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1
Семенов, Євгеній Олександрович, та Олександр Олександрович Буров. "До питання безпеки дитячих атракціонів". Thesis, НТУ "ХПІ", 2018. http://repository.kpi.kharkov.ua/handle/KhPI-Press/36254.
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Розглянуто стан сучасної проблеми дитячих атракціонів в Україні. Запропоновані заходи, що направлені на підвищення безпеки дитячих атракціонів.<br>The state of the modern problem of children's attractions in Ukraine is considered. Proposed measures aimed at improving the safety of children's attractions.
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Fulton, June Elizabeth. "Traumatic persecutory internal presences." Click here for text online. The Institute of Clinical Social Work Dissertations website, 2003. http://www.icsw.edu/_dissertations/fulton_2003.pdf.
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Dissertation (Ph.D.) -- The Institute for Clinical Social Work, 2003.<br>A dissertation submitted to the faculty of the Institute of Clinical Social Work in partial fulfillment for the degree of Doctor of Philosophy.
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De, Ruiter Anne. "Traumatic burn injuries : mothering the acutely hospitalised adult child /." [St. Lucia, Qld.], 2005. http://www.library.uq.edu.au/pdfserve.php?image=thesisabs/absthe19053.pdf.
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Nyanga, Kanyisa. "A case study of child-centred play therapy with a child suffering from posttraumatic stress disorder." Thesis, Nelson Mandela Metropolitan University, 2014. http://hdl.handle.net/10948/8802.
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Child-centred play therapy is not the preferred treatment approach for Posttraumatic Stress Disorder (PTSD), because of the limited research demonstrating this treatment as a proper approach for childhood trauma. The purpose of this case study was to explore and describe the process of child-centred therapy with a four-year-old child with PTSD. An exploratory descriptive case study approach was utilised as it allowed for an in-depth description of a phenomenon in its therapeutic context. Data was collected through multiple sources to establish a comprehensive database. The data was analysed through Alexander’s content analysis and Guba’s model of trustworthiness. Findings included themes observed in the research participant dealing with PTSD of perfectionism, control, shame, mistrust, needing control, and perfectionism. The therapist’s application of Axline’s principles indicated these principles being enough for treating PTSD in a child. Some of those principles had immediate impact while others were cumulative in their effect.
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Isenwater, W. "Parent-child interaction and childhood post-traumatic stress : a prospective study." Thesis, University College London (University of London), 2004. http://discovery.ucl.ac.uk/1446615/.
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There is to date no comprehensive theoretical account of how PTSD develops in children. Theories of adult PTSD (e.g. Brewin, Dalgleish and Joseph, 1996, Ehlers and Clarke, 2000) exist yet their applicability to childhood PTSD is somewhat limited, as they fail to account for the developmental level of the child and the child's context (dependency on their parent/s). Previous research in the field has demonstrated the influential role of family risk factors. Further, parent-child interaction has been found to be influential in many other childhood mental health problems, though has not been studied in children who have experienced a trauma. The present study aims to investigate the influence of parent-child interaction on the development of PTSD using observational methods. The current sample of children presenting to A E following a traumatic event was observed completing two interaction tasks with their primary caregiver within four weeks of the event. The tasks consisted of a difficult anagram task and a discussion task about the trauma. Both interactions were analysed and coded for warmth/criticism and over-involvement. The discussion task was also analysed for parental avoidance, help in re-appraising the child's sense of threat, and parental management of fear. The parents and children were re-assessed at a 3-month follow up. Parental avoidance, poor management of fear and little help with reappraising threat were strongly associated with child PTSD symptoms at Time 1. Warm/critical and over-involved parenting behaviours were not significantly associated with child PTSD symptoms. None of the parenting behaviours significantly affected the rate of change of the child's symptoms, yet there was a trend between parental involvement in the discussion task and change in child PTSD symptoms over time.
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Glanville, James. "A critique of various pastoral care methods in regard to the traumatic death of a child the traumatic death of a child - a challenge for pastoral care /." Pretoria : [S.n.], 2007. http://upetd.up.ac.za/thesis/available/etd-07242008-091748/.
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Sayer, MacKenzie Ann. "Examination of Maternal Versus Paternal Ratings of Child Pre-Injury Functioning in Predicting Child Post-Traumatic Stress Symptoms." Kent State University / OhioLINK, 2021. http://rave.ohiolink.edu/etdc/view?acc_num=kent161901126298331.
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Yoma, Galleguillos Tomás, and Saavedra Edgardo Zúñiga. "Estudio epidemiológico del trauma cráneofacial en pacientes mayores de 15 años del Servicio de Urgencia del Complejo Asistencial Barros Luco Trudeau, Santiago Chile: período enero 2006 a marzo 2010. Santiago, Chile." Tesis, Universidad de Chile, 2010. http://repositorio.uchile.cl/handle/2250/133985.
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Trabajo de Investigación Requisito para optar al Título de Cirujano Dentista<br>El trauma craneofacial representa un importante problema de salud
mundial. Está asociado a alta morbilidad, pérdida de función, secuelas estéticas y
un alto costo financiero. En Chile existen muy pocos estudios sobre trauma
craneofacial, debido a esto, existe la necesidad de recopilar datos epidemiológicos
de trauma craneofacial para identificar el perfil del paciente que acude a los
Servicios de Urgencias. Un mejor entendimiento de los patrones demográficos,
factores de riesgo asociados y etiología de los traumatismos permitirá elaborar e
implementar protocolos de tratamiento y medidas preventivas más eficientes, con
el fin de destinar la mayor cantidad de recursos (monetarios,personal
capacitado,etc) para cubrir las demandas del país.
Se realizó un estudio retrospectivo descriptivo de tipo cuantitativo en el
Servicio de Urgencia del Hospital Barros Luco, consistente en la recolección
retrospectiva de datos mediante la revisión de fichas clínicas pertenecientes a los
pacientes atendidos en dicho servicio durante el período comprendido entre Enero
de 2006 hasta Marzo de 2010. Los datos obtenidos fueron tabulados utilizando el
programa Microsoft Acces 2007.
En el universo de 603.308 consultas, se obtuvo un total de 3160 pacientes
con trauma craneofacial. La proporción entre sexo masculino y femenino fue de
1,5:1, siendo el grupo etario entre los 20-29 años de edad el más afectado y la
violencia interpersonal como el factor etiológico más frecuente de este grupo. Sin
embargo, del total de pacientes registrados el factor etiológico más frecuente
fueron las caídas (53%). El alcohol estuvo presente en el 5,1% de los casos y la
lesión concomitante más frecuente fue en las extremidades superiores (27,9%). La
cantidad total de lesiones registradas fue de 4.699, registrando un 63,6% a nivel
de tejidos blandos, siendo las contusiones nasales las más frecuentes. En tejidos
duros (36,4%), el 75,9% correspondieron a traumatismos dentoalveolares, y el
24,1% restante correspondió a fracturas óseas, siendo las fracturas mandibulares
las más frecuentes.
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Los resultados obtenidos en este estudio permiten identificar los individuos
más afectados y los patrones de distribución de estas lesiones. Sin embargo, es
necesario que se realicen más estudios en nuestro país para obtener un perfil
epidemiológico representativo de estos traumas.
9
Corno, Federica. "The role of family factors in child post-traumatic stress disorder (PTSD)." Thesis, King's College London (University of London), 2012. https://kclpure.kcl.ac.uk/portal/en/theses/the-role-of-family-factors-in-child-posttraumatic-stress-disorder-ptsd(17d36a4a-c003-4be8-ab18-d4f6081a259b).html.
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Background: There is a large body of evidence showing that children experience high levels of Post Traumatic Stress Disorder (PTSD) in the aftermath of a trauma. It is often assumed that the child’s response to the trauma is influenced by: i) the parents’ own symptomatology; ii) the family’s avoidance of trauma reminders and discussion; iii) the general parenting style (e.g. the degree of warmth, criticism and emotional over-involvement); and iv) the general family environment. Given that few attempts have been made to test these hypotheses and research findings have been mixed, determining additional factors affecting children exposed to trauma was important. Aims and Objectives: The purpose of the present study was to add to the existing literature by looking at family factors and their relation to post-traumatic responding in the child. To address this aim we explored the relationship between the child’s self-reported PTSD and: 1) parental expressed emotion; 2) the degree of cohesion, emotional expressiveness and conflict in the family environment; 3) the parent’s self-reported symptoms of PTSD, depression and anxiety; and 4) family post-trauma communication. Method: Twenty-two children (aged 7 – 17 years) exposed to trauma, and their main care-giver, were recruited from child and adolescent mental health services across South-East London. All parents completed self-report measures of PTSD, anxiety and depression, as well as scales rating their child’s anxiety and depression. Parental expressed emotion was rated using a five-minute, audio-taped interview where the parent was asked to talk about their child and their relationship. The parents completed the Family Environment Scale (FES) which measures family cohesion, emotional expressiveness, and conflict. The children completed self-report measures of PTSD, anxiety and depression. Finally, children and parents completed a newly-developed questionnaire that assesses their view of the consequences of talking about the trauma in the family. Results: Contrary to expectations, parental expressed emotion, parental own symptomatology, and the parent’s ratings of the degree of family cohesion, conflict, emotional expressiveness encouraged in the family (measured by the FES) were unrelated to the child’s self-reported PTSD symptomatology. However, poor family communication was associated with PTSD symptoms in the child. Overall, the factors found to most strongly relate to the child’s PTSD severity were the strength of their own negative trauma-related beliefs and comorbid anxiety and depression. Conclusions: Little support was found for the widely held view that parental expressed emotion and parenting/family style directly influence the child post-traumatic responding. The best predictor of the child’s response was their own trauma-related beliefs. On the other hand, family post-trauma communication directly influenced the child’s post-traumatic symptoms levels. Future studies should aim to confirm the findings from the present study and attempt to examine family post-trauma coomunication using multi-method and multi-informant measures in longitudinal and experimental designs.
