Reduced heart rate responding to trauma reliving in trauma survivors with PTSD: correlates and consequences

The authors investigated whether heart rate (HR) responses to voluntary recall of trauma memories (a) are related to posttraumatic stress disorder (PTSD), and (b) predict recovery 6 months later. Sixty-two assault survivors completed a recall task modeled on imaginal reliving in the initial weeks postassault. Possible cognitive modulators of HR responsivity were assessed; dissociation, rumination, trauma memory disorganization. Individuals with PTSD showed a reduced HR response to reliving compared to those without PTSD, but reported greater distress. Notably, higher HR response but not self-reported distress during reliving predicted greater symptom reduction at follow-up in participants with PTSD. Engagement in rumination was the only cognitive factor that predicted lower HR response. The data are in contrast to studies using trauma reminders to trigger memories, which have found greater physiological reactivity in PTSD. The authors' observations are consistent with models of PTSD that highlight differences between cued or stimulus-driven retrieval and intentional trauma recall, and with E B. Foa and M.J. Kozak (1986) hypothesis that full activation of trauma memories facilitates emotional processing.

The Article 51 reporting requirement for self-defense actions

This article examines one legal criterion for the exercise of the right of self-defense that has been significantly overlooked by commentators: the so-called “reporting requirement.” Article 51 of the United Nations (UN) Charter provides, inter alia, that “[m]easures taken by members in the exercise of this right of self-defense shall be immediately reported to the Security Council.” Although the requirement to report all self-defense actions to the Council is clearly set out in Article 51, the Charter offers no further guidance with regard to this obligation. Reference to the practice of states since the UN’s inception in 1945 is therefore essential to understanding the scope and nature of the reporting requirement. As such, this article is underpinned by an extensive original dataset of reporting practice covering the period from January 1, 1998 to December 31, 2013. We know from Article 51 that states “shall” report, but do they, and—if so—in what manner? What are the various implications of reporting, of failing to report, and of the way in which states report? How are reports used, and by whom? Most importantly, this article questions the ultimate value of states reporting their self-defense actions to the Security Council in modern interstate relations.

Does stakeholder pressure influence corporate GHG emissions reporting? Empirical evidence from Europe

Purpose – The purpose of this paper is to seek to shed light on the practice of incomplete corporate disclosure of quantitative Greenhouse gas (GHG) emissions and investigates whether external stakeholder pressure influences the existence, and separately, the completeness of voluntary GHG emissions disclosures by 431 European companies. Design/methodology/approach – A classification of reporting completeness is developed with respect to the scope, type and reporting boundary of GHG emissions based on the guidelines of the GHG Protocol, Global Reporting Initiative and the Carbon Disclosure Project. Logistic regression analysis is applied to examine whether proxies for exposure to climate change concerns from different stakeholder groups influence the existence and/or completeness of quantitative GHG emissions disclosure. Findings – From 2005 to 2009, on average only 15 percent of companies that disclose GHG emissions report them in a manner that the authors consider complete. Results of regression analyses suggest that external stakeholder pressure is a determinant of the existence but not the completeness of emissions disclosure. Findings are consistent with stakeholder theory arguments that companies respond to external stakeholder pressure to report GHG emissions, but also with legitimacy theory claims that firms can use carbon disclosure, in this case the incomplete reporting of emissions, as a symbolic act to address legitimacy exposures. Practical implications – Bringing corporate GHG emissions disclosure in line with recommended guidelines will require either more direct stakeholder pressure or, perhaps, a mandated disclosure regime. In the meantime, users of the data will need to carefully consider the relevance of the reported data and develop the necessary competencies to detect and control for its incompleteness. A more troubling concern is that stakeholders may instead grow to accept less than complete disclosure. Originality/value – The paper represents the first large-scale empirical study into the completeness of companies’ disclosure of quantitative GHG emissions and is the first to analyze these disclosures in the context of stakeholder pressure and its relation to legitimation.

Våld på jobbet : Beskrivningar av våld i arbetslivet 1978–2004 i facklig press

Violence at work as a social problem: a study of the media coverage on workplace violence in Swedish trade union journals 1978–2004 The main purpose of this study was to find out the extent of the unions media coverage on workplace violence and the ways in which the topic was framed. The study shows that the reporting of violence in the workplace described in journals is on a stable level during the period 1978–98. However from the year 2000 and onwards, there is a clear increase in the attention. Four categories of workplace violence were used to identify and recognize different types of violence: intrusive-, consumer-, relationship-and organizational violence. This shows that much of the attention over time has shifted from intrusive violence to organizational violence and consumer violence. What seems to have happened is that workplace violence has become more than just robberies and assaults in the retail business. The stereotypical image of the criminal is challenged by non-traditional criminals like nurses, elderly people and companies. Certain groups, e.g. care workers, come to account for an increasing proportion of attention, both as perpetrators and victims of violence. This study is an important step in understanding the increased reports of workplace violence in Sweden.

