Treatment Of Trauma Research Articles

Fast examination and interventional ultrasound in the diagnosis and treatment of combat abdominal trauma

To improve the diagnosis and surgical treatment of wounded patients with combat abdominal trauma by methods of emergency ultrasound diagnostics and minimally invasive surgery under the control of ultrasound. The purpose of the work is to improve the results of diagnosis and surgical treatment of wounded patients with combat abdominal trauma by emergency ultrasound examination techniques and minimally invasive surgical interventions under ultrasound control. A clinical and statistical analysis of the results of the surgical treatment of 293 wounded patients with combat abdominal trauma treated at the Military Medical Clinical Centre of the Southern Region was conducted. In the main group, additional therapeutic and diagnostic measures were performed — focused assessment with sonography in trauma (FAST), puncture rehabilitation and drainage surgery under the control of ultrasound. In the main group, in contrast to the control group, FAST examination was conducted in all wounded patients. The widespread introduction of the FAST examination and diagnostic punctures under ultrasound control into diagnostics reduces the level of more traumatic diagnostic laparocentesis from 24.7 to 2.2% and unreasonable surgical interventions from 3.2 to 0.7 %. An algorithm of diagnostic and therapeutic measures for wounded patients with combat abdominal trauma based on the results of the FAST examination was developed. The data obtained indicate that the widespread implementation of FAST, percutaneous puncture and sanitation interventions under ultrasound control in the diagnosis and treatment of combat abdominal trauma and its complications helps to reduce the number of invasive and more traumatic (often useless) interventions, which leads to faster recovery and shorter treatment time.

Evaluation ofGender Disparity inTactical Combat Casualty Care.

Women comprise nearly 19% of the U.S. military and now serve in almost all operational roles, increasing their risk of combat trauma and injuries.3 Data from the Joint Trauma Registry during Operation Enduring Freedom shows that battle-injured females had a higher case fatality rate at 36% compared to their male counterparts at 17%.1 The Tactical Combat Casualty Care curriculum is used to prepare battlefield medics to provide immediate care to wounded service members, but fails to address differences in the care of female versus male casualties. The students, who are presented with life-threatening injuries in simulated trauma scenarios, may be slower to assess, identify, and treat injuries in female patients as compared with male patients. This observational program analysis was reviewed by the Uniformed Services University Human Research Protections Program and approved for execution as an exempt protocol under the provision of 32 CFR 219.104(d)(1). The study assessed the performance of male and female Mexican military personnel during a Tactical Combat Casualty Care course, using standardized trauma scenarios. Anatomically, correct male and female manikins were used to compare response time for different gender patients presenting with the same injuries. There was a statistically significant increase in time required to complete an initial blood sweep, identify a gunshot wound to the chest, and call for medical evacuation when treating a female patient compared to a male patient. A lack of female representation in trauma training may have contributed to the higher case fatality rate of female soldiers compared to male soldiers during Operation Enduring Freedom. Female live actors and Gender Retrofit Kits can augment trauma casualty assessment and treatment training scenarios and better prepare our forces to respond to life-threatening emergencies.

Mental Health in the Shadow of the Holocaust: Psychological Interventions in Jewish Displaced Persons Camps

This study interrogates the historical methodology that underpins research undertaken by historians writing about mental health in the postwar world. I question their near-exclusive reliance on medical elites’ studies, correspondence and reports, and call instead for a closer analysis of the experiences of front-line workers, including social workers and nurses, to better understand the social, political, cultural, economic and gender dynamics that shape the diagnosis and treatment of civilian wartime trauma. Drawing upon the case reports and correspondence of a psychiatric social worker who counselled Holocaust survivors in a Displaced Persons camp in the American Zone of Allied-occupied Germany, I use this article as an opportunity to rethink how we write about the history of trauma and mental health.

