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<p> Traumatic Brain Injury (TBI) is one of the most prevalent causes of injury in young adults,  and is a leading cause of hospitalization, disability, and even death. Although severe TBI can lead  to serious acute injury (such as brain hemorrhaging and skull fractures) and chronic disability, the vast majority (~80%) of TBIs are mild in nature, and do not present with such drastic symptoms.  As such, these mild TBIs may go undiagnosed or underreported. Without overt, acute symptoms,  mild TBIs may be particularly insidious as they are shown to correlate with increased risk of  chronic social and cognitive processing impairments, as well as the risk of developing  neurodegenerative diseases later in life. Additionally, many people who suffer TBIs, whether on  the sports field, field of battle, or even in everyday life, often are at increased risk of additional  TBIs, which likely increase the risk of life-long post injury complications. Given these risk factors,  there is a clear need to understand how mild TBIs affect the brain both acutely and chronically and  develop tactics to properly diagnose and treat mild injuries early.  In this dissertation, we argue for the potential use of Auditory Evoked Potentials (AEPs), a  clinically used noninvasive set of tests, as an effective route for improved diagnostics of mild TBIs.  To achieve this, we must first understand the relationship between underlying anatomical changes  and chronic deficits in mild injury. In blast induced TBIs, some of the most common sequalae,  both acutely and chronically, are auditory in nature. Temporary changes in hearing thresholds or  tinnitus are very common, but chronic impairments in more complex auditory processing tasks,  such as hearing speech-in-noise, are often reported as well. Although acute changes are likely due  to damage to the peripheral auditory system, there is mounting evidence suggesting damage to central auditory regions may play a clear role in chronic processing changes, however, this is still  poorly understood. Recent studies of concussions in sports medicine have found that impact  induced TBIs may produce long-term, but not acute, deficits in subtle auditory processing function  as well. Given its potential for ubiquitous damage following TBIs of multiple forms, understanding  the post-injury central auditory system can act as a window into the time-course and severity of  secondary biochemical changes and chronic processing issues seen following mild TBI.  Here we use a well-established rat blast TBI model to examine the acute and chronic time  course of auditory processing changes, as well as biochemical and anatomical changes. We show  a clear biphasic response of acute and chronic changes in auditory processing. Changes in  oxidative stress, inflammation, and inhibition/excitation show similar patterns within key regions  of the central auditory system (CAS), suggesting a link between AEP results and underlying  chronic damage. Our second objective was to design a more clinically relevant and consistent  animal model of free-range of motion impact induced TBI. Once developed, we examined similar  AEP and immunohistochemical tests to determine the degree of similarity of CAS changes in a  second form of TBI. Interesting, while AEP results suggest some long-term changes in auditory  processing, these were not identical to blast changes. Finally, we utilized a computational model  for axonal node damage to assess one method of potential damage resulting from the oxidative  stress changes post injury and provides a framework for future modeling techniques for improved  diagnosis and treatment. These results together suggest that AEPs have the potential to improve  diagnostics and monitoring tools in mild TBIs, regardless of injury type.  </p>

Intimate partner violence occurs globally at alarming rates. Many experience adverse health impacts such as traumatic brain injury. Healthcare providers do not know the role of the speech-language pathologist, or the rehabilitation needs of survivors. Aims: This scoping review aims to identify speech-language pathology services for survivors of intimate partner violence with a resulting traumatic brain injury, and knowledge of healthcare providers on the rehabilitation needs of this population. A search was completed in May to October 2023, resulting in a total of 13 articles reviewed. Main contributions: Speech-language pathologists lack knowledge to provide services to intimate partner violence survivors with a resulting traumatic brain injury. Healthcare providers that work with survivors are unaware of the rehabilitation needs of survivors. Conclusions: Healthcare providers require knowledge of the needs of intimate partner violence survivors with a traumatic brain injury. Research regarding this population is warranted to meet their needs.

The study aimed at giving a thick description of African families' experiences, views, cultural beliefs and interpretations of traumatic brain injury (TBI), and making recommendations for rehabilitation. It was conducted from the qualitative research paradigm, adopting a phenomenological research method. Twenty-two pairs of participants (patients and their caregivers )were interviewed about their perception of TBI. The semi-structured interviews were conducted at the participants' homes in Sesotho, and where necessary in their home languages. The consequences of TBI were found to follow universal trends (Oddy, 1984). However, participants' perceptions, as shaped by their experiences, views and cultural beliefs, were found to be unique. On analysing the gathered data, using inductive data analysis, it was found that African families' interpretations of TBI were based on beliefs about witchcraft, thwasa, Satanism, ancestral anger and God's wish. Based on these findings, rehabilitation services in the form of education, advocacy, networking and family therapy are recommended. / Psychology / M.A.(Clinical Psychology)