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Flatley, Ailish Shona. "Social knowledge and communication in children with traumatic brain injury & research portfolio." Thesis, University of Glasgow, 2007. http://theses.gla.ac.uk/19/.
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Mancilla, Villalobos Claudia. "Estudio epidemiológico del trauma cráneofacial en el Hospital de Urgencia de Asistencia Pública (HUAP) : período 2004-2006. Santiago, Chile." Tesis, Universidad de Chile, 2010. http://repositorio.uchile.cl/handle/2250/134290.
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Trabajo de Investigación Requisito para optar al Título de Cirujano Dentista<br>Autor no autoriza el acceso a texto completo de su documento<br>El trauma cráneofacial representa un importante problema de salud mundial ya
que está asociado a alta morbilidad, pérdida de función, desfiguramiento y un alto
costo financiero. Los patrones de trauma cráneofacial en Sudamérica han sido
poco estudiados y son muy escasos los estudios sobre este tema en nuestro país.
Un mejor entendimiento de los patrones demográficos, factores de riesgo
asociados y etiología de los traumatismos es necesario para desarrollar e
implementar medidas preventivas efectivas, además de colaborar con la
elaboración de protocolos y guías clínicas de tratamiento.
Se realizó un estudio retrospectivo descriptivo de tipo cuantitativo en el Servicio
de Urgencia del Hospital de Urgencia de la Asistencia Pública (HUAP), consistente
en la recolección de datos mediante la revisión de fichas clínicas de los pacientes
atendidos desde junio 2004 a diciembre 2006. Los datos obtenidos fueron
tabulados utilizando el programa Microsoft Office Access 2007.
En un universo de 356.350 consultas médicas por urgencia, se obtuvo un total
de 9.218 pacientes con trauma cráneofacial. La proporción entre el sexo
masculino y femenino fue de 2,3:1, siendo el grupo etario de los 20 a 29 años el
más afectado. El alcohol estuvo presente en 11% de los casos y el factor
etiológico más predominante fue la violencia interpersonal. La lesión concomitante
más frecuente fue en las extremidades superiores (30,6%). La cantidad total de las
lesiones registrados fue de 15.842, distribuidas en tejidos blandos (83,3%), con las
contusiones orbitarias como las más frecuentes (15,5%); y en tejidos duros
(16,7%), siendo la más frecuente la fractura en la región nasal (69,5%). En cuanto
a la distribución comunal, la mayoría de los pacientes residían en la comuna de
Santiago con previsión Fonasa nivel A.
Los resultados obtenidos en este estudio permiten identificar los individuos
más afectados y los patrones de distribución de estas lesiones. Sin embargo, es
necesario que se realicen más estudios en nuestro país para obtener un perfil
epidemiológico representativo de estos traumas.
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Wongvatunyu, Suporn. "Mothers' experience of helping the young adult with traumatic brain injury." Free to MU Campus, others may purchase, 2003. http://wwwlib.umi.com/cr/mo/fullcit?p3091981.
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Westaway, Joan Lorraine. "Post-traumatic stress disorder in a group of sexually abused children." Master's thesis, University of Cape Town, 1994. http://hdl.handle.net/11427/26367.
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Ostrowski, Sarah Anne. "Development of Child Posttraumatic Stress Disorder in Pediatric Trauma Victims: The Impact of Initial Child and Caregiver PTSD Symptoms on the Development of Subsequent Child PTSD." [Kent, Ohio] : Kent State University, 2008. http://rave.ohiolink.edu/etdc/view?acc%5Fnum=kent1216651334.
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Thesis (Ph.D.)--Kent State University, 2008.<br>Title from PDF t.p. (viewed Oct. 27, 2009). Advisor: Douglas Delahanty. Keywords: PTSD; pediatric trauma victims; parent PTSD symptoms. Includes bibliographical references (p. 73-87).
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Wise, Anna Elizabeth. "THE DIFFERENTIAL IMPACT OF MATERNAL VERSUS PATERNAL POST-TRAUMATIC SYMPTOMS ON CHILD SYMPTOM DEVELOPMENT." Kent State University / OhioLINK, 2020. http://rave.ohiolink.edu/etdc/view?acc_num=kent1588264051459885.
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Alisic, Eva, Shaminka Gunaratnam, Anna Barrett, et al. "Injury talk: spontaneous parent–child conversations in the aftermath of a potentially traumatic event." BMJ PUBLISHING GROUP, 2017. http://hdl.handle.net/10150/626115.
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Background: While talking about traumatic experiences is considered central to psychological recovery, little is known about how these conversations occur in daily life. Objective: We investigated spontaneous injury talk among parents and children in the aftermath of a child's hospitalisation due to physical trauma, and its relationship with children's socioemotional functioning. Methods In a prospective naturalistic observation study, we audio-sampled the daily life of 71 families with the Electronically Activated Recorder after their child (3-16 years old) was discharged from hospital. We collected close to 20 000 snippets of audio information, which were double-coded for conversation characteristics, and measured children's socioemotional functioning with the Strengths and Difficulties Questionnaire (SDQ) at 6 weeks and 3 months postinjury. Findings The children were involved in injury talk for, on average, 46 min/day, 9 min of which referred to emotions. Children had significantly more injury conversations with their mothers than with their fathers. The tone of injury conversations was significantly more positive than that of non-injury conversations. More direct injury talk was associated with fewer problems on the emotion subscale of the SDQ at 3 months. Other associations between aspects of injury talk and children's socioemotional functioning were mostly non-significant, although they appeared to be stronger at 3 months than at 6 weeks. Conclusions Families spontaneously talked about the injury and associated issues for about the same amount of time per day as a therapist might within a session (a 'therapy hour'). Clinical implications Making full use of naturally occurring injury talk may be a valuable direction for parent and family-focused post-injury interventions. However, the study design prevents causal inference, and further exploration is warranted.
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Garcia, Dainelys. "Parent-Child Interaction Therapy as a Family-Focused Approach for Young Children with Traumatic Brain Injury." FIU Digital Commons, 2016. http://digitalcommons.fiu.edu/etd/2577.
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Traumatic Brain Injury (TBI) is the leading cause of death and disability in children and adolescents in the U.S. and disproportionately affects young children. The negative consequences of early childhood TBI include deficits in behavior and attention, cognitive abilities, and academic skills. Behavior problems in particular are one of the most common and persistent consequences following TBI in young children. Therefore, interventions are needed that target the adverse effects of TBI on behavior. The purpose of the current work was to examine the initial outcome, feasibility, acceptability, and satisfaction of a time-limited and intensive format of Parent-Child Interaction Therapy (PCIT) for families with a child aged 2 to 5 years who had sustained a TBI and displayed clinically elevated externalizing behavior problems. The open trial included 10 families that completed a baseline assessment, received the intervention over 5 weeks, and completed post-intervention and 2-month follow-up assessments. Results indicated that children who completed the intervention showed significant improvements in both externalizing and internalizing behavior problems at post-intervention and 2-month follow-up, with the exception of non-significant change in self-regulation at post-intervention and 2-month follow-up, and attention problems at 2-month follow-up. In addition, significant improvements were found on all cognitive measures examining working memory, receptive language, and executive functioning at post-intervention and 2-month follow-up. Similarly, caregivers who completed the intervention displayed significant improvements in their parenting skills during play with their child and reported significant reductions in overall caregiver stress and caregiver stress related to their child’s difficult behaviors. Despite limitations inherent in an open trial (e.g., small sample, lack of a control group, generalizability), the current study addressed a relatively unexplored research question and suggests that an intensive format of PCIT may be a promising approach for improving domains commonly affected by early childhood TBI (e.g., behavioral, cognitive, and family functioning) prior to the development of more severe and persistent problems.
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Federico, Dino Ray. "Identifying the Experiences of Secondary Traumatic Stress in Rural Child Welfare Workers| Action Research Study." Thesis, Capella University, 2017. http://pqdtopen.proquest.com/#viewpdf?dispub=10261762.
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<p> Secondary traumatic stress is the physiological reaction to vicarious traumatization. Public child welfare workers are exposed daily to the traumas of child maltreatment from neglect to death. Unlike other first responders, child welfare workers have continued exposure to the trauma of child maltreatment with every report, change in placement, and discussion. Rural child welfare workers have an added burden of issues common to both the children and families they serve, and to themselves as members of their communities: isolation, social proximity, dual relationships, remoteness, and fewer resources. In an effort to identify the experiences of secondary traumatic stress in rural child welfare workers in this study, eight child welfare workers were individually interviewed from two separate, remote, rural communities. Using semi-structured, open-ended questions, discussions of their experiences produced a wealth of data that was analyzed using qualitative content analysis. The findings gave discovery that rural child welfare workers do experience secondary traumatic stress, and included symptoms such as: depression, frustration, exhaustion, sleeplessness, crying, hypervigilance, avoidance, guilt, loss of appetite, and more. Many of these symptoms were exacerbated by the characteristics of the remote, rural community as there were few outlets and venues for discussing and debriefing in privacy. Conclusions were rural child welfare agencies need to engage in providing trauma informed training and support to their workers, and include secondary trauma as part of their culture in supervision and management. Finally, several new resources are discussed which are available to agencies and staff from national child welfare institutes, agencies, and online publications.</p>
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Kilby, Jane. "Animated testimony : feminism, witnessing and childhood sexual trauma." Thesis, Lancaster University, 2000. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.369467.
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Tume, Lyvonne Nicole. "The effect of intensive care nursing interventions on the intracranial pressure in children with moderate to severe traumatic brain injury." Thesis, Liverpool John Moores University, 2009. http://researchonline.ljmu.ac.uk/5951/.