A pilot study of trauma-sensitive yoga and Breathe2Relax among service members in an intensive outpatient program

ABSTRACT Emerging research indicates that yoga is a promising adjunct to psychological trauma treatment. The current pilot study examined the associations between psychophysiological stress, diaphragmatic breathing (DB), and a trauma-sensitive yoga (TSY) regimen developed specifically for trauma-exposed service members in alignment with recent calls for precision in reporting therapeutic yoga protocols. Participants were 31 service members enrolled in a trauma-focused intensive outpatient program (IOP). Service members participated in a brief diaphragmatic breathing (DB) session using the Breathe2Relax (B2R) app followed by the TSY session. Heart rate (HR) and perceived stress were measured at baseline and after both the DB practice and the TSY session. We assessed Yoga and DB expectancies at baseline and post TSY. Participants also rated the acceptability and usability of the B2R app. Results of linear mixed effects regression models showed decreases in HR and perceived stress, compared to baseline, following DB (HR, b = −8.68, CI 95% = −13.34, −4.02; perceived stress, b = −1.77, CI 95% = −2.35, −1.18) and TSY (HR, b = −12.44, CI 95% = −17.15, −7.73; perceived stress b = −3.69, CI 95% = −4.29, −3.08). Higher levels of expectancies, compared to lower levels, related to stronger decreases in HR and perceived stress, particularly after TSY. Overall, participants rated the B2R usability as high; virtually all participants reported that “most would learn to use the app quickly,” and 76.6% reported that they would use it frequently.

MINIMAL INVASIVE FOR MAXIMAL RECOVERY IN DENTAL TRAUMA : A CASE REPORT

Introduction: Dentoalveolar fractures can be treated in a simple non-surgical procedure by repositioning the fractured fragments and immobilizing them. One of the factors affecting the success of dentoalveolar fracture treatment is the choice of material and immobilization technique. Case: A 16-year-old girl came to the Emergency Department with complaints of bleeding from the mouth due to a traffic accident 5 hours ago. Her lip hit the handlebar of a motorcycle. There was no history of fainting, vomiting, and bleeding from the ears and nose. Extraoral examination revealed an asymmetrical face. Edema and laceration on the upper lip. Intraoral examination revealed gingival laceration of teeth 12-22 and avulsion of teeth 12,22. Panoramic x-ray revealed supra position of teeth 11, 21 and avulsion of teeth 12, 22. Case Management: Wound debridement, indirect root canal treatment of teeth 12, 22, repositioning of teeth 12-22, fixation with wire and composite splinting, selective grinding, antibiotics, and analgesics were performed. Post-operative instructions included maintaining oral hygiene, a soft diet, and a return for splinting control. Discussion: The goal of dentoalveolar trauma treatment is to restore the normal function and shape of the masticatory organs. The treatment in this case uses flexible splinting because it has ability to resemble the physiological mobility condition of the teeth which can help the healing of the periodontal ligament. The treatment results showed soft and hard tissue healing after one month of treatment. Conclusion: Successful treatment of dentoalveolar fractures will be achieved if performed promptly and if accurate immobilization and accurate tools are used. Simple tools and techniques make flexible splinting a good treatment for simple dentoalveolar fractures.

The Potential of Mind-Body Medicine for Prevention and Treatment of Stress and Trauma

The Potential of Mind-Body Medicine for Prevention and Treatment of Stress and Trauma

