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A Preliminary Scoping Review of Trauma Recovery Pathways among Refugees in the United States 美国难民创伤恢复途径的初步范围审查
Pub Date : 2022-11-29 DOI: 10.3390/traumacare2040048
C. R. Mbamba, J. Asare, Clinton Gyimah
When people move across borders to seek asylum because of violence, conflicts, persecution, or human rights violations, they experience a complex mix of psychological and traumatic downfalls. Often, refugees and asylum seekers’ trauma is compounded by the behaviours of individuals, communities, and the systemic climate of host countries. The United States is host to refugees and asylees from several countries. Evidence shows that several asylum seekers are held up in deplorable conditions in immigration detention centres where they are battling acute trauma. Therefore, consequent to this, coupled with the varying trauma that refugees face, this preliminary scoping review explores the scope and context of available peer-reviewed scholarship on trauma recovery pathways among refugees in the United States to identify gaps for further research. Following the PRISMA-compliant scoping review guidelines, we identified and curated data on the scope and context of peer-reviewed literature on trauma recovery approaches among refugees in the United States. This study identified the following as trauma recovery pathways among refugees: (1) macro-level structural intervention—preventing re-traumatization; (2) culturally sensitive therapeutic intervention; and (3) diagnosis and therapy. This study concludes that little research on the recovery pathways among refugees exists in the United States, hence the need for scholarship in this area.
当人们因暴力、冲突、迫害或侵犯人权而越境寻求庇护时,他们会经历复杂的心理和创伤。难民和寻求庇护者的创伤往往因个人、社区的行为和东道国的系统性气候而加剧。美国收容了来自几个国家的难民和寻求庇护者。有证据表明,几名寻求庇护者被关押在移民拘留中心,条件恶劣,他们正在那里与严重的创伤作斗争。因此,鉴于此,再加上难民面临的不同创伤,本次初步范围界定审查探讨了美国难民创伤恢复途径的现有同行评审奖学金的范围和背景,以确定进一步研究的差距。根据符合PRISMA的范围审查指南,我们确定并整理了关于美国难民创伤恢复方法的同行评审文献的范围和背景的数据。本研究确定了以下难民创伤恢复途径:(1)宏观层面的结构性干预——防止再次创伤;(2) 文化敏感性治疗干预;(3)诊断和治疗。这项研究得出的结论是,美国对难民康复途径的研究很少,因此需要这方面的奖学金。
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引用次数: 0
Epidemiological Criminology and COVID: A Transdisciplinary Analysis of Violent Crime and Emergency Department Admissions during COVID 流行病学犯罪学与新冠肺炎:新冠肺炎期间暴力犯罪与急诊入院的跨学科分析
Pub Date : 2022-11-23 DOI: 10.3390/traumacare2040047
Lindsey E. Wylie, Julie D. Garman, Gaylene S. Armstrong, Ashley Farrens, J. Burt, M. Foxall, Michael Visenio, Macall Cox, Cynthia S. Hernandez, C. Evans, A. Raposo-Hadley
As little is known about the influence of COVID-19 on rates of violent crime, the purpose of this study is to examine violent injury captured by emergency department admissions and by law enforcement in a mid-sized midwestern city (Omaha, Nebraska) from January 2016 to December 2020. Although COVID-19 did not show a direct significant relationship, weeks during the COVID-19 period showed a marginal increase in incident rate ratios for violent incidents in both datasets. While violence remained stable during the pandemic, racial differences between samples were observed. This study emphasizes the utility of a transdisciplinary approach to understand the underlying drivers of violent crime and victimization.
