Post-traumatic stress in 30 male survivors of an airplane crash-landing was studied through interviews and questionnaires based on a nonpathological model of preventive psychological intervention and monitoring. Five questionnaires were given initially 12 days after the event and repeated at 2, 5, 10, and 12 months. Two of the brief measures were given weekly from 2 to 8 weeks after the event. As a group, the survivors experienced high levels of stress initially, which decreased rapidly and leveled off over time. There was, however, significant variability among individuals in this seemingly homogeneous group of college basketball players and supportive personnel in their experience of stress to the same traumatic event. There was also a marked contrast between group questionnaire results and individual verbal descriptions of their reaction to an unrelated, fatal airplane crash on the campus of the survivors 1 month after their own crash-landing. Questionnaire data are presented descriptively and discussed in relation to other normative data in the literature and to the methods of observation in this study. Recommendations are offered for professionals attempting this type of field study.

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Trauma is deeply rooted in South African society. South Africa has been considered one of the most violent countries and has been termed the “rape capital of the world” (Human Rights Watch, 1995). Prior studies evidence high levels of community violence, intimate partner violence, and rape. Research measuring morbidity/mortality has suggested a link between trauma and mental health problems. 34 However, national lifetime prevalence of multiple forms of trauma is not firmly established. Further, nationally-based studies on trauma in South African context have not examined multiple traumas simultaneously. Given the assumed burden of trauma in South Africa, it is important that research uncovers precise rates of traumas and links to mental health. Investigating individual and cumulative effects of trauma in a large, national sample can contribute to understanding the trauma burden. Thus, using nationally representative data from the South Africa Stress and Health Study, we examine lifetime prevalence of a variety of traumas and multiple traumas (number of events). Employing regression analysis, we study individual and cumulative effects of traumas on psychological distress. Results indicate most South Africans (approximately 75%) experience at least one traumatic event during their lives, with the majority reporting multiple. With few exceptions, exposure to traumatic events is associated with greater distress. Results further indicate a cumulative effect of trauma, evidenced by a graded relation between multiple traumas (1, 2, 3, 4-5, 6+) and distress. Those with the most traumas (6+) appear at five- times greater risk of high distress. This study provides a previously unavailable glimpse of exposure to a range of traumas in a nationally representative sample of adults in South Africa. Moreover, implicated by our findings of a cumulative effect of multiple traumas and that the majority experience such multiple traumas is a possible burden of mental health in South Africa.

This qualitative study, with elements of co-operative enquiry and phenomenology, endeavoured to describe the impact of rape on the occupations of women who have been raped. Data were gathered from participants who were clients at Rape Crisis, Observatory, through 4 unstructured focus groups and analyses to explore changes in their occupations. What emerged was that the participants were all dissatisfied with their occupations. The overwhelming impact of symptoms of Post Traumatic Stress Disorder (PTSD) on all their occupations was discussed. A dynamic between Person, Occupation and Environment impacted on the occupational engagement and avoidance by the participant. Recommendations for the rape survivors, service providers and family members were made.

The objective of this work was to evaluate the efficacy of an induced normothermia protocol by comparing patient mortality and outcomes in patients treated at Boston Medical Center (BMC) before and after the implementation of the protocol. The controls (regular fever management) and the cases (induced normothermia) were demographically similar, except there were more whites (p = 0.01) in the control group and more of the patients in the control group were transferred to BMC from outside hospitals (p = 0.006), although there was not a higher incidence of death among patients who were transferred from outside hospitals (p = 0.55). The patients in the case group were kept normothermic throughout the first 7 days of their hospital stay more effectively than those in the control group (p = 0.0001). Average intracranial pressure (ICP) and cerebral perfusion pressure (CPP) were not different between the two groups, although mean arterial pressure (MAP) was (p = 0.84; p = 0.08; p = 0.02, respectively). Mortality was lower in the case group by hospital discharge (p = 0.007) and patients in the case group were more likely to achieve a positive functional outcome (p = 0.03). In light of these findings, there is a need for high-quality prospective trials to assess the efficacy of induced normothermia compared to regular fever management.

