Academic literature on the topic 'Trauma agencie'
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Journal articles on the topic "Trauma agencie"
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Hausman, Ken. "Trauma Database Links Agencies, Psychiatrists." Psychiatric News 37, no. 17 (September 6, 2002): 12. http://dx.doi.org/10.1176/pn.37.17.0012.
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Koury, Samantha P., and Susan A. Green. "Developing Trauma-Informed Care Champions: A Six-Month Learning Collaborative Training Model." Advances in Social Work 18, no. 1 (September 24, 2017): 145–66. http://dx.doi.org/10.18060/21303.
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This paper describes a six-month learning collaborative for service providers seeking to implement trauma-informed care (TIC) into their agencies. Although the professional literature on trauma-informed care has grown substantially over the past 10 years, little research has focused on how to effectively train agencies in creating a trauma-informed culture shift. Participants were trained as “TIC champions” to help facilitate the creation of trauma-informed approaches in their agencies. Through a parallel process, they learned the skills for planning and implementing a trauma-informed approach in their agency. At the completion of the training, trainers observed champions becoming more confident in their ability to assist their agencies in creating a trauma-informed culture shift. Though quantitative studies evaluating the learning collaborative are needed, initial findings suggest the collaborative approach is an effective means of guiding champions through the process of becoming trauma-informed.
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Dansiger, Stephen, Roshni Chabra, Lauren Emmel, and Justine Kovacs. "The MET(T)A Protocol: Mindfulness and EMDR Treatment Template for Agencies." Substance Abuse: Research and Treatment 14 (January 2020): 117822182097748. http://dx.doi.org/10.1177/1178221820977483.
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Evidence indicating the relationship between trauma and substance use disorders (SUDs), in addition to relapse and treatment retention rates for this population, suggests there is a need for a trauma-focused solution to treat SUDs. Eye movement desensitization and reprocessing (EMDR) therapy has been studied extensively as an effective approach for treating trauma and Posttraumatic Stress Disorder (PTSD). The research evaluating its treatment for other mental health disorders such as SUDs is promising. Merging mindfulness and ethical mindfulness practices with EMDR therapy lends additional evidence-based elements to make the case for this integrative system of treatment to be studied as a trauma-focused primary psychotherapy to treat SUDs. The resulting treatment, the MET(T)A Protocol (Mindfulness and EMDR Treatment Template for Agencies), has been created to address the need for a trauma-focused solution to treat SUDs. Procedures of the MET(T)A Protocol as applied in each of the 8 phases of EMDR therapy are described in detail. Clinical examples are provided to explain the application of the MET(T)A Protocol.
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Bender, Eve. "Agencies Often Overlook Need To Assess Trauma in Children." Psychiatric News 40, no. 9 (May 6, 2005): 10–50. http://dx.doi.org/10.1176/pn.40.9.00400010.
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Wood, Leila, Dessie Clark, Laurie Cook Heffron, and Rachel Voth Schrag. "Voluntary, Survivor-Centered Advocacy in Domestic Violence Agencies." Advances in Social Work 20, no. 1 (July 30, 2020): 1–21. http://dx.doi.org/10.18060/23845.
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Voluntary, survivor-centered advocacy is a model of practice used in domestic violence organizations; however, more information is needed from the perspective of survivors on how to best facilitate survivor-centered approaches in a voluntary service format. This qualitative study used a thematic analysis to uncover core advocacy approaches from 25 female-identified survivors dwelling in domestic violence emergency shelter and transitional housing programs in two states. Themes revealed that three core approaches aid a voluntary, survivor-centered advocacy model: 1) Establishing a safe base for support, 2) Facilitating access and connection, and 3) Collaboration. Advocacy approaches that emphasize safety, mutuality, and availability of support best engage survivors in voluntary services to address needs and meet goals. Use of a strengths-based approach, psychoeducation, and resource-building contributes to the social and emotional well-being of survivors. Findings indicate community DV advocates should use adaptable advocacy models aimed at service access, connection, and collaborative resource acquisition. Voluntary, survivor-centered models use principals of trauma-informed care, though more widespread use of trauma-informed care (TIC) in voluntary services are needed. Advocates need organizational support to meet survivor needs. Implications for research include the need for fidelity studies and longitudinal research.
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Kusmaul, Nancy, Molly R. Wolf, Shalini Sahoo, Susan A. Green, and Thomas H. Nochajski. "Client Experiences of Trauma-Informed Care in Social Service Agencies." Journal of Social Service Research 45, no. 4 (October 25, 2018): 589–99. http://dx.doi.org/10.1080/01488376.2018.1481178.
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Costa, Deborah A. "Transforming Traumatised Children within NSW Department of Education Schools: One School Counsellor's Model for Practise – REWIRE." Children Australia 42, no. 2 (June 2017): 113–26. http://dx.doi.org/10.1017/cha.2017.14.
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Adequately supporting the needs of maltreated and traumatised children within New South Wales (NSW) public education system schools is often frustrated by poor perception of the impact of developmental trauma on children's school-based functioning and the need for additional, specialist support; the push for, and provision of, behaviour diagnoses for these children to fund basic assistance and supervision; competing demands on an overextended School Counselling resource impacting capacity for school-based trauma informed psychological services, and seemingly stretched capacity of government/non-government agencies to reliably provide effective support. This is accompanied by a lack of understanding of behavioural signals of distress children display and underreporting to agencies; persistent, simplistic behaviourist views of children's behaviours within schools and low-level collaboration between schools and external agencies. Facilitating a trauma sensitive environment within NSW schools can ameliorate these frustrations and attend to these inadequacies in a pragmatic, achievable way. This practice paper presents a School Counsellor-led model (REWIRE) for achieving this.
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Levenson, Jill. "Translating Trauma-Informed Principles into Social Work Practice." Social Work 65, no. 3 (July 1, 2020): 288–98. http://dx.doi.org/10.1093/sw/swaa020.
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Abstract Trauma-informed social work is characterized by client-centered practices that facilitate trust, safety, respect, collaboration, hope, and shared power. Many agencies have adopted trauma-informed care (TIC) initiatives and many social workers are familiar with its basic principles, but it is challenging to infuse these ideals into real-world service delivery. This article offers 10 trauma-informed practices (TIPs) for translating TIC concepts into action by (a) conceptualizing client problems, strengths, and coping strategies through the trauma lens and (b) responding in ways that avoid inadvertently reinforcing clients’ feelings of vulnerability and disempowerment (re-traumatization). TIPs guide workers to consider trauma as an explanation for client problems, incorporate knowledge about trauma into service delivery, understand trauma symptoms, transform trauma narratives, and use the helping relationship as a tool for healing.
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Hernandez-Mekonnen, Robin, and Dawn Konrady. "Title IV-E Child Welfare Training and University Partnerships: Transforming State Child Protection Services into a Trauma-Informed System." Advances in Social Work 18, no. 1 (September 24, 2017): 235–49. http://dx.doi.org/10.18060/21323.
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Children who are involved in the child welfare system have experienced trauma, and research indicates that parents of those children also frequently grapple with their own unresolved trauma. In addition, child welfare workers face high rates of secondary traumatic stress. Federal legislation from 2011 requires states to conduct universal trauma screening on children in foster care. The Administration on Children and Families (ACF) urges state Child Protection agencies (CPS) to become trauma-informed, however, many states still struggle to integrate a trauma focused practice model. This article describes the outcomes of a national, empirically driven, Core Concepts in Child Trauma for Child Welfare curriculum utilized in a Title IV-E university partnership program to teach graduate level child welfare agency supervisors. Findings suggest that the graduate trauma course demonstrates statistically significant gains in confidence, and also has a profound impact on the agency’s transformation into a trauma-informed system
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Braslow, Judith B., and Joan A. Snyder. "Trauma System Development and Future Directions." Prehospital and Disaster Medicine 8, no. 2 (June 1993): 111–14. http://dx.doi.org/10.1017/s1049023x00040152.
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AbstractTraumatic injury, both unintentional and intentional, is a serious public health problem. Trauma care systems play a significant role in reducing mortality, morbidity, and disability due to injuries. However, barriers to the provision of prompt and appropriate emergency medical services still exist in many areas of the United States. Title XII of the Public Health Service Act provides for programs in support of trauma care planning and system development by states and localities. This legislation includes provisions for: 1) grants to state agencies to modify the trauma care component of the state Emergency Medical Services (EMS) plan; 2) grants to improve the quality and availability of trauma care in rural areas; 3) development of a Model Trauma Care System Plan for states to use as a guide in trauma system development; and 4) the establishment of a National Advisory Council on Trauma Care Systems.
Dissertations / Theses on the topic "Trauma agencie"
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Hardman, Tiffany Ann. "Trauma Social Workers' Perspectives on the Response of Rural Social Work Agencies to Vicarious Trauma." ScholarWorks, 2019. https://scholarworks.waldenu.edu/dissertations/6210.
