892 resultados para thorax penetrating trauma


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This project has investigated how the architecture of the blood vessels supplying nutrients to skeletal muscles is affected by muscle contusion injuries, and how it changes during healing with or without initial treatment of the injury by icing. In order to do this, we used contrast agents to visualise blood vessels in 3D with micro-computed tomography imaging. This research significantly contributes to the fields of orthopaedics, traumatology and sports medicine, as it improves our understanding of muscle contusion injuries. Furthermore, the methods developed in this thesis may help to improve the diagnosis and monitoring of these injuries.

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The occurrence and nature of civilian firearm- and explosion-injuries in Finland, and the nature of severe gunshot injuries of the extremities were described in seven original articles. The main data sources used were the National Hospital Discharge Register, the Cause-of-Death Register, and the Archive of Death Certificates at Statistics Finland. The present study was population based. Epidemiologic methods were used in six and clinical analyses in five papers. In these clinical studies, every original hospital record and death certificate was critically analyzed. The trend of hospitalized firearm injuries has slightly declined in Finland from the late 1980s to the early 2000s. The occurrence decreased from 5.1 per 100 000 person-years in 1990 to 2.6 in 2003. The decline was found in the unintentional firearm injuries. A high incidence of unintentional injuries by firearms was characteristic of the country, while violence and homicides by firearms represented a minor problem. The incidence of fatal non-suicidal firearm injuries has been stable, 1.8 cases per 100 000 person-years. Suicides using firearms were eight times more common during the period studied. This is contrary to corresponding reports from many other countries. However, the use of alcohol and illegal drugs or substances was detected in as many as one-third of the injuries studied. The median length of hospitalization was three days and it was significantly associated (p<0.001) with the type of injury. The mean length of hospital stay has decreased from the 1980s to the early 2000s. In this study, there was a special interest in gunshot injuries of the extremities. From a clinical point of view, the nature of severe extremital gunshot wounds, as well as the primary operative approach in their management, varied. The patients with severe injuries of this kind were managed at university and central hospital emergency departments, by general surgeons in smaller hospitals and by cardiothoracic or vascular surgeons in larger hospitals. Injuries were rarities and as such challenges for surgeons on call. Some noteworthy aspects of the management were noticed and these should be focused on in the future. On the other hand, the small population density and the relatively large geographic area of Finland do not favor high volume, centralized trauma management systems. However, experimental war surgery has been increasingly taught in the country from the 1990s, and excellent results could be expected during the present decade. Epidemiologically, explosion injuries can be considered a minor problem in Finland at present, but their significance should not be underestimated. Fatal explosion injuries showed up sporadically. An increase occurred from 2002 to 2004 for no obvius reason. However, in view of the historical facts, a possibility for another rare major explosion involving several people might become likely within the next decade. The national control system of firearms is mainly based on the new legislations from 1998 and 2002. However, as shown in this study, there is no reason to assume that the national hospitalization policies, or the political climate, or the legislation might have changed over the study period and influenced the declining development, at least not directly. Indeed, the reason for the decline to appear in the incidence of unintentional injuries only remains unclear. It may derive from many practical steps, e.g. locked firearm cases, or from the stability of the community itself. For effective reduction of firearm-related injuries, preventive measures, such as education and counseling, should be targeted at recreational firearm users. To sum up, this study showed that the often reported increasing trend in firearm as well as explosion-related injuries has not manifested in Finland. Consequently, it can be recognized that, overall, the Finnish legislation together with the various strategies have succeeded in preventing firearm- and explosion-related injuries in the country.

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Stone Baby: An Exploration of Affect and Trauma in Visual Art was held at the Block, QUT Creative Industries Precinct on August 27-28, 2014. At the conclusion of my Masters project, this exhibition was a showcase of the outcomes of my material and digital explorations in the form of installation, sculpture and film. My primary motivation can be described as a relational and ethical attempt to find a balance between the erotic and the aggressive. This is experienced in the self as feelings of attraction and repulsion in response to the new and unknown "other". Consequently creative practice is necessarily a complex affair that is experienced as a completely immersive and self-contained psychological space. It is within this space that both physical sensation and raw emotion are able to tangibly and conceptually interact with psychoanalytic theory, and concrete materials video and sound.

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Objective: To describe the prevalence and demographic, clinical and functional correlates of childhood trauma in patients attending early psychosis clinics. Method: Participants were recruited from outpatients attending four early psychosis services. Exposure to childhood trauma was assessed using the Childhood Trauma Questionnaire (CTQ). Psychopathology was measured using the Positive and Negative Syndrome Scale and the Depression, Anxiety and Stress Scale. Social and vocational functioning and substance use were also assessed. Results: Over three-quarters of the 100 patients reported exposure to any childhood trauma. Emotional, physical and sexual abuse were reported by 54%, 23% and 28% of patients, respectively, while 49% and 42% of patients reported emotional and physical neglect, respectively. Female participants were significantly more likely to be exposed to emotional and sexual abuse. Exposure to childhood trauma was correlated with positive psychotic symptoms and higher levels of depressive, anxiety and stress symptoms; however, it had no impact on social or vocational functioning or recent substance use. Conclusion: Exposure to childhood trauma was common in patients with early psychosis, and associated with increased symptomatology. Existing recommendations that standard clinical assessment of patients with early psychosis should include inquiry into exposure to childhood trauma are supported.