COMPARATIVE ANALYSIS OF CONSERVATIVE AND SURGICAL TREATMENT OUTCOMES IN PATIENTS WITH DIAPHYSEAL HUMERUS FRACTURES

The frequency of diaphyseal humerus fractures varies from 1% to 5% of the total number of skeletal fractures in humans. A clear bimodal gender and age distribution of patients with fractures in the studied area has been established. The main methods of treatment for closed intra-articular humerus fractures are conservative functional and surgical treatment. Treatment of diaphyseal humerus trauma involves not only restoring the axis and length of the bone but also ensuring sufficient mobility of adjacent joints. The aim of the study was to conduct a comparative analysis of the outcomes of conservative and surgical treatment in patients with diaphyseal humerus fractures. The study involved 57 patients with diaphyseal humerus fractures aged from 19 to 83 years. The first clinical group comprised of 24 patients aged from 24 to 80 years who were treated using functional fixation devices. The second clinical group consisted of 33 patients aged from 19 to 83 years who were treated using surgical techniques, namely antegrade locked intramedullary nailing and cortical plate and screw osteosynthesis. Rehabilitation measures were initiated within the first two days for patients in the first group and in the early postoperative period for patients in the second group. The range of motion of adjacent joints was assessed using the CMS and MEPS scales. The use of surgical treatment techniques in combination with early rehabilitation measures, compared to conservative functional treatment, allows achieving significantly higher and statistically significant (p<=0.01) functional outcomes of elbow joint mobility.

Facial artery: anatomical variations in the perioral region in cadavers.

In recent years, there has been an increase in reports of perioral vascular complications resulting from filler injections, such as necrosis of the lip or alar rim, occlusion, and in severe cases, blindness. Conversely, the use of perioral arterial flaps is becoming more prevalent in the treatment of cleft lips, cancer, and trauma. A thorough understanding of perioral arteries is essential to minimize complications and maximize the success of these flaps. However, the course of the facial artery (FA) in the perioral region remains incompletely understood. The aim of this study was to describe the variations of the FA in the perioral region. We dissected 52 embalmed and formaldehyde-fixed Vietnamese cadavers. We then studied the size and distribution of perioral arteries in 102 specimens. The superior labial artery (SLA) was the most common branch, occurring in 87.25% of cadavers, followed by the inferior labial artery (ILA) at 78.43%. The SLA primarily originated above the mouth corner (cheilion), accounting for 91.01% of cases, and predominantly exhibited a tortuous course within the submucosa (78.65%). The ILA's branching pattern varied, but it was primarily located below the cheilion (91.25%). The ILA also followed a twisted path, generally within the submucosa. The ILA exhibited two patterns: the typical pattern, distributed at the vermilion border of the lower lip (8.82%), and the horizontal labiomental artery pattern, which ran horizontally in the middle of the lower lip area (69.61%). At their origin, the SLA and ILA had average external diameters of 1.29 mm and 1.28 mm, respectively. Numerous anatomical variations in the FA in the perioral region were found. A detailed anatomic description, suggested landmarks, and angiography before the procedure will be useful to help doctors avoid complications.

COMPARATIVE ANALYSIS OF ORTHOPEDIC TRAUMA INTERVENTIONS: A REGISTRY-BASED STUDY ON TREATMENT OUTCOME

Musculoskeletal injuries represent a substantial public health challenge, significantly burdening healthcare providers and hospitals in developing nations. Efficiently managing the diagnosis and treatment of these injuries can result in cost savings in healthcare and a reduction in the duration of preventable disabilities among affected patients. This study aimed to analyze and compare the treatment outcomes of various orthopedic trauma interventions. In this retrospective cohort study conducted at the SMBB Institute of Trauma, a Tertiary Care Hospital, between January 2017 and December 2021, 4557 limb injuries sustained by 4557 patients were investigated. The study included patients with both upper and lower limb trauma. Detailed information regarding the injuries, trauma management strategies, and subsequent outcomes was meticulously extracted from the patient's medical records. Data analysis was conducted using SPSS version 27 to uncover relevant patterns and insights in the management and outcomes of these limb injuries. A total of 4557 patients with 4557 limb injuries were enrolled in the study. The incidence of upper and lower limb injuries was 24.5% (n=1108) and 75.5% (n=3449), respectively. Surgical intervention was employed in 4191 (92%) cases, while the remaining 366 (8%) were managed conservatively. Open reduction and internal fixation (ORIF) were the most common surgical procedure performed, accounting for 1441 cases (34.4%), followed by Intramedullary Nailing with 491 cases (11.7%) and external fixation in 434 cases (10.4%). The overall mortality rate was 16 (0.35%), among which 10 cases were not associated with either the trauma itself or its management. The assessment of outcomes associated with injuries identifies potential areas of trauma care that require enhancement and suggests strategies to reduce the mortality rate. Registry data has the potential to aid in the formulation of preventative strategies and enhance the effectiveness of management protocols.