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Social workers are susceptible to the potential negative impacts of vicarious trauma. Perspectives of trauma social workers on the responsiveness of rural social work agencies to vicarious trauma have not been explored even though the trauma-informed care model has been available since 2006 and outlines best practice in all settings of trauma social work. Considering the risk factors and negative effects vicarious trauma has on social workers, an increased understanding of the perspectives of social workers on how rural social work agencies are responding to vicarious trauma was needed. The purpose of this study was to explore this response through consideration of the trauma-informed care principles of safety, trustworthiness, choice, collaboration, and empowerment. The guiding research question was, what are the perspectives of social workers on the response of rural social work agencies on vicarious trauma and self-care. For this narrative study, storytelling was used as a way to understand and answer the research question. Data were collected using purposeful sampling from 10 trauma social workers through face-to-face interviews and analyzed using a coding and theming process. Organizational culture was identified as a suppressive force that has the potential to be a source of support to therapists. The findings support the need for change in organizational practice standards and furthers knowledge about the potential effects of vicarious trauma on clients, agencies, and therapists and how to mitigate those effects. The awareness this study provided to organizational leaders and policy makers has the potential to be the catalyst for positive practice and policy change.
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Peppiatt, A. J. "Self-agency and psychosis : trauma, sense of agency and locus of control." Thesis, University College London (University of London), 2013. http://discovery.ucl.ac.uk/1408028/.
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This thesis is presented in three parts, all of which focus broadly on the experience of agency in relation to psychosis or psychotic-like experiences. Part one, a systematic review of the literature, examines whether ‘sense of agency’, a subjective awareness of intentional actions, is altered in psychosis and evaluates the evidence for different models proposed to explain such alterations. The evidence suggests SoA is altered in psychosis in a number of ways and is associated with delusions of control and other psychotic phenomena. The research with non-clinical populations, however, is less clear. Several methodological limitations were identified. Future research and clinical implications are considered. Part two is an empirical paper that investigates whether different levels of self-agency - namely, action awareness (sense of agency) and a higher order level of agency (locus of control) - are related. It also explores the potential mechanisms by which self-agency alterations contribute to the development of psychotic-like experiences. External LoC was found to mediate the relationship between childhood trauma and psychotic-like experiences. The two levels of agency (SoA and LoC) were not associated. Part three, a critical appraisal of the research, discusses conceptual and methodological issues that arose and the implications for future research in the area of agency experiences. In addition, it includes the author’s personal reflections on the research process more generally and consideration of the scientist-practitioner model.
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Connell, James Astley. "Displacing the 'authentic account' : historical trauma, political subjectification and the overdetermination of Tibetan youth subjectivities and agencies." Thesis, University of Birmingham, 2017. http://etheses.bham.ac.uk//id/eprint/7568/.
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This thesis considers the reputedly constitutive effects of violence and (intergenerational) loss on youth political subjectivities and agencies, with specific regard for young Tibetans of the refugee-diaspora of Northern India. While the effects of violence on socialisation and agency are currently a significant concern, prevailing clinical, cultural, and even radical psychoanalytical explanations tend – in universalising the traumatic event – to advance underdetermined accounts of experience, subjectivity and agency, leading to depoliticisation of the young or overstatement of their agency. In contrast, this study draws on the Foucauldian concept of political subjectification to reflect on the displaced wider overdeterminative material-discursive field through which young subjects, their subjectivities, and agencies are constituted. Through an ethnographically-informed genealogical method I attempt to trace the signification and affective-internalisation of a specific masternarrative of (national) loss, and the displacements the advent of this account has caused –with specific regard for the displacement of classed, gendered and generational experiences of loss. Finally, drawing on Foucault’s parrhesia as a heuristic for decentred agency, I consider how far young people in exile are able to resist patrifilial hegemony through indexing alternative forms of loss.
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Wilson, Joshua Mosquera. "Bringing My Whole Self to Work: A Grounded Theory Investigation of Survivor-advocates in Domestic Violence Agencies." Thesis, Boston College, 2019. http://hdl.handle.net/2345/bc-ir:108400.
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Thesis advisor: Lisa A. GoodmanRecent research suggests that half or more of today’s domestic violence (DV) advocates are survivors of intimate partner violence (IPV) or other forms of abuse, consistent with the survivor-led early stages of the DV movement. Advocates who are themselves survivors (survivor-advocates) are at risk of experiencing vicarious trauma and other negative outcomes in response to their challenging work. Emerging research has also identified the possibility of deriving personal growth and healing from the work of advocacy, which bolster survivor-advocates against the stressors in their work. However, the processes by which survivor-advocates navigate their work and cope with its challenges are poorly understood. To date, only one qualitative study has asked survivor-advocates about their experiences. This study began illustrating some of the ways that survivor-advocates approach and experience their work; however, it is vital that we develop a richer understanding of how survivor-advocates experience their work as both healing and harmful, in order to maintain the sustainability and effectiveness of the services they provide. This study used grounded theory methodology to explore how survivor-advocates apply their survivorship to their work, and how their work influenced their well-being and recovery. The theoretical model that emerged was anchored by a central process called bringing my whole self to work, which participants described as consisting of four interrelated components: 1) constructing a personal narrative about how their identity connects to their work, 2) applying those connections to shape their work in numerous ways, 3) experiencing healing as an outcome of the previous two components and 4) the organizational contexts that shaped the process through validating or invalidating the survivor identity. Successfully engaging in this process helped survivor-advocates feel a greater sense of connection and integrity to their survivor identity and work, as well as possibly enhanced well-being. This process suggests numerous ways for DV organizations to encourage and support survivor-advocates to engage more openly, meaningfully, and effectively in their work and points toward new directions in understanding vicarious trauma
Thesis (PhD) — Boston College, 2019
Submitted to: Boston College. Lynch School of Education
Discipline: Counseling, Developmental and Educational Psychology
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Jain, Julija. "The therapists' perspective on the impacts and coping strategies of counselling adult survivors of sexual abuse within specialised agencies." Thesis, University of Manchester, 2019. https://www.research.manchester.ac.uk/portal/en/theses/the-therapists-perspective-on-the-impacts-and-coping-strategies-of-counselling-adult-survivors-of-sexual-abuse-within-specialised-agencies(1409c7cd-1aa4-4016-b127-90e30d97bb89).html.
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Background: Sexual abuse is a highly distressing traumatic experience that negatively affects the lives of sexual abuse survivors. The number of individuals who reported sexual abuse has increased, which makes it a public and global concern. As a result, survivors of sexual abuse turn to counselling to cope with the traumatic impacts. Counsellors, psychotherapists, and psychologists engage in deep and meaningful explorations of the sexual abuse in order to support survivors. However, very little is known about the impacts and coping strategies involved in this type of work. Objectives: The objective of this study, therefore, was to explore the experiences of UK-based counselling professionals who counsel survivors of sexual abuse. The research questions were as follows: 1. What is the impact of counselling survivors of sexual abuse? and 2. What self-care strategies and coping techniques have been beneficial when counselling survivors of sexual abuse? Method: An inductive qualitative design was used for the purposes of this study. Semi-structured interviews were conducted with twelve UK-based counselling professionals who provided counselling to individuals who had experienced sexual abuse. The collected data were then analysed using thematic analysis. Findings: The themes developed from the first research question revealed a number of ways in which counselling survivors of sexual abuse affected counselling professionals. Three main themes emerged from the data analysis: work-related impacts, impacts on personal wellbeing and relationship impacts. These themes encompassed a total of fourteen sub-themes. Another two main themes were developed when exploring participants' self-care techniques and coping strategies: holistic self-care and work environment selfcare. Both of these main themes incorporated twelve more sub-themes. These are introduced and outlined in depth in turn. Conclusions: This research has provided a unique insight into the impacts and coping strategies of UK-based counselling professionals working with survivors of sexual abuse. The findings suggest that the counsellors experienced a number of negative impacts, some of which were perceived as traumatic in nature. Further, the impacts were not limited to the counsellors themselves; partners, children, extended family, and friends were also affected by the work. Such far-reaching impacts of sexual trauma have not been sufficiently explored previously. Contrary to the negative tendencies expressed in the research literature, some of the findings indicate positive aspects, such as high job satisfaction and evolved personal growth. The findings of this study provide a rare insight into the useful self-care techniques and copings strategies specific for counselling survivors of sexual abuse. Although the strategies are similar to those used in other areas of counselling, they emphasize organisational and educational responsibilities to support counsellors' wellbeing. Suggestions are proposed for research, educational, organisational, and ethical developments.
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Paz-Amor, Windy. "Damned If You Do--Damned If You Don't: A Queer Woman of Color's Journey of Trauma, Agency, and Leadership." ScholarWorks @ UVM, 2015. http://scholarworks.uvm.edu/graddis/364.
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ABSTRACT
Navigating systems of leadership in Predominantly White Institutions (PWIs) in higher education as a Queer Woman of Color can be a challenging and complex process--one that integrates identity, experience, expertise, knowledge, patience, and most importantly the ability to risk; while remaining authentic and professional. It is a balance, which in my own experience and expertise requires constant reflection, evaluation, and adaptation. A negotiation of owning that one has power and agency, while realizing that the many intersecting identities that one holds influences how dominant culture perceives that power and agency. To reach authentic reflection and evaluation in leadership it is critical to examine and investigate one's own vocation to lead and to ask, what leads us and sustains us in that leadership?
This dissertation will offer a counter-narrative of leadership in prose-poetry through a lens of intersectionality outside of the hegemonic or dominant ways that define the parameters of leadership. Through the use of personal narratives reinforced by scholarship using the methodology of Scholarly Personal Narrative (SPN), I explore my own experiences of trauma throughout my life that led to agency and inevitably to leadership. I additionally examine the overarching tenants and themes that continue to inform, sustain and strengthen my leadership.
