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This paper describes the contribution of earlier traumatic loss to the later violent eruptions, with fatal consequences, of two young men, one who killed his mother and one who killed an unknown woman. Their developing personalities became disordered during their disturbed childhoods and the link between these developing personality disorders and psychoses is referred to. The need for long-term treatments is emphasised, as well as the importance of communication between therapist and clinical team.

Lauren Levine’s paper illustrates how she straddled the lines between helping her patient to grieve his substantial loss and exploring new psychic possibilities. As she discusses the transformation of traumatic loss into developing capacities for mourning and regeneration, she also examines the analyst’s limits that are directly and indirectly expressed to the patient. This discussion examines the intrinsic relationship in analytic work between grieving, the depressive position, and psychic change.

Cryptic relations in James’s “The Aspern Papers,” considered in the light of Derrida’s writings on cryptophoria and the archive, illuminate James’s place as a writer of modernity, enacting traumatic loss in the uncertainty and instability of meaning and history.

Post traumatic loss of segment of the central tendon of extensor expansion is common in crush injury of the hand. Central tendon forms the inherent part in the dynamics of extensor expansion mechanism. When a segmental loss of central tendon occurs, usually the reconstruction of the tendon is done with autogenous Palmaris longus tendon as it is more expendable. In this particular clinical scenario, the absence of Palmaris longus tendon was dealt with partial removal of Flexor Carpi radialis tendon which proved to be effective. The outcome following surgery was reasonable. Post operatively Hyperbaric oxygen therapy was given to improve the survival of crushed tissue. [Hand Microsurg 2020; 9(3.000): 167-170]

This experimental research investigated the effects of Family Resiliency Program (FRP) on post-traumatic stress, grief, and family resiliency level for women with traumatic grief. The study was conducted with 24 women who applied to the non-governmental organization between 2012 and 2013 due to the traumatic loss of their husbands and who obtained a high score on the post-traumatic stress disorder checklist civil version (PCL-C), and the grief inventory (GI), and a low score on the family resiliency scale (FRS) in pre-test assessment. The experimental group (n=12) received an eight session (FRP) intervention developed by the researcher. A group of women in a control group (n=12) received no intervention. To determine the immediate and long-term effects of the FRP program with traumatic grief, post-tests (PLC-C, GI, FRS) were given to the experimental and control group in two and a half month and six month intervals, respectively. In data analysis of this study two way repetead measures Anova was used. In study results, FRP for women with traumatic grief was found to be significantly effective in decreasing post-traumatic stress and grief levels and increasing family resiliency level. The effects of the program persisted during the follow-up tests. The results of this research were discussed in light of the literature, with recommendations presented for counselors and researchers.

V magistrskem delu smo raziskovali travmatično žalovanje in njegovo povezanost s stopnjo stresa, s stopnjo zdravja primarne družine ter načinom izgube in odnosom s pokojno osebo. V prvem delu magistrskega dela poglobljeno razložimo pojem »travmatično žalovanje«. V teoretičnem delu tako razčlenimo besedilo o procesu žalovanja in vrstah pomoči, ki so nam na voljo ter poudarimo pomembnost preventive na tem področju. Ob tem pregledamo vlogo duhovnosti, družbe in najpomembneje, vlogo relacijskega terapevta v terapevtskem procesu v primeru travmatičnega žalovanja. Predstavili smo razlikovanje med travmatičnim žalovanjem ter ostalimi duševnimi motnjami, opredeljenimi v DSM-V. Pobliže si ogledamo doživljanje stresa v primeru travmatičnega žalovanja in njuno prepletenost ter pomen zdravja v primarni družini. Ob zaključku teoretičnega dela opozorimo na travmatičen način izgube bližnje osebe ter na odnos, ki ga je pred izgubo imel žalujoči s pokojno osebo. V raziskovalnem delu smo preverjali štiri hipoteze. V raziskavi je sodelovalo 34 moških (25,8%) in 98 žensk (74,2%). Rezultati so pokazili, da travmatično žalovanje ni statistično pomembno povezano z zdravjem primarne družine, je pa statistično pomembno povezano s stopnjo doživljanja stresa. Rezultati so pokazali, da bolj, kot je žalovanje travmatično, večjo stopnjo stresa doživlja posameznik. Nadalje je iz rezultatov razvidno, da med skupinama tistih, ki so izgubili otroka in tistih, ki so izgubili starša, ne obstaja statistično pomembno razlika, obstaja pa med skupinama, ki so izgubile bližnjo osebo na različne načine. Rezultati so pokazali, da osebe, ki so izgubili bližnjo osebo nenadne smrti, žalujejo bolj travmatično v primerjavi z osebami, ki so izgubile osebo pričakovane smrti. The author in this thesis investigates traumatic grieving and its connection with the level of stress, the level of health of primary families and with the nature of loss and with the relationship with the deceased person. In the first part, the theoretical part, the term "traumatic mourning" is thoroughly explained. Through the theoretical part, she breaks down the grieving process and in shows what kind of help is available and talks about preventive measures in the area of grieving process. In this light, she examines the role of spirituality, society and most important, the role of a relational family therapists in the therapeutic process in case of traumatic mourning. The author presents a distinction between traumatic grief and other mental disorders defined in DSM-V. She looks closely stress in case of traumatic mourning and their intertwining and the importance of health in the primary family. In the conclusion of the theoretical part, the author warns about traumatic ways of loss and the type of relationship that a grieving person had with the deceased before the loss. In the empirical part the author examined four hypotheses. The survey involved 34 men (25.8%) in 98 women (74.2%). The results showed no statistically significant correlations of traumatic mourning to the health of the primary family, but it is statistically significantly correlated to the degree of stress experienced. The results show that the higher the score of traumatic grieving, the higher the level of stress is experienced by the individual. Furthermore, it can be seen from the results that there are no statistically significant differences between groups of those who have lost a child in those who have lost their parents, but there is a difference between groups who have lost loved ones in different ways. Results show, that the level of traumatic grieving is higher with those, who have lost someone in an unpredicted way, in comparison with those who were expecting loss.

