published_or_final_version / Paediatric Dentistry / Master / Master of Dental Surgery

This study examines how violence affects youth in marginalized urban communities, focusing on the experiences of three groups of young people: gang members, activists, and the “jóvenes encerrados”, youth who live confined to their homes due to fear. Based on 14 months of ethnographic research in El Mezquital, an extensive marginalized urban area in Guatemala City, I explore the socio-economic conditions that trigger violence in these communities, the responses of young people and the community to violence, and the State’s role in exacerbating violence in impoverished neighborhoods. In this dissertation I argue that gang members and activists are expressing a deep-seated social discontent against the exclusion, humiliation, and social stigmatization faced by young people in marginalized urban neighborhoods. However, the two groups express their discontent in significantly different ways. Initially, gangs used violence to express their discontent, but they gradually resorted to a perverse game of crime, in complicity with the police, and they distanced themselves from their own communities; in this work I analyze gangs’ process of transformation and the circumstances that led to this change. Activists express their discontent through community art and public protest, but their demonstrations have limited social impact, since public attention continues to focus on gangs; here I examine activists’ motivations, struggles, and obstacles. However, the vast majority of young people live in a state of fear, preferring to keep quiet and withdraw into their homes; here I show how violence, fear, and distrust affect the generation born into postwar Guatemala. This study illustrates the perverse role of the State in impoverished urban neighborhoods and its responsibility for the escalation of urban violence in Guatemala. On the one hand, the State shuns residents from these neighborhoods and systematically denies them basic services; it criminalizes and abuses young people, even forming social cleansing groups to eliminate gang members. On the other hand, the State fosters crime in these communities and acts as gangs’ accomplice in extortions, drug trade, and robberies. As in many other Latin American countries, the Guatemalan State penalizes crime, but simultaneously encourages and benefits from it; the State is complicit in crime. / text

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Research over the past several decades has revealed that the amygdala is involved in aversive, or fear, conditioning. However, the precise nature of this involvement remains a matter of debate. One hypothesis suggests that disrupting amygdala function eliminates the storage of memories formed during aversive conditioning, eliminating the production of internal responses that alter the expression of observable behaviors. Alternatively, lesions or inactivation of the amygdala may impair the modulation of memories in other brain regions and disrupt the ability to perform certain observable behaviors. The experiments reported in the present thesis examined these arguments by making multiple behavioral measures during exposure to unconditioned (US) or conditioned (CS) aversive cues. Amygdala activity was inferred from changes in c-Fos protein expression or activity was temporarily suppressed with muscimol injections. The relationship between the behavioral measures and the role of the amygdala in producing them was examined. Amygdala neurons expressing the c-Fos protein tracked exposure to the US and CS but did not coincide with expression of freezing. Temporary inactivation of the amygdala with muscimol injections before presentation of the US or exposure to the CS attenuated the expression of freezing and active place avoidance; two incompatible behaviors. Finally, temporary inactivation of amygdala activity blocked freezing, place avoidance, and memory modulation produced by the same posttraining exposure to an aversive CS. Since amygdala activation alone was not sufficient to produce freezing and inactivation of the amygdala eliminated freezing, place avoidance, and memory modulation, the results cannot be interpreted as reflecting a direct role for the amygdala in production of observable behaviors. The results also preclude the idea that memory modulation is the only function of the amygdala. Rather, the results of all three studies suggest that the amygdala stores an aversive representation of the US which promotes the expression of various behaviors, possibly through the production of internal responses reflecting an aversive affective state.

In classical conditioning the amygdala is a critical area for the convergence of the unconditioned (US) and conditioned stimulus (CS). During this process the CS acquires some of the properties of the US. By assessing the US properties of foot-shock, namely reflex, pain and fear, the neural systems of pain and fear were evaluated in the rat basolateral and central amygdala. The central fear state produced by footshock was compared to the central fear state expressed during the fear-potentiated startle paradigm. By analysing the similarities and differences in the fear states, the effects of GABAergic, glutamatergic, and dopaminergic systems and protein synthesis inhibition on these fear states were investigated. The basolateral amygdala was sensitive to GABAergic modulation during US and CS presentations. This was interpreted as a central fear effect. The central amygdala was sensitive to glutamate but not to GABAergic modulation. NMDA receptor antagonism prevented fear arousal to US but not CS presentation. This effect was interpreted as a deficit in pain processing. Non-NMDA receptor antagonism could significantly attenuate both US and CS fear expression. This was interpreted as an overall non-NMDA receptor inhibitory effect that affected pain and conditioned fear expression. Results of these experiments have implications for our understanding of the circuitry involved in processing the US. The basolateral amygdala appears to support emotional neural plasticity while the central amygdala appears to support pain neural plasticity. Finally and and most importantly each area processes different properties of the US.

Background Adolescents and adults suffering from needle phobia have an unreasonable fear of needles that leads to negative experiences if they do not get the support they need. Negative experiences lead to patients avoiding health care, or these experiences affect important aspects of life. The suffering that a patient experiences may be obvious to some, but others hide it, and then it will be more difficult to detect. The nurse's role is to recognize the suffering and its different reactions in order to alleviate and prevent unnecessary suffering of the patient. AimThe purpose of this study was to describe about young people's and adults' experiences of having needle phobias. Method A literature review methodology, using eight quantitative articles and one qualitative article relevant for the aim of study.The analysis was done by comparing the similarities and differences from the result's content.Afterwards the most important parts in the result was coded to build categories and themes. Results Patients with needle phobias experience many different physical reactions such aspain, vasovagal reaction and other reactions during venipuncture, injections or just by seeing a needle. Long waiting times worsened the experience and strengthened the response. Patients experience more anxiety and fear because of their previous negative experiences and because of the medical environment. Experiences and reactions differ between ages, gender and level of education. Conclusion Patients with needle phobias have different experiences and reactions vary from person to person. Nurses on care institutions need more knowledge about patient'sexperiencesof needle phobias to better support and ease the suffering that afflicts the patients.

Thesis (M.A.)--University of Hawaii at Manoa, 2007. / Includes bibliographical references (leaves 19-22). / v, 22 leaves, bound ill. 29 cm

Thesis (M.A.)--Georgia State University, 2007. / Title from file title page. Timothy O'Keefe, committee chair; Andrew Altman, Christie Hartley, committee members. Electronic text (39 p.) : digital, PDF file. Description based on contents viewed Dec. 31, 2007. Includes bibliographical references (p. 39).

Thesis (Ph.D.). / Written for the Dept. of Psychology. Title from title page of PDF (viewed 2008/08/04). Includes bibliographical references.

Dissertation (PhD)--University of Stellenbosch, 2007. / Bibliography. Also available via the Internet.