Breaching the Alps

The Roman preoccupation with the Alps as the tutamen of Italy owed its epistemic immediacy to a much more recent event—the Cimbric Wars (113-101 BCE). This traumatic episode had reawakened imagery of the northern enemies penetrating the “Wall of Italy,” which in some cases went all the way back to the Mid-Republican narrative traditions of the Gallic Invasions and the much more frequently debated shock of Hannibal’s invasion. The significance of this imagery continued even beyond the Augustan era, so that remnants of the same Roman insecurity about the “Wall of Italy” being breached, especially by northerners, are preserved in narratives about later Julio-Claudians such as Caligula and Nero. This article first looks at the likely origins of the idea of the Alps as the “Wall of Italy” in Middle-Republican perceptions, projected back onto the past and presenting Rome as predestined to dominate Italy and the Gauls in particular as external intruders in the peninsula. Next, the Late Republican and Augustan stages of the motif is reviewed, and the impact of the Cimbric Wars on this imagery is debated. Finally, there will be brief discussion of anecdotes found in Tacitus and Suetonius about later Julio-Claudian episodes in which the fear of a northern invasion breaching the Alps seem to have gripped the Romans.

Psychological prevention of injuries of the musculoskeletal system in elite athletes

The article presents a study of traumatic experiences by high-class athletes (members of the Russian national teams). Data on the subjective sensations of athletes who have suffered from injury of the musculoskeletal system are obtained, patterns in the perception of the consequences of an injury event are revealed. Also we present data on the attitude of athletes to injury in the aspect of professional activity. The analyzed information is an important component in the development of personalized programs for the prevention of reinjury in elite sports.Objective: to assess the psychoemotional experiences of sports trauma by elite athletes in the process of rehabilitation treatment after the musculoskeletal system injury.Materials and methods: a specially developed medical and psychological interview was conducted with athletes-members of the sports national Russian Federation teams, who are inpatient treatment in the sports traumatology department, in order to obtain primary subjective information from the athlete about his presentation of his own experiences of a traumatic episode. Further, the information obtained from the interviews was analyzed and grouped for further evaluation.Results: we state the significant influence exerted by the previous traumatic experience on the future life and professional activity of an athlete. Moreover, the influence can be both negative (fear, anxiety, kinesiophobia, uncertainty in sports-specific movements) and positive (acquired skills of coping with traumatic experiences, gaining new knowledge about one’s physical and psychological capabilities).Conclusions: thus, despite the diversity of individual reactions of athletes to injury, different life situations, sports and traumatic events, it is possible to identify general patterns in the perception of elite athletes of the injury itself, as well as the entire process of recovery and return to sports. This information is very important both for minimizing the negative impact of a sports injury on the psychological recovery of an athlete by switching his attention to identifying the “positive” consequences of the injury, and for the prevention of repeated injuries in elite sports.

Randomized Controlled Trial: Self-Care Traumatic Episode Protocol (STEP), Computerized EMDR Treatment of COVID-19 Related Stress

Healthcare workers and Mental Health clinicians are at heightened risk for mental health issues while they support their communities during the COVID-19 pandemic, and early psychological intervention is crucial to protect them. The Self-Care Traumatic Episode Protocol (STEP) is a computerized intervention adapted from the Eye Movement Desensitization and Reprocessing Group Traumatic Episode Protocol (EMDR G-TEP). This study evaluated the effectiveness of STEP for Mental Health clinicians in the context of COVID-19. Thirty-four Mental Health clinicians were randomly allocated to treatment (n = 17) or waitlist (n = 17). The Generalized Self-Efficacy Scale (GSE) and Depression and Anxiety Stress Scale (DASS- 21) were completed by the treatment group at baseline and 1-week follow-up postintervention and by the waitlist group at baseline, preintervention, and 1-week follow-up postwaitlist. Pre–post comparisons showed a significant decrease in depression, anxiety, and stress for Immediate Treatment, t(15) = −3.64, p < .01, d = .73, and for Delayed Treatment, t(15) = −3.53, p < .01, d = .68, There was also a significant increase in general self-efficacy for Immediate Treatment, t(15) = 2.87, p < .05, d = .46, and Delayed Treatment, t(15) = 3.72, p < .01, d = .56. The randomized controlled trial (RCT) indicated that STEP may be effective in increasing general self-efficacy and reducing symptoms of depression, anxiety, and stress among Mental Health clinicians in the context of COVID-19. Further research investigating the potential of utilizing the STEP intervention on a larger scale and with other populations is needed.

