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1.
Sci Rep ; 14(1): 8561, 2024 04 12.
Article in English | MEDLINE | ID: mdl-38609468

ABSTRACT

Trauma scientists have raised the alarm about the devastating consequences of the Ukraine war on mental health. We examined how higher education students-as indirect victims-coped with this conflict and how they emotionally reacted during 2022. We involved 2314 students from 16 countries through an online survey. A structural equation model indicated significant relations between war-related worry about military and macroeconomics domains and two coping strategies (opposition, support giving), in turn significantly linked with six emotions. The model was strongly invariant across gender, study field, and geographic area. The most frequent emotions were anger and anxiety, followed by two future-centred emotions (hopelessness and hope). Emotions were more frequent for females and students of the countries geographically close to the war region. Our findings call for evidence-based policy recommendations to be implemented by institutions to combat the negative short and long-term psychological sequelae of being witnesses of armed conflicts.


Subject(s)
Anxiety , Emotions , Female , Humans , Ukraine , Coping Skills , Students
2.
Article in English | MEDLINE | ID: mdl-38035795

ABSTRACT

The COVID-19 pandemic has had many traumatic consequences for the physical and psychological functioning of children and adolescents. Internet-based interventions can reach a large audience and be a potentially powerful resource for promoting well-being among young people. We tested the efficacy of the web application PandHEMOT®, developed ad hoc for increasing knowledge about pandemics, emotions, and emotion regulation. We involved a sample of 147 Italian third and seventh graders. The sample was assigned to an experimental (participating in the training) and a waitlist condition (who participated following a waitlist design). All the participants completed pretest and posttest measures. The intervention was structured into three units. The training took place between November and December 2021. Generalized linear mixed models and linear mixed models revealed that knowledge about pandemics, emotions, emotion regulation, and metacognitive awareness increased for the experimental condition. Moreover, adolescents performed better than children. The findings supported the efficacy of an Internet-based training for increasing children and adolescents' resilience, according to the standards of evidence-based research.

4.
Br J Psychol ; 114(4): 871-907, 2023 Nov.
Article in English | MEDLINE | ID: mdl-37171875

ABSTRACT

Natural disasters, including earthquakes, can have a traumatic impact on children's psychological wellbeing and development. The efficacy of interventions aimed at enhancing children's socio-emotional learning has been documented in the literature. At the same time, these techniques are the key for training children for possible future disasters by enhancing their knowledge about behavioural preparedness and emotional competence. However, research on evidence-based training programs on earthquakes combining digital and traditional activities is scarce. We tested the efficacy of a 10-unit training program for primary school children, developed within the Emotional Prevention and Earthquakes in Primary School (PrEmT) project. The program aimed at increasing knowledge of and metacognition about earthquakes, safety behaviours, emotions, and coping strategies, through digital (using the web-application HEMOT® , Helmet for EMOTions, developed ad-hoc) and traditional activities (completing paper-and-pencil tasks). The participants were 548 second and fourth-graders from Italian schools. They were divided into an experimental group (participating in the training program) and a control group. Both groups participated in pretests and posttests to evaluate changes in their knowledge of training-related contents. For ethical reasons, we also measured children's wellbeing. Generalized linear mixed models indicated an improvement in the experimental group's knowledge and metacognition about earthquakes, safety behaviours, emotions, and coping strategies after the training program, compared to the control group. Children's general wellbeing did not deteriorate during participation in the project. The results documented the efficacy of the evidence-based training program developed within the PrEmT project. The program provides a preventive method for enhancing earthquake-related resilience that could be generalized to other kinds of disasters.


