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Trauma Care, Volume 3, Issue 1 (March 2023) – 5 articles

Cover Story (view full-size image): Homelessness is often accompanied by risk factors for poor health, such as uninhabitable living conditions, violence, substance use, decreased access to health care, and health issues in general, including but not limited to traumatic brain injury (TBI). The rates of TBI are significantly higher among individuals experiencing homelessness compared to the general population. Individuals experiencing homelessness are at a disproportionately high risk for sustaining a TBI. This is in part because individuals experiencing homelessness are more likely to be victimized by assaults, have a higher propensity for risk-taking, and have higher rates of substance use. The relationship between TBI and homelessness is not well understood. This paper aims to better understand the intersection of TBI and homelessness and the impact of COVID-19. View this paper
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9 pages, 266 KiB  
Article
Medication Adherence to Psychotropic Medication and Relationship with Psychiatric Symptoms among Syrian Refugees in Turkey: A Pilot Study
by Gül Dikeç and Kübra Timarcıoğlu
Trauma Care 2023, 3(1), 37-45; https://doi.org/10.3390/traumacare3010005 - 25 Feb 2023
Viewed by 1346
Abstract
Background: Due to experiencing traumatic and stressful events, refugees are at risk of having mental disorders. The refugees might need to use psychotropic agents to treat mental disorders. It is essential to understand this population’s adherence rate to psychotropic medication. Aim: This study [...] Read more.
Background: Due to experiencing traumatic and stressful events, refugees are at risk of having mental disorders. The refugees might need to use psychotropic agents to treat mental disorders. It is essential to understand this population’s adherence rate to psychotropic medication. Aim: This study aimed to evaluate adherence to psychotropic medication and the relationship with psychiatric symptoms among Syrian refugees in Turkey. Method: The study design was descriptive and correlational. The study was conducted with 55 Syrian refugees attending a community health center in southern Turkey. The data was collected with General Medication Adherence Scale–Arabic Version (GMAS–AR) and Brief Psychiatric Inventory (BPI). Results: 78.2% (n: 43) of the participants’ medication adherence was poor, and a significant negative and weak correlation was found at 0.01 level between GMAS–AR and BPI (r: −0.37). According to multiple linear regression analysis, the model with gender and BPI was significant, and this model explained 19% of GMAS–AR total points (p < 0.001). Conclusion: Mental health professionals should test the effectiveness of psychosocial interventions that increase adherence to treatment for the cultural characteristics of societies. Full article
13 pages, 257 KiB  
Article
The Impact of COVID-19 on Access to Resources among Individuals Experiencing Homelessness and Traumatic Brain Injury
by Stephanie Chassman, Blair Bacon, Sara Chaparro Rucobo, Grace Sasser, Katie Calhoun, Emily Goodwin, Kim Gorgens and Daniel Brisson
Trauma Care 2023, 3(1), 24-36; https://doi.org/10.3390/traumacare3010004 - 17 Feb 2023
Viewed by 1497
Abstract
The rates of traumatic brain injury (TBI) are higher among individuals experiencing homelessness compared with the general population. Individuals experiencing homelessness and a TBI may experience barriers to care. COVID-19 may have further impacted access to basic resources, such as food, shelter, and [...] Read more.
The rates of traumatic brain injury (TBI) are higher among individuals experiencing homelessness compared with the general population. Individuals experiencing homelessness and a TBI may experience barriers to care. COVID-19 may have further impacted access to basic resources, such as food, shelter, and transportation for individuals experiencing homelessness. This study aimed to answer the following research question: What is the impact of COVID-19 on access to resources among individuals experiencing homelessness and TBI? A cross-sectional study design and purposive sampling were utilized to interview 38 English-speaking adults experiencing homelessness and who had sustained a TBI (ages 21–73) in one Colorado city. Qualitative questions related to the impact of COVID-19 were asked and qualitative analysis was used to analyze the responses. Three primary themes emerged regarding the types of resources that were restricted by COVID-19: basic/biological needs, financial needs, and a lack of connection. COVID-19 has shown the social work field the need for continued innovation and better practice standards for individuals who are not housed. For those living with a reported TBI history and experiencing homelessness, COVID-19 made it difficult to access basic services for survival. Full article
2 pages, 232 KiB  
Editorial
Acknowledgment to the Reviewers of Trauma Care in 2022
by Trauma Care Editorial Office
Trauma Care 2023, 3(1), 22-23; https://doi.org/10.3390/traumacare3010003 - 16 Jan 2023
Viewed by 805
Abstract
High-quality academic publishing is built on rigorous peer review [...] Full article
13 pages, 1064 KiB  
Systematic Review
Does Blast Mild Traumatic Brain Injury Have an Impact on PTSD Severity? A Systematic Review and Meta-Analysis
by Raphael Borinuoluwa and Zubair Ahmed
Trauma Care 2023, 3(1), 9-21; https://doi.org/10.3390/traumacare3010002 - 08 Jan 2023
Cited by 2 | Viewed by 2393
Abstract
Blast mild traumatic brain injury (mTBI) is a unique injury in the military population and post-traumatic stress disorder (PTSD) is shown to be linked with it. The main purpose of the systematic review was to understand the impact of blast mTBI on PTSD [...] Read more.
