Bakgrund: Accidentell hypotermi är ett tillstånd där kroppstemperaturen oavsiktligt understiger 35 °C. Hypotermi kan delas in i lindrig, måttlig och grav hypotermi, alla tre stadier medför livshotande komplikationer för patienten. Tidigare forskning visar att vårdpersonal har otillräcklig kunskap om definitionen av hypotermi samt vilka omvårdnadsåtgärder som är mest lämpliga för patienten.  Syfte: Syftet med denna studie är att undersöka vilka omvårdnadsåtgärder sjuksköterskan bör använda vid accidentell hypotermi. Metod: Deskriptiv design med litteraturstudie har valts som metod för att skapa en översikt över kunskapsläget inom det omvårdnadsrelaterade området. Artikelsökningarna gjordes via Uppsala Universitets databaser PubMed och CINAHL. Relevanta sökord valdes på svenska och översattes med hjälp av Svensk MeSH  (Medical Subject Headings) för att få korrekta sökord till databaserna. Samtliga artiklar kvalitetsgranskades med Forsberg och Wengströms (2016) granskningsmallar.  Resultat: Resultaten från denna studie visar att varmlufttäcke är en effektiv metod för att bibehålla och öka kroppstemperaturen för att förebygga hypotermi. Filtar, kemiska heat packs, uppvärmd madrass och självvärmande filt har inte visat en signifikant effekt för att öka patienternas kroppstemperatur. Dock så har de patienterna upplevt en ökad känsla av värme och komfort. Slutsats: Vilken metod som sjuksköterskan ska använda bör bedömas efter vilken miljö patienten befinner sig i. Varmlufttäcke är den mest effektiva metoden för att öka kroppstemperaturen. Det krävs mer forskning inom de olika uppvärmningsmetoderna för att sjuksköterskan ska kunna implementera rätt evidensbaserade metoder inom sitt omvårdnadsarbete

Masters of Art / This study examines the effects of domestic violence on adults who witnessed abuse as children in their homes. It seeks to ascertain if the childhood emotional trauma of domestic violence influences the growth and social adaptation of children in their later years. Despite the growing awareness of domestic violence worldwide, there is nevertheless an alarming number of women reporting abuse, and there are those who are reportedly beaten or inflicted with bodily harm at the hands of their abusers. However, most of these domestic or household conflicts take place in situations where children are involved. These children witness such abuse and grow up carrying emotional and physical scars that impact their functioning as members of society. The study adopts a life history approach to investigate 15 adult participants (five women and ten men) within evolving themes relating to their experiences of domestic violence and other life ordeals during their childhood that made them end up at the Elim Night Shelter in Cape Town, South Africa. The study is anchored on the explication of such key concepts as domestic violence, abuse and the physical, social, emotional and behavioural effects of abuse. Furthermore, the study identifies the social consequences of growing up in an abusive environment. The findings of the study reveal that people who witnessed acts of domestic violence as children experience negative consequences as adults. Recommendations have been listed which could assist the further study expansion on the topic, together with intervention strategies.

This thesis inquiries into trauma, its historical developments, experience, and symptoms. The theoretical part lays stress on post-traumatic stress disorder and its classification and diagnosis for the readers to have an extensive knowledge of trauma. The readers are also presented with the quintessential aftermath of trauma. The practical part adverts to childhood trauma of the main protagonists of The Gathering and The Hiding Place by the authors Anne Enright and Trezza Azzopardi. The intention is to query what happened to these characters, rather than focusing on what is wrong with them. The objective is to see the person behind his or her behaviour. Many studies refer to increasing problems in terms of mental health by children and adolescents associated with early childhood trauma. The aim in what follows is to consider whether the harm to childhood trauma can be remedied or whether childhood trauma persists until old age. KEY WORDS: Childhood trauma; post-traumatic stress disorder; trauma fiction; Enright; Azzopardi; The Gathering; The Hiding Place

Varje år kommer det tusentals asylsökande till Sverige. Bland dem finns det barn som sannolikt upplevt någon typ av trauma. Förskolan är en av de första svenska samhällsinstitutioner som flyktingfamiljer kommer i kontakt med och blir därigenom en del av barnens hjälpsystem i deras återhämtning. Syftet med den här studien är därför att skapa mer kunskap om flyktingbarns trauma samt hur arbetet med detta ser ut i svenska förskoleverksamheter. Denna kvalitativa studie baseras på intervjuer med personal från förskolor, som har personliga erfarenheter av att ha arbetat med flyktingbarns trauma. Vi utförde halvstrukturerade intervjuer för att få djupare och detaljerade svar. Empirin har sedan analyserats utifrån anknytningsteorin och Traumamedveten omsorg (TMO) och diskuterats i förhållande till befintlig forskning inom ämnet. Resultatet visar att barns trauma kan visa sig på många olika sätt och att flyktingbarnen är i stort behov av trygghet och närhet av pedagogerna. Relationsbyggandet, både med barnen och deras familjer, har visat sig spela en viktig roll för att skapa förståelse och tillit. God kunskap krävs för att förskolepersonal på bästa sätt ska kunna hjälpa traumatiserade barn. För att detta ska kunna uppnås behöver förskolepersonal få kollegial stöttning och utbildningar som fokuserar på trauma.