This autoethnography explores the phenomenon of marriage after traumatic brain injury (TBI). Capturing as its data, through a series of audio-recorded conversations and journal entries, the first-hand, co-constructed experiences of a married couple, it provides an ‘insider’ and as such, intimate perspective on life together following such an unexpected, disruptive and life-altering event. Situated within ‘a systemic constructionist’ epistemology, it spotlights, in particular, the relational aspects of the post-TBI marriage unfolding over time, rather than just the individual perspectives of each spouse at a single point in time - as most existing studies on the topic do. As a qualitative study, it made allowance for the collection and use of rich, nuanced data so as to do some justice to the complex nature of the topic being studied. David Reiss’ explanatory theory on ‘crisis and the development of the family paradigm’ was applied deductively during the carrying out of a thematic analysis of the data, with the intention of bringing new insights to the understanding of the phenomenon of the post-TBI marriage. Data were also analysed inductively, in that themes emerging from the data itself were also used. A discussion based on the findings of the data analysis was proffered. Based on these findings, recommendations on what issues therapists working from within a family-systems orientation might focus their attention on were made. A recommendation for TBI couples to receive support from early intervention and follow-up services was also made, along with identifying the consequent need for research first to be done on developing and implementing such a service / Psychology / M.A. (Psychology)

Blast-induced traumatic brain injury (bTBI) has been described as the defining injury of Operations Enduring Freedom and Iraqi Freedom (OEF/OIF). Previously, most blast injury research has focused on the effects of blast on internal, gas filled organs due to their increased susceptibility. However, due to a change in enemy tactics combined with better armor and front-line medical care, bTBI has become one of the most common injuries due to blast. Though there has been a significant amount of research characterizing the brain injury produced by blast, a sound understanding of the contribution of each component of the shockwave to the injury is needed. Large animal models of bTBI utilize chemical explosives as their shockwave source while small animal models predominantly utilize compressed air-driven membrane rupture as their shockwave source. We designed and built a multi-mode shock tube capable of utilizing compressed gas (air or helium)-driven membrane rupture or chemical explosives (oxyhydrogen – a 2:1 mixture of hydrogen and oxygen gasses, or RDX – high order explosive) to produce a shockwave. Analysis of the shockwaves produced by each mode of the McMillan Blast Device (MBD) revealed that compressed air-driven shockwaves exhibited longer duration positive phases than compressed helium-, oxyhydrogen-, or RDX-driven shockwaves of similar peak overpressure. The longer duration of compressed air-driven shockwaves results in greater energy being imparted on a test subject than would be imparted by shockwaves of identical peak overpressures from the other sources. Animals exposed to compressed air-driven shockwaves exhibited more extensive brain surface hematoma, more blood-brain barrier compromise, more extensive reactive astrocytosis, and greater numbers of activated microglia in their brains than did animals exposed to oxyhydrogen-driven shockwaves of even greater peak overpressure. Taken together, these data suggest that compressed air-driven shockwaves contain more energy than their chemical explosive-derived counterparts of equal peak overpressure and can result in greater injury in an experimental animal model. Additionally, these data suggest that exposure to longer duration shockwaves, which is common in certain realworld scenarios, can result in more severe bTBI. The results of this study can be used to aid design of blast wave mitigation technology and future clinical intervention.

Children with a recent history of TBI often demonstrate impaired memory, which can be affected by impaired attention, processing speed or impaired verbal information processing. The purpose of this study was to determine if qualitative differences exist among the narrative recall of TBI patients that is not adequately accounted for by standard scoring methods. Sixty-six TBI subjects ranging in age from 6 to 16 were given the Wide Range and Memory and Learning (WRAML) Story Memory subtest and selected subtests from the Wechsler Intelligence Scale for Children - Third Edition (WISC-III). Mean elapsed time since injury was 53 days. Recall of the story on the WRAML subtest was hand-recorded by the examiner. A supplemental scoring method accounted for differences in length, errors, and disorganization. Comparisons were made to a randomly selected control group consisting of 16 hospitalized subjects between 7 and 15 years with no history of head injury, neurological condition or event. Findings suggest the WRAML Story Memory subtest is relatively robust in providing information regarding the quality of recall, with the exception of not accounting for the addition of erroneous details. Subjects with both cortical and subcortical injuries were more likely to add superfluous details to their stories. Results also demonstrated significant differences between the TBI subjects and control group in how well the stories were recalled, primarily in the order of details recalled and in retention after a 30 minute delay. Location was not a significant predictor of narrative organization. Although using this comprehensive supplemental scoring system a regular basis has practical limitations, hand-recording the narrative takes relatively little time and does appear to provide useful additional information concerning the nature of the child's verbal memory difficulties. Furthermore, the more knowledgeable the child, parents and teacher are about these difficulties and about remediation strategies, the more likely the child will have a successful learning experience upon return to the classroom.