Medicine and Health Sciences Commons^™

Probiotic Use In Trauma Patients: A Pathway To Determining The Standard Of Care To Improve Outcomes, Heather Vitko

Electronic Theses and Dissertations

The gut microbiome consists of normally non-pathogenic bacteria, viruses, and fungi. These friendly microbes serve to maintain GI barrier function and integrity, play a role in host nutrient and drug metabolism, immunomodulation, and prevent pathogenic bacteria from colonizing or causing disease. The importance of a healthy microbiome for the overall health of the host is just recently being appreciated within the medical and science communities. Disruption of the microbiome places one at greater risk for illness and infection. Patients who suffer a traumatic injury are among those at highest risk for complications associated with microbial imbalance, or dysbiosis. In addition …

Traumatic Complications Of Inpatient Massage Therapy: Case Report And Literature Review, Ishna Sharma, D'Andrea Joseph, Orlando Kirton

Abington Jefferson Health Papers

No abstract provided.

Mental Health And Resilience In Adolescent Refugees Resettled In Philadelphia, Saya Bery, Pia Ghosh, Mph, Ellen Plumb, Md

Phase 1

Introduction: Mental health in adolescents has a large impact on physical health, academic achievement, and overall well-being; moreover, refugee youth are at an increased risk for mental health disorders. While growing evidence shows that positive youth development interventions can prevent health risk behaviors, there is need for further evaluation that shows how to tailor interventions to meet population-specific needs.

Objective: The aim is to assess how targeted interventions can enhance protective factors and reduce negative adult outcomes in vulnerable refugee adolescents. The goals are to understand the current status of mental health and access to resources among resettled adolescents in …

An Evaluation Of Implementing Trauma-Informed Care Training In Healthcare Settings, Amanda Kis

Capstone Experience

Background: Trauma-informed care (TIC) has recently become a popular topic in medical science. Many patients’ health conditions have been diagnosed and treated purely as medical issues, yet emerging research indicates that trauma is sometimes the source of many physical and mental conditions. Implementing TIC education in healthcare systems may lead to preventing the onset of symptomology related to undiagnosed, chronic trauma experience.

Objectives: The primary goal of this Capstone project was to implement TIC training developed by Trauma Matters Omaha Coalition and assess preliminary evidence for changes in participants’ confidence, clinical knowledge, professional knowledge, self-awareness, and assumptions and biases regarding …

Repeat Lactate Level Predicts Mortality Better Than Rate Of Clearance, Zachary D. W. Dezman, Angela C. Comer, Gordon S. Smith, Peter F. Hu, Colin F. Mackenzie, Thomas M. Scalea, Jon Mark Hirshon

Clinical and Translational Science Institute

Background Lactate clearance has been developed into a marker of resuscitation in trauma, but no study has compared the predictive power of the various clearance calculations. Our objective was to determine which method of calculating lactate clearance best predicted 24-hour and in-hospital mortality after injury. Study design Retrospective chart review of patients admitted to a Level-1 trauma center directly from the scene of injury from 2010 to 2013 who survived >15 min, had an elevated lactate at admission (≥3 mmol/L), followed by another measurement within 24 h of admission. Lactate clearance was calculated using five models: actual value of the …

Efficaciousness Of Mindfulness Interventions For Trauma Using Psychophysiological Measures: A Review, Sherief Y. Eldeeb

Scholarly Undergraduate Research Journal at Clark (SURJ)

In recent decades the efficaciousness of mindfulness has been proven in a wide variety of contexts, but some crucial populations remain understudied. This review critically examines the literature on mindfulness in individuals with trauma using psychophysiological measures. Psychophysiological measures offer critical insight into this intersection of mindfulness and trauma due to the known somatic components in each, as well as serving as an objective response. Mindfulness-based treatments seem to show great promise in treating trauma, however there are significant limitations in the literature. Future studies should standardize the minimum length of treatment, utilize gender-balanced and ethnically diverse samples, and introduce …

New York After 9/11 [Chapter: Conflict And Change], Zachary Baron Shemtob, Patrick Sweeney, Susan Opotow

