It is generally supposed that a supportive family can have an influence on outcomes for an adult with severe brain injury, but there is very little known about what effective families actually do. In this research the families of five such individuals were involved in an ethnographic project that lasted for one year. The literature review brought together insights from brain injury, care ethics, disability studies and anthropology. These insights were combined with a process of reflective equilibrium that was applied to the ethnographic material in order to determine the ethics of the carers. Ethics of care in this setting was conceived of as a positive practice ethic, rather than as a series of negative conundrums posed by the brain injury. The practice ethic shared by carers meant that they all conceived of the need created by brain injury in humanistic terms, rather than in terms of pathology. Carers demonstrated virtues appropriate to their practice as they helped the adult with brain injury to connect with aspects of ordinary life. The best outcomes for the adult with brain injury included being able to engage in productive activity and to make a place in the world. These outcomes could only be achieved with due regard for their safety and subsistence. The practice ethic of carers was demonstrated in the skills and concern that ensured a satisfactory outcome for the adult with brain injury. This research is a departure from recent research about families affected by brain injury, which has focused on the burden involved in care. An examination of what carers achieve suggests that burden may be associated with the development of caring practice. The transformative capacity of care, for both the carer and the adult with brain injury, is emphasized. However contextual factors, such as adequate compensation, are connected to the capacity of the carer to engage in good practice and these are explored also in this thesis. In particular, relevant aspects of the relationship between families and the Accident Compensation Corporation are explored.

Includes bibliography (leaves 191-219). / Copy 2 lacks some pages. / x, 219 leaves : / Title page, contents and abstract only. The complete thesis in print form is available from the University Library. / Examines the levels of insulin-like growth factor and the presence of IGF binding proteins in human wound fluid. Tests the potency of IGF-1 and 2 analogues in in vitro models of fibroblast activity and their effect on healing in normal and diabetic rodent wounds. Shows that IGF-1, IGF-2 and their binding proteins are present in fluid from a partial thickness cutaneous wound; that the binding proteins negatively modulate the activity of insulin-like growth factors in vitro, but that the IGFs do not necessarily show enhanced activity in vivo at the wound site if binding protein affinity is decreased. Discusses possible roles of these binding proteins in wound repair. / Thesis (M.D.)--Dept. of Surgery, University of Adelaide, 2001?

Thesis (M.S.) -- Mississippi State University. Department of Agricultural and Biological Engineering. / Title from title screen. Includes bibliographical references.

Tibial stress fractures are common in runners. However, it is unclear what factors are associated with tibial stress fractures. This study aimed to investigate 1) magnitudes of bone contact forces occurring while running 2) whether or not repeated application of running loads is sufficient to explain tibial stress fractures and 3) whether or not muscle fatigue alters the potential of tibial stress fractures. Tibial stress fractures were predicted through an estimation of the minimum number of cycles to failure (Nfail) using an integrated experimental and mathematical modeling approach. Short running trials within a speed range of 3.5-4 m/s of ten male runners were evaluated with a coupled force plate and 3 dimensional motion analysis system. The collected data were used to estimate joint reaction forces (JRF) and joint moments. Using these JRF and muscle forces predicted from optimization, 2-D bone contact forces at the distal end of the tibia were determined. Next, tibial stresses were estimated by applying these bone contact forces to a tibial model, which were then used to predict the Nfail. All procedures were repeated after plantarflexors fatigued from prolonged running. This study found that peaks of compressive and posterior shear forces occurred during mid stance, and these peaks equaled 8.91 ± 1.14 BW and -0.53 ± 0.16 BW, respectively. These bone contact forces led to a backward bending of the tibia during most of the stance phase and resulted in the maximum stresses of - 43.4 ± 10.3 MPa on the posterior face of the tibia. These maximum stresses predicted the group mean of Nfail as being 5.28*10⁶ cycles. However, 2.5% to 56% of population of runners have a chance of getting tibial stress fractures within 1 million cycles of a repeated foot impact. Within the context of muscle force and stress estimation procedures used in this study, Nfail appeared to increase after fatigue, not decrease as we hypothesized. / Graduation date: 2005

