Peritraumatic Reactions and Intrusive Memories among Disaster Survivors: A Mixed Methods Investigation

Intrusive memories represent a hallmark symptom of post-traumatic stress disorder (PTSD). Cognitive theories of PTSD hypothesize that intrusive memories result from disruptions in information processing during traumatic memory encoding. The affective, cognitive, and behavioural reactions taking place during trauma have been termed peritraumatic reactions. These include reactions such as peritraumatic dissociation and tonic immobility. Experimental evidence has supported the theoretical claims concerning the role of peritraumatic reactions in the development of intrusive memories. This literature, however, presents a number of limitations. First, it relies on a conceptualisation of peritraumatic reactions based largely on quantitative measures with a large degree of conceptual overlap. Secondly, the identification of peritraumatic reactions has relied on clinical expertise, theory, and animal models, rather than on systematic investigations of survivors’ lived experience. Finally, studies on peritraumatic reactions and intrusive memories, have generally assessed peritraumatic reactions for the entire trauma rather than for the specific moments experienced as intrusive memories. This thesis set out to address these limitations. Firstly, I investigated the factorial structure of the six most widely used peritraumatic measures. This led to the identification of a psychometrically validated model comprising five distinct peritraumatic reactions. Secondly, I explored using a largely inductive analytical framework the lived experienced of peritraumatic reactions spontaneously reported in interviews. Finally, building on these findings, I confirmed the theory-informed claims that the specific moments of a trauma experienced as intrusive memories would be characterised by higher levels of peritraumatic reactions compared to moments from the same trauma that did not intrude. All research was conducted among earthquake survivors. The current findings hold various implications for the conceptualisation of peritraumatic reactions and intrusive memories. Additionally, they have a number of practical implications for the prevention and management of intrusive memories as well as for the wellbeing of disaster survivors more generally

Remembering the earthquake: intrusive memories of disaster in a rural Italian community

Background: Disasters can have long-lasting impacts on mental health. Intrusive memories have been found to be common and persistent in the aftermath of earthquakes. / Objective: To explore, using diaries, intrusive memories’ presence, content, characteristics, and relationship with probable post-traumatic stress disorder (PTSD) in a small rural community exposed to mass destruction and loss of life. / Methods: Survivors of the 2016–2017 Central Italy earthquakes (N = 104) were first interviewed to investigate the presence of intrusive memories of the disaster. Those that reported intrusive memories were subsequently asked to complete a 7-day paper-and-pen diary tracking their spontaneous memories of the earthquake events. / Results: Twenty months after the earthquakes, 49% (n = 51) of the sample reported having experienced intrusive memories post-earthquake and 38% (n = 39) reported at least one intrusive memory in their diaries. Memories were rated as being distressing, vivid, and experienced as a mixture of images and thoughts. The content of intrusive memories generally focused on sensations and experiences during the earthquake. Other common categories of content were the material environment and physical objects as well as human loss & death. Several memories had a social focus. A minority of memories contained more positive content as well as content from before and after the earthquake. Some participants (28%) experienced repeated intrusive memories of the same content. Memories of participants with and without probable PTSD did not significantly differ on characteristics or content. / Conclusions: Intrusive memories can be common, distressing, and persistent occurrences following disasters, even in survivors not suffering from probable PTSD

Common Musculoskeletal Disorders in the Elderly: The Star Triad

Musculoskeletal disorders are debilitating conditions that significantly impair the state of health, especially in elderly subjects. A pathological triad of inter-related disorders that are highly prevalent in the elderly consists of the following main “components”: sarcopenia, tendinopathies, and arthritis. The aim of this review is to critically appraise the literature relative to the different disorders of this triad, in order to highlight the pathophysiological common denominator and propose strategies for personalized clinical management of patients presenting with this combination of musculoskeletal disorders. Their pathophysiological common denominator is represented by progressive loss of (focal or generalized) neuromuscular performance with a risk of adverse outcomes such as pain, mobility disorders, increased risk of falls and fractures, and impaired ability or disability to perform activities of daily living. The precise management of these disorders requires not only the use of available tools and recently proposed operational definitions, but also the development of new tools and approaches for prediction, diagnosis, monitoring, and prognosis of the three disorders and their combination

Operative Management of Sciatic Nerve Palsy due to Impingement on the Metal Cage after Total Hip Revision: Case Report

This paper discusses a sciatic nerve palsy developed after a right total hip revision with a Burch-Schneider metal cage. A sciatalgic nerve pain appeared after surgery, while the palsy developed in about fifteen days. An electromyography showed the delay of the nerve impulse gluteal level. During the surgical exploration of the hip, a compression of the nerve on the metal cage was observed. The nerve was isolated, released from the fibrotic tissue and from the impingement, and was protected with a muscular flap. The recover from the pain was immediate, while the palsy recovered one month later

Adult Congenital Permanent Bilateral Dislocation of the Patella with Full Knee Function: Case Report and Literature Review

Congenital permanent dislocation of the patella is a rare disorder of the knee joint in which the patella is permanently displaced, even in extension and is fixed on the lateral aspect of the femoral condyle. The dislocation is irreducible without surgical techniques. This rare condition is usually detected within the first decade of life, because of inability of active extension in the knee and impaired ability during walking. This report presents an unusual case of a 51-year-old man with bilateral congenital permanent dislocation of the patella. The pathology had never been treated because there were few symptoms. The patient presented with right knee pain caused by a fall on the knee during his work. The right knee was painful on the lateral side and the clinical signs were positive for pathology of the lateral meniscus, confirmed by MRI. The clinical and the imaging findings suggested a lesion of the lateral meniscus as the probable cause of the pain. Therefore we performed a knee arthroscopy, whose intra-operative findings confirmed the MRI findings. During the surgery we performed just a selective arthroscopic meniscectomy, without correcting patella dislocation, because the condition was unusually asymptomatic before the trauma

