• Title/Summary/Keyword: community trauma

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Beloved: Identity Recovery through Rememory (『빌러비드』: 재기억을 통한 정체성 회복)

  • Kim, Hyejin
    • English & American cultural studies
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    • v.16 no.2
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    • pp.29-45
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    • 2016
  • The purpose of this study is to research how the writer describes characters of the text who overcome traumatic experiences and restore their identity through rememory in Toni Morrison's Beloved. The writer, Morrison gives the female characters their voices to recover their ethnic identities. By breaking silence, they establish their identities and become Americans from "unspeakable thoughts" to "speaking subjects." The ex-slave Sethe and her daughter, Denver have experienced trauma which works from traces of memory and history after slavery was abolished. Sethe and Denver are isolated from the community at the 124 Bluestone Road. When Beloved, ghost who was killed by Sethe, appears, Sethe and Denver are wondering who she is. Rememorying in Beloved is the important form of narrative that Morrison uses to recover their trauma. Morrison emphasizes the need to reconcile with the community and the aid of community for Sethe and Denver to heal their truma. Thanks to Beloved who leads Sethe and Denver to the community, they can be finally one of the community members in America.

Predictors of mortality by age in patients with major trauma in Korea (연령대별 사망 중증외상환자의 특성 비교)

  • Sang-Kyu Park;Tai-Hwan Uhm
    • The Korean Journal of Emergency Medical Services
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    • v.27 no.1
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    • pp.91-100
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    • 2023
  • Purpose: In patients with major trauma, mortality varies by age. This study aimed to identify predictors of death according to age. Methods: Data from the Community-Based Severe Trauma Survey in Korea were analyzed using a retrospective case-control design. Factors associated with death were identified by age using independent-samples t-tests, Welch's test, and χ2 tests. Results: There were statistically significant differences in mortality by sex (p=.006), location (p=.029), mechanism of injury (MOI) (p<.001), intention (p<.001), transportation (p<.001), surgery (p<.001), and Injury Severity Score (ISS) (p<.001) in the ≤44 years age group; by location (p<.001), MOI (p=.004), intention (p<.001), transportation (p<.001), surgery (p<.001), and ISS (p<.001) in the 45-54 years age group; by location (p=.040), MOI (p<.001), transportation (p<.001), transfusion (p<.001), surgery (p<.001), and ISS (p<.001) in the 55-64 years age group; by location (p=.015), intention (p<.001), surgery (p<.001), and ISS (p<.001) in the 65-74 years age group; and by location (p=.002), intention (p<.001), transfusion (p=.020), surgery (p<.001), and ISS (p<.001) in the ≥75 years age group. Conclusion: In patients with major trauma, predictors of mortality varied by age.

A Qualitative Study using the Grounded Theory on the Trauma Experiences of State Violence Victims (국가폭력 트라우마 경험에 대한 근거이론적 탐구)

  • Seok-Woong Kim;Young-Shin Kang
    • Korean Journal of Culture and Social Issue
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    • v.30 no.1
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    • pp.1-33
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    • 2024
  • This study analyzed the experiences of victims of state violence, discovered differences between state violence and general trauma, and proposed ways to help heal trauma. Participants were composed of state violence victims and their families in total, including 11 from the Jeju 43 Incident, 11 from the Yeos u·Sunchoen 10.19 Incident and 6 form May 18th Democratic Uprising. As a result of using the grounded theory to analyze data, a total of 170 concepts, 57 subcategories, and 20 categories were derived. The central phenomenon was direct damage caused by state violence. This included 'post-traumatic stress', 'social stigma', 'isolation from community', 'socio-economical issues' and 'family dissolution'. As a result of the process analysis, the participants experienced six phases: 'trauma', 'isolation', 'resistance', 'resignation', 'recovery', and 'growth.' Each phase is sequential but at the time mutually affect each other. Based on the results, this study verified the difference between state violence and general trauma, and emphasized social and cultural factors, such as community support, were important factors in healing state violence trauma. Besides, the implications and limitations as well as suggestions for future research were mentioned.

