A survey of dental and oral trauma in south-east Queensland during 1998

Background: This project investigated the aetiology of dental and oral trauma in a population in southeast Queensland. The literature shows there is a lack of dental trauma studies which are representative of the general Australian population. Method: Twelve suburbs in the south-east district of Queensland were randomly selected according to population density in these suburbs for each 25th percentile. All dental clinics in these suburbs were eligible to participate. Patients presenting with dental and oral trauma were eligible to participate. Results: A total of 197 patients presented with dental/oral trauma over a 12 month period. The age of patients ranged from 1-64 years whilst the most frequently presenting age group was 6-10 years. There was a total of 363 injured teeth with an average of 1.8 injured teeth per patient. Males significantly outnumbered females in the incidence of trauma. Conclusions: The highest frequency of trauma occurred in the 6-10 year age group. Most injuries in this group occurred while playing or riding bicycles. In the next most prevalent trauma group, 16-20 years, trauma occurred as a result of fighting and playing sport. Overall, males significantly outnumbered females by approximately 1.8:1.0. The majority of injuries in the deciduous dentition were to periodontal tissues. In the secondary dentition most injuries were to hard dental tissue and pulp.

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.

The Trauma Towers: Dimensions of Trauma in 9/11 Literature

The topic of this dissertation is the aspects of trauma and reaction to the traumatic experience that can be found in 9/11 literature. The research engages in a comparative analysis of five books that can be categorised as 9/11 literature, which means that the events of 9/11 are central in the novels and are a recurrent theme. The books have been written by authors of different nationalities: "Extremely Loud & Incredibily Close" by J. S. Foer, "Falling Man" by D. DeLillo, "Windows on the World" by F. Beigbeder, "Saturday" by I. McEwan and "The Reluctant Fundamentalist" by M. Hamid. The characters have either experienced the attacks personally or their lives have been largely influenced by the event. In either case, the protagonist has been traumatised by the tragedy. Therefore, in this study two different fields are fused together – the field of comparative literature and that of trauma studies.

Aporias of Trauma in Joyce's Ulysses and Faulkner's Light in August

In this thesis, I explore the relationships between trauma, memory, and narrative, particularly the ways in which trauma simultaneously disrupts and engenders narrative structures. I consider various trauma theories by authors such as Cathy Caruth, Judith Herman, Ruth Leys, and Dominick LaCapra. I also consider how psychoanalytic theory and criticism, specifically the writings of Sigmund Freud, inform the study of traumatic experience from both literary and personal perspectives. Furthermore, I consider theories regarding the relationship between trauma and narrative by authors such as Peter Brooks and John Pilkington. James Joyce¿s Ulysses and William Faulkner¿s Light in August serve, for my purposes, as trauma-texts and reflect the ways in which trauma might complicate the simultaneous destruction and creation of narrative strategies. Reading Ulysses and Light in August as trauma-texts that are both in mourning and melancholic gives us complementary, and contradictory, reasons for why we enjoy them. Mourning constructs a relationship between victim and witness, in which we can hear the voice of trauma and engage it in discourse. Conversely, melancholia creates a relationship between performer and spectator, in which we experience, and are fascinated by, the spectacle of another¿s trauma. Laughter, perversity, sorrow, and respite engage the reader in both texts, and raise questions about how one `remembers-to-forget¿ traumatic experiences. The narratives of each text¿s characters offer unique performances of mourning and melancholia. Thus, while this thesis engenders more questions than answers, I hope to argue that Ulysses and Light in August are significant literary works because each engages the reader in traumatic discourse, entertains the reader with the traumatic spectacle, and enlightens the reader on the complex relationship between trauma and narrative.