由于人们对新冠肺炎对暴力犯罪率的影响知之甚少,本研究的目的是研究2016年1月至2020年12月中西部一个中等城市(内布拉斯加州奥马哈)急诊科入院和执法部门记录的暴力伤害。尽管新冠肺炎没有显示出直接的显著关系,但在新冠肺炎期间的几周内,两个数据集中暴力事件的发生率比率略有增加。尽管暴力在疫情期间保持稳定,但观察到样本之间的种族差异。这项研究强调了跨学科方法的效用,以了解暴力犯罪和受害的潜在驱动因素。
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引用次数: 0
Trauma-Sensitive Mindfulness for War Refugees: Communication of Preliminary Findings 战争难民的创伤敏感正念:初步发现的交流
Pub Date : 2022-11-20 DOI: 10.3390/traumacare2040046
Laila Jeebodh-Desai, V. Dwarika
Mindfulness and meditation was explored with the view to support the use of trauma-sensitive mindfulness (TSM) in clinical practice with survivors of war refugees in the treatment of post-traumatic stress disorders. The following questions were explored: (1) How are mindfulness and meditation defined? (2) What are the practices and perceived value of mindfulness practices? (3) What are the evidence and non-evidence-based treatments for post-traumatic stress disorder (PTSD)? (4) What are the possibilities of using TSM to support war-traumatised refugees in the treatment of PTSD in a refugee camp setting? Findings that measured currently actioned interventions for war-traumatised refugees did not account for psychological support that could be implemented in a refugee camp setting on a once-off basis. In response to the gaps and limitations highlighted, the study suggests an adaptation of the TSM intervention and professional development of practitioners in the art of TSM therapy.
为了支持创伤敏感正念(TSM)在战争难民幸存者治疗创伤后应激障碍的临床实践中使用,探讨了正念和冥想。本文探讨了以下问题:(1)正念和冥想是如何定义的?(2)正念练习的实践和感知价值是什么?(3)创伤后应激障碍(PTSD)的循证治疗和非循证治疗有哪些?(4)在难民营环境下,使用TSM支持战争创伤难民治疗PTSD的可能性有多大?调查结果衡量了目前对受战争创伤的难民采取的干预措施,但没有考虑到可以在难民营环境中一次性实施的心理支持。针对突出的差距和局限性,本研究提出了TSM干预的适应性和从业者在TSM治疗艺术方面的专业发展。
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引用次数: 0
Heterotopic Ossification after a Prolonged Course of COVID-19: A Case Report and Review of the Literature 新冠肺炎病程延长后异位骨化的病例报告及文献回顾
Pub Date : 2022-10-18 DOI: 10.3390/traumacare2040045
Jacob E. Milner, Ean C. Schwartz, Joseph S. Geller, David S. Constantinescu, Paul R. Allegra, Justin E. Trapana, Fernando E. Vilella
We report the case of a 20-year-old male who developed severe HO of the left hip secondary to a prolonged course of COVID-19 pneumonia. Upon extubation, he was found to have debilitating left hip pain and significant functional deficits with regard to his range of motion and functional status. There are numerous known causes of heterotopic ossification (HO), including trauma, surgery, and traumatic brain or spinal cord injuries. An increased incidence of HO has also been reported in patients who undergo prolonged intubation. While the COVID-19 virus has many known respiratory and medical complications, it has also resulted in unforeseen complications that present long-term challenges for patients. When treating patients with coronavirus, physicians should be aware of HO as a possible complication and consider it as a cause of musculoskeletal pain.
我们报告了一例20岁男性因新冠肺炎肺炎病程延长而出现严重左髋关节HO的病例。拔管后,他被发现左髋关节疼痛,活动范围和功能状态明显缺陷。异位骨化(HO)有许多已知的原因,包括创伤、手术和创伤性脑或脊髓损伤。据报道,在接受长时间插管的患者中,HO的发生率也有所增加。虽然新冠肺炎病毒有许多已知的呼吸道和医疗并发症,但它也导致了不可预见的并发症,给患者带来了长期挑战。在治疗冠状病毒患者时,医生应意识到HO是一种可能的并发症,并将其视为肌肉骨骼疼痛的原因。
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引用次数: 1
Exploring Mindful Self-Care as a Potential Mediator between Compassion Satisfaction and Compassion Fatigue among Student Services Professionals 在学生服务专业人员中,正念自我护理作为同情满意度和同情疲劳之间的潜在中介
Pub Date : 2022-10-16 DOI: 10.3390/traumacare2040044
Portia Jackson Preston, D. Sanchez, K. Preston
Higher education professionals are subject to high levels of stress as they support student populations at risk of trauma. Compassion fatigue, which represents dimensions of secondary traumatic stress and burnout, is associated with a poorer health-related quality of life (HRQOL) among those providing student services. Prior studies on helping professionals have found that mindful self-care mediates the relationship between compassion satisfaction, the positive aspects of helping others in one’s role, and compassion fatigue, but this has not been sufficiently explored in this population. A total of 559 respondents (faculty, students, and staff) who provide non-instructional support across 23 student service areas at 22 comprehensive regional universities completed a cross-sectional survey assessing mindful self-care, professional quality of life and HRQOL. Path analyses were conducted using EQS 6.4 software to test one model controlled for age, progressing from compassion satisfaction to mindful self-care, to compassion fatigue, to HRQOL. Mindful self-care, particularly supportive structure, mediated the relationship between compassion satisfaction and compassion fatigue. Compassion satisfaction was positively associated with HRQOL through mindful self-care and compassion fatigue. Institutions seeking to address compassion fatigue and promote well-being should implement policies to facilitate self-care by ensuring manageable workloads and balancing internal and external demands.