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Objective The aim of this study was to examine the effects of selected routine nursing interventions - endotracheal suctioning and manual ventilation (ETSMV), log-rolling, eye care, mouth care and washing - on the intracranial pressure (ICP) in children with traumatic brain injury. Design Prospective observational study over three years. Setting Single tertiary paediatric intensive care unit in the North West of England. Patients Twenty five children with moderate to severe closed traumatic brain injury and intraparenchymal intracranial pressure monitoring in intensive care (2 -17 years of age). Interventions Routine nursing care interventions. Measurements and main results ICP measured one minute before the procedure, at the maximal value during the procedure and five minutes after the procedure was recorded for the purpose of this study. Time to recovery was also recorded, in minutes. A total of 25 measurements (the first one in each child) in the first 36 hours of the child's PICU admission were analysed. Both ETSMV and log-rolling were associated with clinically and statistically significant changes in ICP from baseline to maximal ICP (p=0.005) and maximal to 5-minute post ICP (p=0.001) for ETSMV and (p < 0.001) baseline to maximal ICP and (p=0.002) for maximal to post-procedure ICP for log-rolling. During ETSMV and logrolling 70% of children exceeded the 20mmHg clinical treatment threshold during the interventions. During both ETSMV and log-rolling children with higher baseline ICPs ( > 15mmHg) showed higher maximal ICPs (but not ICP rise), suggesting a linear relationship between baseline and maximal ICP, although this was more pronounced during turning. One third of the children had not returned to their baseline ICP by 5 minutes after ETSMV, compared with 60% children after log-rolling. Neither eye care nor mouth care showed any clinically significant effects on ICP in these children, suggesting these procedures are not noxious and are tolerated very well. However, there was only a small number of washing episodes reported in this study therefore the observations are not conclusive. Conclusions Endotracheal suctioning and log-rolling in moderate to severe traumatic brain injured children can cause significant intracranial instability and should only be performed as required and with careful planning and execution. Eye and mouth care and washing appear to be well tolerated interventions and could be performed when necessary.
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Freeman, Kecia Rachel. "Exploring the Lived Experiences of Supervising Child Protection Social Workers." ScholarWorks, 2016. https://scholarworks.waldenu.edu/dissertations/2652.
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Social workers in child protective services often handle hundreds of cases regarding children traumatized by abuse and/or neglect. In time, social workers' experiences can become emotionally and psychologically challenging. A problem for supervising child protection social workers (SCPSWs) is that they might experience the same challenges; however, there was no research that described the lived experiences of SCPSWs. This phenomenological study explored the lived experiences of SCPSWs. Conceptually, constructivist self-development theory (CSDT) provided the framework for understanding how SCPSWs managed their lived experiences and the issues related to them. Ten SCPSWs volunteered their time for face-to-face interviews and provided data for this study. Saldana's coding manual was used to guide the identification and coding of key words and phrases. SCPSWs experienced occupational trauma in the form of vicarious trauma, compassion fatigue, secondary traumatic stress, and/or burnout similar to that experienced by front line workers. SCPSWs' experiences required them to set boundaries, stop taking work home and support each other in the workplace. Enhanced resources for training on self-care plus increased administrative and peer support could potentially improve the lives of these SCPSWs and increase their longevity and effectiveness in the workplace. Retaining experienced supervisors also has the potential to promote positive social change by improving the support supervisors can provide to front line staff, thus indirectly helping children, families, and communities they serve.
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MacEachern, Alison. "An exploration into the experiences of police officers who investigate child protection cases and secondary traumatic stress." Thesis, University of Dundee, 2011. https://discovery.dundee.ac.uk/en/studentTheses/eb04dcee-a7a0-4cc4-8850-8692d7014300.
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Child protection is an area of Police work that has grown in the last decade, involving Police Officers working in departments that specialise in the investigation of cases of child abuse. Although Police Officers in this field may be at greater risk of experiencing Secondary Traumatic Stress (STS), there remains a paucity of research in this area of policing. Analogies can be drawn to existing research in policing and with social service workers involved in child protection.A mixed methodology was used to conduct the study and involved a self-completion postal questionnaire, followed up by a longitudinal case study of three of the trainee Detective Officers. The questionnaire sample consisted of 63 Detective Officers involved in the investigation of child abuse within the host Police Force, including Detective Constables, Sergeants and Inspectors.The Study found that 51% of the respondents experienced a degree of STS, findings that are suggestive that STS is being experienced by a significant portion of Detective Officers who, as part of their daily duties, investigate child protection cases. The longitudinal case study found that 2 out of the 3 cases indicated that their views and experiences of the symptoms of STS changed mid way through their training.The implications for Police Forces to provide safe working environments and appropriate counselling for employees as a tool to manage stress, to inform practice and from which the basis of reasonable precautions, risk assessments, monitoring and appropriate interventions will be discussed.
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Nabhan, Inshirah Nimer. "Correlates of Post-Traumatic Stress Disorder and Disorder of Extreme Stress Not Otherwise Specified among Palestinian Child Ex-Detainees." Thesis, University of North Texas, 2011. https://digital.library.unt.edu/ark:/67531/metadc84259/.
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The objective of this study is to investigate the variations in the type of trauma (post-traumatic stress disorder (PTSD) and disorder of extreme stress not otherwise specified (DESNOS) resulting first from group membership, and second from variations in socioeconomic status, and last, from exposure to physical and psychological methods of interrogation due to imprisonment. I use a diverse sample of 202 child ex-detainees who served sentences in Israeli prisons and were 17 years of age or less at the time of arrest. Various regression techniques were utilized to determine the most parsimonious way to distinguish between the three groups in their trauma responses. The key finding in this study is that child refugee ex-detainees living in refugee camps, in general, did not report PTSD or DESNOS reactions compared to their counterparts. Continuing PTSD and DESNOS symptoms were more prevalent among the group of refugees living outside the camps. However, there is at least one finding that supported what I hypothesized: refugees living in camps were more likely to experience elevated levels of alterations in attention or consciousness (DESNOS2). For refugees in camps, the DESNOS absence tells us that the volatile childhood these children experienced was not associated with severe pathological reactions or heightened sensitization to trauma. In contrast, refugees living outside camps suffer from alterations in self-perception DESNOS4 symptomology, in addition, to elevated levels of complex trauma DESNOS and they qualified for the DESNOS diagnosis more than the other two groups of children. Refugees living outside camps were the only group subjected to interpersonal stressors.
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Castillo, Mazuelos Karen, and Arismendi Constanza Vizcaíno. "Estudio piloto de identificación y descripción de las lesiones más frecuentes en deportistas de escalada en Santiago de Chile." Tesis, Universidad de Chile, 2012. http://www.repositorio.uchile.cl/handle/2250/117221.
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La escalada como práctica deportiva ha ido ganando popularidad a nivel nacional e internacional, con ello la importancia de comprender las lesiones más frecuentes que pueden prevenirse o abordarse desde la kinesiología aparece como fundamental. Este estudio busca identificar y caracterizar las lesiones más frecuentes en de Santiago de Chile y determinar qué factores se encuentran asociados a la presencia de ésta tales como edad cronológica, frecuencia de práctica de escalada, tipo de escalada realizada, nivel de exigencia en el momento de la lesión y años de práctica de escalada. Se utilizó un acercamiento cuantitativo, transversal y analítico de los datos obtenidos. Éstos fueron obtenidos de la construcción de un cuestionario, diseñado especialmente y validado. Se realizó una búsqueda exhaustiva de la población máxima accesible, accediendo a 220 escaladores entre 18 y 45 años de edad. El muestreo propositivo basado en criterios de selección específicos y validados por expertos, reducido a una muestra final de 192 participantes que conocían el diagnóstico de su lesión. Se registraron antecedentes demográficos y características de la lesión. De los 192 la mayoría fueron hombres (83,9%) con 28 años promedio de edad. El número promedio de lesiones fue de 1,82 (±1,223) en donde la mayoría se encontró en el miembro superior (87,7%), más específicamente en la mano (37,7%) de los cuales el tipo más común fue tendinosa y de bursa (48,4%). Al referirnos de comportamiento tras la lesión el 87,5% consulta por ésta, de estos 80,4% acude al médico. Sólo se encontró asociación estadísticamente significativa entre la presencia de lesión y los años de práctica de escala (p=0,016) utilizando Chi-cuadrado a un 95% de confianza. Se observa una mayor incidencia en los miembros superiores concentrándose en las regiones de la mano, hombro y codo. Del total de las lesiones presentadas las más frecuentes corresponden a tendones y bursas, seguidas de las ligamentosas. En cuanto a los factores de riesgo en este estudio, sólo encontramos la existencia de asociación entre los años de práctica de escalada y la presencia de lesión durante la práctica de escalada.
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Williams, Graham Ross. "Shattered narratives and the search for meaning : the experiences of parents whose child sustains traumatic brain injury." Thesis, University of Hertfordshire, 2009. http://hdl.handle.net/2299/3763.
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This study looked in detail at the parental experience of having a child sustain traumatic brain injury (TBI); beginning with the child sustaining the injury, through the acute and chronic stages of rehabilitation, to the child’s return home. Mother and father dyads were interviewed in their own homes using a semi-structured interview schedule. A narrative analysis highlighted important findings through the identification and construction of several plots and subplots within parent narratives. These include that parents themselves appear to undergo trauma as a consequence of their child sustaining TBI; that parents made - and wanted to make - a major contribution throughout their child’s rehabilitation, and that all parents went - and are continuing to go - through a number of transitions in this process. Given that fathers have historically been neglected from research into child health issues, the finding here that mothers and fathers made a substantial contribution throughout the rehabilitation process is timely and important. For most parents, this event led to profound and long-lasting changes in their lives and life stories where their previous, hitherto narratives were ‘shattered’. On the child’s return home, these changes appear neither recognised nor supported by services. There seemed little if anything in service provision and coordination to meet the needs of children and parents, which resulted in parents continually fighting for services. Clinical implications are discussed as well as directions for future research.