The Ultimate Secrecy: Feminist Readings of Masculine Trauma in Vietnam War Literature

It is a widely acknowledged and often unquestioned fact that patriarchy and its modes of behaviour and social organization favour the appearance of trauma on the weakest (and defenceless) members of society: women. In the last decades, trauma seems to have taken the baton of typically female maladies such as 19th c. hysteria or 20th c. madness. Feminists in the 20th c. have long worked to prove the connection between the latter affections (and their reflection in literary texts) and patriarchal oppression or expectations of feminine behaviour and accordance to roles and rules. With Trauma Studies on the rise, the approach to the idea of the untold as related to femininity is manifold: on the one hand, is not trauma, which precludes telling about one’s own experience and keeps it locked not only from the others, but also from ourselves, the ultimate secrecy? On the other hand, when analyzing works that reflect trauma, one is astounded by the high number of them with a female protagonist and an almost all-female cast: in this sense, a ‘feminist’ reading is almost compulsory, in the sense that it is usually the author’s assumption that patriarchal systems of exploitation and expectations favour traumatic events and their outcome (silence and secrets) on the powerless, usually women. Often, traumatic texts combine feminism with other analytical discourses (one of the topics proposed for this panel): Toni Morrison’s study of traumatic responses in The Bluest Eye and Beloved cannot be untangled from her critique of slavery; just as much of Chicana feminism and its representations of rape and abuse (two main agents of trauma) analyze the nexus of patriarchy, new forms of post-colonialism, and the dynamics of power and powerlessness in ethnic contexts. Within this tradition that establishes the secrecies of trauma as an almost exclusively feminine characteristic, one is however faced with texts which have traumatized males as protagonists: curiously enough, most of these characters have suffered trauma through a typically masculine experience: that of war and its aftermath. By analyzing novels dealing with war veterans from Vietnam or the Second World War, the astounding findings are the frequent mixture of masculine or even ‘macho’ values and the denial of any kind of ‘feminine’ characteristics, combined with a very strict set of rules of power and hierarchy that clearly establish who is empowered and who is powerless. It is our argument that this replication of patriarchal modes of domination, which place the lowest ranks of the army in a ‘feminine’ situation, blended with the compulsory ‘macho’ stance soldiers are forced to adopt as army men (as seen, for example, in Philip Caputo’s Indian Country, Larry Heinemann’s Paco’s Story or Ed Dodge’s DAU: A Novel of Vietnam) furthers the onset and seriousness of ulterior trauma. In this sense, we can also analyze this kind of writing from a ‘feminist’ point of view, since the dynamics of über-patriarchal power established at the front at war-time deny any display of elements traditionally viewed as ‘feminine’ (such as grief, guilt or emotions) in soldiers. If trauma is the result of a game of patriarchal empowerment, how can feminist works, not only theoretical, but also fictional, overthrow it? Are ‘feminine’ characteristics necessary to escape trauma, even in male victims? How can feminist readings of trauma enhance our understanding of its dynamics and help produce new modes of interaction that transcend power and gender division as the basis for the organization of society?

Sleeping Beauty in Chelmno: Jane Yolen's Briar Rose or Breaking the Spell of Silence

AbstractThis article analyses Jane Yolen's Briar Rose (1992) from the perspective of trauma studies as a novelistic transposition of "Sleeping Beauty" in the context of the Holocaust. It argues that the fairy tale fulfils a psychological and even existential role for the fictional survivor of the extermination camp, but also a pedagogical, moral and political one through the figure of the cowitness central to the economy of the novel. Through Becca's recovery of the biographical elements underlying her grandmother's retelling of the story, Yolen shows how the fairy tale can serve to communicate traumatic personal memories and transmit collective cultural knowledge to counter the disappearance of first-hand witnesses.RésuméCet article analyse le recours au conte de fées dans un roman récent de Jane Yolen, Briar Rose, qui transpose le conte de La Belle au bois dormant dans le contexte de l'Holocauste. A partir des études sur le traumatisme (trauma studies), il montre comment le conte de fées remplit plusieurs rôles: psychologique voire existentiel pour la survivante du camp, mais aussi didactique, politique et moral à travers la figure du co-témoin placée au coeur du dispositif narratif. Yolen fait ainsi appel à deux genres pédagogiques, le conte et la literature de jeunesse sur l'Holocauste comme outils pédagogiques permettant la transmission d'une mémoire individuelle et collective qui problématise la question épineuse de la représentation de l'Holocauste et de la fictionnalisation de l'histoire qui accompagne la disparition des témoins directs.