Thesis submitted in partial fulfilment of the requirements for the degree of Doctor of Philosophy in the Department of Psychology, Faculty of Arts at the University of Zululand, South Africa, 2012. / This qualitative study investigated the prevalence of post-traumatic stress disorder within the mining industry. It further reviewed systems used to manage the same disorder following a disastrous mining accident in the Slater Coal Mines. There are key challenges that were reviewed as part of improving diagnosis and management of post-traumatic stress disorder. Two focus groups consisting of six African mineworkers, working in the Slater Coal Mines, were conducted. All participants were isiZulu speakers. The data was analysed using grounded theory, which is a qualitative technique. In using this data analysis technique, data labelling, open coding, axial coding and selective coding were the steps that were followed as a guide. Research findings indicated that post-traumatic stress disorder is prevalent within the mining industry and differs from post-traumatic stress. Existence of post-traumatic stress disorder was represented by symptoms such as intrusive thoughts, avoidant behaviours and terror. Further, causes of mining accidents and accident management measures were the findings. Different work conditions were implicated in the study as contributing to trauma in the mines in addition to accidents that happen underground.

Working is a form of societal participation highly valued in American culture. The state-federal vocational rehabilitation system helps people with disabilities obtain and maintain employment in their communities. Although some people with traumatic brain injury return to work with minor adjustments, high proportions do not return to former employment or find work after their injuries. Analyzing vocational rehabilitation services, and other variables that impact competitive employment outcomes for this population, is important. This study examined the association of types and degree of limitations to functional capacities, and competitive employment outcomes; and selected VR services, and competitive employment, after controlling for demographic variables. The sample for this study consisted of 340 consumers of Illinois state-federal VR system whose cases were closed in fiscal years 2006 and 2007. Eligible individuals with TBI who did not receive services were also described (N=120). The present study also provided information on the types and reasons for case closure, length of rehabilitation, case expenditure, types and number of services received, and weekly earnings at case closure. Contrary to expectations, the degree of limitation across all areas of functional capacity, used by VR counselors to determine severity of disability, and priority for services, were not found to be significantly related to competitive employment among customers with TBI. Results also found that, when relevant demographic characteristics are controlled, the odds of achieving competitive employment increased significantly for VR clients with TBI in Illinois who received job placement and on-the-job supports. For clients who were of minority background, received SSI/SSDI at application, or had lower socioeconomic status (based on income, education and pre-service work status), these odds significantly decreased. Service variables were stronger predictors of competitive employment than demographic variables. Implications, future directions, and limitations of this study are also discussed.

Cognitive impairment is the most frequent cause of disability in humans following traumatic brain injury (TBI), yet the behavioral tasks used to assess cognitive behavior in rodent models of brain injury are underrepresented in the field. Additionally, few of these tasks have been used to assess behavior across degrees of injury severity. The goal of the present study was to compare four behavioral tasks commonly used in the field in frontally-injured rats with both mild and moderate-to-severe brain injuries. At the start of the study, rats were assigned to two of the following behavioral tasks: Dig scent discrimination (Dig) task, novel object recognition (NOR) task, Morris water maze (MWM), and passive avoidance (PA) task. Four days prior to injury, Dig rats were trained to dig in unscented sand and MWM rats were trained to locate a hidden platform positioned in the northeast quadrant of the MWM. Following training, bilateral controlled cortical impact injuries were induced (mild bilateral frontal TBI, moderate-to-severe bilateral frontal TBI, or non-injured, sham). Following a seven day recovery period, rats were tested on the two assigned behavioral tasks. Following testing, linear mixed effects modeling was performed assessing performance differences on the four tasks as a function of injury (injured vs. non-injured), injury severity (mild TBI vs. moderate-to-severe TBI), and task interaction. The results indicated that, while all four behavioral tasks were effective at assessing injury, some of the tasks were more effective at differentiating between injury severities than others. Specifically, the Dig task and MWM were effective at differentiating between rats with mild TBIs and rats with moderate-to-severe TBIs. Interactions between tasks also occurred such that Dig rats also assigned to the NOR task had significantly higher learning curves on the scent discriminations. The results from the current study indicate that all four behavioral tasks have the potential to assess cognitive impairment after TBI. However, these results are only a beginning. More work is needed before we can fully understand the efficacy of each of these tasks as behavioral assessment measures for cognitive functioning after TBI.

No description available.

No description available.