Subject(s)
Disasters , Earthquakes , Humans , Child , Emotions , Adaptation, Psychological
5.
Child Youth Care Forum ; 52(1): 25-63, 2023.
Article in English | MEDLINE | ID: mdl-35221639

ABSTRACT

Background: Following disasters, children and adolescents can use coping strategies to feel better. A growing body of studies investigated the relation between them and maladjustment/adjustment, i.e., negative symptomatology/positive indicators of development. Yet, these constructs are studied separately. Objective: We conducted two meta-analyses to examine the mean correlation between disaster-related coping strategies and indicators of maladjustment/adjustment following natural disasters in children and adolescents, considering the role of some moderators. Methods: We used PsycINFO, PubMed, Eric, and Scopus databases to identify articles on natural disasters (filters: participants ≤ 18 years at the disaster, peer-review, English language). Inclusion required investigating the relation between at least one coping strategy and at least one indicator of maladjustment (e.g., post-traumatic stress disorder, depression) and/or adjustment (e.g., self-efficacy, emotion understanding), for a total of 26 studies (k = 64, n = 9692, for maladjustment; k = 37, n = 3504, for adjustment). Results: There were global positive significant correlations between coping strategies and negative symptomatology (r pooled = .23) for maladjustment, and positive indicators (r pooled = .17) for adjustment. Negative symptomatology positively correlated with escape (r = .19), social isolation (r = .15), submission (r = .64), and opposition (r = .16); positive indicators positively correlated with problem solving (r = .31), social support (r = .22), and submission (r = .30). We found a moderating role of age, disaster type, and continent for maladjustment. Conclusions: The study presented an analysis of the coping strategies that can be effective for children and adolescents dealing with natural disasters.

6.
Nat Commun ; 13(1): 7840, 2022 12 21.
Article in English | MEDLINE | ID: mdl-36543787

ABSTRACT

West Antarctic ice-shelf thinning is primarily caused by ocean-driven basal melting. Here we assess ocean variability below Thwaites Eastern Ice Shelf (TEIS) and reveal the importance of local ocean circulation and sea-ice. Measurements obtained from two sub-ice-shelf moorings, spanning January 2020 to March 2021, show warming of the ice-shelf cavity and an increase in meltwater fraction of the upper sub-ice layer. Combined with ocean modelling results, our observations suggest that meltwater from Pine Island Ice Shelf feeds into the TEIS cavity, adding to horizontal heat transport there. We propose that a weakening of the Pine Island Bay gyre caused by prolonged sea-ice cover from April 2020 to March 2021 allowed meltwater-enriched waters to enter the TEIS cavity, which increased the temperature of the upper layer. Our study highlights the sensitivity of ocean circulation beneath ice shelves to local atmosphere-sea-ice-ocean forcing in neighbouring open oceans.


Subject(s)
Atmosphere , Bays , Oceans and Seas , Temperature , Hot Temperature , Ice Cover , Antarctic Regions , Caspase 1
7.
Front Psychol ; 13: 995232, 2022.
Article in English | MEDLINE | ID: mdl-36405186

ABSTRACT

Wars and armed conflicts have a devastating impact at the economic, social, and individual level. Millions of children and adolescents are forced to bear their disastrous consequences, also in terms of mental health. Their effects are even more complicated when intertwined with those of other disasters such as the current COVID-19 pandemic. To help them face such adverse events, lay adults can be supported by psychoeducational interventions involving simple tools to assist children and adolescents emotionally. Hence, we planned and implemented two public communication campaigns concerning wars to support adult carers such as parents, teachers, educators, psychologists, first responders, and others interested in young people's wellbeing. We developed psychoeducational materials to help children and adolescents cope with negative emotions related to indirect and direct exposure to wars. This study had the objective to identify the content for two pamphlets, testing their comprehensibility, usability, and utility, and monitoring their dissemination. First, based on classifications of coping strategies and on a previous campaign about COVID-19 pandemic, we decided to include in the psychoeducational materials basic information on news about wars and common reactions to wars, respectively; on emotions that might be experienced; and on coping strategies for dealing with negative emotions. For the first pamphlet, we identified the strategies involving 141 adults. They completed an online survey with open-ended questions concerning ways to help children and adolescents cope with negative emotions associated with the Russia-Ukraine war. For the second pamphlet, we selected the contents based on Psychological First Aid manuals. Through content analyses, we chose 24 strategies. Second, data gathered with 108 adults who had consulted the psychoeducational materials supported their comprehensibility, usability, and utility. Third, we monitored the visibility of the campaigns after the release of the pamphlets, using Google Analytics™ data from the HEMOT® website through which we disseminated them. To conclude, our findings supported the comprehensibility, the usability, and the utility of the two pamphlets, to be disseminated as psychoeducational materials in the early phase of a disaster.