La resistenza dei legami. Narrazioni e rappresentazioni della famiglia nella trilogia di romanzi “Past Imperfect” (2004-2011) di Nuruddin Farah

Il presente progetto di ricerca riguarda la terza trilogia di romanzi di Nuruddin Farah, “Past Imperfect” (2004-2011). L’analisi dei tre testi che compongono la trilogia – “Links” (2004), “Knots” (2007) e “Crossbones” (2011) – evidenzia la persistente rilevanza delle narrazioni e delle rappresentazioni della famiglia all’interno di tutta la produzione letteraria dell’autore. Questa prospettiva critica richiede l’impiego di una metodologia che riunisce vari aspetti della critica letteraria di matrice post-strutturalista e, per altri versi, di stampo materialista, assecondando così le due principali tendenze critiche presenti all’interno degli studi postcoloniali. Lo stesso approccio teorico-metodologico può essere applicato anche in altri due ambiti critici chiamati in causa dalla trilogia di Nuruddin Farah: la cosiddetta “world literature” e la cosiddetta “failed-state fiction”. L’analisi delle narrazioni e delle rappresentazioni della famiglia richiede, inoltre, un approccio interdisciplinare molto esteso, stimolando ricerche negli ambiti della semiotica, dell’antropologia, della psicanalisi, dei Gender Studies e dei Trauma Studies.

"Que mi nombre no se borre de la historia" : El tratamiento de la guerra civil española en la literatura contemporánea en España: el caso de Las 13 rosas

Uno de los rasgos caracterizadores de la novela de los últimos años del siglo XX es la utilización de episodios traumáticos como escenarios o bases argumentativas bien por su relación con colectivos socialmente "marginados", tales como mujeres o minorías étnicas y culturales, o bien por su relación con episodios políticamente conflictivos, tales como el Holocausto nazi, las dos Guerras Mundiales, o los procesos de descolonización. Este tipo de procesos ficcionales ha sido uno de los principales ámbitos de estudio de los denominados "estudios de trauma" (Trauma Studies), en los que se asocia la trasposición del término y concepto médico del "desorden de estrés postraumático" al ámbito de la literatura y de la teoría crítica literaria. Así, en la última década se pueden encontrar en la literatura europea ejemplos de novelas en las que se intenta mostrar los efectos devastadores de los conflictos bélicos que enfrentaron a individuos del mismo país, de la misma ciudad e incluso de la misma familia. En España también se ha adoptado esta tendencia, y se puede decir que la guerra civil española ha tomado protagonismo en la producción literaria -y cinematográfica- de los últimos años. Cabe destacar dentro de esta producción la utilización de los testimonios de los perdedores de la guerra como una forma de reescribir este hecho histórico, un factor que se puede interpretar como un intento de recuperación de la memoria personal e histórica de quienes vivieron la guerra, intentando abstraerse de los discursos políticos que han permeado los últimos treinta años del siglo XX. Este es el objetivo de esta comunicación, ver cómo este tipo de estrategias son las que subyacen a la ficcionalización de un episodio concreto: el fusilamiento de "las trece rosas", y cómo, a su vez, esta ficcionalización ha permitido que este hecho histórico se convierta en un fenómeno literario y cinematográfico.

"Que mi nombre no se borre de la historia" : El tratamiento de la guerra civil española en la literatura contemporánea en España: el caso de Las 13 rosas

Uno de los rasgos caracterizadores de la novela de los últimos años del siglo XX es la utilización de episodios traumáticos como escenarios o bases argumentativas bien por su relación con colectivos socialmente "marginados", tales como mujeres o minorías étnicas y culturales, o bien por su relación con episodios políticamente conflictivos, tales como el Holocausto nazi, las dos Guerras Mundiales, o los procesos de descolonización. Este tipo de procesos ficcionales ha sido uno de los principales ámbitos de estudio de los denominados "estudios de trauma" (Trauma Studies), en los que se asocia la trasposición del término y concepto médico del "desorden de estrés postraumático" al ámbito de la literatura y de la teoría crítica literaria. Así, en la última década se pueden encontrar en la literatura europea ejemplos de novelas en las que se intenta mostrar los efectos devastadores de los conflictos bélicos que enfrentaron a individuos del mismo país, de la misma ciudad e incluso de la misma familia. En España también se ha adoptado esta tendencia, y se puede decir que la guerra civil española ha tomado protagonismo en la producción literaria -y cinematográfica- de los últimos años. Cabe destacar dentro de esta producción la utilización de los testimonios de los perdedores de la guerra como una forma de reescribir este hecho histórico, un factor que se puede interpretar como un intento de recuperación de la memoria personal e histórica de quienes vivieron la guerra, intentando abstraerse de los discursos políticos que han permeado los últimos treinta años del siglo XX. Este es el objetivo de esta comunicación, ver cómo este tipo de estrategias son las que subyacen a la ficcionalización de un episodio concreto: el fusilamiento de "las trece rosas", y cómo, a su vez, esta ficcionalización ha permitido que este hecho histórico se convierta en un fenómeno literario y cinematográfico.