Detection of temporary surface water bodies in Niger using high resolution imagery

Temporary surface water bodies in sub-Saharan areas have important socio-cultural values, providing freshwater for population and many agro-pastoral services. Nevertheless, they can be the perfect habitat for insects and pests, thus endangering human health. Moreover, temporary water bodies can cover vast areas of cities and villages hindering the practicability of the roads networks. Addressing the problem within villages and cities requires not only the identification of the extension and position of the water bodies, but also of their seasonal maximum potential extension. Temporary surface water bodies are usually remote sensed from satellite imagery. This technique is very effective on large scale, although limited at local scale by temporal and spatial resolutions of satellites. Traditional surveys can be time-consuming and limited by the hard surveying condition of the area, a valuable alternative to collect punctual and high resolution data are the UAVs (Unmanned Aerial Vehicles). This contribution presents a semi-automatic method to detect temporary surface water bodies at local scale using UAV high resolution imagery. It was tested in two villages of the Tillaberì region, South-West Niger. A digital terrain model (DTM, 10 cm grid) generated from UAV imagery and analysed to localize the depressions of the area with fill sink algorithm. The depressed areas were classified based on their depth and extension. The areas presenting high depth and extension were considered as potentially interested by temporary surface water bodies. The method was validated by the comparison to radiometric information (6cm/pixel) collected from near infrared (IR) and visible (Red Green Blue) sensors mounted on UAV during the rainy season, in a period of minimum expansion of temporary surface water bodies. The radiometric data were elaborated in a Normalized Difference Water Index (NDWI); which information correspond to the one obtained from the DTM. The proposed methodology appears solid and effective, and allows the identification of those areas that may be interested by temporary stagnant water in case of abundant precipitations. The cross-reading of radiometric and digital elevation information provides a high resolution localization of present, and potentially present, temporary surface water bodies

Algo-Functional Indexes and Spatiotemporal Parameters of Gait after Sacroiliac Joint Arthrodesis

Aims of the study were to evaluate the reliability and validity of the Italian version of the Majeed and Iowa questionnaires and to investigate the long-term surgical outcomes following sacroiliac joint arthrodesis. Twenty one patients who underwent a sacroiliac joint arthrodesis and 21 healthy subjects were evaluated. The experimental procedure consisted of gait analysis and a physical activity assessment (in both groups) and of administration of outcome questionnaires and pain assessment (in the patient group). The Majeed and Iowa questionnaires showed excellent reliability, excellent (for the Majeed questionnaire) and good (for the Iowa questionnaire) construct validity, and poor convergent validity (for both questionnaires) relative to walking speed. Most of the patients reported no pain and minimum pain-related disability and their physical activity profile was comparable to healthy controls. Patients showed an impaired walking performance (i.e., they walked slower and using shorter steps) compared with healthy controls. Long-term walking pattern abnormalities following sacroiliac joint arthrodesis may occur despite excellent clinical results. Given their excellent reliability and construct validity, the Majeed and Iowa questionnaires can be used in combination with the assessment of spatiotemporal gait parameters for the prognostic assessment and/or follow-up of surgical patients

Cross-cultural adaptation and validation of the Victorian Institute of Sports Assessment for Gluteal Tendinopathy questionnaire in Italian and investigation of the association between tendinopathy-related disability and pain

Background The Victorian Institute of Sports Assessment for gluteal tendinopathy (VISA-G) questionnaire has recently been proposed as a condition-specific patient reported outcome measurement tool to assess the tendinopathy-related disability. Aim The aim was to evaluate the reliability of the Italian version of the VISA-G questionnaire and its construct validity and to investigate the association between tendinopathy-related disability and pain. Design It consists in a cross-sectional study. Setting The location of the study was a university laboratory. Population We evaluated patients with gluteal tendinopathy (N.=38) and healthy controls (N.=38). Methods Subjects were asked to fill the VISA-G questionnaire twice to evaluate its reliability. The construct validity was evaluated by comparing the VISA score with the Oswestry Disability Index score. Moreover, pain intensity, extent and location were also investigated. Results The VISA-G scores showed non-significant changes in the median values and the values of intraclass correlation coefficient showed very high correlation between the first and second administration (ICC>0.90 in both populations). No significant correlations were found between VISA-G score and either pain extent (R=-0.05, P=0.76), or resting pain intensity (R=-0.13, P=0.45), or palpation pain intensity (R= 0.01, P=0.97). Conversely, a high (and significant) negative correlation was obtained between VISA-G score and Oswestry Disability Index score (R=-0.80, P<0.0001). Conclusions These results indicated that the VISA-G Italian version presents excellent test-retest reliability. Clinical rehabilitation impact The evaluation of gluteal tendinopathy-related disability through VISA-G can be useful for the prognostic assessment and/or follow-up of tendinopathy patients in combination with the pain drawing assessment of pain extent

Climatological Analysis and Early Warning System in the Sirba basin

Climatological Analysis on the Sirba basin: evaluation of rain climate inde