Comparative study of geographic differences of severe trauma mortality in Korea (한국의 중증외상 사망률의 지역적 차이에 대한 비교 연구)

  • Jeong, Tae-Wook;Jo, Ji-Yeon;Kim, Seong-Ho
    • The Korean Journal of Emergency Medical Services
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    • v.25 no.3
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    • pp.37-48
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    • 2021
  • Purpose: Mortality due to trauma is relevant to both low-income and high-income countries. A diversity of causes leads to mortality such as, socioeconomic status and geographic factors. This study sought to differentiate between cases of mortality in a metropolitan city and a rural area, with data from critical trauma patients. Methods: Community-based severe trauma surveillance data from 2018 was used in this study. Logistic regression was conducted to compare the odds ratios between deaths that occurred in a metropolitan city and a rural area. Multiple logistic regression by controlling variables such as type of medical institution and injury severity score was conducted to estimate the effect on the trauma patients. Results: In total, 28,217 participants were selected as total population. We observed that the odds of death decreased as the level of the trauma center increased. Compared to the metropolitan city, the odds ratio of rural areas was 1.44. The odds ratio increased as the injury severity score increased. Conclusion: This study suggests that the mortality of critical trauma patients is higher in rural areas than in metropolitan cities. More studies are needed to expand on this.

Endovascular embolization of persistent liver injuries not responding to conservative management: a narrative review

  • Simon Roh
    • Journal of Trauma and Injury
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    • v.36 no.3
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    • pp.165-171
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    • 2023
  • Trauma remains a significant healthcare burden, causing over five million yearly fatalities. Notably, the liver is a frequently injured solid organ in abdominal trauma, especially in patients under 40 years. It becomes even more critical given that uncontrolled hemorrhage linked to liver trauma can have mortality rates ranging from 10% to 50%. Liver injuries, mainly resulting from blunt trauma such as motor vehicle accidents, are traditionally classified using the American Association for the Surgery of Trauma grading scale. However, recent developments have introduced the World Society of Emergency Surgery classification, which considers the patient's physiological status. The diagnostic approach often involves multiphase computed tomography (CT). Still, newer methods like split-bolus single-pass CT and contrast-enhanced ultrasound (CEUS) aim to reduce radiation exposure. Concerning management, nonoperative strategies have emerged as the gold standard, especially for hemodynamically stable patients. Incorporating angiography with embolization has also been beneficial, with success rates reported between 80% and 97%. However, it is essential to identify the specific source of bleeding for effective embolization. Given the severity of liver trauma and its potential complications, innovations in diagnostic and therapeutic approaches have been pivotal. While CT remains a primary diagnostic tool, methods like CEUS offer safer alternatives. Moreover, nonoperative management, especially when combined with angiography and embolization, has demonstrated notable success. Still, the healthcare community must remain vigilant to complications and continuously seek improvements in trauma care.

Influence of Trauma Experiences and Social Adjustment on Health-related Quality of Life in North Korean Defectors (북한이탈주민의 외상경험과 사회적응이 건강 관련 삶의 질에 미치는 영향)

  • Jo, Eun Joo;Cho, Hyun Mee;Choi, Eun Joung
    • Research in Community and Public Health Nursing
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    • v.29 no.4
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    • pp.488-498
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    • 2018
  • Purpose: This study was conducted to identify the influence of trauma experiences and social adjustment on health-related quality of life in North Korean defectors. Methods: The subjects were 117 North Korean defectors living in B and Y city. The data were collected from September 1 to September 20, 2014, and analyzed by the SPSS/WIN 18.0 program. Results: Significant differences were found in the health-related quality of life with respect to the subjects' education, marriage status, types of dwelling, family types, duration of residence in South Korea, jobs in South Korea and in North Korea, families left in North Korea or other surrounding countries, and subjective health status. Health-related quality of life is negatively related to trauma experiences during escape from North Korea and during their life in South Korea. Health-related quality of life positively is related to social adjustment. The meaningful variables which influenced the subjects'health-related quality include social adjustment, job in South Korea, job in North Korea, current family structure, and trauma experiences in South Korea. Total explanatory power of these factors for health-related quality in North Korean Defectors is 43.0% and social adjustment is the most influential factor. Conclusion: Therefore, in order to enhance health-related quality of life in North Korean defectors, it is necessary for them to increase social adjustment and decrease trauma experiences. In addition, methods are needed to provide job opportunities, better education and family services for North Korean defectors.

A study on the characteristics of severe trauma patients by health insurance system (건강보험제도에 따른 중증외상 환자 특성 비교 연구)

  • Choi, Mi-Young;Lee, Hyo-Ju;Yun, Seong-Woo
    • Proceedings of the Korean Institute of Information and Commucation Sciences Conference
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    • 2022.10a
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    • pp.309-313
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    • 2022
  • This study was attempted to analyze the status of emergency room use of severe trauma patients using the health insurance system and to understand their characteristics. This study used data from the 'Community-based Severe Trauma Surveillance' investigated from January 1, 2018 to December 31, 2019. As a result, there were differences in the degree of disability after injury and whether treatment(surgery, trauma embolism, transfusion) was performed according to the type of medical insurance (p< .001), it was found that there was a statistically significant difference between the degree of disability before and after damage depending on the type of medical insurance (p< .001). Reviews of the health insurance system located for the well-being of the people should be continued from various angles, and specific improvement plans should be proposed.