The bidirectional associations between caregiver and child symptoms in the parent-led treatment stepping together for children after trauma

BackgroundAn innovative approach to child trauma treatment in which caregivers are allocated treatment tasks has shown promising results, but less is known about the bidirectional associations between caregiver and child symptoms during treatment. MethodsEighty-two child-caregiver dyads who participated in the parent-led therapist-assisted Stepping Together for Children after Trauma (ST-CT) were included (child age: 7–12 years, mean = 9.9 years). Caregivers' emotional reactions and anxiety/depression and children's posttraumatic stress (PTS) and depression were assessed pretreatment, mid-treatment, and posttreatment. We investigated the possible directional associations between caregivers' emotional reactions and anxiety/depression and children's PTS and depression using random intercept cross-lagged panel models. ResultsSymptoms improved in both caregivers and children. Lower levels of caregiver emotional reactions at pretreatment predicted improved child PTS at mid-treatment; lower levels of caregiver emotional reactions at mid-treatment predicted improved child depression at posttreatment; and lower levels of child PTS at mid-treatment predicted improved caregiver emotional reactions at posttreatment. ConclusionsThese findings suggest that caregivers and children can impact each other's responses to a parent-led child trauma-focused treatment. Notably, children with caregivers who were less affected by their own emotional reactions exhibited greater improvement in both PTS and depression. Supporting the caregivers may benefit both children and caregivers. Clinical trial registrationClinicalTrials.gov NCT04073862; https://clinicaltrials.gov/ct2/show/NCT04073862.

Demography, Clinical Features and Outcome of Bacterial Keratitis Presenting in Tertiary Eye Care in Nepal

Background and Objectives: Bacterial keratitis is an important cause of ocular morbidity in developing country like Nepal and this warrants a detail study of it including its outcome.
 Material and Methods: Data of demography, clinical features and risk factors of bacterial keratitis were segregated from our previous cross-sectional study of microbial keratitis and retrospective data of treatment and outcome were taken from electronic medical record.
 Results: Among 123 cases of bacterial keratitis, 111 had bacteria isolated in the culture whereas 12 had bacteria seen only in Gram stain. Average age of patients was 52.6 years; 65(52.8%) were female; 68.3% of total subjects were farmers. Patients had visited the tertiary hospital at an average of 12.9 days since onset of symptoms. Of culture isolates, 55 were Streptococcus pneumonia followed by Staphylococcus aureus (n­­=25) and Streptococcus viridians (n=14). Regarding clinical characteristics, 78(63.4%) cases had hypopyon; 24.3% (n=30) had infiltrate size of >¼ of corneal surface; 16(13.0%) were either perforated or impending to perforate at presentation. Trauma was the main risk factor in 35% (n=43), followed by topical steroid (19.5%, n=24) and dacryocystitis (16.2%, n=20). Patients were treated with combination of fortified cefazoline and amikacin or monotherapy with moxifloxacin or ofloxacin. Overall, 90(73.2%) responded to medical treatment, 19(15.4%) underwent therapeutic penetrating keratoplasty and 3(2.4%) needed evisceration. Smaller sized ulcers had better healing rates (81%) with statistical significance.
 Conclusion: Patients with bacterial ulcers present late in tertiary eye center causing increased morbidity and even loss of eyes. Awareness, protective measures from trauma and proper treatment has to be undertaken for controlling its occurrence and for better prognosis of the ulcers.

Timing of imagery rescripting during schema therapy for borderline personality disorder: the LUCY trial.

