Trauma Commons^™

Breakthrough Series Collaborative To Support Trauma-Informed Practice In Early Care & Education, Anne Douglass

Office of Community Partnerships Posters

This study investigated the use of a Breakthrough Series Collaborative (BSC) to promote the adoption of trauma-informed practices in urban early care & education (ECE) programs. Through this BSC, ECE programs implement new practices to promote safe, stable, and nurturing relationships and prevent trauma exposure; protect children exposed to trauma, help children heal, and support family protective factors that help children thrive.

A Statewide Survey Of Institutional Trauma Human Resource Allocation And Associated Patient Mortality, Bryan G. Kane Md, Quincy Gerrald Do, Catherine Fischer Do, Kevin Vong Do, Mary Sibley Do, Justin Binstead Do

Department of Emergency Medicine

No abstract provided.

Does Destination Determine Destiny? A Statewide Analysis Of Trauma Center Mortality, Bryan G. Kane Md, Quincy Gerrald Do, Catherine Fischer Do, Kevin Vong Do, Mary Sibley Do, Justin Binstead Do

Department of Emergency Medicine

No abstract provided.

Laboring To Mother In The Context Of Past Trauma: The Transition To Motherhood, Berman Helene, Robin Mason, Jodi Hall, Susan Rodger, Catherine C. Classen, Marilyn K. Evans, Lori E. Ross, Gloria Alvernaz Mulcahy, Leonarda Carranza, Fatmeh Al-Zoubi

Journal Articles

The occurrence of interpersonal trauma is a reality for many women, with effects that often persist long after the traumatic events end. The purpose of this feminist grounded theory study was to examine how past trauma shaped the lives of women as they became new mothers. We recruited a purposive sample of 32 women from two Canadian communities and conducted semistructured, dialogic interviews during the second trimester of pregnancy. We analyzed data using thematic content analytic methods, including open coding whereby we read transcripts line by line and applied codes to portions of text that illustrated concepts or themes. The …

Head Impact Exposure In Male And Female Collegiate Ice Hockey Players, Bethany J. Wilcox, Jonathan G. Beckwith, Richard M. Greenwald, Jeffrey J. Chu, Thomas W. Mcallister, Laura A. Flashman, Arthur C. Maerlender, Ann-Christine Duhaime, Joseph J. Crisco

Department of Psychology: Faculty Publications

The purpose of this study was to quantify head impact exposure (frequency, location and magnitude of head impacts) for individual male and female collegiate ice hockey players and to investigate differences in exposure by sex, player position, session type, and team. Ninety-nine (41 male, 58 female) players were enrolled and 37,411 impacts were recorded over three seasons. Frequency of impacts varied significantly by sex (males: 287 per season, females: 170, p < 0.001) and helmet impact location (p < 0.001) but not by player position (p = 0.088). Head impact frequency also varied by session type; both male and female players sustained more impacts in games than in practices (p < 0.001), however the magnitude of impacts did not differ between session types. There was no difference in 95th percentile peak linear acceleration between sexes (males: 41.6 g, females: 40.8 g), but 95th percentile peak rotational acceleration and HITsp (a composite severity measure) were greater for males than females (4424, 3409 rad/s2, and 25.6, 22.3, respectively). Impacts to the back of the helmet resulted in the greatest 95th percentile peak linear accelerations for males (45.2 g) and females (50.4 g), while impacts to the side and back of the head were associated with the greatest 95th percentile peak rotational accelerations (males: 4719, 4256 rad/sec², females: 3567, 3784 rad/sec², respectively). It has been proposed that reducing an individual’s head impact exposure is a practical approach for reducing the risk of …

Prescribing Multiple Neurostimulants During Rehabilitation For Severe Brain Injury., Amy A. Herrold, Theresa Louise-Bender Pape, Ann Guernon, Trudy Mallinson, Eileen Collins, Neil Jordan

Clinical Research and Leadership Faculty Publications

Background. Despite a lack of clear evidence, multiple neurostimulants are commonly provided after severe brain injury (BI). The purpose of this study is to determine if the number of neurostimulants received during rehabilitation was associated with recovery of full consciousness or improved neurobehavioral function after severe BI.

Method. Data from 115 participants were extracted from a neurobehavioral observational study database for this exploratory, retrospective analysis. Univariate optimal data analysis was conducted to determine if the number of neurostimulants influenced classification of four outcomes: recovery of full consciousness during rehabilitation, recovery of full consciousness within one year of injury, and meaningful …

Research Brief: "Suicides In The Military: The Post-Modern Combat Veteran And The Hemingway Effect", Institute For Veterans And Military Families At Syracuse University

Institute for Veterans and Military Families

This brief is about current suicide prevention interventions within the military. In policy and practice, practitioners should monitor the wellness of aging veterans and ensure that a support system exists for their veteran patients, while veterans should participate in social events with other veterans; the VA and DoD should implement programs to ensure that veterans have feelings of belongingness and the VA should monitor veterans' well-being for 2-3 years after service during transitions. Suggestions for future research include examining the communities and veteran service organizations that produce the most useful support for veterans with mental health problems.