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Nugent, Nicole Renee. "THE EFFICACY OF EARLY PROPRANOLOL ADMINISTRATION AT PREVENTING/REDUCING PTSD SYMPTOMS IN CHILD TRAUMA VICTIMS: PILOT." [Kent, Ohio] : Kent State University, 2007. http://rave.ohiolink.edu/etdc/view?acc%5Fnum=kent1182616758.
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Micklewright, Jackie Lyn. "Adaptive Functioning following Pediatric Traumatic Injury: The Relationship between Parental Stress, Parenting Styles, and Child Functional Outcomes." Digital Archive @ GSU, 2009. http://digitalarchive.gsu.edu/psych_diss/55.
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Moderate and severe pediatric traumatic brain injuries (TBI) are associated with significant familial stress and child cognitive and adaptive sequelae (Taylor et al., 1999). Research has demonstrated a relationship between familial stress and resources and child recovery of functioning following TBI (Taylor et al., 1999). We built on these findings by examining authoritarian parenting values and styles as a mediator of the relationship between parental stress and child adaptive outcomes 12-36 months following TBI or orthopedic injury (ORTHO). Participants were 21 children/adolescents with traumatic brain injuries and 23 with orthopedic injuries and one of their parents/guardians. Parents completed measures of demographics, parental stress, parenting values and styles, and child adaptive functioning. Child participants completed brief demographic questionnaires and intelligence screeners. Moderation was examined using hierarchical multiple regression. Mediation and moderated mediation were examined using bootstrapping tests of the indirect effect of parental stress on child adaptive functioning. After controlling for family insurance status, higher levels of parental stress were associated with reduced child adaptive functioning in the TBI group but not the ORTHO group. An examination of the mediational analyses revealed that higher levels of parental stress were associated with a greater reliance on authoritarian parenting styles, which was associated with reduced overall adaptive functioning and daily living skills across the two injury groups. Therefore, across groups, the relationship between parental stress and child overall adaptive functioning and daily living skills was found to be partially mediated by an authoritarian parenting style. Moderated mediation results revealed the presence of a significant interaction and 95% confidence interval on the socialization domain and indicated that the relationship between authoritarian parenting styles and child adaptive social skills differed significantly between the two groups. Our findings suggest a relationship between parental stress, authoritarian parenting styles, and child adaptive functioning in the 12-36 months following pediatric traumatic injury. Future research should explore the association among these, as well as other potentially mediating variables, both within and between the two groups with the goal of further elucidating the relationship between familial/environmental variables and child adaptive functioning following traumatic brain and orthopedic injury.
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Micklewright, Jackie L. "Adaptive functioning following pediatric traumatic injury the relationship between parental stress, parenting styles, and child functional outcomes /." restricted, 2009. http://etd.gsu.edu/theses/available/etd-06132009-131148/.
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Thesis (Ph. D.)--Georgia State University, 2009.<br>Title from file title page. Tricia Z. King, committee chair; Chris Henrich, Kathleen O'Toole, Erin Tone, Frank Floyd, committee members. Description based on contents viewed Sept. 28, 2009. Includes bibliographical references (p. 124-136).
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Plokar, Amanda. "Development of a child dissociation assessment system using a narrative story stem task." Thèse, Université de Sherbrooke, 2017. http://hdl.handle.net/11143/11006.
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Abstract : Complex Trauma (CT) refers to the exposure to chronic or prolonged experiences of maltreatment that often occur in the context of a caregiving relationship. This concept also refers to the numerous sequelae that CT can have on the child’s functioning, including dissociation. Dissociation reflects a continuum of behaviours and processes that range from normative (e.g., daydreaming) to pathological (e.g., amnesia). The majority of children in the child welfare system have been victim to experiences of chronic maltreatment, which represents an important precursor in the development of disorganized attachment (DA). As such, many authors highlight the importance of assessing for CT exposure and associated sequelae given the pathological trajectories that are associated to these, including DA and the development of dissociative symptoms. The MacArthur Story Stem Battery (MSSB; Bretherton, Oppenheim, Buschbaum, Emde, & the MacArthur Narrative Group, 1990) is a narrative task whose purpose is to activate children’s attachment representations. The Attachment-Focused Coding System for Story Stems (AFCS; Reiner & Splaun, 2008) is a valid coding system which uses four stories (out of the 14 available) from the MSSB that are considered more likely to activate the child’s attachment system. However, this system differs in that it is quicker to administer and to code, making it more accessible to researchers and clinicians. The AFCS screens for the majority of sequelae associated to CT but does not consider dissociation. The first theoretical article outlines the current state of knowledge surrounding child dissociation, as well as how this concept relates to DA and exposure to CT. This article also explores difficulties related to the assessment of dissociation symptoms in maltreated children and argues the relevance of using a narrative task like the MSSB to do so. The second empirical article aims to develop a child dissociation assessment system which examines
the verbal and non-verbal manifestations of children that emerge during the MSSB stories selected for use with the AFCS. The Child Dissociation Assessment System (CDAS) is composed of two complementary measures, the Child Dissociation Code (CDC), which screens for dissociative symptoms, and the Child Dissociation Tool (CDT), which then assesses how these symptoms affect several domains of functioning, should this be necessary. The CDAS is a response to the current lack of child dissociation instruments available and takes limitations identified amongst existing measures into account. Through this exploratory study, the authors sought to obtain interrater agreement, with an intraclass correlation coefficient (ICC) of 0.75. To achieve this, 20 MSSB protocols of children between 6 and 12 years old (10 from a clinical sample and 10 from a non-clinical sample) were scored using the CDAS. The Mann-Whitney statistical test was then applied to the CDC to compare the average scores obtained on this measure by both groups of children to verify whether it discriminated between a clinical and non-clinical population. Preliminary results indicated that the CDAS possesses adequate to excellent inter-reliability and that the CDC discriminated between a clinical and non-clinical sample of children, highlighting the relevance of using the CDAS and of pursuing a validation study.<br>Les traumatismes complexes (TC) décrivent l’exposition à de multiples événements de vie traumatiques qui se produisent de manière répétée et prolongée et dont la figure parentale est souvent l’auteur. Cette nomenclature réfère également aux multiples impacts des TC sur le fonctionnement de l’enfant, dont la dissociation. La dissociation reflète une gamme de comportements et de processus allant de normaux (p. ex., rêverie) à pathologiques (p. ex., amnésie). La majorité des enfants suivis par la protection de la jeunesse (PJ) ont été victimes de maltraitance chronique, qui constitue l’un des principaux précurseurs de l’attachement désorganisé (AD). Ainsi, plusieurs auteurs notent l’importance d’évaluer l’exposition aux TC et leurs séquelles compte tenu des trajectoires pathologiques qui y sont associées, dont l’AD et le développement de symptômes dissociatifs. Le MacArthur Story Stem Battery (MSSB; Bretherton, Oppenheim, Buschbaum, Emde, & the MacArthur Narrative Group, 1990) est une tâche narrative qui vise à activer les représentations d’attachement chez les enfants. L’Attachment-Focused Coding System for Story Stems (AFCS; Reiner & Splaun, 2008) est un système de codage se voulant simple et accessible pour les chercheurs et les cliniciens, qui est appliqué à quatre histoires du MSSB (sur 14) jugées plus susceptibles d’activer l’attachement de l’enfant. L’AFCS tient compte d’indices reflétant la majorité des séquelles engendrées par les TC mais ne considère pas la dissociation. Le premier article théorique vise à dresser un portrait de l’état des connaissances au sujet de la dissociation telle qu’elle se manifeste chez les enfants, son lien avec l’AD et avec l’exposition aux TC. L’article explore également les difficultés liées à l’évaluation des symptômes de dissociation chez les enfants et discute de la pertinence d’évaluer ceux-ci en utilisant une tâche narrative telle que le MSSB. Le deuxième article empirique vise à développer un système d’évaluation de la
dissociation chez l’enfant à partir des manifestations verbales et non-verbales de la dissociation qui émergent lors des histoires du MSSB sélectionnées par l’AFCS. Le Child Dissociation Assessment System (CDAS) est composé de deux outils complémentaires, soit le Child Dissociation Code (CDC), qui permet un dépistage de symptômes dissociatifs, et le Child Dissociation Tool (CDT) qui dans un deuxième temps précise les domaines de fonctionnement atteints par ces symptômes, le cas échéant. Le CDAS répond à un manque actuel d’instruments pour évaluer la dissociation infantile et comble les limites identifiées parmi ceux qui existent. À travers cette étude exploratoire, les auteurs visent un accord inter juges satisfaisant pour le CDAS, soit un coefficient de corrélation interclasse (CIC) de 0,75 ou plus. Pour ce faire, 20 protocoles du MSSB d’enfants âgés de 6 à 12 ans (10 issus d’une population clinique et 10 d’une population non-clinique) ont été codés à l’aide de ce nouveau système de dissociation. Ensuite, le test statistique de Mann-Whitney a été appliqué au CDC afin de comparer la moyenne des scores de dissociation obtenus par les deux groupes d’enfants pour vérifier si cet outil discrimine entre la population clinique et non-clinique. Les résultats préliminaires indiquent que le CDAS possède un taux d’accord inter juges adéquat à excellent et que le CDC discrimine entre des enfants issus d’une population clinique et non-clinique. Ces résultats soulignent la pertinence du CDAS et justifient la poursuite d’un travail de validation.
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Diamond, Terry. "The relationships among PTSD symptomatology and cognitive functioning among adult survivors of child maltreatment." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1999. http://www.collectionscanada.ca/obj/s4/f2/dsk2/ftp03/MQ56171.pdf.
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Moran, Lisa M. "Do post-concussive symptoms discriminate injury severity in pediatric mild traumatic brain injury?" The Ohio State University, 2009. http://rave.ohiolink.edu/etdc/view?acc_num=osu1250198689.
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Whitt-Woosley, Adrienne. "Identifying the Trauma Recovery Needs of Maltreated Children: An Examination of Child Welfare Workers' Effectiveness in Screening for Traumatic Stress." UKnowledge, 2016. http://uknowledge.uky.edu/csw_etds/11.