8.
Learn Instr ; 80: 101629, 2022 Aug.
Article in English | MEDLINE | ID: mdl-35578734

ABSTRACT

The outbreak of the COVID-19 pandemic has had a wide range of negative consequences for higher education students. We explored the generalizability of the control-value theory of achievement emotions for e-learning, focusing on their antecedents. We involved 17019 higher education students from 13 countries, who completed an online survey during the first wave of the pandemic. A structural equation model revealed that proximal antecedents (e-learning self-efficacy, computer self-efficacy) mediated the relation between environmental antecedents (cognitive and motivational quality of the task) and positive and negative achievement emotions, with some exceptions. The model was invariant across country, area of study, and gender. The rates of achievement emotions varied according to these same factors. Beyond their theoretical relevance, these findings could be the basis for policy recommendations to support stakeholders in coping with the challenges of e-learning and the current and future sequelae of the pandemic.

9.
Psychol Trauma ; 14(7): 1107-1116, 2022 Oct.
Article in English | MEDLINE | ID: mdl-31697107

ABSTRACT

OBJECTIVE: Previous literature documented the traumatic consequences of exposure to disasters on psychological functioning, but little attention has been paid to the intergenerational transmission of the memory of disasters. We explored long-term effects on the memory of the Vajont dam disaster in Northeast Italy that claimed 1,910 lives in 1963. METHOD: We collected data from 52 two-generation families in which the first generations were born before the disaster and the second generations after. The families were divided into an experimental group whose first generation survived the disaster and a control group whose first generation had moved there afterward. The interviews included an open-ended narrative on the memory of the disaster. We coded free narratives focusing on the richness of the memories (i.e., length, causes, core, aftermath), analyzing negative emotions and salience of the natural and psychological domains. RESULTS: We applied generalized linear mixed models. The richness of the memories, including references to negative emotions, diminished with lower exposure and with intergenerational transmission. Moreover, the participants built a shared representation of the disaster that did not markedly differ across exposure or generation. The reported causes were attributed more to the natural rather than the human domain; the consequences more to the psychological compared to the material domain. CONCLUSIONS: Our findings highlight the processes through which collective memories of historical traumatic events are built over the long term and the way a collective identity develops to bear the burden of highly dramatic events and to transmit intergenerational lessons from the past. (PsycInfo Database Record (c) 2022 APA, all rights reserved).


Subject(s)
Disasters , Attention , Humans , Italy , Narration
10.
Front Psychol ; 12: 725344, 2021.
Article in English | MEDLINE | ID: mdl-34566809

ABSTRACT

The psychological consequences of epidemics/pandemics, such as the COVID-19 pandemic, include an increase in psychopathological symptoms, such as depression, anxiety, and stress, and negative emotions, such as fear. However, relatively little attention has been paid to how people cope with the pandemic. Coping is a multi-component process, helping to diminish the traumatic impact of stressful events in a variety of ways. We studied how university students coped with the first wave of the COVID-19 pandemic, by developing the Robust - Pandemic Coping Scale (R-PCS), a new scale for measuring coping strategies related to epidemics/pandemics. The scale is based on a classification of coping strategies referred to the needs of competence, relatedness, and autonomy. To create a robust scale, such that the item values would be independent of the sample used for developing it, we employed Rasch modeling. We used a sample of 2,987 Italian university students who participated in an online survey including the R-PCS and the Power to Live with Disasters Questionnaire (PLDQ), during March 2020. First, we applied a dual approach combining exploratory and confirmatory factor analyses, which supported the goodness of a 4-factor model (i.e., Despair, Adjustment, Proactivity, and Aversion) for the R-PCS, invariant across gender and age of respondents (younger or as old as 23 years, older than 23 years). We then transformed the raw scores of the R-PCS into interval logit scale scores applying the Rasch model. Second, our findings supported the discriminant validity and the criterion validity of the R-PCS, examining the correlations with the PLDQ. They also confirmed its predictive validity: the R-PCS scores were related to 2-month-later enjoyment and anger, indicating that Adjustment and Proactivity were adaptive while Despair and Aversion were maladaptive. Third, our study revealed gender and age differences: the scores were higher for Despair, Adjustment, and Proactivity for females; for Aversion for males; and for Proactivity for students older than 23 years. The study suffers from limitations related to social desirability, gender imbalance, and self-selection effects in the recruitment.