New York State City & Regional

An estimated 2 billion people around the world watched the catastrophic destruction of the World Trade Center. The enormity of the moment was immediately understood, and both news coverage and history of the catastrophe quickly took on global proportions—less understood has been the effect on the locus of the attacks, New York City, not as a seat of political or economic power, but as a community; not in the days and weeks afterward, but in the months and years. This period of tumultuous change offers important insights about New York today and holds important lessons for the future. New York …

Negative Voice-Content As A Full Mediator Of A Relation Between Childhood Adversity And Distress Ensuing From Hearing Voices, Cherise Rosen, Simon Mccarthy-Jones, Nev Jones, Kayla A. Chase, Rajiv P. Sharma

Mental Health Law & Policy Faculty Publications

A key predictor of whether or not an individual who hears voices (auditory verbal hallucinations; AVH) meets criteria for a psychiatric diagnosis is the level of negative content of the voices (e.g., threats, criticism, abuse). Yet the factors that contribute to negative voice-content are still not well understood. This study aimed to test the hypotheses that levels of childhood adversity would predict levels of negative voice-content, and that negative voice-content would partially mediate a relation between childhood adversity and voice-related distress. These hypotheses were tested in a clinical sample of 61 patients with formally diagnosed psychotic disorders (48 schizophrenia …

What’S Your Story? Assessing Childhood Maltreatment Using The Thematic Apperception Test In An Adult Inpatient Population., Thachell C. Tanis

Dissertations, Theses, and Capstone Projects

There is a robust evidence that childhood maltreatment contributes to the development of adult psychopathology (Brown & Anderson, 1991; Johnson, Cohen, Brown, Smailes, & Bernstein 1999; Johnson, Smailes, Cohen, Brown, & Bernstein, 2000; Ruggiero et al., 1999). However, the identification of childhood maltreatment remains a methodological problem that results in inconsistencies in the reported incidence and psychological sequelae of maltreatment. A primary method for identifying histories of childhood maltreatment among adults is retrospective self-report measures which are susceptible to multiple biases (Briere, 1992; Cicchetti & Rizley, 1981; Shaffer, Huston, & Egeland, 2008). This present study suggests that childhood maltreatment can …

How Can Developmental Transformations Address Culture Shock To Those Moving From Collectivist Societies Into Individualistic Ones, Such As, Chinese Immigrants Into The United States?, Fabiola Valdivia

Expressive Therapies Capstone Theses

Immigration has always existed, and lately with the heyday of social networks and media, we have witnessed high rates of immigration due to different social and political contexts that have forced people to leave their homes looking for a better situation. Many of these individuals have emigrated and continue to emigrate to the United States of America, in search of, what in some cases they believe will be, the American dream.

This document explores the implementation of developmental transformations (DvT), originally a drama therapy approach, with an immigrant population coming from a collective society such as the Asian into an …

A Six-Month Retrospective Study Of Resources Burden By Trauma Victims In The Surgical Intensive Care Unit Of A University Hospital In Pakistan, Muhammad Rizwan, Madiha Hashmi, Hasnain Zafar

Department of Anaesthesia

Introduction: Trauma is the fourth leading cause of death globally and constitutes a huge burden on limited critical care resources. Aim This study aimed to identify the trauma patient burden in terms of resources used in the surgical intensive care unit (SICU) of Aga Khan University Hospital in Pakistan which also included characteristics and outcomes of trauma and non-trauma patients.
Methods: We retrospectively reviewed all patient data for adult patients (>16 years old) admitted to the SICU from July through December 2014.
Results: Of 141 SICU cases included in our study period, 32 (22.7%) trauma patients were identified. On …

Improve Effectiveness In Trauma Teamwork, Ginger Miramontes

Master's Projects and Capstones

On average, each Ventilator-Associated Event (VAE) is anticipated to increase the length of stay in the Intensive Care Unit (ICU), resulting in potential adverse events and cost to the organization. The Center for Disease Control (CDC) defines VAE as the increase of daily minimum positive end-expiratory pressure (PEEP) and fraction of inspired oxygen (FiO2) values, after a baseline period of patient stability or improvement on the ventilator (CDC, 2018). Standard endotracheal tube designs have led to the incidence of VAE because of the accumulation of subglottic secretions in the trachea. Untreated VAE can later result in Ventilator Associated Pneumonia (VAP). …