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The purpose of this work is to use the concepts of human time and cultural trauma in a biographical study of the turning points in the recent history of Estonia. This research is primarily based on 148 in-depth biographical interviews conducted in Estonia and Sweden in 1995-2005, supplemented by excerpts from 5 collections and 10 individually published autobiographies. The main body of the thesis consists of six published and of two forthcoming separate refereed articles, summarised in the theoretical introduction, and Appendix of the full texts of three particular life stories. The topic of the first article is the generational composition and the collective action frames of anti-Soviet social mobilisation in Estonia in 1940-1990. The second article details the differentiation of the rites of passage and the calendar traditions as a strategy to adapt to the rapidly changed political realities, comparatively in Soviet Estonia and among the boat-refugees in Sweden. The third article investigates the life stories of the double-minded strategic generation of the Estonian-inclined Communists, who attempted to work within the Soviet system while professing to uphold the ideals of pre-war Estonia. The fourth article is concentrated on the problems of double mental standards as a coping strategy in a contradictory social reality. The fifth article implements the theory of cultural trauma for the social practice of singing nationalism in Estonia. The sixth article bridges the ideas of Russian theoreticians concerning cultural dialogue and the Western paradigm of cultural trauma, with examples from Estonian Russian life stories. The seventh article takes a biographical look at the logic of the unraveling of cultural trauma through four Soviet decades. The eighth article explores the re-shaping of citizen activities as a strategy of coping with the loss of the independent nation state, comparatively in Soviet Estonia and among Swedish Estonians. Cultural trauma is interpreted as the re-ordering of the society s value-normative constellation due to sharp, violent, usually political events. The first one under consideration was caused by the occupations of the Republic of Estonia by the Soviet army in 1940-45. After half a century of suppression the memories of these events resurfaced as different stories describing the long-term, often inter-generational strategies of coping with the value collapse. The second cultural trauma is revealed together with the collapse of the Soviet power and ideology in Estonia in 1991. According to empirical data, the following three trauma discourses have been reconstructed: - the forced adaptation to Soviet order of the homeland Estonians; - the difficulty of preserving Estonian identity in exile (Sweden); - the identity crisis of the Russian population of Estonia. Comparative analyses of these discourses have shown that opposing experiences and worldviews cause conflicting interpretations of the past. Different social and ethnic groups consider coping with cultural trauma as a matter of self-defence and create appropriate usable pasts to identify with. Keywords: human time, cultural trauma, frame analysis, discourse, life stories

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Ballast fouling is created by the breakdown of aggregates or outside contamination by coal dust from coal trains, or from soil intrusion beneath rail track. Due to ballast fouling, the conditions of rail track can be deteriorated considerably depending on the type of fouling material and the degree of fouling. So far there is no comprehensive guideline available to identify the critical degree of fouling for different types of fouling materials. This paper presents the identification of degree of fouling and types of fouling using non-destructive testing, namely seismic surface-wave and ground penetrating radar (GPR) survey. To understand this, a model rail track with different degree of fouling has been constructed in Civil engineering laboratory, University of Wollongong, Australia. Shear wave velocity obtained from seismic survey has been employed to identify the degree of fouling and types of fouling material. It is found that shear wave velocity of fouled ballast increases initially, reaches optimum fouling point (OFP), and decreases when the fouling increases. The degree of fouling corresponding after which the shear wave velocity of fouled ballast will be smaller than that of clean ballast is called the critical fouling point (CFP). Ground penetrating radar with four different ground coupled antennas (500 MHz, 800 MHz, 1.6 GHz and 2.3 GHz) was also used to identify the ballast fouling condition. It is found that the 800 MHz ground coupled antenna gives a better signal in assessing the ballast fouling condition. Seismic survey is relatively slow when compared to GPR survey however it gives quantifiable results. In contrast, GPR survey is faster and better in estimating the depth of fouling. (C) 2011 Elsevier B.V. All rights reserved.

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Identification and mapping of crevasses in glaciated regions is important for safe movement. However, the remote and rugged glacial terrain in the Himalaya poses greater challenges for field data collection. In the present study crevasse signatures were collected from Siachen and Samudra Tapu glaciers in the Indian Himalaya using ground-penetrating radar (GPR). The surveys were conducted using the antennas of 250 MHz frequency in ground mode and 350 MHz in airborne mode. The identified signatures of open and hidden crevasses in GPR profiles collected in ground mode were validated by ground truthing. The crevasse zones and buried boulder areas in a glacier were identified using a combination of airborne GPR profiles and SAR data, and the same have been validated with the high-resolution optical satellite imagery (Cartosat-1) and Survey of India mapsheet. Using multi-sensor data, a crevasse map for Samudra Tapu glacier was prepared. The present methodology can also be used for mapping the crevasse zones in other glaciers in the Himalaya.