Bakgrund: Fem miljoner människor dör och miljontals skadas årligen världen över av ett trauma. Det bidrar till en stor belastning på sjukvården och utgör ett globalt hälsoproblem. Utfallet efter traumat skapar ett stort fysiskt och psykiskt lidande för den enskilde individen. Därtill har det visat sig att även sjuksköterskor upplever det komplext att vårda dessa patienter. Kunskap om deras erfarenheter behövs för att bemöta deras behov. Syfte: Syftet med denna litteraturstudie var att beskriva personers erfarenheter av att överleva ett stort trauma. Metod: En litteraturstudie baserad på åtta kvalitativa vetenskapliga artiklar från två databaser, CINAHL och PubMed.  Resultat: Utifrån analysen skapades tre huvudteman och sju subteman. Huvudtemana som bildades var: ‘En förlorad identitet’, ‘En emotionell kamp’ och ‘En förändrad relation’.  Konklusion: Att överleva ett stort trauma medför ett stort lidande. Det innebär både en fysisk och emotionell påverkan. Behovet av rätt stöd och vård är stort. Samtidigt upplever de en bristande förståelse från sjukvårdspersonal om deras situation. Omvårdnaden som givits upplevs sällan personcentrerad och därav behövs en förbättring. Vidare forskning behövs angående hur sjuksköterskor kan arbeta eller verksamheter kan organisera arbete för att tillgodose patienternas omvårdnadsbehov efter ett stort trauma. / Background: Five million people die and millions get injured every year around the world of a trauma. This contributes a large weight on healthcare and poses a global health problem. The outcome after a trauma creates physical and psychological suffering. Nurses experience a complex caregiving around these patients. Knowledge about people's experience is needed to receive their needs.  Aim: The aim of this study was to describe people's experiences of surviving a major trauma. Methods: A literature study based on eight scientific articles. The articles were found in two databases, CINAHL and PubMed.  Results: From the analysis three main themes and seven subthemes were created. The main themes were: ‘A lost identity’, ‘An emotional struggle’ and ‘A changed relationship’.  Conclusion: Surviving a major trauma results in a huge suffering. It contains physical and emotional impact. The need for support and care is necessary, people experience a lack of understanding about their situation from healthcare professionals. The care has rarely been perceived person-centered and needs to improve. Further research is needed concerning how nurses can work or care organisations can organize their work to achieve patients needs of nursing after a major trauma.

Magister Chirurgiae Dentium - MChD / Introduction: Maxillofacial and oral surgeons often encounter challenges when choos-ing an appropriate surgical access for patients who sustained periorbital and orbital trauma. There are various surgical approaches/incisions (transcutaneous and transcon-junctival) used to access the periorbital skeletal framework. However, there is no consen-sus in the literature regarding the aesthetical outcome of these approaches/incisions. Complications of the lower lid such as entropion, ectropion, retraction of lower lid, scar-ring, oedema of lid, canthal mal-position and chemosis are associated with these ap-proaches. Surgeons are posed with these challenges and aim for best aesthetic outcomes and low post-operative complications. Aim: The aim of this study was to compare aesthetic outcome of the transcutaneous ap-proach (subtarsal) to that of the transconjunctival approach when managing orbital trauma. Objectives: The objectives were to compare the aesthetic outcomes between the trans-conjunctival and transcutaneous (subtarsal) approach; to assess unwanted clinical out-comes, such as scaring, lid malposition (ectropion, entropion, scleral show), lid oedema, chemosis, haematoma, ecchymosis, wound dehiscence, infection and canthal malposition for the two approaches. Methodology: Twenty-two patients were enrolled in this study, 11 of which underwent “transconjunctival incision”, and 11 underwent "subtarsal incision". A high quality dig-ital photograph of each patient’s face was taken at specified time periods up to nine months after surgery. Ten Maxillofacial and Plastic surgeons were instructed to rank or-der the 22 photographs applying Q-sort scaling. Results: Eleven patients underwent the transconjunctival (retroseptal) incision. Ten of which had pure blowout fractures and one had a zygomatic complex fracture. Of the 11, seven were black Africans, two were Caucasians and two mixed race. There were four males and seven females in the transconjunctival incision group. The remainder of the 22 underwent the transcutaneous (subtarsal) incision. Six of the 11 were black Africans and five mixed race. There were nine males and two females in the tranconjunctival group. In this group, two patients had pure blowout fractures and nine had zygomatic complex fractures. Scars were visible in the subtarsal group after six months in seven out of the 11 cases (63.6%), but all the scars were rated as mild on the modified Vancouver Scar Scale. Scle-ral show was noted after six months in four of the 11 cases with the subtarsal approach and in two of the 11 cases with the transconjunctival approach. Only one case of ectropion was seen with both approaches and only one case of entropion was noted in the transcon-junctival group. According to the findings of the study, both approaches were found to have good aesthetic outcomes. Results from the expert rating showed a high-quality rank of 96.8% for the transconjunctival incision versus 90.5% for the subtarsal incision. Conclusion: Both approaches demonstrated good aesthetic results. The transconjunctival incision was associated with scleral show and entropion, while the subtarsal incision was more associated with scar formation. However, when performed meticulously, both inci-sions can provide aesthetically pleasing results.