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Children in the child welfare system comprise a group characterized by their exposure to trauma via experiences of maltreatment, under circumstances presenting multiple risk factors for traumatic stress. High rates of posttraumatic stress have been observed in this population. However, there is currently no standard for the universal screening of children in child welfare for trauma exposure and traumatic stress. The purpose of this study was to analyze the trauma experiences of a sample of maltreated children and examine whether child welfare workers are effective screeners of traumatic stress symptoms with children from their caseloads. Method: A sample of children (N= 131) with trauma screenings completed by their child welfare workers and clinical measures of traumatic stress symptoms based on self or caregiver report was analyzed. Descriptive and correlational analyses were conducted. Hypotheses were tested with a series of four hierarchical regression models to determine whether workers’ screening information regarding child age, trauma exposure history and symptoms of traumatic stress were predictive of outcomes on the clinical measures completed. Results: Findings from the analyses revealed complex trauma exposure histories and high rates of traumatic stress symptoms among this generally younger sample of maltreated children. Additionally, the models tested supported workers’ efficacy in screening for symptoms of total posttraumatic stress and specific trauma symptoms of intrusion and avoidance. Workers were less effective in screening for the traumatic stress symptoms associated with arousal. Implications: These findings support the importance of identifying the trauma recovery needs of maltreated children and the utility of child protection workers in assisting with the trauma screening process. Implications are provided for associated practices, policies and training efforts regarding the implementation of a trauma screening protocol in child welfare. This would serve as a critical pathway for creating trauma-informed systems that better address the needs of maltreated children and their families.
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Paul, de Cock Theodor. "Early environmental factors in psychosis : childhood traumatic events and a new typology of the early parent-child relationship." Thesis, University of Ulster, 2010. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.530091.
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Martin, Victoria Anne. "Relationships between learned helplessness factors, child abuse, combat exposure, and severity of chronic combat-related PTSD /." view abstract or download file of text, 2001. http://wwwlib.umi.com/cr/uoregon/fullcit?p3018381.
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Thesis (Ph. D.)--University of Oregon, 2001.<br>Typescript. Includes vita and abstract. Includes bibliographical references (leaves 86-96). Also available for download via the World Wide Web; free to University of Oregon users.
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Rodgers, Shano. "Examining Trauma Exposure, Organizational Climate, and Job Outcomes in Child Welfare." ScholarWorks, 2018. https://scholarworks.waldenu.edu/dissertations/4814.
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Exposure to traumatic situations is routine for child welfare workers in California, and the attrition rate for newly hired social workers in some states is estimated to be nearly 50% in the 1st year of employment. Prior research has indicated that reasons for dissatisfaction included dysfunctional organizational climate and culture. The purpose of this study was to examine the extent to which trauma exposure contributed to secondary traumatic stress and intent to quit and to examine the degree to which organizational climate moderated the exposure among direct service child welfare employees. Kurt Lewin's field theory, Figley's theory of secondary traumatic stress or compassion fatigue, and McCann and Pearlman's constructivist self-development theory were foundational for this study. The research questions determined whether a) trauma exposure to would relate positively with secondary traumatic stress and intent to quit, b) organizational climate would relate negatively with secondary traumatic stress and intent to quit, and c) organizational climate would moderate the relationship between trauma exposure and secondary traumatic stress as well as intent to quit. Pearson correlations indicated that exposure to traumatic situations was statistically related to secondary traumatic stress but not intent to quit, and organizational climate was statistically significant in relation to secondary traumatic stress and intent to quit. Hierarchical regression analysis indicated no interaction effect on either dependent variable but might have approached significance with a larger sample. Positive social change can occur through child welfare organizations emphasizing strategies that can reduce secondary traumatic stress and turnover.
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Trance, Deborah A. "The prediction of functional outcome by trauma scores in infants and young children with traumatic head injuries." Thesis, Boston University, 1991. https://hdl.handle.net/2144/37169.
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Thesis (M.S.)--Boston University<br>PLEASE NOTE: Boston University Libraries did not receive an Authorization To Manage form for this thesis or dissertation. It is therefore not openly accessible, though it may be available by request. If you are the author or principal advisor of this work and would like to request open access for it, please contact us at open-help@bu.edu. Thank you.<br>In this pilot study, 28 subjects ages 0 to 6 years who had sustained head injuries were assessed as to their functional status at one and six months post hospital discharge. The functional assessments used were the Rand Child Health Scale, the Battelle Developmental Inventory Screening Test, the Battelle Developmental Inventory Motor Domain, and the Pediatric Evaluation of Disability Inventory. Correlations between these functional measures and trauma scores reported through the National Pediatric Trauma Registry (Glasgow Coma Scale; Injury Severity Score, and Pediatric Trauma Score) were calculated to determine the predictive capacity of the trauma scores in determining functional outcome. The trauma scores were not found to be reliable predictors of functional outcome in these young children.<br>2031-01-01
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Lane, Mary Kathleen. "Post-traumatic stress disorder in previously abused male sex offenders." Diss., Virginia Tech, 1991. http://hdl.handle.net/10919/39835.
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One hundred, primarily incarcerated, adult male sex offenders, were interviewed to determine the extent of their own experience of childhood sexual abuse and their incidence of post-traumatic stress disorder (PTSD). Also investigated were the roles played by various aspects of sexual abuse in the development of PTSD and other psychological disorders.
Fifty seven percent of the sample reported having been sexually victimized. Findings regarding age when the abuse began, use of force and severity of body violation were consistent with previous studies. As was found in prior research, the majority of their abusers were known to them and were women. Abuse by men and having been anally penetrated were correlated with the development of PTSD. Also implicated in the development of PTSD and related symptomology was the use of force during the abuse, severity of bodily violation, and, inconsistently, duration of the abuse. Regression analysis revealed use of force, not telling about the abuse as a child, a closer relationship to one's perpetrator, and increased severity of body violation to be, in combination, most consistently predictive of PTSD development. In the sexually abused sample, 33% received a retrospective diagnosis of PTSD, while five percent were currently diagnosed. This contrasts with rates found in the non-sexually abused sample of 7% past diagnosis of PTSD and 2% current diagnosis of PTSD.<br>Ph. D.
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McFarland, Laura Dolores. "The relationship between unresolved loss and trauma, childhood abuse, frightening experiences and frightened/frightening caregiving : a comparison of mothers and fathers /." Full text (PDF) from UMI/Dissertation Abstracts International, 2000. http://wwwlib.umi.com/cr/utexas/fullcit?p3004336.
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Kurowski, Brad G. "Executive Dysfunction after Moderate and Severe Pediatric Traumatic Brain Injury Predicts Clinical Dysfunction on the Child and Adolescent Functional Assessment Scale." University of Cincinnati / OhioLINK, 2012. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1342543308.
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Dickes, Sara Jean. "Treating sexually abused children versus adults an exploration of secondary traumatic stress and vicarious traumatization among therapists /." Full text available online (restricted access), 1998. http://images.lib.monash.edu.au/ts/theses/dickes.pdf.
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Huppert, Daru. "Libido and the destruction of the psychic reality : a Freudian account of traumatic neurosis in child survivors of Nazi persecution." Thesis, University of Cambridge, 2009. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.604821.
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This thesis delineates and presents a new explanation of the ‘survivor syndrome’, the most severe form of the traumatic condition. Clinical material regarding this condition has yet to receive an adequate theoretical interpretation, a situation that this study attempts to redress on the basis of my interviews with child survivors of the Nazi persecution of minorities, conducted at Esra, a psychiatric clinic in Vienna. Freud’s theory has been almost wholly neglected in studies of this pathology, and I argue that, when brought to bear in depth, it can provide an incisive account that illuminates the most disturbing features of trauma. In the first part of my investigation, the focus is therefore upon Freud’s analysis of the traumatic neurosis. I develop and extend Freud’s theory of the drives in relation to the central features of the survivor syndrome: anxiety, depression and guilt. Having provided a general account of the condition, my investigation then examines five case histories of child survivors in detail. I conclude by demonstrating how the findings of the thesis helps us to explain the way in which traumatised groups are treated within society, and how this changes our conception of their survival. Unlike most clinical studies in this field, my thesis emphasises the impact of trauma on the sufferers’ unconscious and fundamental impulses, thereby highlighting what is most acute in their experience. Yet my analysis also shows that there can be a disruption of unconscious processes in the severe traumatic condition, in which drive impulses are even more relentless than has been previously assumed. In this way, my study demonstrates that Freud’s theory can grasp even the agonising quality of the survivor syndrome, yet also how this obliges us to rethink our conception of the pivotal structures and forces operating within the psyche.
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Schutt, Alexandra Dimitra, and Alexandra Dimitra Schutt. "Shaken Baby Syndrome Prevention: Implementation of an Individualized, Patient-Centered Education Program." Diss., The University of Arizona, 2016. http://hdl.handle.net/10150/622929.