Early childhood adversity plays an important role in the etiology of borderline personality disorder (BPD). Current evidence suggests that trauma treatment for patients with BPD can be performed safely and that early trauma treatment has a positive effect on the course of PD. However, there is a scarcity of RCTs comparing the effects of the timing of trauma treatment during schema therapy (ST) for BPD on BPD severity. Therefore, the LUCY trial investigates the effects of the timing of trauma treatment by comparing early trauma treatment using imagery rescripting (ImRs) on the course of BPD during ST to trauma treatment in the middle of the treatment course. In this multicenter RCT, two conditions are compared among 73 individuals with BPD. The participants receive combined individual and group ST in both conditions. However, in condition (A), participants directly start ImRs in the individual sessions in months 2-4, and in condition (B), participants receive ST-as-Usual (STAU), in which ImRs is not allowed during months 2-4. The treatment follows ST treatment protocols, consists of a fixed combination of individual sessions and group sessions with a maximum of nine patients, and has a maximum duration of 25 months. The primary outcome is change in BPD severity, which is assessed using the Borderline Personality Disorder Severity Index-5 by independent raters blinded to the treatment. Secondary outcome measures include treatment retention, disconnection/rejection schemas, general functioning, posttraumatic stress disorder symptoms, general psychopathological complaints, quality of life, happiness, schemas, and schema modes. Multilevel analysis will be performed to analyze and compare changes in BPD severity between conditions and generalized linear mixed model analyses to test predictors and moderators. This study will increase the knowledge on whether trauma treatment early in therapy positively affects the course of BPD manifestations during ST. When the early application of ImRs leads to a faster decrease in BPD manifestations, the treatment of BPD patients might be shortened, leading to improved treatment outcomes and decreased healthcare expenses. Moreover, the planned sub-studies will expand our knowledge of how ST works and the factors that influence the outcome of treatment.

Addressing experiences of trauma within Indigenous-focused substance use residential treatment: a systematic review and environmental scan

Indigenous individuals in Canada disproportionally experience higher rates of substance use concerns. This study examined clinical practices currently implemented with Indigenous-led residential treatment facilities to simultaneously address substance use and post-traumatic stress. A systematic review of relevant literature retrieved published approaches to address these concurrent disorders with Indigenous individuals. This review retrieved 35 sources related to trauma and substance use treatment among Indigenous individuals or communities. Among these sources, all leveraged cultural approaches as a dual treatment for trauma symptoms and substance use. Inconsistent results were reported among those sources (n = 3) who analyzed comparisons with wait-list controls or used randomized-controlled designs. Using culture-as-treatment was elaborated upon in the second goal of this study: an environmental scan of Indigenous-led treatment programs and qualitative interviews with 10 treatment center staff to understand how programs may address both substance use and traumatic symptoms among Indigenous-led substance use treatment centers across Canada. When we searched the websites of these centers, we found that approximately 38% (16 of 43) of treatment centers discussed implementing some form of treatment that addressed trauma symptoms in conjunction with primary substance use. Among the 10 staff participants, all discussed how trauma can impede client success in treatment, and ACE-specific programming is useful within their respective treatment programs. Results showed that when manualized treatments are used, they must be adapted to meet the specific needs of Indigenous communities, and culture-as-treatment is a popular approach among Indigenous-led treatment centers, particularly for addressing trauma symptoms.

Pancreatic Trauma; Surgical Management, 4 Cases Reported

Pancreatic traumas are rare, but particularly serious. Its management involves diagnostic and therapeutic difficulties. The mechanism of injury generally corresponds to crush injuries or direct trauma during public road accidents. They most often occur during polytrauma and the associated lesions then determine the prognosis and treatment methods. In stable patients, an imaging assessment using CT, magnetic resonance imaging, or even endoscopic retrograde pancreatography determines the type and topography of pancreatic lesions and specifies the damage of the main pancreatic duct, which accounts for the seriousness of the pancreatic trauma. The treatment of pancreatic trauma essentially depends on the integrity or not of the Wirsung duct. Treatment can be solely medical, but above all surgical and endoscopic when canal is damaged. There is report of 4 patient observations who were treated in the surgical emergency department at Annaba Algeria University Hospital during the year 2023 for isolated trauma of the pancreas. There are diagnostic circumstances and description of therapeutic conduct and the surgical consequences.