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The crack tip driving force of a crack growing from a pre-crack that is perpendicular to and terminating at an interface between two materials is investigated using a linear fracture mechanics theory. The analysis is performed both for a crack penetrating the interface, growing straight ahead, and for a crack deflecting into the interface. The results from finite element calculations are compared with asymptotic solutions for infinitesimally small crack extensions. The solution is found to be accurate even for fairly large amounts of crack growth. Further, by comparing the crack tip driving force of the deflected crack with that of the penetrating crack, it is shown how to control the path of the crack by choosing the adhesion of the interface relative to the material toughness.

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O presente trabalho investiga os diferentes processos sociais relacionados ao surgimento do transtorno de estresse pós-traumático (TEPT) no contexto brasileiro. Categoria diagnóstica norte-americana instituída na década de 1980 pela terceira edição do Manual Diagnóstico e Estatístico de Transtornos Mentais (Diagnostic and Statistical Manual of Mental Disorders DSM-III) uma publicação da Associação Americana de Psiquiatria (American Psychiatric Association APA) o TEPT tornou-se, desde a sua aparição, uma das categorias nosológicas mais difundidas, estudadas e diagnosticadas da psiquiatria contemporânea. A partir do cotidiano de um laboratório de pesquisa e tratamento do TEPT, de análises conversacionais dos atendimentos médicos, de um estudo das diferentes escalas psiquiátricas utilizadas no acompanhamento dos pacientes e de pesquisas sobre a mídia relacionada às experiências traumáticas buscou-se entender os entrelaçamentos entre os processos de difusão e a construção da legitimidade da categoria diagnóstica do TEPT. A abordagem aqui proposta pretende ir além do aparente dilema entre uma concepção medicalizada que assumem a existência o TEPT como um fenômeno natural e as abordagens sócio-antropológicas que veem o TEPT como uma experiência culturalmente construída. Por fim, pretendo mostrar, pela investigação dos alicerces políticos e culturais dos denominados transtornos mentais, que o estatuto social dos diagnósticos e dos tratamentos da moderna psiquiatria só pode ser compreendido tendo como referência as dinâmicas de longo prazo nas sociedades contemporâneas.

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O transtorno de estresse pós-traumático (TEPT) é um transtorno de ansiedade que pode ser desenvolvido após a ocorrência de um evento traumático, e que costuma vir acompanhado de um significativo comprometimento da qualidade de vida. Indivíduos diagnosticados com o TEPT apresentam níveis de frequência cardíaca mais elevados em situações de exposição a eventos estressores, como sons e imagens que relembram a experiência traumática. No entanto, estudos que avaliaram a frequência cardíaca no momento do trauma como preditor do desenvolvimento de TEPT não apresentam resultados consistentes. Os objetivos deste trabalho foram: verificar se frequência cardíaca (FC) peritraumática de repouso, após exposição ao trauma, é um fator preditor para o desenvolvimento do TEPT e para a gravidade dos sintomas de TEPT em adultos. Foi realizada uma revisão sistemática, seguida de metanálise, utilizando-se as bases eletrônicas PUBMED, LILACS, PILOTS, PsycoINFO e Web of Science. Foram incluídos 17 estudos nesta revisão sistemática. Os resultados de dez estudos foram utilizados para a metanálise das diferenças de médias de FC combinada. Oito estudos foram utilizados para a metanálise das correlações entre a FC e a gravidade dos sintomas de TEPT. Modelos de meta-regressão foram ajustados para identificar variáveis que pudessem explicar a heterogeneidade entre os estudos. A FC peritraumática no grupo de pacientes com TEPT é, em média, 3,98 batimento por mimuto (bpm) (p=0,04) maior em comparação com aqueles sem o transtorno, e o coeficiente de correlação de Pearson combinado foi de 0,14 (p=0,05).Consistente com a hipótese levantada, a frequência cardíaca peritraumática de repouso foi maior em indivíduos que desenvolveram o TEPT. Contudo, mensuração mais próxima do evento traumático e a exclusão de casos dissociativos poderão ampliar a magnitude do efeito encontrado, tornando este biomarcador simples e facilmente obtido um preditor clinicamente útil do desenvolvimento de TEPT.

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The leakage mechanism of GaN-based p-i-n (p-AlGaN/i-GaN/n-GaN) UV detector has been investigated. With the same dislocation density, devices made from material with higher density of V-pits on surface produce larger leakage current. SEM images show that some V-pits penetrate into i-GaN layer, sometimes even the n-GaN layer. If p-ohmic contact metal (Ni/Au) deposits in the V-pits, Schottky contact would be formed at the interface of metal and i-GaN, or form ohmic contact at the interface of metal and n-GaN. The existence of parallel Schottky junction and ohmic contact resistance enhances the leakage current greatly.