INTRODUCTION: The nasolabial flap can be used for reconstruction of the orofacial region. The procedure is of a short duration and treats orofacial soft tissue defects of small to moderate size, especially when microsurgical free flaps are less feasible due to lack of infrastructure, expertise or financial constraints. AIMS AND OBJECTIVES: To study the effectiveness of the nasolabial flaps in reconstruction of orofacial defects of various origins. MATERIALS AND METHODS: In this prospective study, 10 patients (18 nasolabial flaps) were selected randomly regardless of age, sex and need for reconstruction—whether it being requirement of tissue coverage following traumatic loss of soft tissue, soft tissue coverage after resection of a benign or malignant tumor, or resection of soft tissue defects after excision of submucous fibrosis bands. Patients were treated under general anesthesia following routine investigations, using either inferiorly or superiorly based, unilateral or bilateral nasolabial flaps for local extraoral and intraoral reconstruction. Patients were evaluated for postoperative complications, flap uptake, donor site morbidity and postoperative extraoral scarring. RESULTS: In all cases, postoperative complications were relatively minor except in one flap where total flap loss was encountered. The average time taken for preparation of recipient site, flap elevation and closure was 72 min. The nasolabial flap proved itself to be extremely vascular and thus safe and suitable with satisfactory cosmetic outcomes. CONCLUSION: The nasolabial flap proves to be a versatile flap with a proven blood supply from the facial, transverse facial and infraorbital vessels. It establishes itself as a simple procedure to execute to reconstruct the various defects of the anterior orofacial region. It is considered to be a safe flap with a low complication rate, and most importantly it offers a cosmetically pleasing and functionally satisfactory solution.

Background The purpose of this article was to introduce calcaneal lengthening for partial traumatic loss of the calcaneus. Effectiveness with the use of the technique was also assessed. Methods From January 2013 to May 2016, calcaneal lengthening was performed in 15 patients who sustained a partial traumatic loss of the tuberosity portion of calcaneus. There were 13 men and 2 women with an average age of 36 years (range, 19–53 years). Combined Achilles tendon rupture was noted in 7 patients, and the tendon was reinserted to the calcaneus before calcaneal lengthening. Calcaneal lengthening was performed using an Ilizarov frame. Clinical outcome was assessed based on the American Orthopedic Foot and Ankle score. Results The mean loss of calcaneus was 27% (range, 19%–35%). Calcaneal lengthening (mean total time is157 days; range, 111–226 days) included three periods, i.e., latency (mean 7 days; range, 7–9 days), distraction (mean 43 days; range, 32–57 days), and consolidation (mean 108 days; range, 84–162 days). The mean amount of lengthening was 28% (range, 19%–38%). The mean follow-up duration was 25 months (range, 24–27 months). Based on the American Orthopaedic Foot and Ankle, there were 8 excellent, 6 good, and 1 fair result. Conclusions For the treatment of partial traumatic loss of the calcaneus, calcaneal lengthening using an Ilizarov frame is a preferable technique to restore the length of calcaneus and foot function.

Significant strides have been made in the trauma and grief fields to address the unique needs of those who have lost a loved one to violent death. Several treatment techniques have been found to be effective for symptoms of trauma and grief that are prevalent among violent loss survivors including restorative retelling and cognitive behavioral strategies. Current interventions either are tailored for a specific mental health problem or are more universal in nature for grief related to violent loss. This paper presents an evidence-based and guided modular approach for responding to the myriad potential mental health needs of violent loss survivors. A comprehensive module-based structured intervention for violent loss survivors, which specifically targets several common mental health difficulties following traumatic loss, may offer clinicians a thorough and flexible approach guided by clinical assessment to address the distinctive and common issues violent loss survivors often face.