11.
Psychol Rep ; 124(2): 417-437, 2021 Apr.
Article in English | MEDLINE | ID: mdl-31694463

ABSTRACT

In recent decades, there has been an increasing volume of research aimed out quantifying the extent to which the natural environment can assist in restoring mental, emotional, and physical well-being. It is commonly assumed that natural environments are more restorative than urban environments. However, studies addressing this issue use a variety of methods for data collection making it difficult to compare the findings of different studies. The research reported here uses a meta-analysis aimed at estimating how much natural environments are perceived as being more restorative than urban environments. We investigated the role of moderator variables such as research design, kind of natural environment, participants, measurement instruments used or the context in which the data were collected. PsycINFO, PsycARTICLES, Scopus, SpringerLINK, Web of Science online databases were used to identity all peer-review articles on restorativeness published to date (k = 167). Reference sections of obtained papers were examined for additional studies. Only 22 studies met inclusion criteria (direct exposure to environment, comparison between one outdoor environment with natural element and one without natural element, and restorativeness measured by self-report scale) and were included in meta-analysis. Results show that natural environments are perceived to be more restorative than urban environments (Cohen's d (confidence interval) = 1.99 (1.38-2.61)). Significant heterogeneity between the study was found (Q(19) = 503.16, p < .001) and variability within studies was very high (I2 = 97%). However, subsequent univariate moderator analyses were not significant. Other methodological differences (e.g., lighting conditions) could explain this variability. We concluded that the variability in studies is more likely to be due to individual differences (e.g., age, connections to nature, and environmental attitude) than the methodological differences.


Subject(s)
Emotions , Health , Rejuvenation , Wilderness , Cities , Humans , Mental Health
12.
Psychol Health Med ; 26(5): 571-583, 2021 06.
Article in English | MEDLINE | ID: mdl-32755469

ABSTRACT

Natural disasters such as earthquakes have a highly traumatic impact on psychological functioning. Recently, the study of children's earthquake-related emotions and coping strategies has gathered attention. However, little is known on the corresponding adults' representation, adults who in case of disasters are frequently key informants on children's reactions. Examining the influence of earthquake experience, we explored adults' expectations on children's earthquake-related emotions and coping strategies. The participants were 572 Italian university students. Referring to what happens during and after earthquakes, they were asked to list children's (a) expected emotions, and (b) coping strategies for diminishing fear and sadness. We coded (a) number of fear, sadness, and anger terms; (b) presence of 13 coping strategies. We used Generalized Linear Mixed Models. Fear was more frequent than sadness, and more frequent during vs. after earthquakes (and vice versa for sadness). Some coping strategies were reported rarely, while others were more salient (i.e. problem-solving, information-seeking, self-reliance, support-seeking, and accommodation). Earthquake experience had a marginal impact. Our findings enable us to deepen knowledge on the emotional representation of earthquakes. At an applied level, they can help professionals to develop training programs aimed at increasing children's emotional preparedness.


