align="left">Limitations of the study include the issue of counsellor variables and the fact that the participants varied between receiving a debriefing on a group or individual basis. The experience of the trauma debriefings were explored but more specific information relating to debriefing could have been elicited. Therefore, these findings cannot be generalised and further research could<font face="Times New Roman"> explore the utility and efficacy of trauma debriefing.</font></p> </font></p>

Diss. (sammanfattning) Stockholm : Karol. inst., 2007. / Härtill 4 uppsatser.

Diss. (sammanfattning) Stockholm : Karolinska institutet, 2005. / Härtill 4 uppsatser.

South African society has been a ected either directly or indirectly by some degree of trauma. Therefore the presence of a trauma unit within a hospital created the ideal opportunity for novice trauma counsellors to have practical experience. The present research is an exploratory study, designed in accordance with ethno- graphic principles in order to understand the psychological e ects of trauma on novice trauma counsellors. It focuses on themes that reverberate throughout the participants narratives. Vicarious trauma and compassion fatigue are two such e ects that were explored in this study. Research into compassion fatigue and vi- carious trauma span over several decades and researchers have moved from merely describing the symptoms of secondary traumatic stress to explaining it in terms of models that highlight the role of various factors that contribute vicarious trauma or compassion fatigue. This study concludes with recommendations to counter the e ects of experiencing secondary trauma. / (M.A. (Clinical Psychology))

Introdução: A fragilidade dos sinais clínicos de fratura de base do crânio (FBC) para o diagnóstico dessa lesão, contraposta pela relevância atribuída a esses sinais, motivou a atual investigação, tendo em vista, sobretudo, a importância do diagnóstico dessa fratura nas intervenções iniciais ao doente traumatizado. Objetivos: Descrever o desempenho dos sinais clínicos de FBC para o diagnóstico dessa lesão; verificar o desempenho do hematoma periorbital e/ou rinorreia para diferenciar a fratura de fossa anterior das demais fraturas da base do crânio; descrever o tempo pós-trauma de aparecimento dos sinais clínicos em vítimas com e sem FBC; descrever o desempenho dos sinais de FBC na identificação precoce desse tipo de lesão; verificar a associação entre a presença de sinais clínicos de FBC e as variáveis idade do paciente e gravidade do trauma craniencefálico (TCE). Método: Estudo prospectivo do tipo follow up realizado por meio de observação estruturada de vítimas de TCE até 48 horas após trauma. Foram estudados indivíduos com idade 12 anos, com TCE contuso, atendidos na Unidade de Emergência Cirúrgica da Casa de Saúde Santa Marcelina entre agosto de 2012 e janeiro de 2013. Essa investigação foi focada nos sinais de FBC clássicos, apreciados rotineiramente na prática assistencial: hematoma periorbital, hematoma retroauricular, otorreia e rinorreia. Nas análises, o padrão-ouro para diagnóstico de FBC foi a tomografia computadorizada ou a visualização direta dessa fratura em cirurgia. Para avaliar o desempenho dos sinais clínicos de FBC, foi calculado seu valor preditivo positivo (VPP) e negativo (VPN), a sensibilidade, a especificidade e a acurácia. O teste quiquadrado foi aplicado para verificar as associações entre as variáveis. Resultados: A casuística foi composta de 136 vítimas com TCE, das quais 28 tiveram FBC. Os sinais clínicos de FBC observados nas primeiras 48 horas pós-trauma apresentaram VPP = 25,7%, VPN = 94,3%, sensibilidade de 92,8%, especificidade de 30,5% e acurácia de 43,4%. Quando detectados na primeira hora, os sinais clínicos tiveram o seguinte desempenho: VPP = 27,1%, VPN = 86,4%, sensibilidade de 67,8%, especificidade de 52,8% e acurácia de 55,9%. Vítimas com e sem FBC tiveram evidências clínicas desse tipo de fratura após a primeira hora do trauma, 21,0% entre 1 e 6 horas e 9,0% após 6 horas. Entre os indivíduos com FBC e sinais clínicos, 26,9% tiveram manifestação mais tardia desse tipo de lesão. A presença de sinais clínicos de FBC em vítimas de TCE se associou com a sua gravidade (p = 0,041 e 0,002), porém não esteve relacionada com a idade (p = 0,350). Nas vítimas com FBC, as evidências clínicas específicas de lesão de fossa anterior tiveram acurácia de 53,6%, VPP = 42,8%, VPN = 85,5%, sensibilidade de 90,0% e especificidade de 33,3%. Conclusão: Os resultados do atual estudo contraindiciam a valorização dos sinais de FBC na decisão do uso da via nasal para introdução de cateter e cânulas no atendimento inicial da vítima de trauma, visto que é baixa a acurácia desses sinais, sua presença tem pouco valor clínico e a ausência apresenta bom valor preditivo tardiamente. / Introduction: The fragility of the clinical signs for skull base fracture (SBF) diagnosis and, on the other hand, the importance attributed to these signals motivated this research, especially because of the importance of the fracture diagnosis in the first interventions on the trauma patient. Objectives: To describe the performance of clinical signs on the SBF diagnosis; to verify the performance of periorbital hematoma and/or rhinorrhea to differentiate a anterior fossa fracture from other skull base fractures; to describe the trauma clinical signs onset in victims with or without SBF; to describe the signs performance in the early identification of SBF; to verify the association between SBF clinical signs and age of the patient and severity of head injury (SHI) variables. Methods: Prospective follow-up conducted through structured observation of skull brain trauma (SBT) victims within 48 hours after trauma. The study was about subjects aged 12 years with blunt SBT, treated at the Emergency Surgical Unit at the Santa Marcelina Hospital between August 2012 and January 2013. This investigation was focused on classical SBF signs routinely examinated in healthcare practice: periorbital hematoma, retroauricular hematoma, otorrhea and rhinorrhea. In the analysis, the gold standard for SBF diagnosis was computed tomography or direct visualization of the fracture on surgery. To evaluate the performance of SBF clinical signs, it was calculated its positive predictive value (PPV) and negative predictive value (NPV), sensitivity, specificity and accuracy. The chi-square test was used to assess relationships between variables. Results: The sample consisted of 136 SBT victims, 28 of whom had SBF. Clinical signs of SBF observed in the first 48 hours post-trauma showed PPV 25.7%, NPV 94.3%, sensitivity 92.8%, specificity 30.5% and accuracy 43.4%. When detected in the first hour, the clinical signs performed as follows: PPV 27.1%, NPV 86.4%, sensitivity 67.8%, specificity 52.8% and accuracy 55.9%. Victims with or without SBF showed clinical evidence of this kind of fracture after the first hour of injury, 21,0% between 1 and 6 hours and 9,0% after 6 hours. Among individuals with SBF and clinical signs, 26.9% had a later manifestation of this lesion. The presence of SBF clinical signs in SBT was associated with severity (p = 0.041 and 0.002), but was not related with age (p = 0.350). In victims with SBF, specific clinical evidence of anterior fossa injury had an accuracy of 53.6%, PPV 42.8%, NPV 85.5%, sensitivity 90,0% and specificity 33.3%. Conclusion: The results of this study contraindicated the recovery of SBF signs in the decision of the nasal cannula use and catheter placement in the initial care of the trauma victim, since the accuracy of these signals is low, their presence has little clinical value and the absence has good predictive value later.