Blast mild traumatic brain injury (mTBI) is a unique injury in the military population and post-traumatic stress disorder (PTSD) is shown to be linked with it. The main purpose of the systematic review was to understand the impact of blast mTBI on PTSD symptom severity. We systematically searched Pubmed, Web of Science, Embase (Ovid), APAPsycINFO (Ovid) and Medline (R) and In-Process, In-Data-Review and Other Non-Indexed Citations (Ovid). Data extraction and quality assessment was completed using the AXIS tool. Statistical analysis was undertaken to determine differences between blast mTBI and the control group (no blast and no TBI in military personnel) and a meta-analysis using the random effects model was used to calculate between-study heterogeneity and variance through I2 and Tau2, respectively. Additionally, the likelihood of PTSD, analysed using the average PTSD Checklist (PCL) score, was also determined based. Statistically higher PCL scores were found in the blast mTBI group compared to control groups, but high heterogeneity was found between the studies (p < 0.001, I2 = 84%, Tau2 = 0.44). Furthermore, all studies reported that blast mTBI had probable PTSD, but this was not the case for the control group. Blast mTBI appears to impact on PTSD symptom severity and the likelihood of developing PTSD, which healthcare professionals need to be aware of. The high heterogeneity present in the studies means that caution must be exercised when interpreting the data from this study. However, future studies require more well-defined, high-quality studies to answer the question of how blast mTBI affects PTSD symptom severity. Full article
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8 pages, 826 KiB  
Article
A Retrospective Study of the Severity of Injury following Potassium Permanganate Ingestion in Teenagers and Adults in KwaZulu Natal, South Africa
by Samantha J. Beningfield, Emily A. Webber, George V. Oosthuizen and Sharon R. Čačala
Trauma Care 2023, 3(1), 1-8; https://doi.org/10.3390/traumacare3010001 - 05 Jan 2023
Viewed by 1458
Abstract
Introduction: Potassium Permanganate (KMnO4) is an uncommon cause of caustic ingestion in teenagers and adults; only case reports are found in the recent literature. At Ngwelezana Hospital in South Africa, KMnO4 ingestion is not an uncommon indication for admission. KMnO [...] Read more.
Introduction: Potassium Permanganate (KMnO4) is an uncommon cause of caustic ingestion in teenagers and adults; only case reports are found in the recent literature. At Ngwelezana Hospital in South Africa, KMnO4 ingestion is not an uncommon indication for admission. KMnO4 is readily available as used in most households and recommended for medicinal purposes by traditional health practitioners. Aim: To ascertain the reasons for KMnO4 ingestion, the extent and severity of injury as determined by upper gastro-intestinal studies, and patient outcomes in comparison with the available global literature. Methods: We performed a retrospective study of 26 teenage and adult patients, admitted to our adult wards following KMnO4 ingestion. Data collected on patient demographics, reason for KMnO4 ingestion, and quantity ingested. Oral inspection and upper gastro-intestinal study findings recorded with grading (Zargar) of corrosive injury to oesophagus and stomach. Patients’ outcome and duration of hospital stay documented. Results: There were 73% females and 27% males, with an average age of 23 years. Reasons for ingestion included parasuicide (84%), accidental ingestion (8%), and for relief of abdominal pain (8%). The vast majority (96%) swallowed KMnO4 in solution rather than in solid form. The volume and concentration of KMnO4 taken was difficult to quantify. Oral discoloration, oedema, and ulceration were found in 58%. Gastro-intestinal endoscopy was performed in 92%; abnormalities were demonstrated in 68% (oesophageal injury 14%, oesophageal and gastric injuries 14%, gastric injury alone 41%). Oesophageal injuries: n = 6; Zargar grade 1—83%, Zargar grade 2A—17%. Gastric injuries: n = 12; Zargar grade 1—42%, Zargar grade 2A—33%, Zargar grade 2B—25%. Average hospital stay was 2.9 days (range 2–8 days). There were no mortalities and no complications at 6 weeks. Conclusion: KMnO4 ingestion by teenagers and adults is not uncommon in our setting, mostly related to suicide attempts and most often taken in liquid form. KMnO4 was possibly of a low concentration as no systemic complications were noted and there were milder gastric and oesophageal injuries as compared to case reports from elsewhere of mucosal necrosis following ingestion of KMnO4. Full article
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