Subject(s)
Disasters , Earthquakes , Emotions , Motivation , Adaptation, Psychological , Adult , Child , Humans
13.
Front Psychol ; 11: 508300, 2020.
Article in English | MEDLINE | ID: mdl-33192758

ABSTRACT

The research project is a small pilot study of the restorative aspects of museum experience on children; these include the sense of fascination during the visit. Museum environmental awareness was a latecomer to Museum and Visitor studies but is now highly valued. No longer just the "objects" contained in the museum fascinate but also the environment itself becomes an object of fascination. Some authors provide a clear categorization of feelings experienced by the visitor during a museum experience and suggest a framework with four categories of satisfying experience: objective, cognitive, introspective, and social. In designing our study, we began with the definition of museum experience and added a fifth category of "environmental experience." With this term, we refer to the extent to which the physical environment in and around a museum affects visitors. Indeed, our aim is to analyze the visitor's stream of feelings and opinions during a museum visit (specifically, the MART-Museum of Modern and Contemporary Art of Trento and Rovereto) to find a proper definition of the aesthetic elements characterizing the "environmental preference." To do this, we referenced classical and experimental paradigms of Environmental Psychology applied to a museum context and building aesthetic researches, combining qualitative and quantitative approaches. The case study involved 41 children, 20 male and 21 female, from two primary school classes in Rovereto (Italy); the average age was 8.3 years old.

14.
Front Psychol ; 11: 2184, 2020.
Article in English | MEDLINE | ID: mdl-33013563

ABSTRACT

Epidemics and pandemics can traumatically impact the emotional wellbeing of adults, children, and adolescents in diverse ways. This impact can be reduced by applying a range of evidence-based coping strategies. Based on previous research, we created a pamphlet-based communication campaign designed to assist adults to provide support for young people confronted with emotional distress associated with the pandemic caused by the novel coronavirus [severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)] and the related disease [coronavirus disease (COVID-19)] in 2020. We developed a pamphlet describing the common emotions children and adolescents report feeling in the face of disasters and the coping strategies that have proven effective in mitigating them. The target population was adults who interact with children and adolescents in both formal and informal settings. The pamphlet included basic information on this specific emergency, emotions that might be commonly experienced, and coping strategies for dealing with negative emotions. The aim of this paper is to describe the planning, development, and implementation of the campaign. First, we monitored how the media gave visibility to the campaign during the 40 days following the release of the pamphlet: it potentially reached a large audience at a national and international level through at least 216 media channels included the HEMOT® (Helmet for EMOTions) website. Second, Google Analytics™ data from the HEMOT® website enabled us to examine the characteristics of the visitors to the website and the behavior of those who viewed the pamphlet. More than 6,000 visitors, most from Europe followed by the Americas, visited the website in the first 40 days after the pamphlet publication. The webpage including the pamphlet obtained over 6,200 views, most directly or via other websites. A cluster analysis suggested that the access to the webpage did not mirror the trend concerning the new cases of COVID-19 in Italy (which increased during the central phase of the campaign) or worldwide (which continued to increase across the 40 days). Third, data gathered with a convenience sample of adults who had consulted the pamphlet provided a perspective on the comprehensibility of the messages conveyed by the pamphlet and on the utility for children and adolescents. The process we have demonstrated in this example could be replicated in different communities and settings to respond to the spread of the COVID-19 or to respond to other widespread or more localized disasters.

15.
Appl Ergon ; 89: 103214, 2020 Nov.
Article in English | MEDLINE | ID: mdl-32791346

ABSTRACT

With the increase in digital communications systems and social media, there is a need for simple graphics-based ways to signal the occurrence of major disasters. We describe the development and initial usability testing of a sign to indicate that an earthquake has occurred. We involved 264 Italian adults, who completed an online survey to evaluate the evocativeness, simplicity, and universality of 16 emojis depicting earthquakes. Through a Self-Organising Map analysis we identified four similar response profiles to the evocativeness scale, differing in their mean strength. A non-metric Multidimensional Scaling suggested that evocativeness was higher for the emojis featuring a damaged building. Linear Mixed Models indicated that emojis with fabricated vs. natural structures were judged as more evocative, simpler, and more universal when characterized by danger from falling objects. In some cases, adding behavioral elements increased evocativeness. Practical implications for informing the development of a new emoji for earthquakes are discussed.