A Multimodal Assessment Of Disgust In Response To Traumatic Event Reminders Among Adolescents, Teah-Marie R. Bynion

Graduate Theses and Dissertations

The majority of youth will report traumatic event exposure by the time they reach adulthood. Research suggests exposure to such events is linked to myriad negative outcomes. Not all traumatic events are alike, however; evidence suggests that, compared to non-interpersonal events, interpersonal events in which another person intentionally perpetrates harm are linked to elevations in the likelihood of negative outcomes, including posttraumatic stress disorder (PTSD). One reason for this discrepancy is that interpersonal traumatic events may elicit greater levels of disgust. However, this is a very under-developed research base, no study has examined this question among youth. The current study …

Trauma Recovery: A Heroic Journey, Brenda Keck, Lisa Compton, Corie Schoeneberg, Tucker Compton

Heroism Science

Trauma survivors who choose to enter into trauma recovery may be viewed as individuals embarking on a hero’s journey. Historically, many of the coping strategies utilized by individuals who are experiencing post-traumatic stress have been viewed as inherently disordered and personally dysfunctional. An alternative perspective of these behaviors calls for an examination of strengths present within trauma survivors, suggesting a reframe of their symptomology as ingenuity in coping during adverse circumstances and an appreciation for the difficulty of living with traumatic memories. This article highlights the challenging process of trauma recovery as it parallels Campbell’s (1949) metaphor of the hero’s …

Hemostatic Nanoparticles Increase Survival, Mitigate Neuropathology And Alleviate Anxiety In A Rodent Blast Trauma Model, W. Brad Hubbard, Margaret Lashof-Sullivan, Shaylen Greenberg, Carly Norris, Joseph Eck, Erin Lavik, Pamela Vandevord

Spinal Cord and Brain Injury Research Center Faculty Publications

Explosions account for 79% of combat related injuries and often lead to polytrauma, a majority of which include blast-induced traumatic brain injuries (bTBI). These injuries lead to internal bleeding in multiple organs and, in the case of bTBI, long term neurological deficits. Currently, there are no treatments for internal bleeding beyond fluid resuscitation and surgery. There is also a dearth of treatments for TBI. We have developed a novel approach using hemostatic nanoparticles that encapsulate an anti-inflammatory, dexamethasone, to stop the bleeding and reduce inflammation after injury. We hypothesize that this will improve not only survival but long term functional …

Wiltse Approach Versus Conventional Open Approach In Neurologically Intact Patients With Thoracolumbar Fractures: Clinical And Radiological Outcome Study, Mohamed Shater, Mohamed Hassanein

Advanced Spine Journal

Background Data: Percutaneous screws fixation became popular as it depends on minimal muscle destruction and no para-spinal muscle stripping. However, there is a lot of disadvantages of percutaneous fixation technique including the high radiation exposure. Complications reported in conventional midline approach including muscle stripping from lamina and spinous processes and long-term postoperative pain and muscle weakness led the spine surgeon to rediscover minimally invasive technique to manage spinal fractures through posterior approach. One of these techniques is Wiltse technique which access the pedicle through blunt dissection between the longissimus muscle and multifidus muscle.Purpose: This study aims to compare pedicle screw …

Thoracoscopically Assisted Vertebral Reconstruction Simultaneously With Percutaneous Pedicle Screws Fixation For Management Of Thoracic And Thoracolumbar Spinal Fractures., Mohamed Shater, Ali Abou-Madawi, Hassan Alshatoury, Khaled Elsayed, Mootaz Shousha

Advanced Spine Journal

Background Data: Thoracic and thoracolumbar fractures are commonly provoked by axial compression which disrupts the anterior column. In this setting, posterior stabilization using pedicle screws alone may lead to delayed kyphosis and hardware failure due to inadequate anterior column support. Application of thoracoscopic anterior column reconstruction while patient in prone position for posterior percutaneous instrumentation is a minimally invasive combined technique.Purpose: To evaluate the outcome of percutaneous pedicle screw instrumentation in combination with thoracoscopically assisted vertebral reconstruction using expandable titanium cage.Study Design: Prospective clinical case study.Patients and Methods: Eighteen patients with acute thoracolumbar fractures with different preoperative neurological status were …