"Que mi nombre no se borre de la historia" : El tratamiento de la guerra civil española en la literatura contemporánea en España: el caso de Las 13 rosas

Uno de los rasgos caracterizadores de la novela de los últimos años del siglo XX es la utilización de episodios traumáticos como escenarios o bases argumentativas bien por su relación con colectivos socialmente "marginados", tales como mujeres o minorías étnicas y culturales, o bien por su relación con episodios políticamente conflictivos, tales como el Holocausto nazi, las dos Guerras Mundiales, o los procesos de descolonización. Este tipo de procesos ficcionales ha sido uno de los principales ámbitos de estudio de los denominados "estudios de trauma" (Trauma Studies), en los que se asocia la trasposición del término y concepto médico del "desorden de estrés postraumático" al ámbito de la literatura y de la teoría crítica literaria. Así, en la última década se pueden encontrar en la literatura europea ejemplos de novelas en las que se intenta mostrar los efectos devastadores de los conflictos bélicos que enfrentaron a individuos del mismo país, de la misma ciudad e incluso de la misma familia. En España también se ha adoptado esta tendencia, y se puede decir que la guerra civil española ha tomado protagonismo en la producción literaria -y cinematográfica- de los últimos años. Cabe destacar dentro de esta producción la utilización de los testimonios de los perdedores de la guerra como una forma de reescribir este hecho histórico, un factor que se puede interpretar como un intento de recuperación de la memoria personal e histórica de quienes vivieron la guerra, intentando abstraerse de los discursos políticos que han permeado los últimos treinta años del siglo XX. Este es el objetivo de esta comunicación, ver cómo este tipo de estrategias son las que subyacen a la ficcionalización de un episodio concreto: el fusilamiento de "las trece rosas", y cómo, a su vez, esta ficcionalización ha permitido que este hecho histórico se convierta en un fenómeno literario y cinematográfico.

Silence and writing: the voices that inhabit us (Woolf, Duras, Perec, Celati)

My thesis investigates the forms, modalities and issues related to the notion of 'silence' in the texts and poetics of Virginia Woolf, Marguerite Duras, Georges Perec and Gianni Celati. This study relates to the 20th century European context and is set within the framework of music-literary studies, since silence is an acoustic phenomenon that concerns the whole word, thus also the written word. The material is structured according to a distribution that firstly involves the construction of a methodological framework that employs music-literary studies, the philosophy of language, the aesthetics of reception and psychoanalytic trauma studies; secondly, an analysis of some of the autobiographical works of the mentioned writers was undertaken, with a particular focus on the notion of trauma associated with silence; thirdly, the focus was placed on the theme of silence in the novelistic and fictional writings of the same authors; finally, a reflection on the poetics and aesthetics of silence was proposed. This study, which brings together several perspectives on silence, aims to shed light, through a comparative and transmedial approach, on the necessity of silence that is inherent in the word, and not a phenomenon opposed to it.

Data quality in trauma transfusion studies and the impact of missing data on predicting massive transfusion