"Damned If You Do--Damned If You Don't" represents a phrase often used amongst marginalized communities that signifies the challenges of navigating one's own power and agency within oppressive dominant systems. This SPN dissertation will be supported by the paradigms of Critical Race Theory (CRT) with a specific focus on Counter-Narrative/Storytelling and Critical Race Gendered Epistemology or Feminist Black/Latino Theory, while also incorporating aspects of positive psychology. It will offer a counter-narrative in leadership that highlights how my multiple intersecting identities, coupled with my life experiences, create meaning and go on to further shape my approach to trauma, agency, and leadership.
As a Queer woman of color in leadership, I find that by honoring and examining my own stories of trauma and agency, and how it led me to leadership. I am better equipped as a professional to honor the narratives, identities, and experiences of those that I serve.
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CAVALCANTE, Aline Ribeiro Teixeira. "Preenchimento da submucosa do anorreto com biopolímero de cana de açúcar para o tratamento da incontinência fecal após trauma do esfíncter anal em ratos." Universidade Federal de Pernambuco, 2015. https://repositorio.ufpe.br/handle/123456789/23847.
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Introdução: A incontinência fecal é a perda indesejável de flatos e fezes devido ao déficit do controle esfincteriano, que resulta na diminuição da qualidade de vida e gera grande impacto econômico. A aplicação de um agente de preenchimento tem sido uma opção para o tratamento da incontinência leve a moderada quando as condutas conservadoras forem ineficazes. Porém os agentes disponíveis na prática clínica são de alto custo e de baixa durabilidade. O gel de biopolímero de cana-de açúcar apresenta-se como uma possível alternativa por ser biocompatível, seguro e com baixo potencial de migração. Objetivo: Avaliar o gel de biopolímero de cana-de açúcar como agente de preenchimento do anorreto de ratos submetidos à disfunção esfincteriana. Materiais e Métodos: Realizou-se ensaio biológico constituído por modelo experimental induzido, de natureza cirúrgica. Foram utilizados 45 ratos Wistar, de ambos os gêneros, alocados randomicamente em três grupos de 15: Controle (GC), esfincterectomia e aplicação de soro fisiológico (GE+SF) e esfincterectomia e aplicação de gel biopolímero de cana-de-açúcar (GE+BPCA). Todos os grupos foram submetidos à manometria anorretal nos tempos D0 (início das avaliações), D15 (quinze dias após D0) e D45 (quarenta e cinco dias após D0). Os grupos GE+SF e GE+BPCA foram submetidos à esfincterectomia no tempo D0 para induzir queda dos níveis pressóricos de repouso da região anorretal induzindo disfunção esfincteriana. No tempo D15 foi feita aplicação de 0,6ml de soro fisiológico no anorreto do GE+SF e de 0,6ml de gel de BPCA no anorreto do GE+BPCA. Sessenta dias após o início dos experimentos (D60) os ratos foram sacrificados e as peças anatômicas foram pesadas e enviadas para estudo histológico. Os dados foram submetidos à análise estatística e considerado significativos se p≤0,05. Resultados: No D15 o GC manteve a pressão anorretal constante, o GE+SF apresentou queda do nível pressórico (GC≠GE+SF, p<0,0001) e o GE+BPCA também manteve a pressão anorretal constante, apesar do trauma esfincteriano (GE+SF≠ GE+BPCA, p=0,0004 e GC≠GE+BPCA, p=0,097). No D45 o GC manteve a pressão anorretal de repouso constante, o GE+SF permaneceu com pressão anorretal de repouso inferior aos outros dois grupos e o GE+BPCA apresentou elevação significativa da pressão anorretal. (GC≠GE+SF, p=0,0003; GE+SF≠GE+BPCA, p=0,0002; CG≠GE+BPCA, p=0,0198). Não foi observado processo inflamatório de reparação e remodelamento tecidual no GC e GE+SF. No GE+BPCA, foi observado o implante estável, homogêneo, apresentando integração ao tecido do hospedeiro, com neovascularização, presença de fibroblastos, fibras colágenas e células inflamatórias incorporando sua matriz de forma centrípeta. Conclusão: O gel de biopolímero de cana-de açúcar elevou os níveis pressóricos de repouso da região anorretal dos ratos submetidos à disfunção esfincteriana. Esse agente de preenchimento permaneceu no local do implante neovascularizado, colonizado por células gigantes multinucleadas, fibroblastos e tecido conjuntivo fibroso de sustentação.
Introduction: Fecal incontinence is the involuntary loss of flatus and stools as a result of poor sphincter control, affecting quality of life and induction major economic impact. Its treatment with bulking agents has been proposed as an option for mild to moderate fecal incontinence when conservative approach is ineffective. However, the current available bulking agents has high cost and low durability. The sugarcane biopolymer gel presents itself as a possible lternative to be biocompatible, safe and low migration potential. Objective: To evaluate the sugarcane biopolymer gel as an anorectal bulking agent of rats sumitted to sphinteric dysfunction. Materials and methods: A biologic assay, performed as an experimental induced model through surgery. The study used 45 Wistar rats randomly divided equally into three groups: 15 rats for control group (GC); 15 for sphincterectomy and injection of physiological saline group (GE+SF); and 15 for sphincterectomy and injection of sugarcane biopolymer gel group (GE+BPCA). All the rats in all the groups were subjected to anorectal manometry at D0 (first day, on the beginning of evaluations), D15 (fifteen days after D0) and D45 (forty-five days after D0). The GE+SF and GE+BPCA groups were subject to sphincterectomy at D0 in order to reduce the anal pressure at rest. At D15, 0,6ml of physiological saline was injected into the anorectum of animals from GE+SF, whereas for GE+BPCA it was injected 0,6Ml sugarcane biopolymer gel. Sixty days after experiments has begun (D60) the rats were sacrificed and their anatomical specimens were weighed and analysed. Results: The manometry analyses at D15 demonstrated that GC maintained a constant anrectal pressure as well as GE+BPCA, nevertheless the sphincter trauma (GC≠GE+BPCA, p=0,097), while GE+SF displayed decreased anorectal pressures (GC≠GE+SF, p<0,0001 and GE+SF≠GE+BPCA, p=0,0004). At D45, GC remained constant the anorectal pressures at rest, while anorectal pressures of GE+SF group remained below the other’s two groups. At same period, GE+BPCA presented a significant increase of anorectal pressure at rest. (GC≠GE+SF, p=0,0003; GE+SF≠GE+BPCA, p=0,0002; CG≠GE+BPCA, p=0,0198). The histopathologic evaluation for GC and GE+SF exhibited no inflammatory process for tissue repairing or remodeling. For GE+BPCA the histopathologic evaluation exhibited the implant as stable, homogeneous, integrated into the surrounding tissue with new blood vessels and presence of fibroblasts, collagen fibers and inflammatory cells embedded in its matrix in a centripetal distribution. Conclusion: Therefore, we conclude that sugarcane biopolymer gel increased anorectal presures at rest in rats submitted to sphincterectomy. This bulking agent remained at injection site and it was colonized by multinucleated giant cells, fibroblasts and dense conjunctive tissue. Key-words: Faecal incontinence. Bulking agent. Sugarcane biopolymer. Cellulosic exopolysaccharide. Anorectal manometry.
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Moser, Michele R., and Kristin Dean. "Sustainment: Developing Support After a Statewide TF-CBT Implementation Initiative to Maintain and Expand Agency Capacity." Digital Commons @ East Tennessee State University, 2013. https://dc.etsu.edu/etsu-works/4979.
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Mohammed, Esosa. "Resilience of Nigerian Widows in the Face of Harmful Widowhood Practices in Southwest Nigeria: An Interdisciplinary Analysis." Digital Commons @ East Tennessee State University, 2018. https://dc.etsu.edu/etd/3508.
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Widows in Nigeria endure adverse and traumatic practices that affect their health, well-being, and rights as women. After decades of struggle and resistance against persistent widowhood practices, this study sought to portray in Nigerian widows, hidden strengths, resilience, and agency rather than their vulnerability and powerlessness. Analysis of secondary scholarship, interviews, and survey questionnaires reveal that some Nigerian widows are able to cope even as they navigate through the challenges and trauma of demeaning and stressful practices. The results also demonstrate that the ability to cope and thrive under stress and adversity links not only to an individual’s personal growth and well-being, but also to their ability to develop agency and empower themselves. This study has implications for female empowerment and sociocultural change. Additionally, the results suggest a need for future research and interventions that further develop the concept of resilience in Nigerian widows.
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Tala, Diaz Denise. "Living Through the Chilean Coup d’Etat: The Second-Generation’s Reflection on Their Sense of Agency, Civic Engagement and Democracy." Antioch University / OhioLINK, 2020. http://rave.ohiolink.edu/etdc/view?acc_num=antioch159302076798197.
Full textBooks on the topic "Trauma agencie"
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Foundation, Sidran Traumatic Stress. Understanding the effects of traumatic stress: A training manual for community agencies. Baltimore, MD: Sidran Press, 2001.