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Epidemiology of Facial Bone Fractures During the Coronavirus Disease 2019 Pandemic: A Single Korean Level I Trauma Center Study

  • Kim, Min Ji;Yang, Kyung Min;Lim, Hyoseob
    • Journal of Trauma and Injury
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    • v.34 no.4
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    • pp.233-241
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    • 2021
  • Purpose: The medical community has been heavily impacted by the coronavirus disease 2019 pandemic. The management of facial trauma patients has been affected by the patient capacity of emergency rooms. In this study, we share our experiences of facial trauma management during the social lockdown period and investigate the epidemiological changes in facial bone fractures. Methods: A total of 997 patients who presented to Ajou University Hospital Emergency Center and were evaluated by plastic or maxillofacial surgeons for facial trauma were included in this retrospective study. Our study design was a comparative study of two groups: the 2019 group (control) and the 2020 group (the experimental group that experienced social lockdown). Results: The total number of emergency room inpatients reflected the national pandemic trends with three peaks in patient numbers. According to these trends, facial bone fractures had two different low points in August 2020 and December 2020. A comparison of the 2019 and 2020 facial bone fractures did not show a statistically significant difference in the total number of patients. An analysis of the causes of trauma showed that domestic accidents increased in 2020 (30.92%; p<0.001). Among the anatomical sites of facial injury in surgical patients, the frontozygomatic complex fracture increased the most in 2020 (p=0.018). Facial injuries with two separate sites of injury or with three or more involved sites also showed a significant increase in 2020 (p<0.001). Conclusions: We demonstrated that the incidence of facial trauma patients correlated with the incidence of patients presenting to the emergency department and that facial trauma is inextricably related to multi-trauma cases. Domestic accidents and facial trauma with multiple anatomically involved sites are increasing trends that need more attention.

Performance Evaluation of Emergency Medical Center (응급의료센터 성과 평가 기준개발과 적용)

  • Kang, Chul-Hwan;Kim, Yoon;Lee, Pyung-Soo;Kwon, Young-Dae;Kim, Chang-Yup;Shin, Young-Soo
    • Journal of Preventive Medicine and Public Health
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    • v.30 no.4 s.59
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    • pp.884-892
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    • 1997
  • Currently, there are 100 community emergency centers which expect to provide professional emergency care like Level 1 trauma centers in U.S.A. To evaluate perforance of emergency centers, most studies have been widely adopted death rate based methods such as Trauma and Injury Severity Score(TRISS) and A Severity Characterization of Trauma(ASCOT). However, these methods are only applicable in situation where registration process of trauma patients is well established. Therefore, an alternative method should be applied to evaluate performance of emergency centers in Korea which does not have well-developed registration scheme. This study aims to develop new performance measures which are applicable to Korea and evaluate performance of 35 community emergency centers through new measures. The new measures are included that 'W-statistic' ; death rate calculated on the basis of International Classification based Injury Severity Score(ICISS), and 'the degree of severity' ; rate of severe trauma patients of each emergency medical centers. The study results can be summarized as follows. First, about 34% of sample emergency centers show they provide proper care in terms of their function. Second, tertiary hospitals, university hospitals, and hospitals located in Seoul show higher severity degree of patients and lower severity-adjusted death rate.

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A Study on Countermeasure against Trauma and PTSD of Police Officers -Focused on In-depth Interview with Targets- (경찰공무원의 심리적 외상(Trauma)과 외상후 스트레스 장애(PTSD) 대응 방안에 관한 연구 -대상자 심층면접을 중심으로-)

  • Kang, Gil-Ju;Lee, Sang-Yeol
    • Korean Security Journal
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    • no.56
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    • pp.31-54
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    • 2018
  • The objective of this study is to provide psychological welfare promotion method of police officers who experience trauma and PTSD due to police activity in local community while handling various accidents and protecting civil life and safety at the forefront of the national disaster accident site. For this objective, following countermeasure was presented through trauma/PTSD-related literature and in-depth interview with police officers who experienced trauma and PTSD. First, psychological examination is required to be performed positively and realistically for the police officers. As police officers have high emotional labor stress not only by physical burden but also by civil service, a regular psychological examination shall be established systematically together with physical rest. Second, proper action for the regular psychological examination result of the police officers is required. Third, a psychological support system for the police officers is required to be established and for this objective, expansion of police-operated mindful accompanying center and its devoted operation are required to be performed. Fourth, an opportunity of getting rid of stress of police officers shall be provided and for this objective, required budget for activating club activity is required to be allocated and activity condition should be created.