Trauma-Informed Services And Trauma Awareness Among Staff On The College Campus, Tricia Wisniewski

Honors Program Theses

For college students to work through the effects of trauma and be able to live a more normalized life, the availability of effective trauma-informed services on campus environments is crucial. Therefore, I chose to investigate the availability of trauma-informed services to all students on the college campus. The purpose of this study is to examine the relatively unexplored area of trauma informed services in the context of college campus through survey methods at the University of Northern Iowa (UNI). In particular, this study focuses on trauma-informed services and employees’ trauma awareness in four service units on the UNI campus: the …

Diagnosis And Acute Management Of Patients With Concussion At Children's Hospitals., Jeffrey D. Colvin, Cary Thurm, Brian M. Pate, Jason G. Newland, Matt Hall, William P. Meehan Iii

Manuscripts, Articles, Book Chapters and Other Papers

Objectives: To describe the number of hospital admissions for concussion at paediatric hospitals in the USA. To describe the use of imaging and medications for acute concussion paediatric patients.

Design: Cross-sectional study.

Setting: Children's hospitals participating in the Pediatric Health Information System in the USA during a 10-year period.

Patients: All emergency department (ED) visits and inpatient admissions with the primary diagnosis of concussion, defined as International Classification of Diseases, Ninth Revision, Clinical Modification codes for: (1) concussion, (2) postconcussion syndrome or (3) skull fracture without mention of intracranial injury with concussion.

Main outcome measures: The proportion of concussion patients …

Absence Of The Genicular Arterial Anastomosis As Generally Depicted In Textbooks., Maher Sabalbal, Marjorie Johnson, Vivian Mcalister

Data and Test Instruments

This article reviews the history of anatomical research, starting with John Hunter and Astley Cooper, into the arterial anastomosis at the knee and uses dissection to determine the reality. The final draft is available below. (Ann R Coll Surg Engl. 2013 Sep;95(6):405-9) INTRODUCTION Textbook representations of the genicular arterial anastomosis show a large direct communication between the descending branch of the lateral circumflex femoral artery (DBLCFA) and a genicular branch of the popliteal artery but this is not compatible with clinical experience. The aim of this study was to determine whether the arterial anastomosis at the knee is sufficient, in …

Research Brief: "Prospectively Assessed Post-Traumatic Stress Disorder And Associated Physical Activity", Institute For Veterans And Military Families At Syracuse University

Institute for Veterans and Military Families

This brief is about the connection between physical activity and symptoms of post-traumatic stress disorder in veterans. In policy and practice, service members who experienced combat should have high levels of physical activity in order to reduce the possibility of developing PTSD, clinicians should mention the importance of physical activity for mental health to service members, as well as recommend alternatives for veterans who are unable to do high levels of physical activity. The VA should implement and promote fitness programs for service members and veterans to lower the possibility of developing PTSD, and policymakers should fund physical activity programs …

Research Brief: "Prevalence Of Childhood Trauma Among U.S. Army Soldiers With Suicidal Behavior", Institute For Veterans And Military Families At Syracuse University

Institute for Veterans and Military Families

This brief is about the link between childhood trauma and servicemember suicide risk within the US Army. In policy and practice, communities should be willing to discuss abuse with servicemembers who experienced childhood trauma, healthcare providers should tell veterans and servicemembers about their treatment options, and family members should assist with the mental health treatment of veterans and servicemembers. Policymakers should create programs that encourage social networks and increase the number of veteran and military support groups. Suggestions for future research include using a different data source for the study, adding a control group, and broadening the sample of veterans …

Trauma And Posttraumatic Stress Disorder In South Africa: Analysis From The South African Stress And Health Study, Lukoye Atwoli, Dan J. Stein, David R. Williams, Katie A. Mclaughlin, Maria Petukhova, Ronald C. Kessler, Karestan C. Koenen

Internal Medicine, East Africa

Background: South Africa’s unique history, characterised by apartheid, a form of constitutional racial segregation and exploitation, and a long period of political violence and state-sponsored oppression ending only in 1994, suggests a high level of trauma exposure in the general population. The aim of this study was to document the epidemiology of trauma and posttraumatic stress disorder (PTSD) in the South African general population.

Methods: The South African Stress and Health Study is a nationally representative survey of South African adults using the WHO’s Composite International Diagnostic Interview (CIDI) to assess exposure to trauma and presence of DSM-IV mental …

Craniocerebral Injuries In War Against Terrorism --- A Contemporary Series From Pakistan, Muhammad-Umair Bashir, Muhammad-Zubair Tahir, Ehsan Bari, Sehreen Mumtaz

Section of Neurosurgery

Objective: Terrorism-related bomb attacks on civilian population have increased dramatically over the last decade. Craniocerebral injuries secondary to improvised explosive devices have not been widely reported in the context of unarmored civilians. This series intends to report the spectrum of these injuries secondary to suicidal and implanted bombs as encountered at the Aga Khan University Hospital, Pakistan (AKUH). Further, a few pertinent management guidelines have also been discussed.
Methods: The hospital database and clinical coding during a 5-year period were examined for head injuries secondary to terrorism-associated blasts. In addition to patient demographics, data analysis for our series included initial …

Massacre In Central Burma: Muslim Students Terrorized And Killed In Meiktila, Richard Sollom, Holly G. Atkinson

Publications and Research

This report details the results of a Physicians for Human Rights (PHR) investigation into the March 20 and 21, 2013, attacks on Muslim students, teachers, and residents in the Mingalar Zayyone quarter of Meiktila, a small town in central Burma.