Subject(s)
Computer Graphics , Disaster Planning/methods , Earthquakes , Facial Expression , Information Dissemination/methods , Adult , Comprehension , Female , Humans , Italy , Linear Models , Male , Photic Stimulation , Social Media , Surveys and Questionnaires
16.
Mar Pollut Bull ; 156: 111258, 2020 Jul.
Article in English | MEDLINE | ID: mdl-32510400

ABSTRACT

Hydrodynamics play a critical role in determining the trajectory of an oil spill. Currents, stratification and mesoscale processes all contribute to how a spill behaves. Using an industry­leading oil spill model, we compare forecasts of oil dispersion when forced with two different hydrodynamic models of the North-West European Shelf (7 km and 1.5 km horizontal resolution). This demonstrates how the trajectory of a deep water (>1000 m) release in the central Faroe-Shetland Channel is influenced by explicitly resolving mesoscale processes. The finer resolution hydrodynamic model dramatically enhances the horizontal dispersion of oil and transports pollutant further afield. This is a consequence of higher mesoscale variability. Stratification influences the depth of subsurface plume trapping and subsequently the far-field transport of oil. These results demonstrate that the choice of hydrodynamic model resolution is crucial when designing particle tracking or tracer release experiments.


Subject(s)
Petroleum Pollution/analysis , Water , Hydrodynamics
17.
PLoS One ; 12(12): e0189633, 2017.
Article in English | MEDLINE | ID: mdl-29261748

ABSTRACT

OBJECTIVES: We explored whether and how the exposure to a natural disaster such as the 2012 Emilia Romagna earthquake affected the development of children's emotional competence in terms of understanding, regulating, and expressing emotions, after two years, when compared with a control group not exposed to the earthquake. We also examined the role of class level and gender. METHOD: The sample included two groups of children (n = 127) attending primary school: The experimental group (n = 65) experienced the 2012 Emilia Romagna earthquake, while the control group (n = 62) did not. The data collection took place two years after the earthquake, when children were seven or ten-year-olds. Beyond assessing the children's understanding of emotions and regulating abilities with standardized instruments, we employed semi-structured interviews to explore their knowledge of earthquakes and associated emotions, and a structured task on the intensity of some target emotions. RESULTS: We applied Generalized Linear Mixed Models. Exposure to the earthquake did not influence the understanding and regulation of emotions. The understanding of emotions varied according to class level and gender. Knowledge of earthquakes, emotional language, and emotions associated with earthquakes were, respectively, more complex, frequent, and intense for children who had experienced the earthquake, and at increasing ages. CONCLUSIONS: Our data extend the generalizability of theoretical models on children's psychological functioning following disasters, such as the dose-response model and the organizational-developmental model for child resilience, and provide further knowledge on children's emotional resources related to natural disasters, as a basis for planning educational prevention programs.


Subject(s)
Earthquakes , Emotions , Adult , Child , Female , Humans , Italy , Male , Middle Aged , Stress, Psychological
18.
Br J Soc Psychol ; 56(2): 393-415, 2017 Jun.
Article in English | MEDLINE | ID: mdl-28198077

ABSTRACT

Retaining blood donors is a cost-effective way of ensuring a safe blood supply, yet despite the plethora of research, only 5.1% of the eligible population in Australia donate blood and 40% of these do not make a second donation. We offer an alternative to traditional approaches by conceptualizing blood donation within social representations theory as socially derived symbolic knowledge with a specific focus on cognitive polyphasia and Guimelli's (1998) normative and functional dimensions. An online survey, completed by 703 residents from NSW Australia, comprised a blood donation word association task, Likert-style questions constructed from previous word association data and contextualized blood donation statements. Individual difference scaling analysis revealed all donor groups (including non-donors) associated blood donation with a few central, albeit contradictory ideas/beliefs. Exploratory factor analysis and confirmatory factor analysis performed on a split data set of the Likert-style items reiterated this finding. Interpreted through Guimelli's dichotomy, all donor groups were aware of these contradictory normative and functional ideas/beliefs but when explicitly asked, it was the functional aspect that differentiated the groups. We argue the key to retaining donors is understanding the interdependence between how blood donation is socially understood at the societal level of discourse and donor behaviour. Translational strategies for recruitment and retention are discussed.