Ossified longitudinal ligament causing same level cord contusion in a case of Klippel-Feil syndrome

Klippel-Feil syndrome (KFS) is a congenital fusion of two or more cervical vertebrae due to faulty segmentation of the vertebral axis during gestation. (1-5) These patients present with a constellation of manifes­tations and are typically prone to cervical cord injury after a minor fall or a major traumatic episode. (2, 5-8) 34 years old gentlemen, a plumber by profession presented with a history of slipped and fall about two stairs height while he was working.

Tibia stress injury and the imaging appearance of stress fracture in juvenile dermatomyositis: six patients’ experiences

Background Tibial stress injuries are frequent injuries of the lower extremity and the most common causes of exercise-induced leg pain among athletes and military recruits. They sometimes occur in patients with pathological conditions of bone metabolism such as osteoporosis or rheumatoid arthritis, but there are previously no cases reported in juvenile dermatomyositis (JDM). Here we report 6 JDM patients who presented with shin pain, and the imaging appearance of tibial stress fractures or stress reactions. Case presentation All 6 patients with JDM presented with shin pain or tenderness in the anterior tibia without any evidence of excessive exercise or traumatic episode. They were diagnosed with tibial stress injuries based on a combination of radiographs, three-phase bone scans, and magnetic resonance imaging (MRI), and 5 out of 6 patients had been treated with prednisone and/or methotrexate at onset of tibial stress injuries. In one patient, we could not find any abnormalities in his radiograph, but the subsequent MRI showed tibial stress reaction. In all 6 patients, the tibial stress injuries improved with only rest and/or analgesics. Conclusion We experienced 6 children with JDM who presented with shin pain, and who were diagnosed with tibial stress fractures or stress reactions. Their underlying disease and weakness, treatment with glucocorticoid and methotrexate, or inactivity may have resulted in these tibial injuries, and made these patients more predisposed than other children. In addition to preventing JDM patients from getting osteoporosis, we need to consider stress reactions when children with JDM complain of sudden shin pain.

Ankle lesions and shortening of the forearm on a female from the Roman city of Augusta Emerita (Mérida, Spain): consequences of an accidental traumatic episode during growth?

In one Roman funerary area (1st-2nd centuries AD) of Augusta Emerita, an adult female skeleton was found, showing multiple healed trauma, being one the first evidences of this kind documented in the capital of Lusitania. This study describes those lesions, reconstructs the possible events responsible and hypothetical impact on the subject’s quality of life. Macroscopic and radiological observation revealed fractures of the left distal third of the radius and the ulnar styloid process, as well as of the distal third of the left fibula. Those of the forearm, caused a shortening of about one centimetre, probably resulting from a fall during growth. The fracture of the fibula would have occurred from an underfoot accident resulting also in a heterotopic ossification of the distal anterior ligament. Since both fractures are well consolidated and without degenerative articular lesions, this woman probably did not suffer significant sequelae thereafter.

Transgenerational Trauma, Shared Vulnerability and Interconnectedness in Zina Rohan’s The Small Book

This article aims at showing that extreme situations, such as wars, can reveal a common human vulnerability, which thus leads to a lack of sovereignty affecting all the agents implied in the traumatic episode. In Zina Rohan’s 2010 novel, The Small Book, this shared vulnerability crosses time and space boundaries by connecting coetaneous characters and their subsequent generations through inherited traumatic memories. These connections lead Rohan to blur the boundaries between what we may understand as victims and perpetrators of trauma. Thus, drawing on significant theories within the fields of trauma and memory studies as well as on conceptions about human vulnerability and interconnectedness, the main aim of this study is to analyse the key narrative mechanisms used by this British–Jewish author in order to represent the shared vulnerability and exposure to trauma that reigns during war and post-war times.

Subcoracoid Impingement – A Global View

Modifications in joint anatomy on both soft and bony tissue level play a key role in subcoracoid impingement syndrome. The diagnostic is primarily clinical and is based on patient history and functional tests. Imaging tests support, but do not establish the diagnostic. Approach can take the form of targeted exercises with progressive load, or that of invasive surgery. Shoulder pain has a diverse etiology which derives from the complex local anatomy which includes the clavicle, acromion, coracoid process and humeral head, the soft tissues surrounding this area, in particular the rotator cuff, but can also be unrelated to all of the above and be a reflection of a pathology located in the neck, arm or trunk, or adjacent visceral organs. More often, it is the manifestation of a traumatic episode or an anatomical anomaly, or it can be secondary to inflammation, tumors, or surgery. It is the third most common musculoskeletal complaint presenting to physiotherapy, and largely impacts both an individual’s quality of life and the public health system. Coracoid impingement syndrome can present itself as a cause of rotator cuff disease, but its role is not fully established yet. It is less prevalent than subacromial impingement, can coexist with it, and therefore should be considered into the differential diagnosis of anterior shoulder pain when a patient presents themselves with activity related anterior shoulder pain.