Socialarbetare tenderar i sitt arbete att möta människor med trauman i större eller mindre utsträckning. Berättelser från både barn och vuxna som varit eller är med om traumatiska händelser på grund av upplevelser av våld, kan hos socialarbetare orsaka sekundär traumatisering (STS). Med sekundär traumatisering menas att socialarbetare kan uppleva samma symtom som de människor hen möter. I den här internationella systematiska litteraturstudien är syftet att undersöka vad som gör att socialarbetare utvecklar STS i mötet med traumatiserade människor, samt om det finns faktorer som gör att fenomenet går att förebygga och/eller motverka. Studien syftar också till att undersöka det upplevda våldets karaktär hos klienterna och dess koppling och inverkan på uppkomsten av STS. Genom en narrativ analysmetod framkom det i studiens resultat, exempel på risker som påverkade uppkomsten av fenomenet, vilka var egenupplevda trauman, avsaknad av egenvård, hög arbetsbelastning, hög exponering av traumaklienter under sin arbetstid, samt bristande eller avsaknad av handledning. Det framkom även att riskerna för STS gick att minska eller åtgärda genom utbildning, egenvårdstekniker, mindre exponering i form av direktkontakt- eller färre antal timmar med traumaklienter per vecka. En upptäckt som gjordes var att utbildning kan ha en stor betydande roll i framtiden för att kunna förebygga och/eller minska riskerna för STS hos socialarbetare.

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Breast ironing (BI) practice is a common practice in Cameroon. Most villages and towns continue with BI because they believe it constitutes a positive cultural lifestyle. However, public health officials and other advocates have branded BI as a harmful traditional practice because of the traumatic impact it has on the women who experience it. The purpose of this quasi-experimental study was to examine the perceived long-term health-related outcomes of BI and the quality of life changes on these women. Underpinning this study was the betrayal theory of trauma. A survey was used to collect data from 230 women. Descriptive analysis of the data showed, BI was more prevalent in some regions of Cameroon and among some ethnic groups more than others. A chi-square test revealed a strong relationship that women who experienced BI perceived long-term physical, psycho-social, and emotional health-related outcomes and negative quality of life changes during and after the practice. A multiple logistic regression model was conducted to examine the relative odds of exposure of other independent predictors on the outcome variable. The chi-square test on severe pain and marital/ family health; breast scars and frequent pain; stress and feeling inferior; sadness and pain, revealed a P-value < .001. The odd ratio (OR) of the confounding predictors breast scars, frustration, shame, depression, self-esteem; burns; abscesses revealed an Exp(B)/ OR