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National Institute for Occupational Safety and Health. Division of Safety Research. Alaska Activity, ed. A Directory of agencies involved in the study of occupational trauma in Alaska. Anchorage, AK: U.S. Dept. of Health and Human Services, Public Health Services, Centers for Disease Control, National Institute for Occupational Safety and Health, Division of Safety Research, Alaska Activity, 1992.
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National Institute for Occupational Safety and Health. Division of Safety Research. Alaska Activity. A Directory of agencies involved in the study of occupational trauma in Alaska. Anchorage, AK: U.S. Department of Health and Human Services, Public Health Services, Centers for Disease Control, National Institute for Occupational Safety and Health, Division of Safety Research, Alaska Activity, 1992.
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Armendáriz, Felipe. CIA Airlines: Cómo un periódico local desveló la trama ilegal contra el terrorismo. Barcelona: Debate, 2006.
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Yael, Danieli, Rodley Nigel S, Weisæth Lars, and United Nations, eds. International responses to traumatic stress: Humanitarian, human rights, justice, peace and development contributions, collaborative actions and future initiatives. Amityville, N.Y: Baywood Publishing, 1996.
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Steele, William. Trauma debriefing handbook for schools and agencies. 2nd ed. National Institute for Trauma and Loss in Children, 2001.
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Trauma and Recovery: The Aftermath of Violence--From Domestic Abuse to Political Terror. Basic Books, 2022.
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Trauma and Recovery: The Aftermath of Violence--From Domestic Abuse to Political Terror. Basic Books, 2015.
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Rosero Reyes, Carlos Alberto, Renato Javier Herrera García, Marco Antonio Guamba Leiva, Rodrigo Ricardo Sandoval Valencia, Christian Javier Marcillo Chávez, Wilson Alfredo Gualotuña Pachacama, Sandra Gabriela Gallardo Aluisa, et al. Manejo de Emergencias Clínico-Quirúrgicas en el Primer Nivel de Atención. Mawil Publicaciones de Ecuador, 2019, 2020. http://dx.doi.org/10.26820/978-9942-826-09-1.
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Se considera trauma a las lesiones producidas de forma abrupta, por agentes externos a nuestro organismo, estos pueden ser físico o químicos cada agente produce lesiones específicas. Estas lesiones pueden variar desde heridas menores hasta complejas que involucra múltiples estructuras del cuerpo, en este caso se habla de politraumatismo. La mayoría las muertes ocurren en la escena o dentro de las primeras cuatro horas del siniestro1. En 1982 se describe por primera vez la distribución trimodal de la muerte como consecuencia de la o las lesiones en el trauma2.
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Ford, James Edward. Thinking Through Crisis. Fordham University Press, 2019. http://dx.doi.org/10.5422/fordham/9780823286904.001.0001.
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Thinking through Crisis turns to 1930s African American literature to offer a critical response to Trauma Theory. This theoretical discourse carries a nostalgia for “European Man” that limits its understanding of racial and class antagonisms. Consequently, its version of “bearing witness” yields a political passivity that cannot address the injustices of racism as they are linked to class conflict. Against the political passivity produced by this idealist approach, this book offers a materialist theory of trauma that develops concepts for identifying the agency that Black life produces amid social breakdown.
Book chapters on the topic "Trauma agencie"
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Miller, Calum. "Abortion's Causal Role in Trauma and Suicide." In Agency, Pregnancy and Persons, 266–87. New York: Routledge, 2022. http://dx.doi.org/10.4324/9781003181576-19.
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Strand, Virginia C. "Applying Trauma Theory to Agency Practice." In Trauma Responsive Child Welfare Systems, 13–18. Cham: Springer International Publishing, 2017. http://dx.doi.org/10.1007/978-3-319-64602-2_2.
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Laine-Frigren, Tuomas. "Traumatized Children in Hungary After World War II." In Palgrave Studies in the History of Experience, 149–76. Cham: Springer International Publishing, 2021. http://dx.doi.org/10.1007/978-3-030-84663-3_6.
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AbstractThis chapter examines how children’s wartime suffering was culturally constructed in postwar Hungary. Laine-Frigren uses a wide variety of source materials, such as published expert discourse, journalism and ego documents to explore how children’s suffering was interpreted and worked upon in different contexts, how the processes of healing were understood, and what kind of political meanings were attributed to children’s traumas. The particular focus is on the agency of people who did actual practical work with children, such as psychologists, teachers and civil society activists. The chapter suggests a multiplicity of responses to childhood trauma, from abstract and future-oriented policy-talk to teachers and psychologists promoting specific ways of healing such as offering children moments of joy, taking them on nature trips and exploring poetry.
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Jackson, Vivian H. "The Role of Cultural Competence in Trauma-Informed Agencies and Services." In Trauma Responsive Child Welfare Systems, 41–64. Cham: Springer International Publishing, 2017. http://dx.doi.org/10.1007/978-3-319-64602-2_4.
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Nicholson, Julie, and Julie Kurtz. "CORE PRINCIPLE: Provide Opportunities for Agency and Control." In Trauma-Responsive Family Engagement in Early Childhood, 158–79. New York: Routledge, 2021. http://dx.doi.org/10.4324/9781003127666-8.
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Bilić, Bojan. "Introduction: In Lesbian Worlds." In Trauma, Violence, and Lesbian Agency in Croatia and Serbia, 1–27. Cham: Springer International Publishing, 2020. http://dx.doi.org/10.1007/978-3-030-22960-3_1.
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Bilić, Bojan. "Coming Out: Announcing Lesbianity in Yugoslavia." In Trauma, Violence, and Lesbian Agency in Croatia and Serbia, 29–56. Cham: Springer International Publishing, 2020. http://dx.doi.org/10.1007/978-3-030-22960-3_2.
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Bilić, Bojan. "Times of Splits: Surviving the 1990s." In Trauma, Violence, and Lesbian Agency in Croatia and Serbia, 57–103. Cham: Springer International Publishing, 2020. http://dx.doi.org/10.1007/978-3-030-22960-3_3.
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Bilić, Bojan. "Away from the Capitals: Decentralising Lesbian Activist Engagement." In Trauma, Violence, and Lesbian Agency in Croatia and Serbia, 105–24. Cham: Springer International Publishing, 2020. http://dx.doi.org/10.1007/978-3-030-22960-3_4.
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Bilić, Bojan. "Speaking Separately: 2015 Belgrade Lesbian March and Its Antecedents." In Trauma, Violence, and Lesbian Agency in Croatia and Serbia, 125–59. Cham: Springer International Publishing, 2020. http://dx.doi.org/10.1007/978-3-030-22960-3_5.
Full textConference papers on the topic "Trauma agencie"
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MELO, SAVIO TORRES, VALDEMIR NOGUEIRA LIMA JUNIOR, VICTOR MATHEUS SILVA DE OLIVEIRA, RUTH OTAMARIA DA SILVA AIRES, AMANDA EVELYN BARBOSA DE AQUINO, FRANCISCA ITAYNARA DE SOUZA ARAUJO, LUANNA DE CARVALHO SANTOS, and REBEKA MANUELA LOBO SOUSA. "PAVIMENTO RÍGIDO E FLEXÍVEL: UM ESTUDO COMPARATIVO DOS PROJETOS PARA VIAS PÚBLICAS." In Brazilian Congress. brazco, 2020. http://dx.doi.org/10.51162/brc.dev2020-00029.
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No Brasil, o transporte rodoviario e responsavel pela movimentacao de mais de 60% de toda a carga que trafega no territorio nacional, existindo cerca de 130 mil empresas de transporte de cargas no Brasil com mais de 1,6 milhoes de veiculos que oferecem servicos, segundo a Agencia Nacional de Transportes Terrestres. A funcionalidade dos pavimentos de fato se torna util, diante do conforto e seguranca, porem o principal comparativo na opcao de uma analise e a parte economica, pois a preferencia para esta opcao e bastante analisada. O comparativo entre pavimentos nao trata, evidentemente, de procurar a simples substituicao dos pavimentos betuminosos pelos de concreto, ignorando toda uma tecnologia desenvolvida durante muitos anos, trata-se de apresentar uma excelente opcao de pavimentacao e de expandir o uso de concreto como pavimento rodoviario. Os pavimentos rigidos apresentam melhores resultados, no aspecto de seguranca, conforto e sustentabilidade, que sao bens nao mensuraveis financeiramente como satisfacao, bem-estar, futuro do planeta, preservacao da vida.,
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Rodrigues, Larissa Cristina. "NOVO AGENTE COCCIDIANO DA DOENÇA INTESTINAL: CYCLOSPORA CAYETANENSIS." In I Congresso Brasileiro de Doenças Infectocontagiosas On-line. Revista Multidisciplinar em Saúde, 2021. http://dx.doi.org/10.51161/rems/2238.