Hiperglicemia no perioperatório de pacientes pediátricos submetidos à ressecção de tumores do sistema nervoso central: incidência e prognóstico

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Estudo de acidentes com motocicletas no município de Presidente Prudente no ano de 2003

Pós-graduação em Saúde Coletiva - FMB

Intraoperative Cardiac Arrest and Mortality in Trauma Patients. A 14-Yr Survey from a Brazilian Tertiary Teaching Hospital

Background: Little information on the factors influencing intraoperative cardiac arrest and its outcomes in trauma patients is available. This survey evaluated the associated factors and outcomes of intraoperative cardiac arrest in trauma patients in a Brazilian teaching hospital between 1996 and 2009.Methods: Cardiac arrest during anesthesia in trauma patients was identified from an anesthesia database. The data collected included patient demographics, ASA physical status classification, anesthesia provider information, type of surgery, surgical areas and outcome. All intraoperative cardiac arrests and deaths in trauma patients were reviewed and grouped by associated factors and also analyzed as totally anesthesia-related, partially anesthesia-related, totally surgery-related or totally trauma patient condition-related.Findings: Fifty-one cardiac arrests and 42 deaths occurred during anesthesia in trauma patients. They were associated with male patients (P<0.001) and young adults (18-35 years) (P = 0.04) with ASA physical status IV or V (P<0.001) undergoing gastroenterological or multiclinical surgeries (P<0.001). Motor vehicle crashes and violence were the main causes of trauma (P<0.001). Uncontrolled hemorrhage or head injury were the most significant associated factors of intraoperative cardiac arrest and mortality (P<0.001). All cardiac arrests and deaths reported were totally related to trauma patient condition.Conclusions: Intraoperative cardiac arrest and mortality incidence was highest in male trauma patients at a younger age with poor clinical condition, mainly related to uncontrolled hemorrhage and head injury, resulted from motor vehicle accidents and violence.

As marcas da memória na escrita de As meninas de Lygia Fagundes Telles

Pós-graduação em Estudos Literários - FCLAR

Trauma traqueal associado à fratura mandibular: relato de caso

Introduction: The mandibular injuries account for about 20% to 50% of cases of facial fractures. Some consider the jaw the second most commonly fractured bone of the skull, and is the only mobile bone of the facial framework, which results in decreased stability compared to the trauma. When one takes into account the degree of airway obstruction in patients with facial fractures, the problem becomes much more serious since it is one of the most troubling complications of trauma. Objective: the relevance of the topic is aimed to report a case of a patient victim of mandibular fracture associated with trauma to the trachea. Case report: Case report: Patient 24 years old patient with tracheal trauma concomitant mandibular fracture surgically treated in conjunction with the thoracic surgeon. After 5 months postoperatively, the patient is in good condition general, no complaints. Final comments: This form is observed that the key to proper treatment of tracheal trauma associated with facial fractures is the knowledge of the type of injury, and an accurate diagnosis multidisciplinary.

Multiple trauma in a 5 years child with a longitudinal follow up

Dental-alveolar trauma in the primary dentition associated with intra-cranial injuries is not common. This article reports the management of a complex trauma involving cranial trauma and multiple luxations and avulsions of primary teeth in a five-year old boy as a consequence of a horse kick. The treatment, including the hospital intervention and dentistry procedures, is described. The clinical outcomes are reported at a 5-year follow-up.

Notificação de violência contra criança: conhecimento e comportamento dos profissionais de saúde

Introduction: The violence against children and teenagers severely damages physical health and psychological development of their victims. Health professionals are in a strategic position to detect cases of assault and legally obliged to report such cases, even suspected. Objectives: This study aimed to assess the knowledge of health professionals who work in the National Health System (SUS) on reporting of violence against children and adolescents. Methods: We conducted interviews with 54 primary care team of four cities from the region of São José do Rio Preto. Results: Through the study could be seen that 92.6% of respondents suspected or witnessed violence against children exercising their profession in the SUS. About Order 1968/2001, 75.5% of practitioners claim ignoring it. 96.2% were not informed about completing the notification form of violence. 88.9% do not know about the existence of the same workplace. The association between obtaining information on work and the act of notification was significant (p = 0.0276). Conclusion: The professionals are still unaware of the legal issues related to notification. It is suggested that the training of them to deal with the bureaucratic side of the issue, once notify contributes to the delineation of the epidemiology of violence and consequent development of public policies

Negativi di memoria. La rappresentazione del trauma nel romanzo del Novecento. Samuel Beckett, Georges Perec, Agota Kristof