高等教育专业人员承受着很高的压力,因为他们支持有创伤风险的学生群体。同情疲劳代表了继发性创伤压力和倦怠的维度,在提供学生服务的人员中,与健康相关的生活质量(HRQOL)较差有关。先前对帮助专业人员的研究发现,正念自我照顾调节了同情满意度、以自己的角色帮助他人的积极方面和同情疲劳之间的关系,但这在这一人群中还没有得到充分的探索。在22所综合性地区大学的23个学生服务区提供非教学支持的559名受访者(教师、学生和工作人员)完成了一项评估正念自我保健、职业生活质量和HRQOL的横断面调查。采用EQS 6.4软件进行通径分析,检验一个控制年龄的模型,从同情满意度到正念自我照顾,到同情疲劳,再到HRQOL。正念自我照顾,尤其是支持性结构,在同情满足和同情疲劳之间起中介作用。正念自我照顾和同情疲劳与同情满意度呈正相关。寻求解决同情疲劳和促进福祉的机构应该实施政策,通过确保可管理的工作量和平衡内部和外部需求来促进自我保健。
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引用次数: 2
The Efficacy of Honey Compared to Silver Sulfadiazine for Burn Wound Dressing in Superficial and Partial Thickness Burns—A Systematic Review and Meta-Analysis 蜂蜜与磺胺嘧啶银在烧伤创面敷料中对浅表和部分厚度烧伤的疗效比较——一项系统综述和荟萃分析
Pub Date : 2022-10-06 DOI: 10.3390/traumacare2040043
S. Osman, H. Umar, Y. Hashmi, Anam Jawaid, Z. Ahmed
Burn dressings play a vital role in protecting the patient from infection and aiding in the wound healing process. At present, the best burn wound dressing remains unknown. This study aimed to assess the efficacy of honey versus silver sulfadiazine dressing (SSD) for the treatment of superficial and partial thickness burns. We performed a systematic review and meta-analysis using the PubMed, MEDLINE and Embase databases to find relevant randomised control trials (RCTs) for inclusion. The outcomes measures included complete burn wound healing time, the proportion of wounds rendered sterile and subjective pain relief associated with the respective dressing type. This review was completed in line with PRISMA guidelines and has been registered with PROSPERO (Study ID: CRD42022337433). All studies in the English language that assessed honey versus SSD for patients with superficial or partial thickness burns were included. Quality and risk of bias assessments were performed using the Cochrane RoB2 tool. Seven studies were identified: totalling a population of 582 patients. From three studies, meta-analysis showed no significant difference in complete wound healing time (p = 0.06). Meta-analysis from five studies highlighted an overall significant difference favouring honey dressing in the proportion of wounds rendered sterile at day 7 post-injury (OR 10.80; 95% CI [5.76, 20.26]; p < 0.00001; I2 = 88%). We conclude that honey dressings may be as or more effective than SSD in the treatment of superficial and partial thickness burn injuries. However, due to the low quality of available studies in this field, further research is necessary to establish the optimum burn dressing. Ideally, this should be conducted in the form of prospective three-arm RCTs in accordance with the CONSORT statement.
