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Trauma Care, Volume 2, Issue 4 (December 2022) – 9 articles

Cover Story (view full-size image): Traumatic brain injury (TBI) is a leading cause of death and disability. In addition to acutely devastating brain injury, TBI is associated with the development of chronic neurodegenerative diseases such as chronic traumatic encephalopathy and Parkinson’s disease. However, the mechanisms by which TBI induces chronic neurodegeneration are poorly understood, hindering the development of advanced diagnostics and therapeutics. In this review, we evaluate the current body of knowledge on chronic neurodegeneration after TBI with an additional emphasis on clinically relevant imaging modalities and translational therapies. View this paper
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11 pages, 256 KiB  
Article
Trauma Care for Forced Migrants
by Nicole Dubus
Trauma Care 2022, 2(4), 600-610; https://doi.org/10.3390/traumacare2040050 - 13 Dec 2022
Cited by 1 | Viewed by 1578
Abstract
Ever since World War II, forced migrations have increased exponentially, shaping our world, economies, and political discussions. When the United Nations formed the United Nations High Commissioner for Refugees (UNHCR) in 1950, it could not predict the escalation of forced migration from civil [...] Read more.
Ever since World War II, forced migrations have increased exponentially, shaping our world, economies, and political discussions. When the United Nations formed the United Nations High Commissioner for Refugees (UNHCR) in 1950, it could not predict the escalation of forced migration from civil unrest, personal persecution, war, and recently, climate crises. As forced migrations increase, we must understand the emotional trauma involved, and how to mitigate it. This study examined how providers of refugee services understand, assess, and treat trauma in the forced migration population. This paper is based on qualitative data collected from social work providers who work with forced migrants. Transcribed interviews were analyzed through content analysis regarding assessment and treatment approaches. The findings show that the lack of trauma-informed care was prevalent among the participants. This was reflected in the participants’ experiences. Three main themes emerged: (1) trauma was misdiagnosed; (2) few were trained in evidence-based practices to manage trauma; and (3) providers felt isolated in their work as if working in silos. These themes and their implications are discussed. Full article
11 pages, 258 KiB  
Concept Paper
Utilization of Presence Awareness in Trauma Therapy
by Michelle M. Lepak
Trauma Care 2022, 2(4), 589-599; https://doi.org/10.3390/traumacare2040049 - 09 Dec 2022
Viewed by 2058
Abstract
Trauma can result in many long-term symptoms including emotional dysregulation, depression, addiction, and PTSD. When triggered by trauma, patients typically experience the world through a myopic lens. Helping clients observe and sense their trauma sequelae in the broader sensory awareness of Presence appears [...] Read more.
Trauma can result in many long-term symptoms including emotional dysregulation, depression, addiction, and PTSD. When triggered by trauma, patients typically experience the world through a myopic lens. Helping clients observe and sense their trauma sequelae in the broader sensory awareness of Presence appears to help clients more easily process and resolve traumatic experience. The Presence Psychotherapy Trauma Protocol (PPTP) provides specific open-ended questions in session to help clients orient to Presence Awareness which can then be utilized to resolve trauma. Options to help clients sense their traumatic experience in the expansive awareness of Grounded Presence, Spacious Presence, Relational Presence, or Transcendent Presence create multiple regulating, processing, and attachment healing opportunities. PPTP’s concept of Reflective View is introduced which provides the clinician with prompts to help the client identify who they are as Presence Awareness early in session. This paper demonstrates, through a case example, how Presence Awareness and specifically Reflective View help clients access, tolerate, and process trauma in a broader sense of Presence Awareness. Full article
10 pages, 359 KiB  
Review
A Preliminary Scoping Review of Trauma Recovery Pathways among Refugees in the United States
by Crispin Rakibu Mbamba, Jennifer Litela Asare and Clinton Gyimah
Trauma Care 2022, 2(4), 579-588; https://doi.org/10.3390/traumacare2040048 - 29 Nov 2022
Cited by 1 | Viewed by 1807
Abstract
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 [...] Read more.