Subject(s)
Blood Donors/psychology , Motivation , Social Responsibility , Adolescent , Adult , Aged , Aged, 80 and over , Donor Selection , Factor Analysis, Statistical , Female , Humans , Male , Middle Aged , Translations , Young Adult
19.
J Bacteriol ; 193(17): 4541-2, 2011 Sep.
Article in English | MEDLINE | ID: mdl-21725020

ABSTRACT

Rhodocyclales are representative of versatile bacteria that are able to utilize a wide variety of organic compounds for growth, but only a few strains have been isolated in pure culture thus far. Here we present the genome sequence of Methyloversatilis universalis FAM5(T), the first cultivable methylotrophic member of the order.


Subject(s)
Genome, Bacterial , Rhodocyclaceae/genetics , Rhodocyclaceae/isolation & purification , DNA, Bacterial/genetics , DNA, Bacterial/isolation & purification , Geologic Sediments/microbiology , Molecular Sequence Data , Multigene Family , Oxidation-Reduction , Phylogeny , Sequence Analysis, DNA , Signal Transduction
20.
J Trauma ; 65(6): 1209-16, 2008 Dec.
Article in English | MEDLINE | ID: mdl-19077603

ABSTRACT

BACKGROUND: Ultrasound (US) has an ever increasing scope in the evaluation of trauma, but relies greatly on operator experience. NASA has refined telesongraphy (TS) protocols for traumatic injury, especially in reference to mentoring inexperienced users. We hypothesized that such TS might benefit remote terrestrial caregivers. We thus explored using real-time US and video communication between a remote (Banff) and central (Calgary) site during acute trauma resuscitations. METHODS: A existing internet link, allowing bidirectional videoconferencing and unidirectional US transmission was used between the Banff and Calgary ERs. Protocols to direct or observe an extended focused assessment with sonography for trauma (EFAST) were adapted from NASA algorithms. A call rota was established. Technical feasibility was ascertained through review of completed checklists. Involved personnel were interviewed with a semistructured interview. RESULTS: In addition to three normal volunteers, 20 acute clinical examinations were completed. Technical challenges requiring solution included initiating US; audio and video communications; image freezing; and US transmission delays. FAST exams were completed in all cases and EFASTs in 14. The critical anatomic features of a diagnostic examination were identified in 98% of all FAST exams and a 100% of all EFASTs that were attempted. Enhancement of clinical care included confirmation of five cases of hemoperitoneum and two pneumothoraces (PTXs), as well as educational benefits. Remote personnel were appreciative of the remote direction particularly when instructions were given sequentially in simple, nontechnical language. CONCLUSIONS: The remote real-time guidance or observation of an EFAST using TS appears feasible. Most technical problems were quickly overcome. Further evaluation of this approach and technology is warranted in more remote settings with less experienced personnel.


Subject(s)
Image Processing, Computer-Assisted/instrumentation , Multiple Trauma/diagnostic imaging , Patient Transfer/methods , Remote Consultation/instrumentation , Resuscitation/instrumentation , Telemetry/instrumentation , Ultrasonography/instrumentation , Adult , Alberta , Athletic Injuries/diagnostic imaging , Crush Syndrome/diagnostic imaging , Equipment Design , Feasibility Studies , Female , Hemoperitoneum/diagnostic imaging , Hospitals, Rural , Humans , Internet/instrumentation , Male , Patient Care Team , Pilot Projects , Pneumothorax/diagnostic imaging , Sensitivity and Specificity , Skiing/injuries , Software , Telecommunications/instrumentation , Trauma Centers , Young Adult
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