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Introdução: O estudo da ciclosporíase está repleto de dificuldades pela pouca conscientização pública. Um fator chave para isso são os métodos especializados de coloração para diagnóstico que não são realizados rotineiramente em laboratórios clínicos, então obtendo o diagnóstico correto é possível aplicar uma medida terapêutica diferenciada para pacientes que possuem esse tipo de enfermidade, visando a inserção de mais técnicas laboratoriais para melhor identificação de novos parasitas. Objetivo: Identificar a presença de Cyclospora cayetanensis em materiais fecais de indivíduos residentes na cidade de Jundiaí. Material e Métodos: Foi executado um estudo prospectivo quantitativo em crianças, adolescentes e adultos de ambos os sexos, sem limite de idade. Sendo critério de escolha pacientes que tenham tido histórico de evacuações aquosas. Em relação aos métodos, utilizou-se, no primeiro momento, o método de sedimentação espontânea (HOFFMAN) realizando a pesquisa de oocistos em fezes frescas na microscopia ótica (objetiva de 40x) e em coloração de ácido resistência, na qual foi utilizada Ziehl Neelsen (não modificado). No segundo momento, para que tivesse um método comparativo, foram visualizadas lâminas á fresco para possível identificação de outras parasitoses, além da qual estava sendo pesquisada. Resultados: Devido a esse protozoário entérico oportunista ser principalmente encontrado em água não tratada, o resultado do presente estudo foi NEGATIVO para a ciclosporíase, bem como outros tipos de parasitoses correlacionadas com a falta de saneamento básico. Sendo um dos fatores chaves para a obtenção deste resultado, a cidade de Jundiaí ser considerada pelo Instituto Trata Brasil como a região com o melhor sistema de tratamento de água no Brasil. Conclusão: Após a obtenção dos resultados, podemos observar que, independente das condições de moradia em regiões mais precárias da cidade de Jundiaí, o sistema de tratamento de água possui uma infraestrutura excelente, que contribui tanto com a população urbana quanto a rural, para que elas possam usufruir da sua excelente qualidade, promovendo segurança à sua saúde e removendo quaisquer probabilidades de contaminação.
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Marquezini, Hellen, Ludmila Guimarães, and Raquel Barreto. "O ensino e aprendizado corporativos como instrumento de dominação, controle e poder organizacional e agente (des)motivacional." In Simpósio Internacional Trabalho, Relações de Trabalho, Educação e Identidade. Appos, 2020. http://dx.doi.org/10.47930/1980-685x.2020.0203.
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Este presente artigo trata da relação entre o ensino e aprendizados corporativos como instrumentos de dominação, controle e poder organizacional. Tem por objetivo descrever a evolução desses métodos de ensino e aprendizado no decorrer da história, e o papel destes enquanto adestradores dos funcionários. Ainda temos por objetivos descrever o papel da motivação na construção desse ambiente de dominação, se esta se relaciona com a produtividade funcional, e se sim como isso ocorre, uma vez que a partir de sua inserção na vida organizacional surgiu um aprofundamento nas relações dominante x dominado. Objetivamos por fim, analisar se os métodos de ensino e aprendizado corporativos visam o aprimoramento dos funcionários enquanto indivíduos independentes das esferas organizacionais.
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Marquezini, Hellen, Ludmila Guimarães, and Raquel Barreto. "O ensino e aprendizado corporativos como instrumento de dominação, controle e poder organizacional e agente (des)motivacional." In Simpósio Internacional Trabalho, Relações de Trabalho, Educação e Identidade. Appos, 2020. http://dx.doi.org/10.47930/1980-685x.2020.0203.
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Este presente artigo trata da relação entre o ensino e aprendizados corporativos como instrumentos de dominação, controle e poder organizacional. Tem por objetivo descrever a evolução desses métodos de ensino e aprendizado no decorrer da história, e o papel destes enquanto adestradores dos funcionários. Ainda temos por objetivos descrever o papel da motivação na construção desse ambiente de dominação, se esta se relaciona com a produtividade funcional, e se sim como isso ocorre, uma vez que a partir de sua inserção na vida organizacional surgiu um aprofundamento nas relações dominante x dominado. Objetivamos por fim, analisar se os métodos de ensino e aprendizado corporativos visam o aprimoramento dos funcionários enquanto indivíduos independentes das esferas organizacionais.
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Braga Neto, Antônio Rodrigues, Gabriela Paiva Soares e. Ladeira Carvalho, Fernanda Freitas, Ana Paula Vieira dos Santos Esteves, Joffre Amim Junior, and Jorge Rezende Filho. "Fatores preditivos para resistência à quimioterapia com agente único na neoplasia trofoblástica gestacional de baixo risco com escore FIGO 5 ou 6: um estudo multicêntrico internacional retrospectivo." In 44° Congresso da SGORJ - XXIII Trocando Ideias. Zeppelini Editorial e Comunicação, 2020. http://dx.doi.org/10.5327/jbg-0368-1416-2020130269.
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Introdução: Pacientes com neoplasia trofoblástica gestacional (NTG) e escore de risco FIGO 5 ou 6 recebem inicialmente quimioterapia de menor toxicidade com agente único. É amplamente aceito que apenas um terço é curado, o restante necessitando de tratamento tóxico com múltiplos agentes para atingir a remissão. Identificar fatores preditivos para resistência a agentes únicos melhoraria a estratificação das pacientes que receberiam quimioterapia com múltiplos agentes, evitando que se inicie esse esquema quimioterápico com maiores efeitos colaterais em todos os casos cujo escore de risco FIGO seja 5 ou 6. Objetivo: Identificar quais pacientes portadoras de NTG com escore de risco FIGO 5 ou 6 são adequadamente tratadas com agente quimioterápico único como primeira linha, e quais requerem terapia inicial com múltiplos agentes. Material e Métodos: Trata-se de um estudo de coorte retrospectivo, multicêntrico, internacional, no qual foi realizada a revisão de prontuários de pacientes portadoras de NTG com escore de risco FIGO 5 ou 6, em três dos maiores centros de referência em NTG do mundo. Foram incluídas pacientes acompanhadas em Londres, no Rio de Janeiro e em Boston, entre janeiro de 1964 e dezembro de 2018. Variáveis significativas associadas à quimiorresistência à terapia com agente único foram testadas em um modelo multivariado. Resultados e Conclusão: Apenas 40,2% (141/351) das pacientes com escore de risco FIGO 5 ou 6 desenvolveram resistência a tratamentos com agente único e necessitaram de quimioterapia com múltiplos agentes para entrar em remissão. A regressão logística univariada e multivariada revelou metástases (odds ratio — OR: 1,6, intervalo de confiança de 95% — IC95% 1,0‒2,6; p=0,044), histopatologia de coriocarcinoma (OR: 3,0, IC95% 1,6‒5,6; p=0,001), gonadotrofina coriônica humana (hCG) pré-tratamento (OR: 2,4, IC95% 1,7‒3,4; p<0,001) e coriocarcinoma metastático (OR: 4,2, IC95% 1,5‒12; p=0,008) como fatores preditivos significativos para resistência a terapias com agente único. O modelo revelou valor preditivo positivo (PPV) de 0,8 para falha da terapia com agente único com hCG pré-tratamento ≥550.000 IU/L em pacientes sem metástases e sem coriocarcinoma, e PPV 0,85 para um hCG ≥110.000 IU/L naquelas com metástases ou coriocarcinoma. Além disso, todas as pacientes com coriocarcinoma metastático, independentemente do nível de hCG, não responderam a agentes únicos e devem receber quimioterapia primária com múltiplos agentes. Mulheres com NTG e escore de risco FIGO 5 ou 6 têm quase 60% (210/351) de chance de atingir remissão com esquemas quimioterápicos com agente único, usados como primeira linha ou sequencialmente. A quase totalidade das demais pacientes apresenta boa resposta com o tratamento subsequente com múltiplos agentes. Nossos novos fatores preditivos de resistência à terapia com agente único ajudarão a selecionar aquelas pacientes que realmente precisam de quimioterapia com múltiplos agentes desde o início do tratamento.
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Fischer, Nicolas, Patrick Martini, Mateus Tomaz, Patrick Priebe, Matheus Konrath, Maurício Konrath, Daniela Bagatini, and Daniela Peranconi. "Chatbot Iara: relacionando e interagindo com dados sobre o novo coronavírus em Santa Cruz do Sul." In I Escola Regional de Computação do Rio Grande do Sul. Sociedade Brasileira de Computação, 2020. http://dx.doi.org/10.5753/ercomprs.2020.14295.
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Percebendo a necessidade de mecanismos para facilitar a disseminação das informações, de forma simples, acerca da pandemia sobre o coronavírus em Santa Cruz do Sul, esse trabalho apresenta a Iara, um chatbot que relaciona dados quantitativos e informações de decretos municipais. O desenvolvimento do assistente ocorreu em três etapas: (1) Captação, curadoria e organização dos dados; (2) Planejamento das decisões e ações; (3) Construção do agente, inclusão dos dados e treinamento. O chatbot trata-se de um protótipo para identificar a aceitação de bots em sites, o qual já fornece uma visão receptiva a ações desencadeadas pelo bot, validando a proposta de relacionar e permitir que usuários interajam com dados públicos com unidade.
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Santos, André Luiz Dos. "PATOLOGIAS OFTALMOLÓGICAS CAUSADAS POR AFECÇÕES MICROBIANAS IMPLICAM EM TRANSPLANTES." In I Congresso Nacional de Microbiologia Clínica On-Line. Revista Multidisciplinar em Saúde, 2021. http://dx.doi.org/10.51161/rems/1165.