Comparison Of Thoracic Epidural Analgesia Versus Parenteral Analgesia For Traumatic Multiple Rib Fractures, Ashraf A. Zein Eldin, Mohamed S. Abdelmotelb, Mohamed M. Abdelsabour, Moharram A. Mohamed

Menoufia Medical Journal

Objective The aim of this study was to compare between epidural analgesia and parenteral analgesia for management of traumatic multiple rib fractures. Background Chest wall trauma is most commonly seen after motor vehicle collision and accounts for 8% of all trauma admissions. It is a marker of severity and contributes to the morbidity and mortality of injured patients, with the elderly and patients with poor respiratory reserve being most vulnerable. Rib fractures are the commonest of all chest injuries and are identified in 10% of patients after trauma. Pain limits one's ability to cough and breathe deeply, resulting in sputum …

Volume Vii (2018), Unm Department Of Orthopaedic Surgery

UNM Orthopaedic Research Journal

No abstract provided.

An Examination Of The Impact Traumatic Events Has On Psychosocial Impairment In Eating Disorder Patients, Jennifer Parker Hackett

Electronic Theses, Projects, and Dissertations

Research suggests that trauma has an impact on eating disorders. While prior research has demonstrated that the trauma from abuse has a significant impact on eating disorders, research has failed to explore other types of trauma. In addition, previous studies have stopped short of examining the impact trauma has on functioning among individuals with an eating disorder. This study aimed to address that gap in the literature. The purpose of this study is to examine whether traumatic life events impact psychosocial functioning among individuals living with an eating disorder. Furthermore, this study aimed to identify which traumas are shown to …

Early Versus Late Intramedullary Nailing For Traumatic Femur Fracture Management: Meta-Analysis, Ayman El-Menyar, Mohammed Muneer, David Samson, Hassan Al-Thani, Ahmad Alobaidi, Paul Mussleman, Rifat Latifi

NYMC Faculty Publications

INTRODUCTION: There is no consensus yet on the impact of timing of femur fracture (FF) internal fixation on the patient outcomes. This meta-analysis was conducted to evaluate the contemporary data in patients with traumatic FF undergoing intramedullary nail fixation (IMN). METHODS: English language literature was searched with publication limits set from 1994 to 2016 using PubMed, Scopus, MEDLINE (OVID), EMBASE (OVID), Web of Science, and Cochrane Central Register of Controlled Trials (CENTRAL). Studies included randomized controlled trials (RCTs), prospective observational or retrospective cohort studies, and case-control studies comparing early versus late femoral shaft fractures IMN fixation. Variable times were used …

Spatial Epidemiology Of Summer Trauma In Scott County, Ia: Use Of Gis To Identify Trauma Incidence In Urban And Rural Areas, Matthew Koch

Celebration of Learning

Traumatic injury is a blanket term referring to acute physical injuries which pose an immediate threat to life and limb, requiring urgent medical care. Unintentional injuries are the fifth-leading cause of death, and fatal injuries cost the American economy over $84 billion annually in lost work and medical costs. Scott County, IA, is a unique environment for trauma research because it served by a single trauma center and features within its 458 square miles distinct urban and rural populations. Patient data from the trauma registry, including age, race, and mechanism of injury (MOI) was combined with the corresponding spatial data …

How Can The Attunement Needs Of Children With Disorganized Attachment Styles Be Supported Through Expressive Arts Therapy?, Jayne Paley

Expressive Therapies Capstone Theses

Treatment strategies for school age children with disorganized attachment are not well established. This population exhibits a range of difficulties in social relationships and self-regulation. Additionally, children with disorganized attachment generally rely on defense mechanisms and present with other comorbid conditions, adding to the complexity of treatment. This paper explores current research and theories about disorganized attachment and then, on the basis of evidence provided throughout this paper, proposes the concept of attunement needs in relation to working with children with disorganized attachment. The attunement needs described in this paper, derived from the literature, include safety/security, control/power, consistency, affective release, …

Efficacy Of The Mnemonic Device “March Paws” As A Checklist For Pararescuemen During Tactical Field Care And Tactical Evacuation, Stephen Rush, John Kosequat, Alex Scott, Isabelle Gallo, Kent Swats, Ian Simonsen

Research Day

Background: The application of TCCC represents evidence-based medicine to improve survival in combat. Over the past several years, USAF Pararescuemen (PJs) have expanded the mnemonic device “MARCH” to “MARCH PAWS” for use during tactical field care and tactical evacuation. It stands for massive bleeding, airway, respiration, circulation, head and hypothermia, pain, antibiotics, wounds, and splinting. We undertook this performance improvement project to determine the efficacy of this device as a treatment checklist.

