Background: The specific clinical impact of delays to hemostatic intervention in trauma is under-explored. Objectives: Investigate the current understanding of the impact of increasing time to hemostasis and assess its relationship with clinical outcomes. Methods: We conducted a systematic review to characterize existing definitions of delayed hemostasis and its clinical sequelae. We conducted a cohort study of 147 trauma patients to investigate the impact of increased time to hemostasis. Results: Most studies demonstrated significant relationships between time to hemostasis and mortality, despite heterogeneity. The cohort study failed to demonstrate a significant association between time to hemostasis and mortality. Discussion: The thesis has taken steps to investigate time to hemostasis with appropriate methodology. The findings are limited by sample size and confounding by indication. Conclusions: There remains a substantial gap in the literature with respect to understanding the impact of increasing time to hemostasis in trauma and larger studies are needed.

Experiencing interpersonal betrayals or trust violations can often create negative consequences for victims when creating new relationships. Past studies have found that trauma from previous betrayals can impair trust and thereby trust behavior for victims in the future. However, little research has been done to empirically characterize this connection and existing studies have provided conflicting results. The goal of this study was to explore the relationship between past trust violations, measured through the Brief Betrayal Trauma Survey (BBTS), and present self-reported trust and trust behavior. Differences in trust behavior between those with or without a history of betrayals was measured through an experimental economic trust game. Results found that those with a history of betrayal trauma had marginally lowered self-rated trust in strangers. While a history of betrayal trauma did not yield main effects on either first or average investments in the trust game, those with a history of betrayal had similar first and average investments in partners regardless of visual cue trustworthiness. Victims of betrayal seem to lack discriminatory trust behavior or possibly disregard visual cues entirely. These findings add to the current understanding of how victims of interpersonal betrayal interpret and respond to visual cues both initially and across multiple interactions and is especially relevant for those who aim to form close relationships with these individuals such as care providers.

This dissertation explores Trauma-Informed Care (TIC) from the perspective of school-based occupational therapists (SB-OTs) to support students who may be negatively affected by adverse childhood experiences (ACEs). TIC focuses on creating an interpersonal culture of safety and respect and is becoming more well known in healthcare and education. Using the Nominal Group Technique (NGT), experienced SB-OTs from across the US participated in focus groups to identify priorities for delivery of TIC in school-based practice. Additionally, the 5 NGT focus groups (n=24) identified facilitators and barriers to effective TIC in schools. Drawing from these findings, the Pediatric Remediation Outcomes: Trauma-Informed Principles (PRO-TIP) program is proposed. PRO-TIP centers on refining fine motor skills through school-based occupations, guided by occupational therapy (OT) theory, and caters to educators and SB-OTs. The program is designed to support students, educators, SB-OTs, and improve the wider workplace culture. By offering fundamental priorities on TIC aspects, this dissertation serves as a valuable resource for entry-level occupational therapists (OTs), researchers, school staff, and administrators seeking to embrace a trauma-informed approach. The framework for the PRO-TIP program emerges as a practical, evidence-based tool designed to be further developed and piloted in elementary-school settings. With original research and a novel program design, this dissertation began with the end in mind: to help young, misunderstood learners with trauma related behaviors change their life trajectory for the better. / Temple University. College of Public Health / Health and Rehabilitation Sciences

AN ABSTRACT OF THE THESIS OFRosemary Pearl Moore, for the Master of Fine Arts in Playwriting, presented on April 3, 2023, at Southern Illinois University Carbondale. TITLE: A LOVE LETTER TO PAST, PRESENT, & FUTURE FRIENDS: THE DEVELOPMENT PROCESS OF MURPHY’S LAW OF PRETENDERS MAJOR PROFESSOR: Dr. Jacob JuntunenThis thesis examines the process of taking Murphy’s Law of Pretenders from pre-writing to a full production at Southern Illinois University in March 2023 and my own growth during this time. My inspiration ranges from different aspects of pop culture to looking a staged versions of Little Women by Louise May-Alcott to The Lion, the Witch, and the Wardrobe by C.S. Lewis. Murphy’s Law of Pretenders continues to explore my style of taking realism and fantasy while exploring deeper issues like mental health, and the idea of what forms does friendship take and what does it do to us.Chapter One examines the process before I started writing the play. Chapter Two explores the development process from the feedback and advice that was provide for me while I was here at Southern Illinois University. Chapter Three dives into the production process here with the director, actors, and designers in The School of Theater and Dance here at Southern Illinois University. Chapter Four details what I’ve learned from my experiences here at Southern Illinois University, and what I hope for the future of my writing. Chapter Five is the play itself, Murphy’s Law of Pretenders, where you will find what I am most proud of from this process.

In this groundbreaking Master's thesis, Rameesha Qazi explores the critical realm of survivor care policies and toolkits within the NGO space, driven by her own experience of sexual violence during my work abroad. Rooted in a survivor-centered and trauma-informed framework, my analysis encompasses an evaluation of policies from organizations and essential toolkits, revealing striking gaps in addressing systemic barriers, recognizing trauma's nuanced impact, and supporting diverse coping strategies. A unique contribution to the field and in recognizing contextual variations in survivor needs, I introduce a country guide as a practical tool for NGOs to enhance their survivor care policies, providing a roadmap for how to address gaps in support. Furthermore, extending the focus beyond policies, I scrutinize toolkits from prominent organizations and propose recommendations, emphasizing the crucial need to engage survivors, provide comprehensive support, and amplify survivor voices. The thesis not only underscores the urgency for trauma-informed, survivor-led approaches but also challenges prevailing norms in the development sector. It aims to reshape the discourse around sexual exploitation and abuse, advocating for tangible, sustainable change in policies and toolkits to ensure the safety, support, and empowerment of survivors within the NGO space. This research stands as a testament to the imperative role of survivor voices in shaping effective, adequate, and sustainable solutions for combating sexual violence within the development sector.

Thesis advisor: Matthew Monnig / Thesis (STL) — Boston College, 2023. / Submitted to: Boston College. School of Theology and Ministry. / Discipline: Sacred Theology.

Growing evidence of the health risks associated with adverse childhood experiences (ACEs) has prompted public health and community initiatives to promote awareness, detection, and responses that are trauma informed. Nationwide programs to integrate trauma-informed care into education, health care, and child serving agencies, have thus far led to the proposal and advancement of trauma-informed policies and practices in many communities. While Mississippi agencies include trauma-specific intervention and training, statewide ACEs initiatives and relevant data are still limited. This project aimed to contribute to the larger goal of a statewide trauma-informed paradigm shift, by increasing ACEs awareness and developing recommendations for the integration of such research into programs aimed at serving vulnerable populations. Sixty-one child-serving professionals participated in adversity and resilience training (ART), a 3-hour workshop addressing childhood adversity, traumatic stress, resilience, and secondary traumatization. Outcomes measured were changes in trauma knowledge, trauma informed attitudes, attributions regarding difficult child-behaviors, and secondary trauma knowledge and self-care. Participants also provided ratings on a training evaluation survey. There were significant changes in trauma knowledge (F(1,22) = 6.418, p = .000, ηρ2 = .226) and trauma-informed attitudes (F(1,22) = 11.014, p = .003, ηρ2 = .334) between pre- and post-training. Training evaluations were generally positive (M = 4.61, SD = 0.13, on a 1 to 5 Likert scale). The current study contributes to the research an evaluation of a training intervention that offers feasible strategies for scalable training and assessment of outcomes.

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