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Introdução: A presente pesquisa trata de destacar as principais infecções provocadas por vírus, bactérias ou fungos que causam doenças no globo ocular ou tecidos circunvizinhos podem levar a cegueira necessitando de tratamentos agressivos e muitos casos de procedimento de transplantes de córneas. Objetivo: Caracterizar infecções provocadas por microorganismos que causam patologias oculares que levam a necessidade de transplantes. Material e métodos: através de leitura criteriosa foram selecionados alguns artigos científicos na plataforma scielo que se destacaram por tratarem de afecções oftalmológicas microbianas capazes de levar a cegueira. Resultados: Verifica-se que não são poucas, nem são raras as patologias relacionadas ao globo ocular que podem levar a cegueira, seja pela impossibilidade de detecção da infecção, seja pelo tratamento necessariamente agressivo ou pela evolução da doença. Algumas doenças, organizadas por ordem alfabética são: a) Blefarite bacteriana: x; b) Ceratite Acanthamoeba: provocado por um protozoário do gênero Acanthamoeba, pode levar a úlceras da córnea e eventual perda de visão; c) Ceratite fúngica: A maioria dos casos de ceratite fúngica, em todo o mundo, é causada por fungos filamentosos septados não pigmentados. Muitos casos podem progredir para infecção fulminante e alguns pacientes perdem a sua visão por culpa do necessário tratamento agressivo; d) Ceratite herpética: Os vírus herpes simples é o vírus causador. A doença corneana decorrente dessa infecção apresenta múltiplas manifestações; e) Conjuntivites: patologias inflamatórias que afetam o tecido conjuntivo que protege o globo ocular do meio externo, observando-se dilatação vascular, infiltração celular e exsudação. As conjuntivites têm origens virais ou bacterianas; f) Endoftalmite: apresenta infecção grave intraocular, afetando humor aquoso, humor vítreo, ou ambos, e ameaça severamente a visão. A Candida albicans é o agente etiológico mais comum; g) Tracoma: infecção causada pela bactéria Chlamydia trachomatis, uma das maiores causas de cegueira infecciosa evitável do mundo. Conclusão: As patologias oftalmológicas provocadas por microorganismos, quando não devidamente tratadas, levam a perda de visão.
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Melo, Jessiane Araújo de. "PERFIL CLÍNICO DA HANSENÍASE EM MENORES DE 15 ANOS NO MUNICÍPIO DE LAGO DA PEDRA, MA." In I Congresso Brasileiro de Saúde Pública On-line: Uma abordagem Multiprofissional. Revista Multidisciplinar em Saúde, 2022. http://dx.doi.org/10.51161/rems/3272.
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Introdução: A hanseníase é uma doença crônica, infectocontagiosa, o Mycobacterium leprae é principal agente etiológico e maioria das vezes transmitido por contato íntimo com pessoas infectadas e não tratadas es não ocorrem em função apenas das características intrínsecas do agente etiológico, mas dependem, sobretudo, da relação com o hospedeiro e o grau de endemicidade do meio, entre outros aspectos. O Brasil é o segundo país em prevalência de Hanseníase no mundo e o Maranhão o terceiro estado brasileiro com maior número de casos. Objetivo: Este estudo tem como objetivo descrever as características clínicas e epidemiológicas da hanseníase em pacientes menores de 15 anos, no município de Lago da Pedra, MA entre os períodos de 2001 a setembro de 2016. Material e Métodos: Trata-se de um estudo quantitativo, retrospectivo com abordagem descritiva, analise do contexto ambiental e distribuição geográfica em saúde. Os dados coletados foram obtidos através dos seguintes instrumentos: a) SINAN (Sistema de Informação de Agravos e Notificação); b) Ficha de Notificação/Investigação, ambas oriundas do município de Lago da Pedra, MA aproximadamente a 347 km da capital maranhense. Resultados: O perfil clinico de menores de 15 anos com hanseníase residentes no município estudado, evidencia que a prevalência da forma paucibacilar, grau 1 e com menos de 5 lesões, em homens, de cor parda e ensino fundamental incompleto. Conclusão: Diante dos resultados obtidos, conclui-se que é necessário desenvolver estratégias de melhorias para aumentar a eficiência do Programa de Controle de Hanseníase entre os menores de 15 anos residentes no município estudado.
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Gomes, Débora dos Santos, Renata Gomes Teixeira, Marina Batista Costa, Sara Janai Corado Lopes, and Ana Paula Bandeira Matos De Serpa Andrade. "CONHECIMENTO DOS AGENTE COMUNITÁRIO DE SAÚDE DE PORTO NACIONAL A CERCA DO PROGRAMA NACIONAL DE CONTROLE DO TABAGISMO." In I Congresso Brasileiro de Saúde Pública On-line: Uma abordagem Multiprofissional. Revista Multidisciplinar em Saúde, 2021. http://dx.doi.org/10.51161/rems/3013.
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Introdução: Segundo a Organização Mundial de Saúde (OMS), o consumo de tabaco é um problema sério para a saúde pública sendo a principal causa de morte evitável no mundo, responsável por cerca de 8 milhões de morte por ano no mundo, o tabagismo constitui como um dos principais fatores de risco para o principal grupo de doenças crônicas não transmissíveis (DCNT) como doenças cardiovasculares, doenças respiratórias crônicas, câncer e diabetes.Objetivo: Avaliar o conhecimento dos Agentes Comunitário de Saúde (ACS) acerca do Programa Nacional de controle ao Tabagismo (PNCT). Material e Métodos: Trata-se de um estudo descritivo e exploratório com abordagem quali-quantitativa, como finalidade de enfatizar sobre a importância do trabalho do ACS frente ao PNCT, a amostra contemplou 22 ACS, foi utilizado Software Microsoft EXCEL 2007, a análise estatística quantitativa foi realizada em porcentagem. Resultados: A maioria dos ACS que participaram deste estudo foram de sexo feminino (86%), com idade entre 40 a 50 anos (37%), e haviam concluído o ensino médio (41 %) seguido de superior completo (32 %). Na pré-capacitação 91% classificou nível de conhecimento médio sobre tabagismo, observou-se que (64%) dos ACS após a capacitação auto classificaram como alto o seu nível de conhecimento acerca do tabagismo. A respeito das dificuldades que encontram para implantar o PNCT na região em que atuam, alguns ACS responderam mais de uma opção, considerando que a maior percentagem refere a assertiva de fumantes com grau avançado de dependência a nicotina, configurando este com 28%. Destaca-se a importância de investimento técnico cientifico em conhecimento para os ACS, tornando-os qualificados para combater o tabagismo, esclarecer dúvidas da comunidade acerca do tabagismo, discutir a melhor forma de abordagem e tratamento em suas visitas domiciliares, sala de espera e ações de educação em saúde entre outros. Conclusão: É de fundamental importância a execução do PNCT através da APS com estratégias e ações voltadas para o combate ao tabagismo no Brasil. Acredita-se, que a capacitação para os ACS, torna-os qualificados para contribuir na implementação do PNCT e consequentemente promovendo qualidade de vida para os usuários de sua área de atuação, contribuindo também para a resolutividade na Atenção Primária a Saúde.
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Rodriguez, Cristian. "Ontofanía Digital: Lo digital como estructura de percepción." In LINK 2021. Tuwhera Open Access, 2021. http://dx.doi.org/10.24135/link2021.v2i1.96.g129.
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Hoy en día, pocas personas cuestionarían el argumento de Negroponte de que la revolución digital ha terminado. Esto no es porque la revolución haya fracasado de alguna manera, sino porque ya ha tocado a todos. Sin embargo, en este panorama posdigital, varios campos diferentes todavía discuten cómo esta presencia ubicua de tecnologías digitales puede enmarcarse conceptualmente. Algunos teóricos se alinean detrás de ideas que se asemejan al modelo de realidad mixta de Milgram y Kishino (1994), donde lo virtual y lo real se representan como un continuo que abarca el entorno virtual en un extremo y el real en el otro. Otros, todavía prefieren lo que Jurgenson (2009) llama dualismo digital, donde el mundo digital es visto como virtual y el mundo material como real, como reinos separados, diferenciados. Ontofanía Digital (Vi al, 2018) sostiene, desde una perspectiva metafísica, que si bien se puede estar de acuerdo con la idea de una sola realidad continua con diferentes propiedades, un concepto central es que las tecnologías a lo largo de los siglos han generado cambios en la forma en que percibimos las cosas (cambios ontofánicos), que sacuden las estructuras dominantes de percepción. Estos cambios están estrechamente relacionados con las capacidades tecnológicas para hacer que las cosas existan y tienen el poder de cambiar nuestra idea de lo que es la realidad. Los dispositivos tecnológicos, por tanto, se convierten en condiciones de posibilidad para la realidad (Vial, 2019), organizando la historia de la humanidad en una serie de Sistemas Tecnológicos. El sistema pre-renacentista mecánico y el sistema industrial mecánico son ejemplos de estos, que crearon no solo sus propios procesos de producción, sino también conjuntos particulares de prácticas sociales. La irrupción de la revolución digital de los años setenta y noventa trajo consigo un nuevo sistema: el Sistema Tecnológico Digital. Las tecnologías digitales, caracterizadas por la introducción de simulaciones, avatares y relaciones mediadas por internet, provocaron un impacto fenomenológico en nuestro ser (industrial) en el mundo. Para sobrevivir a este trauma ontofánico, creamos la distinción entre los mundos virtual y real, regidos por sus propias reglas fenomenológicas. Rechazando este dualismo, la Ontofanía Digital define el ser como una construcción antropo-técnica, donde los objetos materiales median creencias, hábitos y agencias. De esta manera, la revolución digital se convierte en un evento filosófico, en el sentido de que afecta nuestra experiencia fenomenológica del mundo. El surgimiento de lo digital no es solo una cuestión de ontología, sino de ontofanía, ya que define cómo los seres (ontos) aparecen (phaino). Las Tecnologías Digitales, por tanto, son estructuras de percepción que crean tanto matrices ontofánicas como condiciones materiales que determinan las manifestaciones fenoménicas que le son exclusivas y particulares. No se trata solo de un cambio de materiales y dispositivos, sino de la transformación del propio acto de percepción y su dinámica fenomenológica. Desde la perspectiva de la Teoría de la Cognición de Santiago, la Ontofanía Digital ofrece una sensibilidad única para analizar las dinámicas de acoplamiento estructural evidenciadas en los procesos de interacción entre el organismo (el aprendiz) y el entorno en la producción de una experiencia de usuario única que transforma a los dispositivos digitales en máquinas filosóficas, condiciones de posibilidades y generadores de realidad (Vial, 2019).