Oggetto di questa tesi è l’analisi delle modalità di rappresentazione del trauma nel romanzo del Novecento e, in particolare, nelle opere di Samuel Beckett, Georges Perec e Agota Kristof. Fondamento dello studio sarà una disamina dei procedimenti linguistici e narrativi di rappresentazione del trauma nelle prose degli autori citati, al fine tracciare le linee di un’estetica in grado di descrivere le caratteristiche peculiari delle narrazioni in cui la dimensione antinarrativa della memoria traumatica assume il ruolo di principio estetico guida. L’analisi si soffermerà sulla cruciale relazione esistente, in tutti e tre gli autori, tra rappresentazione del trauma e sviluppo di strategie narrativi definibili come “denegative”. L’analisi dei testi letterari è condotta sulla base del corpus critico dei Trauma Studies, dell’ermeneutica della narrazione di stampo ricœuriano e della teoria del linguaggio psicoanalitica e affiancata, ove possibile, da uno studio filologico-genetico dei materiali d’autore. Alla luce di tali premesse, intendo rivalutare il carattere rappresentativo e testimoniale della letteratura del secolo scorso, in contrasto con la consuetudine a vedere nel romanzo novecentesco il trionfo dell’antimimesi e il declino del racconto. Dal momento che le narrazioni traumatiche si costruiscono intorno e attraverso i vuoti di linguaggio, la tesi è che siano proprio questi vuoti linguistici e narrativi (amnesie, acronie, afasie, lapsus, omissioni e mancanze ancora più sofisticate come nel caso di Perec) a rappresentare, in modo mimetico, la realtà apparentemente inaccessibile del trauma. Si tenterà di dimostrare come questi nuovi canoni di rappresentazione non denuncino l’impossibilità del racconto, bensì una sfida al silenzio, celata in più sottili e complesse convenzioni narrative, le quali mantengono un rapporto di filiazione indiretto − per una via che potremmo definire denegativa − con quelle del romanzo tradizionale.

[CONSORT 2010 Explanation and Elaboration: updated guidelines for reporting parallel group randomised trials (Chinese version)]

Overwhelming evidence shows the quality of reporting of randomised controlled trials (RCTs) is not optimal. Without transparent reporting, readers cannot judge the reliability and validity of trial findings nor extract information for systematic reviews. Recent methodological analyses indicate that inadequate reporting and design are associated with biased estimates of treatment effects. Such systematic error is seriously damaging to RCTs, which are considered the gold standard for evaluating interventions because of their ability to minimise or avoid bias. A group of scientists and editors developed the CONSORT (Consolidated Standards of Reporting Trials) statement to improve the quality of reporting of RCTs. It was first published in 1996 and updated in 2001. The statement consists of a checklist and flow diagram that authors can use for reporting an RCT. Many leading medical journals and major international editorial groups have endorsed the CONSORT statement. The statement facilitates critical appraisal and interpretation of RCTs. During the 2001 CONSORT revision, it became clear that explanation and elaboration of the principles underlying the CONSORT statement would help investigators and others to write or appraise trial reports. A CONSORT explanation and elaboration article was published in 2001 alongside the 2001 version of the CONSORT statement. After an expert meeting in January 2007, the CONSORT statement has been further revised and is published as the CONSORT 2010 Statement. This update improves the wording and clarity of the previous checklist and incorporates recommendations related to topics that have only recently received recognition, such as selective outcome reporting bias. This explanatory and elaboration document-intended to enhance the use, understanding, and dissemination of the CONSORT statement-has also been extensively revised. It presents the meaning and rationale for each new and updated checklist item providing examples of good reporting and, where possible, references to relevant empirical studies. Several examples of flow diagrams are included. The CONSORT 2010 Statement, this revised explanatory and elaboration document, and the associated website (www.consort-statement.org) should be helpful resources to improve reporting of randomised trials.

CONSORT 2010 Explanation and Elaboration: Updated guidelines for reporting parallel group randomised trials

Overwhelming evidence shows the quality of reporting of randomised controlled trials (RCTs) is not optimal. Without transparent reporting, readers cannot judge the reliability and validity of trial findings nor extract information for systematic reviews. Recent methodological analyses indicate that inadequate reporting and design are associated with biased estimates of treatment effects. Such systematic error is seriously damaging to RCTs, which are considered the gold standard for evaluating interventions because of their ability to minimise or avoid bias. A group of scientists and editors developed the CONSORT (Consolidated Standards of Reporting Trials) statement to improve the quality of reporting of RCTs. It was first published in 1996 and updated in 2001. The statement consists of a checklist and flow diagram that authors can use for reporting an RCT. Many leading medical journals and major international editorial groups have endorsed the CONSORT statement. The statement facilitates critical appraisal and interpretation of RCTs. During the 2001 CONSORT revision, it became clear that explanation and elaboration of the principles underlying the CONSORT statement would help investigators and others to write or appraise trial reports. A CONSORT explanation and elaboration article was published in 2001 alongside the 2001 version of the CONSORT statement. After an expert meeting in January 2007, the CONSORT statement has been further revised and is published as the CONSORT 2010 Statement. This update improves the wording and clarity of the previous checklist and incorporates recommendations related to topics that have only recently received recognition, such as selective outcome reporting bias. This explanatory and elaboration document-intended to enhance the use, understanding, and dissemination of the CONSORT statement-has also been extensively revised. It presents the meaning and rationale for each new and updated checklist item providing examples of good reporting and, where possible, references to relevant empirical studies. Several examples of flow diagrams are included. The CONSORT 2010 Statement, this revised explanatory and elaboration document, and the associated website (www.consort-statement.org) should be helpful resources to improve reporting of randomised trials.