A two-person team, the authors of the report, from PHR conducted 33 interviews about the attacks, which resulted in the deaths of at least 20 children and four teachers. The report details the attacks by the Buddhist mobs, provides evidence that local police officers were complicit in the crimes, and lists policy recommendations for the Burmese government and the international …

A Systematic Review Of Ptsd Prevalence And Trajectories In Dsm-5 Defined Trauma Exposed Populations: Intentional And Non-Intentional Traumatic Events, Patcho N. Santiago, Robert J. Ursano, Christine L. Gray, Robert S. Pynoos, David Spiegel, Roberto Lewis-Fernandez, Matthew Friedman, Carol S. Fullerton

Dartmouth Scholarship

Objective: We conducted a systematic review of the literature to explore the longitudinal course of PTSD in DSM-5-defined trauma exposed populations to identify the course of illness and recovery for individuals and populations experiencing PTSD.

Methods: We reviewed the published literature from January 1, 1998 to December 31, 2010 for longitudinal studies of directly exposed trauma populations in order to: (1) review rates of PTSD in the first year after a traumatic event; (2) examine potential types of proposed DSM-5 direct trauma exposure (intentional and non-intentional); and (3) identify the clinical course of PTSD (early onset, later onset, chronicity, remission, …

Development And Pilot Implementation Of A Locally Developed Trauma Registry: Lessons Learnt In A Low-Income Country, Amber Mehmood, Junaid Abdul Razzak, Sarah Kabir, Ellen J. Mackenzie, Adnan A. Hyder

Department of Emergency Medicine

Background

Trauma registries (TRs) play an integral role in the assessment of trauma care quality. TRs are still uncommon in developing countries owing to awareness and cost. We present a case study of development and pilot implementation of “Karachi Trauma Registry” (KITR), using existing medical records at a tertiary-care hospital of Karachi, Pakistan to present results of initial data and describe its process of implementation.

Methods

KITR is a locally developed, customized, electronic trauma registry based on open source software designed by local software developers in Karachi. Data for KITR was collected from November 2010 to January 2011. All patients …

Disseminating Childhood Home Injury Risk Reduction Information In Pakistan: Results From A Community-Based Pilot Study, Aruna Chandran, Uzma Rahim Khan, Nukhba Zia, Asher Feroze, Sarah Stewart De Ramirez, Cheng-Ming Huang, Junaid A. Razzak, Adnan A. Hyder

Department of Emergency Medicine

Background: Most childhood unintentional injuries occur in the home; however, very little home injury prevention information is tailored to developing countries. Utilizing our previously developed information dissemination tools and a hazard assessment checklist tailored to a low-income neighborhood in Pakistan, we pilot tested and compared the effectiveness of two dissemination tools.

Methods: Two low-income neighborhoods were mapped, identifying families with a child aged between 12 and 59 months. In June and July 2010, all enrolled households underwent a home hazard assessment at the same time hazard reduction education was being given using an in-home tutorial or a pamphlet. …

School-Based Injury Outcomes In Children From A Low-Income Setting: Results From The Pilot Injury Surveillance In Rawalpindi City, Pakistan, Uzma Rahim Khan, Junaid A. Bhatti, Nukhba Zia, Umar Farooq

Department of Emergency Medicine

Background

School-based injuries account for one in five unintentional childhood injuries. Little is known about the epidemiology of school-based injuries in low-income settings. The objective of our study was to compare emergency department (ED) outcomes of the school-based injuries with respect to age, sex, and injury mechanisms in a Pakistani urban setting.

Findings

A pilot injury surveillance study was conducted at the EDs of three major tertiary-care hospitals of Rawalpindi city from July 2007 to June 2008 and included children of less than 15 years injured at school. The World Health Organization’s questionnaire for injury surveillance was used. There were …

Traumatic Pancreatic Injury: An Elusive Diagnosis: Experience From A Developing Country Urban Trauma Referral Centre, Ayaz Ahmed Memon, Hasnain Zafar, Rushna Raza, Ghulam Murtaza

Section of General Surgery

Objective: To determine the frequency of pancreatic injury in patients presenting with trauma and to review the mechanism of injury, management, subsequent complications and in-hospital mortality rate associated with these patients.
Methods: The retrospective study included all patients over 18 years of age presenting with pancreatic injury due to trauma at the Aga Khan University Hospital, Karachi, between January 1990 and December 2009. Patients with iatrogenic pancreatic injury were excluded. The severity of the injury was assessed using the Injury Severity Score, while it was graded according to the scale defined by the American Association for the Surgery of Trauma. …