Reports on the topic "Trauma agencie"
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Vergani, Matteo, Angelique Stefanopoulos, Alexandra Lee, Haily Tran, Imogen Richards, Dan Goodhardt, and Greg Barton. Defining and identifying hate motives: bias indicators for the Australian context. Centre for Resilient and Inclusive Societies, November 2022. http://dx.doi.org/10.56311/pozs1016.
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This report presents bias indicators for the Australian context and discusses their concept, uses, benefits and risks. The bias indicators we present are the result of extensive consultations with local experts including academics and practitioners working in law enforcement agencies, government and non-government organisations and community organisations. Trigger warning: this report discusses multiple forms of trauma, hate, and discrimination, including physical violence, racism, and homophobia.
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Melton, Patricia A. Enacting an Improved Response to Sexual Assault: A Criminal Justice Practitioner’s Guide. RTI Press, July 2020. http://dx.doi.org/10.3768/rtipress.2020.op.0066.2007.
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Sexual assault is a violent crime that traumatizes individual victims and endangers entire communities. Every victim of sexual assault deserves an opportunity for justice and access to the resources they need to recover from this trauma. In addition, many perpetrators of sexual assaults are serial offenders who also commit other violent crimes, including armed robberies, aggravated assaults, burglary, domestic violence, and homicides, against strangers and acquaintances. Criminal justice agencies have the power to create a strategic, sustainable plan for an improved response to sexual assault that aligns with current best practices and national recommendations. In this document, we define an “improved response” as an approach that supports effective investigation and prosecution of sexual assault cases, holds perpetrators accountable, and promotes healing and recovery for victims of sexual assault. This guide will help prosecutor and law enforcement agencies create a process with milestones, goals, and suggested actions, all designed to support a successful and sustainable approach for addressing sexual assault cases. Improving the criminal justice system’s response to sexual assault ultimately improves public safety and promotes trust between criminal justice agencies and the communities they serve.
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O’Neil, Maya E., Tamara P. Cheney, Yun Yu, Erica L. Hart, Rebecca S. Holmes, Ian Blazina, Stephanie P. Veazie, et al. Pharmacologic and Nonpharmacologic Treatments for Posttraumatic Stress Disorder: 2022 Update of the PTSD Repository Evidence Base. Agency for Healthcare Research and Quality (AHRQ), October 2022. http://dx.doi.org/10.23970/ahrqepcptsd2022.
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Objectives. Identify and abstract data from randomized controlled trials (RCTs) examining treatment for posttraumatic stress disorder (PTSD) and comorbid PTSD/substance use disorder to update the previous Agency for Healthcare Research and Quality (AHRQ) report and National Center for PTSD (NCPTSD) PTSD Trials Standardized Data Repository (PTSD-Repository). Data sources. We searched PTSDpubs, Ovid® MEDLINE®, Cochrane CENTRAL, PsycINFO®, Embase®, CINAHL®, and Scopus® for eligible RCTs published from June 1, 2018, to January 26, 2022. Review methods. In consultation with AHRQ and NCPTSD, we updated the evidence tables for the PTSD-Repository by including evidence published after publication of the last update and expanding abstraction of results to include calculated standardized effect sizes. The primary publication for each RCT was abstracted; data and citations from secondary publications (i.e., companion papers) appear in the same record. We assessed risk of bias (RoB) for all newly included studies using the Revised Cochrane Risk of Bias 2 (RoB 2) tool for randomized trials. For studies already in the PTSD-Repository, we will add calculated standardized effect sizes and update RoB using the new RoB 2 tool over the next several annual updates. Results. We added 48 new RCTs examining treatments for PTSD, for a total of 437 included studies published from 1988 to July 30, 2021. Among the 48 newly added RCTs, psychotherapy interventions were the most commonly employed (50%), followed by complementary and integrative health (17%). Approximately half of studies were conducted in the United States (46%), and enrolled community participants (52%) and participants with a mix of trauma types (48%). Studies typically had sample sizes ranging from 25 to 99 participants (69%). RoB was rated as high for 52 percent of studies, 31 percent were rated as low RoB, and the remaining studies were rated as having some concerns (15%). Conclusions. This report updates the previous AHRQ report to include 48 recently published RCTs, for a total of 437 studies. This update adds comprehensive data, standardized effect sizes for PTSD outcomes, and RoB assessment for the newly included RCTs. As with the previous AHRQ update, this report will inform updates to the PTSD-Repository, a comprehensive database of PTSD trials.
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Carney, Nancy, Tamara Cheney, Annette M. Totten, Rebecca Jungbauer, Matthew R. Neth, Chandler Weeks, Cynthia Davis-O'Reilly, et al. Prehospital Airway Management: A Systematic Review. Agency for Healthcare Research and Quality (AHRQ), June 2021. http://dx.doi.org/10.23970/ahrqepccer243.
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Objective. To assess the comparative benefits and harms across three airway management approaches (bag valve mask [BVM], supraglottic airway [SGA], and endotracheal intubation [ETI]) by emergency medical services in the prehospital setting, and how the benefits and harms differ based on patient characteristics, techniques, and devices. Data sources. We searched electronic citation databases (Ovid® MEDLINE®, CINAHL®, the Cochrane Central Register of Controlled Trials, the Cochrane Database of Systematic Reviews, and Scopus®) from 1990 to September 2020 and reference lists, and posted a Federal Register notice request for data. Review methods. Review methods followed Agency for Healthcare Research and Quality Evidence-based Practice Center Program methods guidance. Using pre-established criteria, studies were selected and dual reviewed, data were abstracted, and studies were evaluated for risk of bias. Meta-analyses using profile-likelihood random effects models were conducted when data were available from studies reporting on similar outcomes, with analyses stratified by study design, emergency type, and age. We qualitatively synthesized results when meta-analysis was not indicated. Strength of evidence (SOE) was assessed for primary outcomes (survival, neurological function, return of spontaneous circulation [ROSC], and successful advanced airway insertion [for SGA and ETI only]). Results. We included 99 studies (22 randomized controlled trials and 77 observational studies) involving 630,397 patients. Overall, we found few differences in primary outcomes when airway management approaches were compared. • For survival, there was moderate SOE for findings of no difference for BVM versus ETI in adult and mixed-age cardiac arrest patients. There was low SOE for no difference in these patients for BVM versus SGA and SGA versus ETI. There was low SOE for all three comparisons in pediatric cardiac arrest patients, and low SOE in adult trauma patients when BVM was compared with ETI. • For neurological function, there was moderate SOE for no difference for BVM compared with ETI in adults with cardiac arrest. There was low SOE for no difference in pediatric cardiac arrest for BVM versus ETI and SGA versus ETI. In adults with cardiac arrest, neurological function was better for BVM and ETI compared with SGA (both low SOE). • ROSC was applicable only in cardiac arrest. For adults, there was low SOE that ROSC was more frequent with SGA compared with ETI, and no difference for BVM versus SGA or BVM versus ETI. In pediatric patients there was low SOE of no difference for BVM versus ETI and SGA versus ETI. • For successful advanced airway insertion, low SOE supported better first-pass success with SGA in adult and pediatric cardiac arrest patients and adult patients in studies that mixed emergency types. Low SOE also supported no difference for first-pass success in adult medical patients. For overall success, there was moderate SOE of no difference for adults with cardiac arrest, medical, and mixed emergency types. • While harms were not always measured or reported, moderate SOE supported all available findings. There were no differences in harms for BVM versus SGA or ETI. When SGA was compared with ETI, there were no differences for aspiration, oral/airway trauma, and regurgitation; SGA was better for multiple insertion attempts; and ETI was better for inadequate ventilation. Conclusions. The most common findings, across emergency types and age groups, were of no differences in primary outcomes when prehospital airway management approaches were compared. As most of the included studies were observational, these findings may reflect study design and methodological limitations. Due to the dynamic nature of the prehospital environment, the results are susceptible to indication and survival biases as well as confounding; however, the current evidence does not favor more invasive airway approaches. No conclusion was supported by high SOE for any comparison and patient group. This supports the need for high-quality randomized controlled trials designed to account for the variability and dynamic nature of prehospital airway management to advance and inform clinical practice as well as emergency medical services education and policy, and to improve patient-centered outcomes.