The purpose of this study was to compare the levels of bone mineral density (BMD) of the whole body (WB) and proximal femurs of physically active men with spinal cord injuries (SCI) to nonactive men with spinal cord injuries. Also, the lean muscle mass (LMM) of active men with SCI was compared to the LMM of nonactive men with SCI. In addition, BMD values of the radii of physically active men with SCI were compared to that of able bodied men of the same age. The subjects N. 46 were between the age of 20-55 (��=37.83 �� 6.63 years), and were at least 2 years post spinal cord injury. Subjects with SCI were matched on similar level of lesion of the spinal cord, age, height, weight, and years post injury for the purpose of analyzing data. There were 14 active men with paraplegia and 14 nonactive men with paraplegia, 9 active men with quadriplegia and 9 nonactive men with quadriplegia. All BMD data was obtained utilizing a Hologic QDR 1000W dual energy x-ray absorptiometer. A two-factor (level by group) analysis of variance revealed no significant difference for all sites (Whole body, Total hip, radii, LMM) comparing the active and nonactive men with SCI. T-scores and z-scores generated from the Ho logic QDR 1000/W were analyzed using two-factor ANOVA (level by group). The active men with paraplegia had significantly higher BMD levels for all sites when compared to the other groups. These values may be explained by the number of incomplete injuries in the experimental group. Subjects in the physically active group did not clearly show a statistically significant difference on any of the dependent measures. However, values for the dependent measures were higher for the physically active group compared to the values of the nonactive group. / Graduation date: 1995

Graduation date: 2006 / We hypothesized that calpain activity is elevated in response to muscle damage. To test this hypothesis, we examined the degradation of α-fodrin into its 150 and 145 kDa fragments following either 20 eccentric or isometric contractions. In addition, experiments were performed in the presence or absence of E-64-d, a calpain inhibitor. Both EDL and SOL muscles displayed significant differences (p<0.003 and p<0.002 respectively) between the raw and normalized 150 and 145 kDa α-fodrin fragments of the DMSO + E-64-d compared to the other bath treatments. Based on our model of exercise-induced muscle damage, we expected to see greater levels of 150 and 145 kDa α-fodrin fragments in those muscles that performed the eccentric protocol. However, there was no evidence that eccentric muscle damage increased the levels of 150 and 145 kDa α-fodrin fragments over the levels observed in the isometric trials. These findings suggest that the magnitude of damage was insufficient to activate calpains.

Augmented Soft Tissue Mobilization, a massage therapy which uses a solid instrument rather than human fingers to treat musculoskeletal injuries, has been successful in treating tendinitis. Davidson et al. studied the functional and morphological affects of ASTM on collagenase induced Achilles tendinitis in Sprague-Dawley rats. Morphological observations showed a significant increase in the number and activation of fibroblasts in the ASTM treated Groups. The authors suggested that the physical force of ASTM may promote tendon healing via increased fibroblast recruitment. An important, but unexplained, question is how ASTM would affect the fibroblasts of native, noncollagenase injured, tendons. Studies have shown that mechanical forces can alter cellular functions. The purpose of this study was to examine the morphological changes in native Sprague-Dawley rat Achilles tendons after ASTM therapy using different application pressures.Three animal Groups were randomly established: A) control Group with no ASTM; B) light ASTM with 1 Newton of pressure; and C) heavy ASTM with 3 Newtons of pressure. Upon completion of the therapy, the Achilles tendons of each Group were examined with light and electron microscopy techniques to assess fibroblast number, tendon morphology, and the presence of type I and type III collagen. Fibroblast counts from each Group were compared using a two-way ANOVA, multiple regression, and curvilinear regression analysis. Morphological differences were shown between the three Groups, especially between the non force Group and the two force Groups. The ASTM Group treated with one Newton demonstrated the greatest mean fibroblast count (165.1+/-55.8&160.7+/-49.8). Electron microscopy revealed the presence of activated fibroblasts in the tendons of the two force Groups, ASTM Groups. Polarizing microscopy showed a dramatic increase in the amount of Type III collagen in the two force Groups compared to the non force Group.Ball State UniversityMuncie, IN 47306