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Background: Child maltreatment is a serious health concern in the United States (U.S.) affecting as many as one in four children throughout their lifetime (Finkelhor, Turner, Ormond, & Hamby, 2013). In 2013, a reported 678, 932 victims of child maltreatment were reported to Child Protective Services (CPS), and of those cases 1,520 were fatal (CDC, 2015a). Out of all the various types of child maltreatment, Shaken Baby Syndrome (SBS) is the leading cause of child abuse deaths in the U.S. (CDC, n.d.). While current research has focused on validating the effectiveness of educational interventions, very few studies have analyzed the efficacy of individualized, patient-centered action plans. Such data would be beneficial to assess the usefulness of action plans in preparing caregivers for coping with an inconsolable infant at home. Purpose: To enhance caregiver knowledge about SBS and to provide parents with the skills and resources necessary to cope effectively and efficiently at home when unable to console their infant. Methods: This study utilized a quasi-experimental pre-test/post-test design. Participants were recruited from the Franciscan Women’s Health Associates located at St. Joseph Medical Center in Tacoma, Washington and were members of the Centering prenatal groups. The entirety of the study was completed during these groups including the pre-test, intervention, action plan, and post-test. Data was analyzed through the utilization of descriptive statistics as well as a paired t test. Results: Overall, results revealed that participant (n=26) knowledge significantly improved after the educational intervention (p=0.000) with a mean score of 87.56% on the pre-test and a mean score of 95.38% on the post-test. In addition, a majority of participants (57.5%) found both the action plan and the education to be extremely useful. Discussion: The results of this study were consistent with current evidence indicating that education on SBS, the dangers of shaking, and healthy coping mechanisms significantly impacts caregiver knowledge. In addition, a majority of participants viewed the action plans favorably identifying that they would be beneficial if they felt frustrated. Future research is warranted to gather more information on the long-term outcomes of educational interventions as well as individualized action plans.
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Bonini, Gabriela Azevedo de Vasconcelos Cunha. "Estudo da tendência das lesões dentárias traumáticas em crianças de 5 a 59 meses de idade. Diadema - São Paulo." Universidade de São Paulo, 2008. http://www.teses.usp.br/teses/disponiveis/23/23132/tde-21012009-142302/.
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As Lesões Dentárias Traumáticas (LDTs) tem apresentado com uma expressiva prevalência em diversos países. Estudos epidemiológicos de traumatismo dentário são importantes para determinar a prevalência da doença e estabelecer estratégias de promoção de saúde. Na literatura não se encontra nenhum estudo na dentição decídua comparando a prevalência em diferentes momentos em uma determinada população. O objetivo desse estudo foi: 1) Determinar a prevalência e distribuição das LDTs em pré-escolares no município de Diadema no ano de 2006 e investigar a associação das LDTs com maloclusões e fatores sócioeconômicos; 2) estudar a tendência da prevalência de LDTs em crianças pré-escolares no Município de Diadema-SP baseado em três estudos transversais conduzidos em 2002, 2004 e 2006. Estes três estudos foram realizados por meio de três levantamentos epidemiológicos em crianças de 5 59 meses de idade utilizando à mesma metodologia. Cirurgiões dentistas treinados examinaram respectivamente 915, 1138 e 1265 crianças nos anos de 2002, 2004 e 2006. As amostras foram selecionadas durante as Campanhas Nacionais de Vacinação Infantil. As LDTs foram diagnosticadas de acordo com a Classificação de Ellis modificada (1952), adicionando-se a esse critério a alteração de cor na coroa do dente. No levantamento de 2006 as crianças foram avaliadas quanto às maloclusões (mordida aberta anterior, selamento labial inadequado e sobressaliência acentuada). Uma entrevista foi realizada com a mãe ou responsável pela criança para a coleta das informações sócio-econômicas utilizando-se o Índice de Jarman (1983). Utilizou-se na análise estatística o teste Qui-Quadrado, regressão logística univariada e multivariada e o teste Qui-quadrado para tendência. Os resultados do estudo de 2006 mostraram uma prevalência de 13,9%. O incisivo central superior foi o dente mais afetado sem diferença entre os lados direito e esquerdo. Não se encontrou diferença estatisticamente significante entre meninas e meninos. O trauma mais comum foi fraturas de esmalte (10,8%); seguida de alteração de cor (2,3%); fratura de esmalte e dentina (1,4%); ausência do dente (0,7%) e fístula (0,2%). Crianças com mordida aberta anterior, trespasse horizontal acentuado e selamento labial inadequado tiveram maior número de trauma quando comparadas com crianças com oclusão normal (p<0,05). Fatores sócioeconômicos não mostraram associação estatisticamente significante com a ocorrência de LDTs. Em relação ao estudo de tendência: as prevalências de LDTs obtidas foram 9,4% em 2002, 12,9% em 2004 e 13,9% em 2006. A análise da tendência mostrou um aumento na prevalência das LDTs estatisticamente significante entre os estudos de 2002 e 2006 (p=0,002). Pode-se observar que houve um aumento significativo da prevalência entre 2002 e 2004 (p = 0,012), porém entre 2004 e 2006 o aumento não foi estatisticamente significante (p = 0,500). Quando cada um dos estudos foi avaliado individualmente, confirmou-se o aumento estatisticamente significante na porcentagem de crianças com LDTs de acordo com o aumento da faixa etária (p<0,001).<br>Traumatic dental injuries (TDI) present high prevalence in many countries. Epidemiological studies on TDI are important to determine the disease prevalence and to establish oral health promotion strategies. No study in the literature shows trend in TDI in primary dentition. The aim of this study was: 1) To determine the prevalence and distribution of TDI in the primary teeth of preschool children living in Diadema, Brazil, and to investigate its association with malocclusions and socio-economic factors; and 2) to assess trend in the prevalence of TDI in preschool children in Diadema, Brazil, during 2002 and 2006. Three cross-sectional surveys were conducted in 2002, 2004 and 2006, using the same protocol. All surveys were on children aged 5-59 months. Participants were selected from all children attending during The National Day of Children Vaccination. TDI were classified according to the modified classification proposed by Ellis (1970). In addition to these criteria the presence of tooth discoloration was also recorded. The presence of malocclusions (anterior open bite, overjet and short upper lip seemed) was assessed based on the criterion of lack of vertical overlap of the incisors in the occlusal position. An interview was carried out with mothers or guardians. The data collected included the Jarman Index (1983). Statistical analysis included Chi-square, Logistic Regression and Chi-square for trend. The prevalence of TDI in 2006 was 13.9%. The maxillary central incisor was the most affected teeth, without differences between the right and the left side. No significant difference between boys and girls. The most common crown fracture was in enamel only (10.8%), followed by tooth discoloration (2.3%), crown fracture of enamel and dentin(1.4%), missing teeth (0.7%) and fistulous tract without signs of caries (0.2%). Children with anterior open bite, overjet and short upper lip seemed to have more TDI compared to those with normal occlusions (p<0.05). Socio-economic factors were not statistically significantly associated with the occurrence of TDI. Concerning the trend analysis, prevalence were: 9.4% in 2002, 12.9% in 2004, and 13.9% in 2006; there was an increase in the prevalence of TDI between 2002 and 2006; and 2002 and 2004 (p = 0.012), however between 2004 and 2006 the increase was not significant (p=0.5). When each study was evaluated separetly, the increase in TDI with the increase of age of the children was confirmed to be significant (p<0.001).
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Vranceanu, Ana-Maria. "Sequelae of Child Abuse: The Role of Social and Personal Resources." [Kent, Ohio] : Kent State University, 2007. http://rave.ohiolink.edu/etdc/view?acc%5Fnum=kent1183738342.
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Nash, Michelle C. "Deployment, Post-Traumatic Stress Disorder and Hypertensive Disorders of Pregnancy among U.S. Active-Duty Military Women." Scholar Commons, 2017. http://scholarcommons.usf.edu/etd/6914.
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Introduction. Today women comprise 15% of the U.S. active-duty military, but are often overlooked in research of the Armed Forces. While some of the challenges faced by women are similar to men, they encounter unique stressors related to childcare while deployed, sexual harassment and assault, and gynecological needs. Women are also more likely than men to develop post-traumatic stress disorder (PTSD). Both stress and PTSD have been linked to the development of chronic hypertension and some adverse birth outcomes. We hypothesized that post-9/11/2001 era military women who deployed or who had indicators of PTSD would be at greater risk of developing a hypertensive disorder of pregnancy (HDP) than non-deployed or non-PTSD military women.
Methods. We conducted a retrospective cohort study using a U.S. Department of Defense database comprised of all active-duty women who gave birth to their first, live-born singleton infant using Tricare from January 1, 2004 to December 31, 2008. The database included maternal and infant birth hospitalization records, maternal mental health visits, and post-9/11/2001 deployment information which included Post-Deployment Health Assessment (PDHA) and Reassessment (PDHRA) screening responses. HDP was defined with ICD-9-CM codes in the maternal birth hospitalization record. We evaluated the risk of HDP associated with overall deployment and timing of deployment ending compared to non-deployed women, in addition to cumulative months of deployment. We also conducted Classification Tree Analysis (CART) to determine appropriate cut-points for categorization of deployment variables among mothers who deployed: cumulative weeks of deployment, percent of study time spent deployed, and dwell time between two most recent pre-birth deployments. We explored effect modification by covariates postulated to potentially modify the relationship between deployment history and risk of HDP. New variables were defined and used in multivariable logistic regression models for each deployment measure. Women fit into four PTSD case-definition categories: confirmed (ICD-9-CM diagnosis), probable (possible plus endorsement of “high risk” items on the PDHA), possible (endorsement of ≥3 PTSD items on the PDHA), or none (no PTSD indicators). We compared mothers with PTSD to non-cases using multivariable logistic regression to quantify the risk of HDP, and repeated the analyses using a ≥2 PTSD item endorsement case-definition criteria. All logistic regression models were adjusted for known confounders and important covariates.
Results. There were a total of 36,675 births, 13.4% of mothers experienced at least one HDP, and 35% of mothers deployed. No increased risk of HDP was observed for deployment overall (OR=1.02, 95% CI: 0.95-1.09), but black mothers who deployed were 13% more likely to develop an HDP (OR=1.13, 95% CI: 1.00-1.27). CART revealed an important cut-point for cumulative deployment length of ≥1 year, which was statistically significant among mothers <35 years old. Mothers with ≥1 year cumulative deployment were 17% more likely to have an HDP than mothers deployed <1 year (OR=1.17, 95% CI: 1.01-1.36). The prevalence of confirmed PTSD was 1.6% in the overall cohort. The prevalence of any PTSD among deployed mothers who completed a PDHA was 6.2%. Overall, PTSD was not significantly associated with HDP except among probable PTSD cases using the ≥2 item criteria (OR=1.30, 95% CI: 1.01-1.67) and among confirmed PTSD mothers identifying as “other” race (OR=6.62, 95% CI: 1.72-25.47).