烧伤敷料在保护患者免受感染和帮助伤口愈合过程中发挥着至关重要的作用。目前,最好的烧伤敷料尚不清楚。本研究旨在评估蜂蜜与磺胺嘧啶银敷料(SSD)治疗浅表和部分烧伤的疗效。我们使用PubMed、MEDLINE和Embase数据库进行了系统综述和荟萃分析,以寻找可纳入的相关随机对照试验(RCT)。结果指标包括烧伤伤口的完全愈合时间、无菌伤口的比例以及与相应敷料类型相关的主观疼痛缓解。该审查是根据PRISMA指南完成的,并已在PROSPERO注册(研究ID:CRD42022337433)。包括所有用英语评估浅表或部分厚度烧伤患者蜂蜜与SSD的研究。使用Cochrane RoB2工具进行偏倚的质量和风险评估。确定了7项研究:共有582名患者。从三项研究中,荟萃分析显示,伤口完全愈合时间没有显著差异(p=0.06)。从五项研究中进行的荟萃分析强调,在受伤后第7天,蜂蜜敷料使伤口无菌的比例总体上存在显著差异(OR 10.80;95%CI[5.7620.26];p<0.00001;I2=88%)。我们的结论是,蜂蜜敷料在治疗浅表和部分厚度烧伤方面可能与SSD一样或更有效。然而,由于该领域现有研究的质量较低,有必要进行进一步的研究,以确定最佳的烧伤敷料。理想情况下,应根据CONSORT声明以前瞻性三组随机对照试验的形式进行。
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引用次数: 3
HIV Prevalence among Injury Patients Compared to Other High-Risk Groups in Tanzania 坦桑尼亚受伤患者与其他高危人群的HIV患病率比较
Pub Date : 2022-09-09 DOI: 10.3390/traumacare2030041
L. Barcenas, A. Tupetz, S. Behrens, A. Kozhumam, Eleanor Strand, Megan von Isenburg, Philoteus Sakasaka, M. Rubach, J. Vissoci, L. Park, J. Bettger, B. Mmbaga, C. Staton
Sixty-eight percent of persons infected with HIV live in Africa, but as few as 67% of those know their infection status. The emergency department (ED) might be a critical access point to HIV testing. This study sought to measure and compare HIV prevalence in an ED injury population with other clinical and nonclinical populations across Tanzania. Adults (≥18 years) presenting to Kilimanjaro Christian Medical Center ED with acute injury of any severity were enrolled in a trauma registry. A systematic review and meta-analysis was conducted to compare HIV prevalence in the trauma registry with other population groups. Further, 759 injury patients were enrolled in the registry; 78.6% were men and 68.2% consented to HIV counseling and testing. The HIV prevalence was 5.02% (tested), 6.25% (self-report), and 5.31% (both). The systematic review identified 79 eligible studies reporting HIV prevalence (tested) in 33 clinical and 12 nonclinical population groups. Notable groups included ED injury patients (3.53%, 95% CI), multiple injury patients (10.67%, 95% CI), and people who inject drugs (17.43%, 95% CI). These findings suggest that ED injury patients might be at higher HIV risk compared to the general population, and the ED is a potential avenue to increasing HIV testing among young adults, particularly men.
68%的艾滋病毒感染者生活在非洲,但只有67%的人知道自己的感染状况。急诊科(ED)可能是艾滋病病毒检测的重要入口。这项研究试图测量和比较ED损伤人群与坦桑尼亚其他临床和非临床人群的HIV流行率。在乞力马扎罗山基督教医疗中心急诊室就诊的任何严重急性损伤的成年人(≥18岁)被纳入创伤登记。进行了一项系统综述和荟萃分析,将创伤登记处的艾滋病毒流行率与其他人群进行比较。此外,759名受伤患者被纳入登记;78.6%为男性,68.2%同意接受艾滋病毒咨询和检测。HIV感染率分别为5.02%(检测)、6.25%(自我报告)和5.31%(两者均为)。该系统综述确定了在33个临床和12个非临床人群中报告HIV流行率(测试)的79项合格研究。值得注意的组包括ED损伤患者(3.53%,95%置信区间)、多发性损伤患者(10.67%,95%置信度)和注射药物的人(17.43%,95%可信区间)。这些发现表明,与普通人群相比,ED损伤患者可能面临更高的艾滋病毒风险,ED是增加年轻人(尤其是男性)艾滋病毒检测的潜在途径。
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引用次数: 0
Radiographic Evaluation of Distal Radius Fracture Healing by Time: Orthopedist versus Qualitative Assessment of Image Processing 桡骨远端骨折愈合时间的影像学评价:骨科与图像处理的定性评价
Pub Date : 2022-09-05 DOI: 10.3390/traumacare2030040
Maria Oulianski, Dana Avraham, O. Lubovsky
Distal radius fractures are among the most prevalent long-bone fractures in the body. Fracture healing assessment is based on clinical evaluation and radiological examinations. A lack of consensus exists regarding the radiographic criteria for fracture union. Our work examined the commonly used criteria for the assessment of fracture healing. Thirty-two patients, conservatively treated for distal radius fracture, participated in a prospective study. Enrolled patients followed protocol for 26 weeks. Four orthopedic surgeons with similar ranks were asked to evaluate three parameters of radiographic measurements for each set of radiographs, including callus formation, the presence of a fracture line, and bridging of fracture sites or sites of fracture edges in 70 radiographs. Ten patients were eligible for the study. The degree of agreement among surgeons was “good” (Cronbach’s alpha): callus formation—0.8, bridging of fracture sites—0.775, blurring of fracture line gap—0.795. A timeline based on the specific week and grading system was made. Radiographic detection of callus formation was seen after the second film, between 6 and 9 weeks, and an agreement among surgeons was achieved for more than half of the patients for the blurring of the fracture gap. The radiographic healing progression of the distal radius can be detected after 6 and 9 weeks in all three parameters with good agreement between different surgeons. A timeline graph such as the one that was made in this model can be used for the follow-up of patients’ fracture healing or early detection of non-union.
