Traumatic brain injury (TBI) is a devastating public health problem for patients and their families. The neurodegeneration that follows TBI is complex, but can be broadly subdivided into primary and secondary damage. Though primary damage is irreversible and therefore unsalvageable, extensive literature aimed at understanding the tissue, cellular, inflammatory and subcellular processes following the injury have proven unequivocally that secondary pathophysiological events are delayed and progressive in nature. Understanding these secondary events at the cellular levels is critical in the eventual establishment of targeted therapeutics aimed at limiting progressive injury after an initial trauma. One such secondary event is referred to in the literature as excitotoxicity; a sustained and de-regulated activation of glutamate receptors that leads to rapid cytotoxic edema and calcium overload. Our understanding of excitotoxicity has evolved to include not only a role for elevated extracellular glutamate in mediating neuronal damage, but also post-synaptic receptor modifications that render glutamate profoundly more toxic to injured neurons than healthy tissue. In this thesis, we explored the hypothesis that glutamate excitotoxicity can be perpetuated by trauma-induced post-synaptic modification of the AMPA receptor. Specifically, we used a cortical culture model of TBI as well as the fluid percussion injury device to test the hypothesis that TBI confers a reduction of surface GluR2 protein, an AMPA receptor subunit that limits neuronal calcium permeability. We conjectured that this decrease in the expression of surface GluR2 would increase the expression of calcium-permeable AMPA receptors, thereby rendering neurons vulnerable to secondary excitotoxic injury. We further investigated the subcellular mechanisms responsible for the internalization of surface GluR2, and the phenotypic consequences of GluR2 endocytosis in both models. Our data revealed that both models of TBI resulted in a regulated signaling cascade leading to the phosphorylation and internalization of GluR2. By exogenously interrupting the trafficking of GluR2 protein with an inhibitory peptide, we further observed that GluR2 internalization was mediated by a protein interaction involving protein interacting with C kinase 1 (PICK1) and protein kinase C alpha (PKCα), two PDZ domain-containing proteins that mediate GluR2 trafficking during constitutive synaptic plasticity. We observed that GluR2 endocytosis was NMDA receptor dependent, and resulted in increased neuronal calcium permeability, augmented AMPA receptor-mediated electrophysiological activity and increased susceptibility to delayed cell death. Finally, we demonstrated that the interruption of GluR2 trafficking is cytoprotective, suggesting that sustaining surface GluR2 protein protects neurons against secondary injury. Overall, our findings suggest that experimental TBI promotes the expression of injurious GluR2-lacking AMPA receptors, thereby enhancing cellular vulnerability to secondary excitotoxicity.

Sara Tuvel Bernstein’s The Seamstress and Rena Kornreich Gelissen’s Rena’s Promise: A Story of Sisters in Auschwitz, both Holocaust memoirs, offer insight into the rise of violent anti-Semitism prior to World War II and the authors’ experiences in concentration camps. The purpose of this project is to better understand the unique trauma women experienced during the Holocaust and the impact of that trauma on their literary responses.

Syfte: Att undersöka ambulanssjuksköterskors upplevelser av att omhänderta pediatriska traumapatienter med fokus på prioriteringar, beslutsfattande, behandlingsriktlinjer (beslutsstöd) samt uppföljning av patientfall. Metod: Kvalitativ intervjustudie med beskrivande och utforskande design. Urvalet bestod av åtta ambulanssjuksköterskor, sju män och en kvinna, med tre till 16 års erfarenhet inom yrket. Data analyserades genom kvalitativ innehållsanalys. Resultat: I mötet med barn inom ambulanssjukvården har ambulanssjuksköterskans eget föräldraskap och barnets föräldrar en betydelse. Praktiska och mentala förberedelser samt ett gott bemötande är viktigt. Att prioritera och bedöma barn är svårt då det föreligger anatomiska/fysiologiska och psykologiska skillnader. Bedömningen grundar sig på A-E principen och kräver erfarenhet, övning och utbildning. Beslutsfattandet grundar sig på den prioritering och bedömning som gjorts. Aktuella beslutsstöd (behandlingsriktlinjer) upplevs olika tillfredställande. Låg frekvens av barntrauman leder till svårigheter i att upprätthålla kompetens. Uppföljning är önskvärt och behovet är stort men förhindras av bl.a. sekretess. Ytterligare förbättringsområden som påtalats var bristande utrustning samt svårigheter i att administrera läkemedel till barn. Slutsats: Regelbunden teoretisk utbildning samt praktisk scenarioövning fodras. Behandlingsriktlinjerna bör ses över i avseende på innehåll/relevans, rekommenderade läkemedelsdoser önskas. Skattningsinstrument för bedömning av barn är önskvärt. Verksamheten bör även se över anställdas behov och önskemål avseende uppföljning av specifika patientfall samt aktuella tillvägagångssätt för detta / Aim: To explore Swedish ambulance nurses´ experiences of caring for pediatric trauma patients regarding priorities, decision making, treatment guidelines and patient follow-up. Method: A qualitative interview study with a descriptive/explorative design. Eight ambulance nurses participated, seven men and one woman. The participants’ experience of the ambulance service ranged from three to 16 years. Data was analyzed with qualitative content analysis. Results: The respondent´s own parenthood and the child´s parents affect the nurse. Practical and mental preparation and a good attitude are important. To prioritize a child is difficult because of anatomical/physiological and psychological differences. The assessment is based on the A-E principle and requires experience, practice and education. Decisions are based on priority and assessment. Various degrees of satisfaction were expressed regarding current treatment guidelines. A low frequency of child traumas leads to difficulties in maintaining expertise. Desired follow-up is prevented by professional secrecy. Other issues that emerged were lack of equipment and difficulties in administrate drugs to children. Conclusion: Regular theoretical education and practical scenario exercise are required. Treatment guidelines should be reviewed in terms of content/relevance; recommended drug dosages are required. Pediatric assessment scales are desired. Procedures for nurses´ follow-ups of specific patient cases should also be reviewed.