Conclusion. Results are suggestive of an elevated risk of HDP among the military population among women who deployed for a year or longer and for black mothers. Although PTSD did not clearly confer additional risk in the overall cohort, there is evidence to support further research using more thorough screening especially across racial/ethnic groups. Our study likely underestimated PTSD and possibly attenuated results since individuals may purposely report inaccurately on the PDHA in order to go home sooner after deployment. Future studies should include information related to deployment-specific experiences and screen all participants for evidence of PTSD.
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Esom, Kenechukwu Chimobi. "Twice traumatised: assessing the unaccompanied refugee child's right to family unity and reunification." Diss., University of Pretoria, 2006. http://hdl.handle.net/2263/1212.
Full textAbstract:
"Chapter II will examine the right to family unity and reunification as provided by the various international and regional instruments. The rigt to family unity and reunification in regard to the concept of state sovereignty, definition of terms and concepts, the scope of application and generally the extent of humanitarian and human rights obligation of states under international law. The concept of family as it applies under these instruments and their regions of application will also be examined. Chapter III will examine state practice in this area generally, legislation relating to and affecting the implementation of the rights to family unity and reunification, case law jurisprudence (where applicable), administrative and procedural challenges and how these impact on the implementation of these rights. The jurisprudence of the European Commission and Court as well as the framework of the European Union, the United States and Canada (which are major asylum countries in North America) and the regime under the African human rights system will be discussed. Chapter IV will examine the framework of specialised agencies, particularly the International Committee of the Red Cross (ICRC) and the United Nationas Office of the High Commission for Refugees (UNHCR), in the implementation of these rights. The responsibility for realising family reunification for the unaccompanied refugee child rests on both the states and specialised agencies. This chapter will examine the various documents on the protection of the unaccompanied refugee child's rights to family unity and reunification by the UNHCR, ICRC and other specialized agencies and NGOs especially in the area of family tracing, unity and reunificaiton rights of the refugee child during the conflict. This chapter will also examine other alternatives to family reunification such as fostering, adoption and institutional care. The aims is to determine how successful these agencies have been in the realisation of their mandate as it related to the family rights of the unaccompanied refugee child. Chapter V will make recommendations on more effective ways for implementing the rights." -- Introduction.<br>Thesis (LLM (Human Rights and Democratisation in Africa)) -- University of Pretoria, 2006.<br>Prepared under the supervision of Dr. Henry Ojambo at the Faculty of Law, Makerere University, Kampala, Uganda<br>http://www.chr.up.ac.za/academic_pro/llm1/dissertations.html<br>Centre for Human Rights<br>LLM
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Arroyo, Ormeño Esteban Alexis. "Trauma máxilofacial en la Unidad Emergencia Adultos : breve sinopsis de su ocurrencia, etiología y características sociodemogáficas en un centro de alta complejidad de la Región Metropolitana en Chile, período abril-julio 2016." Tesis, Universidad de Chile, 2017. http://repositorio.uchile.cl/handle/2250/146523.
Full textAbstract:
Trabajo de Investigación Requisito para optar al Título de Cirujano Dentista<br>Introducción: El trauma maxilofacial corresponde a una de las patologías
traumáticas clasificada dentro de la tercera causa de muerte a nivel mundial y la
cuarta en nuestro país. Se ha descrito que como problema de salud pública
involucra importantes costos en intervención con pérdidas a nivel individual y
productivo, estableciéndose una amplia variabilidad en su presentación a partir de
factores sociodemográficos, culturales y del nivel de desarrollo. Es por ello que el
presente estudio propuso aportar información actualizada y validada describiendo
las características asociadas a su comportamiento en un centro asistencial de alta
complejidad de la Región Metropolitana de Chile.
Material y métodos: Estudio observacional, transversal de base individual,
realizado con la exploración de los registros de la Unidad Emergencia Adultos
(UEA), en el Complejo Asistencial Dr. Sótero del Río, para el periodo abril-julio
2016. Se trabajó con la serie clínica de mayores de 18 años con datos completos
en las variables de interés, ingresados en la Unidad Maxilofacial. Se establecieron
medidas de resumen y diferencias por sexo y edad con la prueba de Chi
Cuadrado y Wilcoxon no pareado. Los datos fueron explotados en Microsoft Excel
y el software estadístico Stata 14.0®.
Resultados: Se estableció un total de 315 consultas con mayor frecuencia
en el horario diurno, los días jueves, sábados y domingos. La razón H:M fue de
1,9:1 y afectó principalmente a individuos de 18 a 30 años, sin diferencias por
sexo (p>0,05). Dentro de las causas que originan el trauma maxilofacial el 80,4%
correspondió a la violencia interpersonal, seguida de los accidentes de tránsito
(8,9%). Un 65,4% de las lesiones correspondió a trauma en tejidos blandos,
siendo principalmente contusiones (53,7%), mientras que, en las lesiones de
tejidos duros, el 82% correspondió a lesiones en el tercio medio, con diferencias
por sexo (p<0,05).
Conclusión: El comportamiento del trauma máxilofacial se presentó con un
perfil similar a lo informado en países de un alto nivel de desarrollo, mediado
principalmente por la violencia interpersonal y un predominio más discreto de los
varones, quienes retardan su edad de presentación. La actualización de este tipo
de conocimiento respecto del perfil epidemiológico y sociodemográfico del trauma
máxilofacial, aportará información para elaborar y evaluar acciones de prevención,
que ayuden a disminuir la incidencia de este tipo de trauma en nuestro contexto
local.<br>Adscrito a proyecto FONIS SA 15/20196
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Barrera, del Valle María Fernanda. "Monitoreo de lesiones en el camarón de río del Sur (Samastacus spinifrons) en un centro de cultivo." Tesis, Universidad de Chile, 2006. http://repositorio.uchile.cl/handle/2250/130904.
Full textAbstract:
Memoria para optar al Título
Profesional de Médico Veterinario<br>En un centro de cultivo de camarones de río del Sur (Samastacus spinifrons), ubicado en Chiloé, durante Junio a Octubre de 2004, se realizó un monitoreo de lesiones macroscópicas e histopatológicas. Para esto se hizo un muestreo dirigido de 62 camarones adultos, confinados en estanques y alimentados con dietas comerciales, que presentaron signos como letargia, heridas o alteraciones en su coloración. Además, se obtuvieron ocho individuos aparentemente sanos, como grupo control para realizar comparaciones.
Mediante un análisis descriptivo se demostró que existían diversas alteraciones macro e histopatológicas. El signo clínico más frecuente fue letargia, mientras las alteraciones macroscópicas más comunes correspondieron a lesiones cuticulares y amputación de apéndices, producida por predación. Se registraron otras lesiones características de síndromes descritos para otros crustáceos, como la coloración blanquecina del abdomen ("cola de algodón") y lesiones cuticulares de color anaranjado compatibles con la enfermedad bacteriana del caparazón. Las lesiones histopatológicas más frecuentes correspondieron a infiltración de tejidos por hemocitos en el hepatopáncreas y en glándula antenal. También se registró la presentación de núcleos hipertrofiados con cromatina marginada en células del epitelio hepatopancreático, lo que podría corresponder a una lesión compatible con una infección viral, no antes descrita para la especie. Otro hallazgo importante fue la presencia de organismos tipo microsporidio en el tejido muscular de los camarones con musculatura blanquecina y en el tejido hepatopancreático de otros camarones. También se demostró la presencia de metacercarias de un trematodo de una especie no identificada en hepatopáncreas y gónadaEl estudio demostró la ocurrencia de lesiones tanto macroscópicas, como histopatológicas, que podrían asociarse a cuadros patológicos en la especie S. spinifrons.<br>Astacicultura Chiloé
Proyecto Dirección de Investigación No. 21-04 Universidad Andrés Bello.
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Karlstorp, Fredrik, and Tomas Ögnelod. "Hur barn upplever den nya livssituationen till följd av traumatiska händelser : En litteraturöversikt med kvalitativ ansats." Thesis, Högskolan i Skövde, Institutionen för hälsa och lärande, 2019. http://urn.kb.se/resolve?urn=urn:nbn:se:his:diva-17836.
Full textAbstract:
Bakgrund: Omvårdnad är sjuksköterskans specifika kompetens som innefattar det barncentrerade vårdarbetet för att kunna möta och hantera barnets unika behov och lindra barnets lidande. Syfte: Syftet var att beskriva hur barn upplever den nya livssituationen till följd av traumatiska händelser. Metod: Uppsatsen är en litteraturöversikt med kvalitativ ansats som baseras på tio vetenskapliga artiklar och analyserades enligt Fribergs metod. Resultat: Vid en traumatisk händelse blir barnet rädd och kan känna sig annorlunda samt ensamt. Detta kan påverka barnet för en lång tid framöver när barnet blir påmind om och återupplever den traumatiska händelsen. Slutsats: Den traumatiska händelsen skapar en ny livssituation som påverkar barnet vid händelsen och långt in i framtiden om barnets behov inte möts och hanteras under vårdtiden.<br>Background: Nursing is the nurse's specific competence that includes the child-centered care work to meet and manage the child's unique needs and alleviate the child's suffering. Purpose: The purpose was to describe how children experience the new life situation as a result of traumatic events. Method: This essay is a literature review with a qualitative approach, based on ten scientific articles that were analyzed according to Friberg's method. Results: In a traumatic event, the child is scared and may feel different and alone. This can affect the child for a long time to come when the child is reminded and relives the traumatic event. Conclusion: The traumatic event creates a new life situation that affects the child at the event and far into the future if the child’s needs are not met and handled during the hospitalization.
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Dozio, Elisabetta. "La transmission du traumatisme de la mère au bébé en contexte humanitaire." Thesis, Sorbonne Paris Cité, 2017. http://www.theses.fr/2017USPCB217.