Epidemiology of limb trauma interventions in France: Current state and future projections

ContextThe distributions and projections of trauma, treated according to the anatomical region, have not been studied in France. The objectives of this study were to obtain French epidemiological data specific to trauma procedures in orthopedic surgery, as well as to establish a statistical trend on the evolution of medical and surgical procedures resulting from this, since 2013 and over the years to come. Our hypothesis was that an increasing trend in trauma procedures since 2013 exists, with an epidemiological forecast of a continuing increase over 50 years, mainly in the context of the management of osteoporotic fractures related to the ageing French population. Material and methodsWe conducted a retrospective study using national data to obtain completion of procedures between the start of 2013 and the end of 2021. ResultsFrom 2013 to 2021, we noted a total of 5,216,567 procedures related to orthopedic traumatology for an average of 579,618 procedures per year. We noted an overall increase in all procedures, continuing from 2013 to 2019, with an average annual increase of 1.125%. The most commonly performed procedure was osteosynthesis, with an average of 276,989 procedures per year. This was followed by wound sutures with an average of 185,023 procedures, orthopedic reductions of fractures and/or dislocations at an average of 62,960, then arthroplasties with 25,425 procedures per year, musculotendinous ruptures were 19,755 procedures per year, surgical reductions of fractures and/or dislocations represented 6920 procedures per year, and fasciotomies with 2848 procedures. From 2013 to 2021, there was an annual average of 276,989 osteosynthesis procedures. Open osteosynthesis, with an average of 146,547 procedures per year, represented 55% of osteosynthesis procedures. Fractures of the proximal end of the femur represented 79,549 procedures on average per year, including 46,621 (58%) involving the trochanter, while 32,852 (41%) were of the femoral neck. Wrist fractures accounted for an annual average of 55,300. Hand fractures represented an annual average of 38,444, of which 52.2% were closed (17,778). On average, 1000 fractures per year involved the carpus without scaphoid involvement, and 2177 scaphoid fractures. Ankle fractures represented 37,951 procedures on average per year, including 74% of the malleolar complex (28,199). Leg fractures represented 17,613 procedures per year, 58% tibial diaphysis (10,091), 41% tibial plateau (6,857). The strengths of this study are the exhaustiveness of the data, presenting all the Common Classification of Medical Procedures (CCAM) chosen during the defined period. ConclusionThis study allowed us to establish, to our knowledge, the first epidemiological database of French orthopedic traumatology. Level of evidenceIV; epidemiological descriptive study.

The association of adverse family experiences, physical activity,and depression in a national sample of US adolescents.

Sufficient engagement in physical activity could foster resilience in adolescents and help alleviate the impact of adverse family experiences (AFEs), such as depression. However, the association between cumulative AFEs exposure, physical activity, and depression remains unclear. The aims of this study are to determine the relationship between AFEs and adolescent depression and whether physical activity moderates this relationship. Secondary analyses were conducted on 29,617 adolescents aged 12-17 years from the 2016-2017 National Survey of Children's Health. Binomial logistic regression was used to examine the relationship among AFEs, child depression, and physical activity. Covariates include individual-level, social-level, and societal-level factors. This study reveals that 7.3% of US adolescents had a depression diagnosis. The odds of having a depression diagnosis among US children were 1.6 times (adjusted OR: 1.6, 95%CI: 1.37-1.86) greater for adolescents with one type of AFEs, and 3.4 times greater (adjusted OR: 3.39, 95%CI: 2.78-4.13) for adolescents with three or more AFEs, compared with children living without AFEs. Physical activity for 1-3 days per week remained a significant, substantial protector of childhood depression among children with at least one type of AFEs (adjusted OR: 0.73, 95%CI: 0.62-0.87). These results suggest a clinical concern for adolescents with more AFEs. Trauma-informed care to address multiple types of trauma and physical activity interventions to reduce depression symptoms may be particularly important.

