Trauma-induced central diabetes insipidus in a cat

A 1-year-old neutered male domestic shorthair cat presented with a 4-week history of polydipsia that began immediately after an 8 metre fall, Trauma-induced central diabetes insipidus was suspected on the basis of the identification of hyposthenuria, normal haematology and serum biochemistry profile and unremarkable abdominal ultrasound examination. Failure to concentrate urine with water deprivation followed by production of hypersthenuric urine with administration of the synthetic antidiuretic hormone, Deamino-8-D-arginine vasopressin (DDAVP), confirmed the diagnosis of central diabetes insipidus. Treatment via conjunctival administration of DDAVP failed to attenuate the polydipsia, however, resolution of polydipsia was achieved with subcutaneous administration of DDAVP and the cat remains eudipsic with twice daily subcutaneous DDAVP administration 17 months after diagnosis.

Psychopathology following trauma: The role of subjective experience

Background: The DSM-IV definition of posttraumatic stress disorder (PTSD) widened the stressor criterion to include objective (A1) and subjective (A2) components. The prevalence of Criterion A2, and its association with traumatic memory and psychopathology, was examined in a large community sample. Method: The presence of Criterion A2 and traumatic memories, as well as DSM-IV anxiety, affective and substance use disorders, were examined in a community sample of 6104 adults with a history of traumatic exposure. Results: Most individuals met Criterion A2 (76%), with higher prevalence in females (81%) than males (69%). A2 was more common following certain traumas (such as assaultive violence). Excluding those people with PTSD, prevalence of most psychiatric disorders was higher in those who met Criterion A2 than in those who only met Criterion A1. Only 3% of those who did not meet A2 went on to suffer persistent traumatic memories. The prevalence of psychiatric disorders was higher in those with A2 and traumatic memories than in those with A2 and no traumatic memories. Limitations: The retrospective nature of the data raises the potential for reporting biases. The data set allowed only one of several possible predictors of posttraumatic adjustment to be examined and only 12-month, and not lifetime, prevalence of psychiatric conditions was available. Conclusions: The experience of powerful emotions at the time of traumatic exposure is common and is associated with increased prevalence not only of PTSD, but also of a range of other psychiatric conditions. Traumatic memories may mediate this association. (c) 2005 Elsevier B.V. All rights reserved.

Epidemiology of open- and closed-globe trauma presenting to Cairns Base Hospital, Queensland

Purpose: To review the epidemiology of serious ocular trauma presenting to Cairns Base Hospital, from the far north Queensland health districts. Methods: A retrospective study of cases from January 1995 to November 2002 inclusive. Cases were analysed with respect to demographics, cause and nature of injury, method of transport and time to and type of ophthalmic treatment, and visual outcomes. Results: There were 226 cases identified, including 71 open-globe and 155 closed-globe injuries. The annual rate of injury was 3.7 per 100 000 for open-globe and 11.8 per 100 000 in total. The Aboriginal and Torres Strait Islander population from the far north Queensland districts showed a disproportionate incidence, with 38% of the total number of injuries, despite representing only 12.3% of the population. Assault in the Aboriginal and Torres Strait Islander population resulted in 69.6% of injuries in men and 75.8% of injuries in women. Of all assaults 76.2% were alcohol-related. The majority (71.5%) of injuries in the Caucasian population were due to accidental blunt and sharp trauma. In total, 77.4% of injuries occurred in men, with an average age of 31 years. Of all open and closed injuries in the study, a final visual acuity of 6/12 or better was achieved in 47.8% of eyes and a final visual acuity of 6/60 or less occurred in 17.7% of patients, 20.8% patients were lost to follow up. In total, 14.1% of open injuries required enucleation/evisceration. Conclusions: The incidence of ocular trauma in far north Queensland is equal to other Australian populations. However, there is a disproportionately high incidence in the Aboriginal and Torres Strait Islander population. Alcohol-related assault is a significant cause of visual loss in the Aboriginal and Torres Strait Islander population. Closed-globe injuries are more common than open globe; however, the latter have poorer visual prognosis. Initial visual acuity of all injuries correlated with final visual acuity.

Effect of information provision on trauma symptoms following therapeutic writing

Recent studies in the area of psychological debriefing (PD) have reported adverse effects. This study examined one possible explanation for such effects, that of sensitisation to the possibility of pathology. Subjects were 161 psychology students (female, n = 121; male, n = 40) who had experienced trauma but received no previous treatment. Subjects either received an explanation (explanation group) or received no explanation at all (no explanation group) about trauma reactions prior to undertaking a therapeutic writing protocol. The hypothesis of increased morbidity where the possibility of pathology was made explicit was not supported. At 2 months, the explanation group had a greater reduction on Impact of Events Scale Revised JES-R) total scores, F(1, 151) = 3.98, p = .048, and on the General Health Questionnaire - 28 (GHQ-28) Anxiety and Insomnia subscale, F(1, 151) = 9.84, p = .002, and total score F(1, 150) 5.05, p = .026. High-avoidance copers in particular appeared to benefit from information provision, F(1, 148) = 4.2 6, p = .044. Results suggest that adverse findings associated with PD may not be due to information sensitising of participants to pathology and that the provision of information to trauma survivors appears to be a useful strategy. Recommendations were made regarding the management of those exposed to trauma and for future research.