Thesis (Ph.D.) -- University of Texas at Arlington, 2008.

Thesis (M.A.)--West Virginia University, 2003. / Title from document title page. Document formatted into pages; contains vi, 64 p. : ill. Vita. Includes abstract. Includes bibliographical references (p. 37-41).

Thesis (Ph. D.)--York University, 2001. Graduate Programme in Social & Political Thought. / Typescript. Includes bibliographical references (leaves 383-410). Also available on the Internet. MODE OF ACCESS via web browser by entering the following URL: http://wwwlib.umi.com/cr/yorku/fullcit?pNQ67930.

Hiroshima Peace Memorial Museum, established in 1955, remains the primary site for recuperating and transforming memories of the atomic bombing into a message for global peace. Within the museum’s transcendental politics, American and European visitors are a key presence, evident in the site’s 1994 renovation adding historical context for the bombings, its design as a bilingual space using both Japanese and English, and in its refusal to criticize the United States for their use of the bomb. However, what remains excluded from this global view is a discussion of race, a critical dimension of U.S.-Japanese relations and Pacific Rim colonialism during and after World War II. This thesis utilizes scholarship on cultural memory and cultural trauma to interrogate how the museum has been constructed as a site of post-racial politics. In examining the mechanics of this space, this thesis focuses on the “objects” that the museum describes as “material witnesses,” to interrogate the historical links between Orientalism and cultural trauma. Through a theoretical development of my fieldwork in Hiroshima in 2011, analysis of the space, and relevant literature, I argue that the gaze of Western tourism is fundamental in the construction of Hiroshima as a global, peaceful, and post-racial experience for museum visitors. / text

Self-compassion is a psychological construct that involves being open to experiencing one's pain and suffering and directing feelings of kindness inwards during moments of distress. Research has found that high levels of self-compassion are negatively associated with depression, anxiety, rumination, and avoidance, and positively associated with overall quality of life. The present study looked at self-compassion as a predictor of psychopathology and functional outcomes in a sample of trauma-exposed OEF/OIF veterans. Baseline data was used from Project PREDICT from of the Department of Veteran Affairs VISN 17 Center of Excellence for Research with Returning War Veterans. The relations among self-compassion, mindfulness, and experiential avoidance were analyzed. Structural equation modeling was used and results found that higher levels of self-compassion and mindfulness predicted lower levels of psychopathology and higher overall functioning. In addition, experiential avoidance partially or fully mediated the association between mindfulness and self-compassion and PTSD symptoms, psychological distress, and functionality. Supplemental regression analyses were also conducted examining the relationship between mindfulness and self-compassion with several outcome variables. Results found that self-compassion significantly contributed to the model predicting acceptance of chronic pain. In addition, mindfulness significantly contributed to the model predicting problematic alcohol use. These findings suggest that inclusion of acceptance-based interventions, specifically self-compassion and mindfulness, may improve emotional distress as well as overall functioning in trauma-exposed combat veterans. / text

published_or_final_version / Comparative Literature / Master / Master of Philosophy

A Thesis submitted to The University of Arizona College of Medicine - Phoenix in partial fulfillment of the requirements for the Degree of Doctor of Medicine. / The objective of this project was to review skeletal survey reports and examine the differences in reporting of non-accidental trauma in patients with similar radiological findings. The overall purpose of this project is to develop a standardized reporting system for radiological findings suspicious for non-accidental trauma. Ten years’ worth of skeletal survey reports were obtained on over 1,500 pediatric patients. These reports were individually reviewed and their findings were categorized in a table separating findings suspicious for non-accidental trauma. After data collection, analysis was completed to inspect the consistency of reports amongst studies with similar fractures specifying non-accidental trauma. The comparison was made between reports containing long bone fractures, metaphyseal corner fractures, rib fractures, or any combination of these. It was concluded that there are inconsistencies in reporting of non-accidental trauma in reports with similar patterns of these fractures. We propose a Skeletal Survey – Reporting and Data System (SS-RADS) score which will help radiologist standardize their reporting methods for more consistent interpretations and clinical outcomes.