Full textAbstract:
Nombreuses prévues et études sur la transmission inter et trans-générationnelle du traumatisme nous confirment l'évidence de la transmission sans pour autant en donner une description détaillé du processus qui pourrait être à la base de la transmission directe de la mère au bébé. La compréhension de ce processus pourrait permettre de penser et promouvoir des dispositifs de soin précoce pour les mères traumatisées et leurs bébés. Cela s'avère d'autant plus important dans les contextes de trauma collectif, comme les situations d'urgence humanitaire, où une large partie de la population est exposée à des événements traumatiques extrêmes et répétés. Dans le but d’identifier les déterminantes propres à la transmissions directe du traumatise psychique de la mère au bébé en contexte humanitaire, nous avons recrutées vingt-quatre dyades mère-bébé, en trois pays affectés par la crise politico-religieuse centrafricaine démarrée en 2013 (République Centrafricaine, Tchad et Cameroun). Dans les vingt-quatre dyades, les mères ont été exposées à un ou plusieurs événements traumatiques, en l'absence du bébé, avant sa naissance ou pendant la grossesse ; l'âge de bébé est compris entre un mois et trois ans. Ces Mères et bébés ont étés rencontré lors d'un entretien semi structuré que nous avons filmé. Cela pour permettre une microanalyse des interactions trans-modales (visuelles, corporelles, vocales) entre mère et bébé, dans l'idée de comprendre si pendant la révocation de l'événement traumatique de la part de la mère, les interactions subissaient des modifications et dans ce cas, lesquels. Les interactions dyadiques ont été aussi observées dans une situation de jeu libre sans la présence d'interviewer. Les représentations maternelles ainsi que les marqueurs traumatiques dans le discours ont été pris en compte comme facteurs contributeurs de la transmission traumatique. Les résultats de l'analyse des échanges dyadiques pendant l'entretien, montrent une évidence dans le changement d'interactions dans le moment de révocation traumatique de la mère. Les détails de cette différence d'interaction entre mère et bébé sont présentés dans la session de résultats. Dans la discussion ils sont ensuite mis en relation avec le discours de la mère où nous pouvons remarquer le rôle de représentations maternelle à propos du bébé qui ont une implication importante dans la transmission traumatique. L'analyse de toutes ces composantes multiples semble nous indiquer que le traumatisme maternelle influence les représentations de la mère à propos du bébé, de sa relation avec lui et du mandat transgénérationnelle dont le bébé va être investi. De plus les mères traumatisées, envahies par leur propre état émotionnel négatif ont des difficultés à interpréter correctement les expressions verbales et non verbales du bébé et à trouver des réponses appropriées. Cette difficulté se traduit dans la transmission de son état émotionnel négatif au bébé, qui interprète l'absence de réponse de la mère ou les réponses pas adéquates à ses sollicitations, comme des signaux négatifs vis-à-vis de son propre état émotionnel. Lé bébé et il n'a pas d' autres stratégies que celle d'internaliser l'état affectif négatif maternel et de le transformer dans son propre état interne. Malgré l'évidence de la transmission de l état émotionnel négatif de la mère au bébé, nous avons pu observer certains facteurs de protection qui peuvent préserver les mères et les bébés de l'inévitabilité de cette transmission. Les mères et les bébés montrent plusieurs ressources et compétences internes qui nous laissent penser qu'une réparation est possible ainsi qu'une prévention de la transmission traumatique quand le processus est déjà démarré. Pour conclure ce travail nous présentons de propositions cliniques de prise en charge des mère ayant vécu un traumatisme et leur bébé, dans le but de réduire les effets de la possible transmission du traumatisme au bébé ou, quand possible, de la prévenir<br>Several studies on the inter- and trans-gerational transmission of trauma confirm the evidence of transmission without giving a detailed description of the process that could be the basis of mother to child direct transmission. Understanding this process could help to think and promote early care for traumatized mothers and their children. This is especially important in contexts of collective trauma, such as humanitarian emergencies, where a large part of the population is exposed to extreme and repeated traumatic events. In order to identify the determinants of the mother to child direct transmission in a humanitarian context, we recruited twenty-four mother-child dyads, in three countries affected by the Central African political and religious crisis started in 2013 (Central African Republic, Chad and Cameroon). The twenty-four dyads were composed by mothers exposed to one or more traumatic events, in the absence of the child, before childbirth or during pregnancy and their children, aged from one month to three years. We met the mother-child dyads during a semi-structured interview that we filmed in order to allow a microanalysis of the cross-modal (visual, bodily, vocal) interactions between mother and child. The objective was to understand whether interactions underwent modifications during the revocation of the traumatic event by the mother, and if yes, to have a better comprehension of these changes. Dyadic interactions were also observed in a free play situation without the presence of interviewers. Maternal representations as well as traumatic markers in mother discourse have been taken into account as factors contributing to the traumatic transmission. The results of the dyadic exchanges analysis during the interview show some evidences in the modification of interactions during the traumatic revocation of the mother. The details of this difference in mother-child interactions are presented in the results session. In the discussion session, the results from the microanalysis of interactions, have been connected to the mother's speech where we can notice the role of maternal representations about the child that have an important involvement in traumatic transmission. The analysis of all these multiple components seems to indicate that maternal trauma influences the mother's representations about the child, her relationship with him and the intergenerational mandate of which the child will be assigned to. In addition, traumatized mothers who are overwhelmed by their own negative emotional state, have difficulties in interpreting the child's verbal and non-verbal expressions correctly and finding appropriate answers. This difficulty is reflected in the transmission of mother negative emotional state to the child, who interprets the mother's lack of response or inadequate responses to his solicitations, as negative signals about his own emotional state. The child has no other strategies than internalizing the maternal negative affective state and transforming it into its own internal state. Despite the evidence of the transmission of the negative emotional state from the mother to the child, we have observed some protective factors that can preserve mothers and children from the inevitability of this transmission. Mothers and children show many internal resources and skills that suggest a possible recovery as well as give the basis to think about the prevention of traumatic transmission, when the process is already underway. To conclude this work we present clinical applications for the management of traumatized mothers and their young children in order to reduce the effects of the possible transmission of trauma to the child or, where possible, to prevent it<br>Diversi studi sulla trasmissione inter e tran-generazionale del trauma confermano l'evidenza della trasmissione, ma senza fornire una descrizione dettagliata del processo che potrebbe essere alla base della trasmissione diretta dalla madre al bambino. Comprendere questo processo potrebbe aiutare a pensare e promuovere la cura precoce delle madri traumatizzate e dei loro bambini. Ciò è tanto più importante nelle situazioni di trauma collettivo, come possono essere le emergenze umanitarie, dove una gran parte della popolazione è esposta a eventi traumatici estremi e ripetuti. Al fine di individuare le caratteristiche specifiche della trasmissione diretta del trauma psichico dalla madre al bambino in ambito umanitario, abbiamo reclutato ventiquattro diadi madre-bambino in tre paesi colpiti dalla crisi politico-religiosa della Repubblilca Centrafricana che ha avuto inizio nel 2013 (Centrafrica, Ciad e Camerun). Nelle ventiquattro diadi, la madre ha assistito a uno o più eventi traumatici in assenza del bambino, prima della nascita o durante la gravidanza e il bambino ha un'età compresa tra un mese e tre anni. Hanno partecipato a un' intervista semi-strutturata che abbiamo filmato per consentire la microanalisi delle interazioni cross-modali (visive, corporee, vocali) tra madre e bambino, con l'obiettivo di comprendere se durante la rievocazione dell'evento traumatico della madre, le interazioni madre-bambino si modificano e in questo caso, come. Le interazioni diadiche sono state osservate anche in una situazione di gioco libero senza la presenza d¿intervistatori. Le rappresentazioni materne e gli elementi identificatori del trauma nel discorso della madre sono stati considerati come fattori che contribuiscono alla trasmissione traumatica. I risultati delle analisi dell'interazione diadica durante l'intervista mostrano un cambiamento evidente dell'interazione nel momento della narrazione traumatica della madre. I dettagli delle differenze osservate nell'interazione madre-bambino sono presentati nella sessione dei risultati e nella discussione sono messi in relazione con il contenuto e la forma del discorso della madre, in cui è possibile vedere il ruolo delle rappresentazioni materne à proposito del bambino, nella trasmissione del trauma. L'analisi di tutti queste componenti multiple suggerisce che il trauma materno ha un impatto sulle rappresentazioni della madre a proposito del suo bambino, del rapporto che ha con lui e del mandato transgenerazionale di cui il bambino sarà portatore. Inoltre, le madri traumatizzate, invase dal proprio stato emotivo negativo, mostrano una difficoltà a interpretare correttamente le espressioni verbali e non verbali del bambino e a trovare delle risposte adeguate alle sue sollicitazioni. Questa difficoltà si traduce nella trasmissione dello stato emotivo negativo della madre al bambino, che interpreta la mancanza di risposta della madre o le risposte inadeguate alle sue richieste, come segnali negativi rispetto al suo stato emotivo. Il bambino non riesce a trovare altre strategie oltre a quella di interiorizzare lo stato emotivo negativo della madre e trasformarlo nel proprio stato emotivo interno. Nonostante le prove della trasmissione dello stato emotivo negativo dalla madre al bambino, abbiamo osservato alcuni fattori protettivi in grado di preservare le madri e i bambini dall'inevitabilità della trasmissione. Madri e bambini mostrano diverse risorse e competenze interne che ci portano a immaginare che una "riparazione" è possibile, cosi come anche la prevenzione della trasmissione traumatica, nel caso in cui il processo è già avviato. Per concludere questo lavoro, presentiamo delle proposte cliniche destinate alle madri traumatizzate e ai loro bambini, al fine di ridurre gli effetti della possibile trasmissione del trauma al bambino o, quando possibile, per impedirla