Contextualizing Not-Knowing: Terminology and the Role of Professional Identity

This chapter provides a context for the concept of not-knowing, including a discussion of how the concept was framed. The experience of not-knowing in professional youth work is framed in relationship to other concepts explored by the social work and therapeutic literature (including vicarious trauma, helplessness, secondary trauma, and burnout), as well as those offered by the limited youth work and nursing literature discussing similar concepts (disruption and hurt, suffering, commitment in spite of conflict, and the struggle to go along when you do not believe). The standing of youth work in the professions and its own struggles to professionalize are explored, with attention to how not-knowing affects and is affected by these efforts.     

Student-to-Student Abuse in the Indian Residential Schools in Canada: Setting the Stage for Further Understanding

The Indian residential school system in Canada was established to assimilate Aboriginal children into mainstream society by removing the “Indian within them.” In the past 20 years survivors of the schools have come forward with stories of physical and sexual abuse perpetrated against them by staff. However, what is significantly less spoken of is the abuse which occurred between students. The Aboriginal Healing Foundation recently held a small gathering of survivors, Elders, advocates, and researchers to discuss ways to bring this issue into the open. This article comes out of the discussions held at the gathering. Within the article we offer a conceptualization of the dynamics and processes of student to student abuse within the Indian residential schools in Canada with the hope that it will encourage a deeper discussion of this issue.     

Trust-Based Relational Intervention (TBRI): A Systemic Approach to Complex Developmental Trauma

Children and youth who have experienced foster care or orphanage-rearing have often experienced complex developmental trauma, demonstrating an interactive set of psychological and behavioral issues. Trust-Based Relational Intervention (TBRI) is a therapeutic model that trains caregivers to provide effective support and treatment for at-risk children. TBRI has been applied in orphanages, courts, residential treatment facilities, group homes, foster and adoptive homes, churches, and schools. It has been used effectively with children and youth of all ages and all risk levels. This article provides the research base for TBRI and examples of how it is applied.     

星形胶质细胞在脑外伤后的反应

本文对星形胶质细胞在脑外伤后的反应进行综述，包括对星形胶质细胞结构和功能的新认识，脑外伤后星形胶质细胞反应的研究模型、检测技术及其在脑外伤后星形胶质细胞发生形态学及代谢方面的变化。强调了星形胶质细胞在脑外伤后形态、蛋白表达和细胞因子表达变化的时间规律性，并对其在脑外伤后法医学鉴定中应用的意义做出展望。     

Comparing the Social Service Utilization, Exposure to Violence, and Trauma Symptomology of Domestic Violence Female “Victims” and Female “Batterers”

Although some authors have suggested that women batterers may really be self-defending victims, to date, no research has been initiated to empirically support this assertion. This paper describes the design and outcomes of a research project that investigated the similarities and differences between women adjudicated as domestic violence batterers and women identified as domestic violence victims. Findings indicated group similarities in the areas of exposure to violence and social service utilization. Although both groups reported high levels of trauma symptomology, victim scores were significantly higher.     

Perimortem or Postmortem Bone Fractures? An Experimental Study of Fracture Patterns in Deer Femora*

The determination of perimortem trauma is important for forensic anthropologists. Characteristics of bone fractures such as sharp edges, presence of fracture lines, the shape of the broken ends, fracture surface morphology, fracture angle on the Z-axis, and butterfly fractures are said to differentiate perimortem from postmortem trauma. A Drop Weight Impact Test Machine was used to break 76 deer femora of various ages since death. The results of this study suggest that the characteristics listed above are unreliable at differentiating a perimortem fracture from a postmortem fracture in a forensic case. There are, however, statistically significant differences between fresh bones broken less than 4 days old and dry bones broken 44 days or 1 year old after death.     

Histologic evidence of repetitive blunt force abdominal trauma in four pediatric fatalities

In cases of acute fatal child abuse, certain injuries, including cutaneous blunt force trauma, skull fractures, subdural hematomas, intra-abdominal hemorrhage, and retinal hemorrhages are common and well described in the pediatric and forensic literature. These gross findings at autopsy, when taken into consideration with scene investigation and interviews with caregivers, may indicate both a clear manner and cause of death. In such cases, the discovery of additional pathologic changes attributable to older abusive injuries helps support a conclusion of death due to inflicted trauma. We discuss four cases of fatal child abuse in which acute blunt force abdominal trauma was the cause of death. In each of these cases, careful examination with proper sectioning and microscopy of select abdominal tissues revealed that the acute tissue trauma was superimposed on a background of older, healing injury. This older trauma was characterized by classic histologic elements of tissue repair, including fibroblast proliferation, early scar formation, increased vascularity, and hemosiderin-laden macrophages. Iron and trichrome stains were used to confirm the presence of hemosiderin and fibrosis in all four cases, but the recognition of fibroblast proliferation and a reactive vascular pattern was best seen on routine hematoxylin and eosin stains. The gross and microscopic autopsy findings, along with available investigative information, established the diagnosis of chronic physical abuse.     

A Proposed Scheme for Classifying Pediatric Rib Head Fractures Using Case Examples

Pediatric rib head fractures are typically described as “posterior” or “costovertebral,” terms lacking specificity. To resolve this issue, a scheme was developed to describe the location of rib head fractures observed in a pediatric forensic population. The scheme uses three anatomical landmarks, terminus (tip), tubercle, and costovertebral articular surface to divide the rib head into two subregions, costovertebral and costotransverse. Examples of five cases of infants with rib head fractures are presented using this scheme. Forty‐eight rib head fractures were observed in these infants with the following frequencies: 56% (three infants) at the terminus; 21% (three infants) in the costovertebral subregion; 21% (one infant) at the costovertebral articular facet; and 2% (one infant) in the costotransverse subregion. Due to the small number of cases assessed, statistical analyses could not be performed; however, the data demonstrate the variation in distribution of pediatric rib head fractures.     

Classification of Pelvic Ring Fractures in Skeletonized Human Remains

Pelvic ring fractures are associated with high rates of mortality and thus can provide key information about circumstances surrounding death. These injuries can be particularly informative in skeletonized remains, yet difficult to diagnose and interpret. This study adapted a clinical system of classifying pelvic ring fractures according to their resultant degree of pelvic stability for application to gross human skeletal remains. The modified Tile criteria were applied to the skeletal remains of 22 individuals from the Cleveland Museum of Natural History and Universidad Nacional Autónoma de México that displayed evidence of pelvic injury. Because these categories are tied directly to clinical assessments concerning the severity and treatment of injuries, this approach can aid in the identification of manner and cause of death, as well as interpretations of possible mechanisms of injury, such as those typical in car-to-pedestrian and motor vehicle accidents.     

Adverse Childhood Experiences and Subsequent Substance Abuse in a Sample of Sexual Offenders: Implications for Treatment and Prevention

The purpose of this study was to explore the prevalence of substance abuse indicators in a sample of male sexual offenders (N = 679) and to examine the influence of adverse childhood experiences (ACE) on the likelihood of substance abuse outcomes. Half of these sex offenders reported a history of drug or alcohol abuse, and nearly one in five reported a substance-related arrest. Higher ACE scores were associated with endorsement of a greater number of substance-abuse-related problems, suggesting that accumulation of early trauma may increase the likelihood for substance misuse. By enhancing our understanding of the frequency and antecedents of dynamic risk factors such as substance abuse, we can better devise clinical interventions that respond to the comprehensive needs of sexually abusive individuals and reduce risk for sexual reoffense. As well, early interventions for at-risk families and maltreated youth may interrupt their trajectory toward adulthood substance abuse and criminal behavior, including sex offending.