A stunning poem that draws the attention of the reading public, Omeros is often regarded as the most famous and most successful of Derek Walcott¡¦s works. In one sense, Omeros is the Greek name for Homer, and Walcott chose it for the title of the poem to show his ambition to be a Caribbean Homer, a poet developing an epic from a West Indian perspective. With the epic form and resonant mythic Greek namesakes, Omeros is built upon Walcott¡¦s innate love for St. Lucia. Structurally, the epic form provides the vast framework he needs to describe the multicultural Creole society. However, after a close reading of the text, we can actually find that it does not follow so much the conventions of a classical tradition, since it is not actually a heroic poem. Unlike the superhuman characters in Homeric epics, the male protagonists in Omeros are common people who endure the suffering of individual in exile and try to put down roots in a place where they think they belong. One famous critic, Robert D. Hamner, reads Omeros as an epic of the dispossessed, one in which each of its protagonists is a castaway in one sense or another. In this respect, the male characters are injured (either spiritually or physically). In contrast, the female characters in Omeros, though few in number, play the important roles of heroines to heal the wounds of the male protagonists and to help them trace their roots. This thesis will, therefore, analyze three female characters in the poem. Chapter 1 will focus on Ma Kilman, a black obeah woman. She embodies the memories of the past as well as the connection between African experience and West Indian culture. Through the practice of obeah, a holistic healing method different from Western diagnosis, she is capable of soothing wounds caused by past sufferings. Chapter 2 will examine Maud Plunkett, a white Irish housewife. She represents the physical link between Ireland and St. Lucia due to their inherent similarities ¡Vboth are being colonized with St. Lucia being divided by race and class, while Ireland is split along religious and class lines. Maud¡¦s existence symbolizes the alienation gap on the island; her death, at the end, bridges the gap and relieves historical traumas. Chapter 3 will deals with Helen, an ebony local woman. Appropriating mythical as well as historical allusions, Walcott gives new voice to this Caribbean Helen. She demonstrates her autonomy to male characters and becomes an unapproachable goddess that they attempt to possess. She reestablishes peace and achieves a new harmony in St. Lucia as a way of cross-cultural healing.

Traumatic brain injury (TBI) is a major health and socioeconomic concern in the United States and across the globe. Experimental models of TBI are used to study the mechanisms underlying cell dysfunction and death that result from injury, the functional deficits that result from injury, and the potential of various therapies to treat injury. This thesis explores the fundamental mechanical damage associated with brain trauma, investigating the effects of mechanical deformation on neurons at the molecular, cellular, tissue, and animal levels. First, a novel hydrogel system was developed to support 3-D neuronal cultures, and the cultures were studied in an in vitro model of neuronal injury. The dependence of cell viability on hydrogel stiffness and extracellular matrix ligand concentration revealed a role for molecular interactions in the cellular response to injury. Subsequently, in a rat model of TBI neuronal plasma membrane damage was observed coincidentally with cell death within the hippocampus; however not all permeable cells died, suggesting a complex role for plasma membrane damage in neuronal degeneration. The spatial profile of permeable cells in the hippocampus reveals further heterogeneity of neuronal plasma membrane damage, with populations of cells in certain hippocampal subregions exhibiting an increased vulnerability to plasma membrane damage. These observations support recent finite element model predictions of strains in the brain during injury. Finally a system for measuring locomotor disturbances is used for the first time following brain injury. Continued investigation of how neurons deform and fail mechanically will contribute to the understanding of the pathophysiology of brain injury and may help identify potential therapeutic targets.

Traumatic brain injury (TBI) affects 1.4 million people a year in the United States alone and despite the fact that 96% of people survive a TBI, the health and socioeconomic consequences can be grave, partially due to the fact that very few clinical treatments are available to reduce the damage and subsequent dysfunction following TBI. To better understand the various mechanical, electrical, and chemical events during neural injury, and to elucidate specific cellular events and mechanisms that result in cell dysfunction and death, new high-throughput models are needed to recreate the environmental conditions during injury. This thesis project focuses on the creation of a novel and clinically relevant single-cell injury model of traumatic brain injury (TBI). The implementation of the model requires the development of a novel injury device that allows specialized micro-interfacing functionality with neural micro environments, which includes the induction of prescribed strains and strain rates onto neural tissue, such as groups of cells, individual cells, and cell processes. The device consists of a high-resolution micro-electro-mechanical-system (MEMS) microtweezer microactuator tool that is introducible into both biological and aqueous environments and can be proximally positioned to specific targets in neural tissue and neural culture systems. This microtweezer, which is constructed using traditional photolithography and micromachining processes, is controllable by a custom developed software-automated controller that incorporates a high precision linear actuator and utilizes a luer-based microtool docking interface. The injury studies will include examination of intracellular calcium concentration over the injury time course to evaluate neuronal plasma membrane permeability, which is a significant contributor to secondary injury cascades following initial mechanical insult. Mechanical strain and strain rate input tolerance criteria will also be used to determined thresholds for cellular dysfunction and death.