Expert consensus on emergency open wound irrigation

Wound irrigation is one of the most effective means to prevent open wound infection after injury. Wound irrigation can reduce the risk of wound infection and promote wound healing by removing the cell fragments, surface bacteria, dressings residues, residual foreign body and wound exudates loosely attached to the wound. The effect of wound irrigation mainly depends on the pressure of irrigation, the direction of fluid flow, the type of liquid, temperature and volume/amount of irrigation fluid. In response to the phenomenon that emergency open wounds are not irrigated in a standardized manner in China, the Posttraumatic Special Infections and Biting Injury Study Group of the Trauma Surgeons Branch of the Chinese Medical Doctor Association and the Animal Injury Treatment Branch of China Association for Disaster and Emergency Rescue Medicine organized domestic experts in the fields of emergency department and trauma treatment centers to collect the latest clinical evidence of emergency open wound irrigation, and wrote this consensus with reference to relevant guidelines, consensus and the clinical experience of Chinese experts. The consensus summarized the important factors affecting wound irrigation and put forward 10 recommendations to improve the knowledge and skills of trauma emergency medical personnel in wound irrigation.

Sexual Objectification Racial Microaggressions Amplify the Positive Relation Between Sexual Assault and Posttraumatic Stress Among Black Women

Black women report higher rates of adult sexual assault (ASA) and sexual objectification compared to White women. Sexual objectification serves as a reminder that Black women's bodies are viewed as sexual objects based on racist/sexist ideologies, though trauma research rarely includes race-specific stressors. In this study, we examined sexual objectification racial microaggressions as a moderator of the relation between ASA severity and posttraumatic stress disorder (PTSD) symptoms among Black women. Data were collected from 129 Black college and community women ( Mage = 33.84). ASA severity was associated with greater overall PTSD symptoms and symptom clusters. The interaction between ASA severity and sexual objectification microaggressions was associated with greater PTSD symptoms and the PTSD symptom cluster, negative alterations in cognition and mood. ASA severity was associated with PTSD at mean and high sexual objectification racial microaggressions but not low levels. Associations with other PTSD symptom clusters were not significant. Findings suggest sexual objectification racial microaggressions amplify the positive relation between ASA and PTSD symptoms, specifically symptoms related to cognition and mood. It is essential that clinicians assess for race-specific stressors during trauma interventions to help reduce mental health disparities. Post-assault interventions should be tailored with multiculturally sensitive practices to address the ways racial discrimination can exacerbate trauma symptoms.

Trauma-informed care within residential aged care settings: A systematic scoping review.

The importance of trauma-informed care (TIC) within residential aged care (RAC) settings has been increasingly recognised. TIC would ensure that older people who have experienced trauma over their lifetime have their needs better understood and accommodated. This scoping review examined the extent to which TIC has been applied within RAC settings. A scoping review was conducted according to Cochrane recommendations and the PRISMA-ScR checklist. A systematic search of six databases (Embase, Emcare, CENTRAL, CINAHL, PsychInfo and Medline) was performed in July 2022 and March 2023 and peer-reviewed primary research, in English and involved RAC staff or residents (aged 65years and over) providing or receiving TIC were eligible for inclusion. Studies focused on trauma intervention, assessment, screening, or treatment were excluded. Thematic synthesis was performed to extract themes relating to trauma-informed practice, barriers and enablers to TIC, and outcomes from the application of TIC approaches. Five articles were included. There was little evidence of the implementation of TIC interventions in RAC settings. Only one study examined the application of a TIC framework in a RAC setting. However, there was some evidence that approaches that consider resident's experience of trauma have emerged from practice experience and been used in RAC as an extension of person-centred care. Whilst trauma-informed approaches to resident care are emerging through practice experience, and despite policy recommendations to do so, there is little evidence that formal TIC interventions or frameworks have been applied to RAC internationally. This study highlights a gap in research and practice and makes several recommendations for further research and implementation of TIC in RAC.

Parent-led therapist-assisted treatment for childhood trauma: Caregivers’ and children’s perceptions of trauma exposure activities and changes.

Parent-led therapist-assisted treatment for childhood trauma: Caregivers’ and children’s perceptions of trauma exposure activities and changes.