This research is a prospective, descriptive survey of adult pedestrian injuries in Cape Town. It profiles 'at risk' pedestrians and describes their injuries, injury severity and outcome. The role which alcohol plays in these collisions is threaded through the thesis. Since no study of this nature has been done in South Africa, it provides baseline data on the epidemiology, alcohol-relatedness, clinical presentation and prevention of adult pedestrian collisions in the metropole. Data were collected prospectively on all injured pedestrians who presented consecutively, within six hours of being injured, to the Trauma Unit of Groote Schuur Hospital over a nine week period in 1993. Data were also gathered retrospectively from the state mortuary on all pedestrians who died before reaching hospital during the same time period. A total of 227 patients were included in the study. Data gathered included demographics, physiological response to injury, anatomical nature and severity of injuries as well as progress and outcome. Injuries were assessed and scored using the Abbreviated Injury Score (1990 revision) and the New Injury Severity Score. Alcohol consumption was assessed using four measures, viz. self-evaluation, clinical assessment, breath alcohol analysis and blood alcohol concentration (SAC). Data were analysed using SAS version 6. The study recorded a very high incidence of alcohol intoxication among injured pedestrians in Cape Town. This is highly suggestive of a causal link. One hundred and forty-one patients (62.1%) were found to have positive BACs; more than 40% had BACs in excess of 0.20 g/100ml. SAC positive pedestrians were found to have more severe injuries, to require longer hospitalisation periods and to need more complex management. They consequently cost more to treat than their sober counterparts. The comparison between the four methods of alcohol assessment revealed that self-evaluation and clinical assessment were poor screening tools. Breath alcohol analysis, using a Lion Alcolmeter S-D2, had a high degree of accuracy when compared to the SAC, which remains the 'gold standard'. It is therefore recommended that all traffic trauma patients be subjected to breath analysis. The study also generated recommendations for the prevention of pedestrian collisions. These address pre-crash, crash and post-crash factors. Control of drunken driving and walking, as well as road safety education, particularly to pedestrians, are key issues. However, there remains a need for improved road engineering and better monitoring of the roadworthiness of vehicles. This thesis highlights the severity of alcohol-related pedestrian injuries and the importance of preventative strategies.

The artist discusses the work in Silly Trip Wires, 2020 his Master of Fine Arts exhibition. The exhibition includes an installation, Silly Trips Wires, and documentation of a smaller site-specific version of the work. The Artist discusses the process of transition from military to civilian, and the potential effects that mental trauma from combat deployments can have on this process. This is tied to an analysis of how communicating the experience of veterans to civilians, through artwork, functions to bring about understanding.

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Previous research suggests that adverse childhood experiences (ACEs) can greatly impact a child’s physical, mental, and emotional wellbeing later in life. ACE exposure has been associated with lower levels of empathy in the literature. Spirituality is often associated with a number of positive outcomes, including those associated with empathy, like prosocial behaviors. The present study examines spirituality as a buffer against reduced empathy in those with exposure to adverse events in childhood. Participants for this study were recruited through the SONA research platform at East Tennessee State University as part of a larger research project, the REACH (Religions, Emotions, and Current Health) study. Results of this study did not support the working hypotheses that we would find a negative correlation between ACEs and empathy, as well as a moderation relationship via spirituality between ACEs and empathy. However, we did find that empathy was positively associated with spirituality, and ACEs were negatively associated with spirituality. Future research should dig deeper into the relationship between ACEs and empathy, as well as search for other possible protective factors for the effects of ACEs.