Maximizing data quality may be especially difficult in trauma-related clinical research. Strategies are needed to improve data quality and assess the impact of data quality on clinical predictive models. This study had two objectives. The first was to compare missing data between two multi-center trauma transfusion studies: a retrospective study (RS) using medical chart data with minimal data quality review and the PRospective Observational Multi-center Major Trauma Transfusion (PROMMTT) study with standardized quality assurance. The second objective was to assess the impact of missing data on clinical prediction algorithms by evaluating blood transfusion prediction models using PROMMTT data. RS (2005-06) and PROMMTT (2009-10) investigated trauma patients receiving ≥ 1 unit of red blood cells (RBC) from ten Level I trauma centers. Missing data were compared for 33 variables collected in both studies using mixed effects logistic regression (including random intercepts for study site). Massive transfusion (MT) patients received ≥ 10 RBC units within 24h of admission. Correct classification percentages for three MT prediction models were evaluated using complete case analysis and multiple imputation based on the multivariate normal distribution. A sensitivity analysis for missing data was conducted to estimate the upper and lower bounds of correct classification using assumptions about missing data under best and worst case scenarios. Most variables (17/33=52%) had <1% missing data in RS and PROMMTT. Of the remaining variables, 50% demonstrated less missingness in PROMMTT, 25% had less missingness in RS, and 25% were similar between studies. Missing percentages for MT prediction variables in PROMMTT ranged from 2.2% (heart rate) to 45% (respiratory rate). For variables missing >1%, study site was associated with missingness (all p≤0.021). Survival time predicted missingness for 50% of RS and 60% of PROMMTT variables. MT models complete case proportions ranged from 41% to 88%. Complete case analysis and multiple imputation demonstrated similar correct classification results. Sensitivity analysis upper-lower bound ranges for the three MT models were 59-63%, 36-46%, and 46-58%. Prospective collection of ten-fold more variables with data quality assurance reduced overall missing data. Study site and patient survival were associated with missingness, suggesting that data were not missing completely at random, and complete case analysis may lead to biased results. Evaluating clinical prediction model accuracy may be misleading in the presence of missing data, especially with many predictor variables. The proposed sensitivity analysis estimating correct classification under upper (best case scenario)/lower (worst case scenario) bounds may be more informative than multiple imputation, which provided results similar to complete case analysis.^

Adaptação transcultural e consistência interna do Early Trauma Inventory (ETI)

As experiências traumáticas precoces são um fator de risco preditivo de problemas psicopatológicos futuros. O Early Trauma Inventory (ETI) é um instrumento que avalia em indivíduos adultos experiências traumáticas ocorridas antes dos 18 anos de idade. Tal instrumento foi traduzido, transculturalmente adaptado e sua consistência interna foi avaliada. Vítimas de violência que preencheram os critérios de inclusão e exclusão foram submetidas a uma entrevista diagnóstica (SCID-I) e ao ETI. Foram incluídos 91 pacientes com o transtorno do estresse pós-traumático (TEPT). O alfa de Cronbach nos diferentes domínios variou de 0,595-0,793, e o escore total foi de 0,878. A maior parte dos itens nos vários domínios, com exceção do abuso emocional, apresentou índices de correlação interitem entre 0,51-0,99. A versão adaptada foi útil tanto na clínica quanto na pesquisa. Apresentou boa consistência interna e na correlação interitem. O ETI é um instrumento válido, com boa consistência para se avaliar a presença de história de traumas precoces em indivíduos adultos.

Intraosseous Anesthesia in Hemodynamic Studies in Children with Cardiopathy

Aliman AC, Piccioni MA, Piccioni JL, Oliva JL, Auler Junior JOC - Intraosseous Anesthesia in Hemodynamic Studies in Children with Cardiopathy. Background and objectives: Intraosseous (IO) access has been used with good results in emergency situations, when venous access is not available for fluids and drugs infusion. The objective of this study was to evaluate IO a useful technique for anesthesia and fluids infusion during hemodynamic studies and when peripheral intravascular access is unobtainable. The setting was an university hospital hemodynamics unit, and the subjects were twenty one infants with congenital heart disease enrolled for elective hemodynamic study diagnosis. Methods: This study compared the effectiveness of IO access in relation to IV access for infusion of anesthetics agents (ketamine, midazolann, and fentanyl) and fluids during hemodynamic studies. The anesthetic induction time, procedure duration, anesthesia recovery time, adequate hydration, and IV and IO puncture complications were compared between groups. Results: The puncture time was significantly smaller in IO group (3.6 min) that in IV group (9.6 min). The anesthetic onset time (56.3 second) for the IV group was faster than IO group (71.3 second). No significant difference between groups were found in relation to hydration (IV group, 315.5 mL vs IO group, 293.2 mL), and anesthesia recovery time (IO group, 65.2 min vs IV group, 55.0 min). The puncture site was reevaluated after 7 and 15 days without signs of infection or other complications. Conclusions: Results showed superiority for IO infusion when considering the puncture time of the procedure. Due to its easy manipulation and efficiency, hydration and anesthesia by IO access was satisfactory for hemodynamic studies without the necessity of other infusion access.