Background: Physically injured elder adults present challenges in the emergent injury phase. Oxidative stress contributes to cellular deterioration, resulting in decreases in physiological reserve. Imbalance of oxidative stress pathways lead to damage and drive the aging process and frailty. Goals of this study were to determine if a new plasma biomarker of oxidative stress is related to: 1) oxidation reduction status in patients who have experienced traumatic injury as well as healthy community dwellers, 2) outcomes of patients who have experienced trauma, 3) frailty measured by established frailty scales in healthy community dwellers. Methods: Prospective study included 1) trauma patients ≥65 admitted to Level I trauma center 2) age, gender matched healthy, community-dwelling participants. Plasma samples tested in duplicate for capacity oxidative reductive potential (cORP, μC; antioxidant reserve), and static oxidative reductive potential (sORP, mV; the current state of oxidative stress). Frailty assessments were performed in healthy participants using established frailty scales. ORP measurements were analyzed using correlation analyses. Univariate analysis analyzed cORP and sORP for differences by the variables gender, age, smoking, diabetes, statin use, vitamin use and any alcohol use in both the injured and healthy populations. Results: 186 subjects included in study (N=93 for both groups). Trauma groups's cORP values were significantly lower in patients with diabetes (p<0.05) and patients that smoked (p<0.01). Similarly the healthy group's cORP was significantly lower for those who smoked and those with diabetes (p<0.05). Non-vitamin use in the healthy group was related to lower cORP values (p<0.05). Trauma patients who smoked and those with diabetes exhibited higher sORP values (p<0.05). In the healthy group, sORP did not differ when considering the variables. No12significant differences were found based on gender, statin or alcohol use for either group. Significant correlation was found for both sORP and cORP with CSHA Clinical Frailty Scale in the healthy group. Conclusion: Findings suggest that the variables of smoking and diabetes are contributory to frailty trajectory. Data suggest the capacity to tolerate oxidative stress, measured by cORP, is lower in aged individuals that smoke or are diabetic and contributes to frailty as a result of oxidative damage.

South Africa has a high incidence of crime where violence is particularly being committed against adolescents. Trauma has a disruptive influence on the development of adolescents. There is a lack of research focussing on pastoral counselling from a postmodern perspective regarding adolescents who experience acute trauma. This study makes use of three theories to make a meaningful contribution namely those of Rudolf Otto (1869 – 1937), René Girard (1923 - ) and Donald Capps (1990, 1993, 1994,1996). This study finds Otto`s theory about the numinous useful to assist traumatized adolescents on the road to healing. A numinous experience causes two results namely an overwhelming feeling of awe and a feeling of fear that comes from respect and distance. Traumatized adolescents should be guided into a meeting with God in a confusing post-modern world. Through the appropriation of the numinous adolescents can reach infinitely more than only being a “seeker”. Girard`s (1978) theory on mimetic violence and the scapegoat mechanism has been used in this study since it throws some light on the manner in which traumatized adolescents process trauma. The scapegoat mechanism theory helps one to understand how violence can be processed by scapegoating someone or something else. Girard`s theory also enlightens on the theme of forgiveness. Forgiveness is the key to overcome the horrors of the past. Adolescents particularly need role models. These role models can be found amongst other things, on television. Role models teach adolescents about revenge and reprisal. This study demonstrates that by applying Girard`s theory to the cross of Jesus, the traumatized and crucified Jesus becomes the role model for the “seekers” rather than identification with the peer group. Girard creates a greater understanding to manage trauma by exposing the scapegoat mechanism. Capps’ theory about hope and reframing on the other hand is useful in the sense that it gives hope for the future to adolescents. Hope therapy entails reframing since the situation needs a new perspective. The work of Capps, Reframing: New method in pastoral care (1990) was used as a framework. Narrative therapy is used because it assists the traumatized in their search for meaning. Ganzevoort’s (2000) theory regarding personal narrative identity proved to be useful in pastoral care to traumatized adolescents. The same applies to Erikson’s (1963) development theory, which includes the concept that the virtue of hope develops during childhood. It can also be associated with Moltmann’s (1974) view of hope as an alternative future for suffering persons. / Thesis (PhD)--University of Pretoria, 2008. / Practical Theology / unrestricted