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. Full article
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10 pages, 236 KiB  
Article
Epidemiological Criminology and COVID: A Transdisciplinary Analysis of Violent Crime and Emergency Department Admissions during COVID
by Lindsey Wylie, Julie Garman, Gaylene Armstrong, Ashley Farrens, Jennifer Burt, Mark Foxall, Michael Visenio, Macall Cox, Cynthia Hernandez, Charity Evans and Ashley Ann Raposo-Hadley
Trauma Care 2022, 2(4), 569-578; https://doi.org/10.3390/traumacare2040047 - 23 Nov 2022
Viewed by 1444
Abstract
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 [...] Read more.
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. Full article
13 pages, 577 KiB  
Communication
Trauma-Sensitive Mindfulness for War Refugees: Communication of Preliminary Findings
by Laila Jeebodh-Desai and Veronica M. Dwarika
Trauma Care 2022, 2(4), 556-568; https://doi.org/10.3390/traumacare2040046 - 20 Nov 2022
Viewed by 2604
Abstract
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? [...] Read more.
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. Full article
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6 pages, 419 KiB  
Case Report
Heterotopic Ossification after a Prolonged Course of COVID-19: A Case Report and Review of the Literature
by Jacob E. Milner, Ean C. Schwartz, Joseph S. Geller, David Constantinescu, Paul R. Allegra, Justin E. Trapana and Fernando E. Vilella
Trauma Care 2022, 2(4), 550-555; https://doi.org/10.3390/traumacare2040045 - 18 Oct 2022
Cited by 2 | Viewed by 1716
Abstract
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 [...] Read more.
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. Full article
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15 pages, 1089 KiB  
Article
Exploring Mindful Self-Care as a Potential Mediator between Compassion Satisfaction and Compassion Fatigue among Student Services Professionals
by Portia Jackson Preston, Delia Sanchez and Kathleen Suzanne Johnson Preston
Trauma Care 2022, 2(4), 535-549; https://doi.org/10.3390/traumacare2040044 - 16 Oct 2022
Cited by 2 | Viewed by 2127
Abstract
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 [...] Read more.
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. Full article
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12 pages, 1749 KiB  
Systematic Review
The Efficacy of Honey Compared to Silver Sulfadiazine for Burn Wound Dressing in Superficial and Partial Thickness Burns—A Systematic Review and Meta-Analysis
by Samatar Osman, Hamza Umar, Yousuf Hashmi, Anam Jawaid and Zubair Ahmed
Trauma Care 2022, 2(4), 523-534; https://doi.org/10.3390/traumacare2040043 - 06 Oct 2022
Cited by 4 | Viewed by 6735
Abstract
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 [...] Read more.
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. Full article
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13 pages, 587 KiB  
Review
Traumatic Brain Injury and Secondary Neurodegenerative Disease
by William S. Dodd, Eric J. Panther, Kevin Pierre, Jairo S. Hernandez, Devan Patel and Brandon Lucke-Wold
Trauma Care 2022, 2(4), 510-522; https://doi.org/10.3390/traumacare2040042 - 26 Sep 2022
Cited by 5 | Viewed by 4400
Abstract
Traumatic brain injury (TBI) is a devastating event with severe long-term complications. TBI and its sequelae are one of the leading causes of death and disability in those under 50 years old. The full extent of secondary brain injury is still being intensely [...] Read more.
Traumatic brain injury (TBI) is a devastating event with severe long-term complications. TBI and its sequelae are one of the leading causes of death and disability in those under 50 years old. The full extent of secondary brain injury is still being intensely investigated; however, it is now clear that neurotrauma can incite chronic neurodegenerative processes. Chronic traumatic encephalopathy, Parkinson’s disease, and many other neurodegenerative syndromes have all been associated with a history of traumatic brain injury. The complex nature of these pathologies can make clinical assessment, diagnosis, and treatment challenging. The goal of this review is to provide a concise appraisal of the literature with focus on emerging strategies to improve clinical outcomes. First, we review the pathways involved in the pathogenesis of neurotrauma-related neurodegeneration and discuss the clinical implications of this rapidly evolving field. Next, because clinical evaluation and neuroimaging are essential to the diagnosis and management of neurodegenerative diseases, we analyze the clinical investigations that are transforming these areas of research. Finally, we briefly review some of the preclinical therapies that have shown the most promise in improving outcomes after neurotrauma. Full article
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