Methods: The mission reports of a sixteen PJs’ combat rescue deployment to OEF from January through June 2012 were reviewed. The triage category, mechanism of injury, …

Social Work Trauma Interventions: Dialectical Behavioral Therapy, Kassie Baumann

Senior Honors Theses

According to Lynne Weilart (2013), in her article on the reasons why people seek out therapy, trauma is the number one reason people attend counseling. Many different trauma-informed approaches are designed specifically to address the consequences of trauma and to facilitate healing. Some of these approaches are as follows: Cognitive Behavioral Therapy (CBT); Dialectical Behavioral Therapy (DBT);Mentalization Based Therapy (MBT); Trauma Systems Therapy (TST); Trauma Assessment Pathway (TAP); and Attachment, Self-Regulation, and Competency (ARC) (de Arellano, Danielson, Ko, & Sprauge, 2008). The effectiveness of each trauma intervention will be examined. DBT is one of these trauma interventions that is growing …

Spinal Cord Trauma: An Overview Of Normal Structure And Function, Primary And Secondary Mechanisms Of Injury, And Emerging Treatment Modalities, Daniel Morin

Senior Honors Theses

The structures of the spinal cord and vertebral column are designed to provide flexibility, while still providing ample protection for the spinal cord deep within. While it does offer remarkable protection against most routine trauma, the spinal cord is still vulnerable to high-force etiologies of trauma and may become damaged as a result. These events are referred to as primary injury. Following the initial injury, the body’s own physiological responses cause a cascade of deleterious effects, known as secondary injury. Secondary injury is a major therapeutic target in mitigating the effects of spinal cord injury (SCI), and much research is …

Expressive Arts Group Therapy With Children And Adolescents Who Have Experienced Trauma, Shade Alfred

Expressive Therapies Capstone Theses

Experiencing traumatic situations is an inevitable part of life that many have struggled to understand and have difficulty working through its effects. This results in persons seeking therapy to better cope and heal from the impact of the traumatic experience. Children and adolescents who are considered vulnerable require more assistance to help them when they have encountered a traumatic experience. Research has highlighted that Expressive Arts Therapies is a favorable treatment option used with traumatized children and adolescents. Hence, this paper reflects research that has been conducted on group expressive arts therapy with children and adolescents who have experienced trauma. …

Tinnitus And Trauma, Marc A. Fagelson

Marc A. Fagelson

Trauma-provoked tinnitus challenges patients and clinicians. Effects of trauma may exacerbate tinnitus, and patients with both tinnitus and posttraumatic stress disorder rate distress levels as higher than patients who experience only one or the other. This presentation will highlight links between tinnitus and trauma histories relevant to clinical audiologists.

Implementing Psychological Methods In The Management Of Trauma-Associated Tinnitus, Marc A. Fagelson

Marc A. Fagelson

Dr. Fagelson, (Professor Audiology, ETSU) will discuss the unusual challenges facing patients and providers when tinnitus severity is linked to traumatic exposure. Interactions between neural mechanisms associated with tinnitus, posttraumatic stress-disorder (PTSD), and traumatic memory will be reviewed with particular attention to the way and degree to which such interactions affect tinnitus and disorders of sound tolerance. Conference attendees will be provided theoretical models of emotional memory consolidation that underscore trauma‘s durable effects on a patient‘s emotional state, reaction to the tinnitus signal, and to potentially-triggering environmental sounds. The putative benefits of tinnitus counseling will be presented in the context …

Jack Peirs, Third Ypres, And Control, Jonathan Tracey

Student Publications

During the First World War, British officers, primarily upper class, struggled to adapt to trauma within the boundaries of social expectations. Viewing the combat experience and letters of Jack Peirs during the battle of Passchendaele offers insight into how officers experienced the war, explained it to their families, and coped with trauma.