桡骨远端骨折是人体中最常见的长骨骨折之一。骨折愈合评估是基于临床评估和放射学检查。关于骨折愈合的影像学标准缺乏共识。我们的工作检查了评估骨折愈合的常用标准。32例保守治疗桡骨远端骨折的患者参与了一项前瞻性研究。入组患者遵循方案26周。要求四名级别相似的骨科医生评估每组x线片的三个x线测量参数,包括70张x线片上的骨痂形成、骨折线的存在以及骨折部位或骨折边缘的桥接。10名患者符合研究条件。外科医生的一致程度为“良好”(Cronbach’s alpha):骨痂形成- 0.8,骨折部位桥接- 0.775,骨折线间隙模糊- 0.795。根据具体的周数和分级制度制定了时间表。第二次平片后,在6 - 9周之间,可以看到骨痂形成的x线检查,超过一半的患者的骨折间隙模糊,外科医生达成了一致。在6周和9周后可以检测到桡骨远端愈合的影像学进展,这三个参数在不同的外科医生之间有很好的一致性。该模型制作的时间轴图可用于随访患者骨折愈合情况或早期发现骨不连。
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引用次数: 1
Recognizing Resilience in Children: A Review 认识儿童的复原力:综述
Pub Date : 2022-08-11 DOI: 10.3390/traumacare2030039
Emily Smith Schafer
Resilience is having the necessary capacity and/or resources available to recover from an external or internal threat to one’s (personal assessment of) well-being at a particular moment. This scoping literature review examines current research on resilience, framing it within the Relational Developmental Systems theory and emphasizing contributing environmental factors, individual characteristics, and their mutual interaction and influence on resilience in children. Practice and policy implications are also discussed.
复原力是指在某一特定时刻,从外部或内部威胁中恢复的必要能力和/或可用资源。本文回顾了当前关于弹性的研究,将其纳入关系发展系统理论,并强调了环境因素、个体特征及其相互作用和对儿童弹性的影响。实践和政策的影响也进行了讨论。
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引用次数: 1
Isolated Gluteus Maximus Tear of a Middle-Aged Fitness Coach; A Case Report 中年健身教练孤立性臀大肌撕裂病例报告
Pub Date : 2022-08-05 DOI: 10.3390/traumacare2030038
Abdelkader Shekhbihi, M. Pfeiffer, Mohammad A Masoud, W. Reichert
Background: Injuries of the hip extensors are not uncommon, with those of the hamstrings being frequent among athletes. On the contrary, isolated injuries of the gluteus maximus muscle have been barely reported in the literature. Case Report: We present a case of a 63-year-old male water aerobics trainer with an acute tear of the right gluteus maximus tendon and describe the clinical presentation, imaging studies, surgical treatment, and functional outcome one year after surgery.
背景:髋关节伸肌损伤并不少见,其中腘绳肌损伤在运动员中较为常见。相反,文献中很少报道臀大肌的孤立损伤。病例报告:我们报告了一例63岁男性水上有氧训练者,右臀大肌腱急性撕裂,并描述了临床表现,影像学研究,手术治疗和手术后一年的功能结果。
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引用次数: 0
期刊
Trauma care (Basel, Switzerland)
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