The role of avoidance coping in the disclosure of trauma

Little research has been undertaken to examine the empirical basis of commonly applied methods of posttrauma intervention. We propose that Pennebaker's work on structured disclosure of trauma provides a suitable analogue to explore questions of interest. The present study asks whether avoidance coping is likely to interfere with abbreviated disclosure of traumatic experiences. Subjects were 118 college students randomly allocated to either a one-session or four-session written trauma-disclosure condition. At 2 months postdisclosure, subjects with high avoidance coping within the one-session condition exhibited significantly more trauma-specific and physical symptoms than all other subjects. Avoidance coping significantly predicted trauma-specific symptoms at 2 months. These findings suggest that single session traumatic disclosure may not be useful for individuals with an avoidance style of coping.

Tackling the burden of injury in Australasia: developing a binational trauma registry

Existing trauma registries in Australia and New Zealand play an important role in monitoring the management of injured patients. Over the past decade, such monitoring has been translated into changes in clinical processes and practices. Monitoring and changes have been ad hoc, as there are currently no Australasian benchmarks for optimal injury management. A binational trauma registry is urgently needed to benchmark injury management to improve outcomes for injured patients.

Feel it and deal with it: mental health practitioners' experiences of exposure to the trauma of survivor clients

Empathic engagement by the trauma therapist with another person's traumatic experiences is believed to create risks for the helping professional. Much attention has been focused upon the mental health professional experiencing symptoms of distress as a result of their exposure to the material of clients who survive traumatic incidents. This thesis contains the findings of a qualitative study that centres on a group of male mental health professionals and their experiences of exposure to the trauma material of survivor clients. The participants of the study practise within an internal Employee Assistance Program that provides, among other duties, a 24 hour, 7 day response to critical incidents to a heavy transport industry. Using semi-structured, in-depth interviews, the effects on the trauma therapists are explored by analysing their reactions to their survivor clients' accounts, the impact of these experiences upon their psychological schema, the organisational culture in which they practise and its influence upon their experiences and the methods participants use to cope with the psychological effects of exposure to trauma material. Participants' experiences are closely examined for critical comparisons with vicarious traumatization. Therapists' responses reveal their continued ability and motivation to empathically engage with the trauma material of survivor clients despite the potential risks.

Design and optimisation of the resonant mirror, an optical biosensor, for the analysis of microalbuminuria in trauma patients

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"I'm a better manager":A biographic narrative study of the impact of personal trauma on the professional lives of managers in the UK

This doctoral study aims to understand how experiences of critical illness or bereavement affect the way managers view and approach their work and their relationships at work. This is an interpretative phenomenological study examining the subjective meanings of personal experience and is underpinned by biographic narratives from four participants and interviews with their nominated workplace witnesses (i.e. colleagues who worked alongside the individual at the time of their trauma). As a consequence of the findings that have emerged across this study, three contributions to theory are presented. All four participants described their traumas as a professional growth experience for themselves as managers, which resulted in self-reported and observed behaviour change at work. Consequently, the first area of theoretical contribution is a suggested extension to the post-traumatic growth (PTG) framework (Calhoun & Tedeschi, 2006) with the addition of a new behavioural dimension called ‘managerial growth’, when applied to the context of ‘ordinary’ organizations. The second area of theoretical contribution arose through the reflexive process that was created during data collection where participants and their witnesses remembered episodes of compassion interaction at work. The second area of contribution thus seeks to extend the existing model of compassion at work (Dutton, Worline, Frost and Lilius, 2006), by conceptualising compassion as a dyadic process between a compassion ‘giver’ and a compassion ‘receiver’ in which the compassion receiver ‘trusts or ‘mistrusts’; ‘discloses’ or ‘withholds’; ‘connects’ or ‘disconnects’ with the compassion giver. The third area of contribution is a new conceptualisation of reflexivity, ‘three-dimensional reflexivity’ (3DR) (Armstrong, Butler and Shaw, 2013). 3DR brings together three of the elements that have been missing from critically reflexive management research; by working with multiple variants of reflexivity in the same study; surfacing different reflexive voices to guard against the researcher’s (potentially) solipsistic own; and remaining sensitive to the concept of reflexive time. In doing so, 3DR not only provides a deeper understanding of individual lived experience; it is also a vehicle in which self-insight is gained. Furthermore, by engaging in its practice, those involved in this study have developed both personally and professionally as a result.

Engaging autobiography:mobility trauma and international relations

This article outlines the possibilities of autobiographical stories to criticize status quo iterations of International Relations (IR). The article draws on the personal experiences of the author’s deportation order issued by the United Kingdom’s Home Office and its associated Border Agency (UKBA) to challenge the accepted assumptions of a cosmopolitan worldview as it relates to orderly international institutional design. It highlights the possibilities of trauma when border management and personal mobility collide. It suggests that mobility trauma ensues when the expectations of human mobility, outlined in Article 13 of the Universal Declaration of Human Rights, infringe the state’s role as security provider. It begins in part one with a challenge to the traditional role and understanding of international borders that sustain order within the international. It examines the unacknowledged role that human vulnerability plays within IR and institutional design while frankly engaging with human vulnerability and trauma in the second section. This section details the experiences of the author when her mobility rights were curtailed and the ensuing identity crisis prompted by such events. The final section investigates the ideas of critical cosmopolitan scholarship demanding that such discourses acknowledge and work through the possibility of failed agency when the demands of state security supersede individual mobility rights. It turns to the possibility of traumatic iterations of IR in order to probe such possibilities. The article suggests, in its conclusion, the possibility of storytelling and psychoanalysis to endorse unorthodox agency, and the possibility of a dynamic international institutional design, that challenges the status quo iterations of IR.