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McDonagh, Marian, Andrea C. Skelly, Amy Hermesch, Ellen Tilden, Erika D. Brodt, Tracy Dana, Shaun Ramirez, et al. Cervical Ripening in the Outpatient Setting. Agency for Healthcare Research and Quality (AHRQ), March 2021. http://dx.doi.org/10.23970/ahrqepccer238.
Full textAbstract:
Objectives. To assess the comparative effectiveness and potential harms of cervical ripening in the outpatient setting (vs. inpatient, vs. other outpatient intervention) and of fetal surveillance when a prostaglandin is used for cervical ripening. Data sources. Electronic databases (Ovid® MEDLINE®, Embase®, CINAHL®, Cochrane Central Register of Controlled Trials, and Cochrane Database of Systematic Reviews) to July 2020; reference lists; and a Federal Register notice. Review methods. Using predefined criteria and dual review, we selected randomized controlled trials (RCTs) and cohort studies of cervical ripening comparing prostaglandins and mechanical methods in outpatient versus inpatient settings; one outpatient method versus another (including placebo or expectant management); and different methods/protocols for fetal surveillance in cervical ripening using prostaglandins. When data from similar study designs, populations, and outcomes were available, random effects using profile likelihood meta-analyses were conducted. Inconsistency (using I2) and small sample size bias (publication bias, if ≥10 studies) were assessed. Strength of evidence (SOE) was assessed. All review methods followed Agency for Healthcare Research and Quality Evidence-based Practice Center methods guidance. Results. We included 30 RCTs and 10 cohort studies (73% fair quality) involving 9,618 women. The evidence is most applicable to women aged 25 to 30 years with singleton, vertex presentation and low-risk pregnancies. No studies on fetal surveillance were found. The frequency of cesarean delivery (2 RCTs, 4 cohort studies) or suspected neonatal sepsis (2 RCTs) was not significantly different using outpatient versus inpatient dinoprostone for cervical ripening (SOE: low). In comparisons of outpatient versus inpatient single-balloon catheters (3 RCTs, 2 cohort studies), differences between groups on cesarean delivery, birth trauma (e.g., cephalohematoma), and uterine infection were small and not statistically significant (SOE: low), and while shoulder dystocia occurred less frequently in the outpatient group (1 RCT; 3% vs. 11%), the difference was not statistically significant (SOE: low). In comparing outpatient catheters and inpatient dinoprostone (1 double-balloon and 1 single-balloon RCT), the difference between groups for both cesarean delivery and postpartum hemorrhage was small and not statistically significant (SOE: low). Evidence on other outcomes in these comparisons and for misoprostol, double-balloon catheters, and hygroscopic dilators was insufficient to draw conclusions. In head to head comparisons in the outpatient setting, the frequency of cesarean delivery was not significantly different between 2.5 mg and 5 mg dinoprostone gel, or latex and silicone single-balloon catheters (1 RCT each, SOE: low). Differences between prostaglandins and placebo for cervical ripening were small and not significantly different for cesarean delivery (12 RCTs), shoulder dystocia (3 RCTs), or uterine infection (7 RCTs) (SOE: low). These findings did not change according to the specific prostaglandin, route of administration, study quality, or gestational age. Small, nonsignificant differences in the frequency of cesarean delivery (6 RCTs) and uterine infection (3 RCTs) were also found between dinoprostone and either membrane sweeping or expectant management (SOE: low). These findings did not change according to the specific prostaglandin or study quality. Evidence on other comparisons (e.g., single-balloon catheter vs. dinoprostone) or other outcomes was insufficient. For all comparisons, there was insufficient evidence on other important outcomes such as perinatal mortality and time from admission to vaginal birth. Limitations of the evidence include the quantity, quality, and sample sizes of trials for specific interventions, particularly rare harm outcomes. Conclusions. In women with low-risk pregnancies, the risk of cesarean delivery and fetal, neonatal, or maternal harms using either dinoprostone or single-balloon catheters was not significantly different for cervical ripening in the outpatient versus inpatient setting, and similar when compared with placebo, expectant management, or membrane sweeping in the outpatient setting. This evidence is low strength, and future studies are needed to confirm these findings.
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Totten, Annette, Dana M. Womack, Marian S. McDonagh, Cynthia Davis-O’Reilly, Jessica C. Griffin, Ian Blazina, Sara Grusing, and Nancy Elder. Improving Rural Health Through Telehealth-Guided Provider-to-Provider Communication. Agency for Healthcare Research and Quality, December 2022. http://dx.doi.org/10.23970/ahrqepccer254.
Full textAbstract:
Objectives. To assess the use, effectiveness, and implementation of telehealth-supported provider-to-provider communication and collaboration for the provision of healthcare services to rural populations and to inform a scientific workshop convened by the National Institutes of Health Office of Disease Prevention on October 12–14, 2021. Data sources. We conducted a comprehensive literature search of Ovid MEDLINE®, CINAHL®, Embase®, and Cochrane CENTRAL. We searched for articles published from January 1, 2015, to October 12, 2021, to identify data on use of rural provider-to-provider telehealth (Key Question 1) and the same databases for articles published January 1, 2010, to October 12, 2021, for studies of effectiveness and implementation (Key Questions 2 and 3) and to identify methodological weaknesses in the research (Key Question 4). Additional sources were identified through reference lists, stakeholder suggestions, and responses to a Federal Register notice. Review methods. Our methods followed the Agency for Healthcare Research and Quality Methods Guide (available at https://effectivehealthcare.ahrq.gov/topics/cer-methods-guide/overview) and the PRISMA reporting guidelines. We used predefined criteria and dual review of abstracts and full-text articles to identify research results on (1) regional or national use, (2) effectiveness, (3) barriers and facilitators to implementation, and (4) methodological weakness in studies of provider-to-provider telehealth for rural populations. We assessed the risk of bias of the effectiveness studies using criteria specific to the different study designs and evaluated strength of evidence (SOE) for studies of similar telehealth interventions with similar outcomes. We categorized barriers and facilitators to implementation using the Consolidated Framework for Implementation Research (CFIR) and summarized methodological weaknesses of studies. Results. We included 166 studies reported in 179 publications. Studies on the degree of uptake of provider-to-provider telehealth were limited to specific clinical uses (pharmacy, psychiatry, emergency care, and stroke management) in seven studies using national or regional surveys and claims data. They reported variability across States and regions, but increasing uptake over time. Ninety-seven studies (20 trials and 77 observational studies) evaluated the effectiveness of provider-to-provider telehealth in rural settings, finding that there may be similar rates of transfers and lengths of stay with telehealth for inpatient consultations; similar mortality rates for remote intensive care unit care; similar clinical outcomes and transfer rates for neonates; improvements in medication adherence and treatment response in outpatient care for depression; improvements in some clinical monitoring measures for diabetes with endocrinology or pharmacy outpatient consultations; similar mortality or time to treatment when used to support emergency assessment and management of stroke, heart attack, or chest pain at rural hospitals; and similar rates of appropriate versus inappropriate transfers of critical care and trauma patients with specialist telehealth consultations for rural emergency departments (SOE: low). Studies of telehealth for education and mentoring of rural healthcare providers may result in intended changes in provider behavior and increases in provider knowledge, confidence, and self-efficacy (SOE: low). Patient outcomes were not frequently reported for telehealth provider education, but two studies reported improvement (SOE: low). Evidence for telehealth interventions for other clinical uses and outcomes was insufficient. We identified 67 program evaluations and qualitative studies that identified barriers and facilitators to rural provider-to-provider telehealth. Success was linked to well-functioning technology; sufficient resources, including time, staff, leadership, and equipment; and adequate payment or reimbursement. Some considerations may be unique to implementation of provider-to-provider telehealth in rural areas. These include the need for consultants to better understand the rural context; regional initiatives that pool resources among rural organizations that may not be able to support telehealth individually; and programs that can support care for infrequent as well as frequent clinical situations in rural practices. An assessment of methodological weaknesses found that studies were limited by less rigorous study designs, small sample sizes, and lack of analyses that address risks for bias. A key weakness was that studies did not assess or attempt to adjust for the risk that temporal changes may impact the results in studies that compared outcomes before and after telehealth implementation. Conclusions. While the evidence base is limited, what is available suggests that telehealth supporting provider-to-provider communications and collaboration may be beneficial. Telehealth studies report better patient outcomes in some clinical scenarios (e.g., outpatient care for depression or diabetes, education/mentoring) where telehealth interventions increase access to expertise and high-quality care. In other applications (e.g., inpatient care, emergency care), telehealth results in patient outcomes that are similar to usual care, which may be interpreted as a benefit when the purpose of telehealth is to make equivalent services available locally to rural residents. Most barriers to implementation are common to practice change efforts. Methodological weaknesses stem from weaker study designs, such as before-after studies, and small numbers of participants. The rapid increase in the use of telehealth in response to the Coronavirus disease 2019 (COVID-19) pandemic is likely to produce more data and offer opportunities for more rigorous studies.