Aims: Traumatic loss of skin, particularly in major burns, requires skin grafting to repair the tissue. For a large burn, where donor sites are limited, the skin graft may need to be expanded. In addition, rapid wound closure is a large factor in successful recovery and is usually achieved by debridement and skin grafting. Micrografting was introduced by Meek and involved dividing the skin into small pieces, allowing for up to a tenfold skin expansion. Methods: We conducted a review of the literature, searched via Medline, Pubmed and Embase (from 1958 to June 2017), searching to identify studies and reports of micrografting. We searched using the Medical Subject Headings (MeSH) ‘micrograft’, ‘micrograft technique’, ‘Meek’, ‘Meek technique’, ‘Parker Cicero’, ‘major burn treatment’ and ‘mesh skin graft’. Results: We analysed 24 articles in which the description and modifications presented by the micrograft technique were presented, along with evidence that supports or rejects its use. The consensus was for the use of micrografting in burns of >30% total body surface area (TBSA). On poor wound beds, the evaluation of re-epithelialisation had greater success due to low metabolic demands and greater skin coverage compared with control groups (pConclusions: Micrografting can be used where there is poor bed vascularity (such as in patients with diabetes), with higher success due to low metabolic demand. This is recommended for major burns, >30% TBSA, with inadequate donor sites and comorbidities, such as diabetes. However, disadvantages include a ‘polka dot’ appearance on healing and the fact the initial surgeries, creating the micrograft squares, are labour-intensive.

The authority of the early church dominated the period from the late Roman Empire to the Renaissance. The teachings of Galen with their determinism emphasizing the creator’s work was perfect in all aspects were popular with the church. Research was not encouraged. Even so small elements of information were noted. Medical learning passed to Arabic world and to Iran and then returned to Europe. The Italian schools of first Salerno and afterwards Bologna were at the forefront of progress. Dissection finally became legal in Bologna in 1405. It was shown patients could survive traumatic loss of brain substance. Moreover, it was documented that injury on one side could lead to contralateral paralysis. Finally, it was shown that a Valsalva could give a clue as to whether a cranial fissure was full thickness or not. All of this knowledge would be subsequently forgotten.

In this documented case study, with its thick descriptions, the author explores and discusses her relationship with Greg, a young man with Down Syndrome, as he journeys through grief. In writing of her spiritual care, the author describes how she works with Greg, helping him to process his emotions, to develop new connections, and to move on and live in his grief. In return, Greg offered her guidance, gifting her with his presence, authenticity and an exuberant love of life.

In this article, I have drawn from my personal experience of exile and my work with patients suffering from similar devastation to illustrate an understanding of traumatic loss and its long-term impact on one’s experience of being in the world. I describe the image of traumatic loss as being an amputation of one’s own experience of being in the world, analogizing that experience to the amputation of a bodily part. I am proposing as well that parts of ourselves that can no longer go on being in relationship to the absent and grieved significant others in our lives are experienced as phantom selves. Using these metaphors permits us to re-conceptualize traumatic loss, broadening our understanding of the long-term effects of grief and mourning. In this effort I am neither pathologizing the senses of amputation or phantom selves, nor am I imposing a designated healing time, or any time when healing ensues at all. Rather, I conceptualize phantom selfhood as a healthy response to trauma that engages the imaginat...

This research is an inquiry into the experience of losing a loved one to murder. The topic is explored and expressed through the lens of autoethnography. The author explores and documents the process of recovery following the murder of her father. The article considers how healing and growth can emerge from tragedy. Implications for theory and research are discussed, and suggestions are made regarding therapeutic support for individuals who have experienced traumatic loss.

The high rates of traumatic experiences reported by women who use alcohol and drugs have been documented in the literature. This study builds on the existing literature by examining the experiences of intergenerational family loss trauma among 226 mothering female substance users from 3 racial and ethnic groups: Native American (26.5%), Latina (24.8%), and White (48.7%). Demographic information, substance use, intergenerational exposure to mothering, and other family traumatic losses were compared across racial and ethnic groups. Data indicate both similarities and significant differences in demographic characteristics, type of drug use, and traumatic family loss experiences—with a higher percentage of Native American women reporting instances of intergenerational family loss. The extent of intergenerational family traumatic loss among women who use substances is discussed, along with social policies that perpetuate such loss. Recommendations for effectively intervening at the individual, family, and poli...

Background: Previous studies on the influence of different types of attachment on grief responses have yielded contradictory outcomes. Little research has been conducted to identify the psychological processes that moderate the relationship between attachment representations and patterns of grief in disaster-related grief. Objective: The present study examines the effects of different attachment types on the grief responses of parents bereaved by loss of a child in a ferry accident, along with the moderating role of coping strategies. Methods: Bereaved parents (n = 81) completed self-report questionnaires evaluating attachment, coping strategies, complicated grief, and shame/guilt. We performed correlational analyses to examine the associations among variables. We also conducted hierarchical regression analyses and simple slope analyses to examine the moderation effects of coping strategies. Results: Anxious attachment was associated with severe shame/guilt, and avoidant attachment correlated with complicated grief. Anxious attachment was positively associated with all types of coping strategies, and avoidant attachment was negatively related to problem- and emotion-focused coping. The use of problem-focused coping strategies was a significant moderator of the relationship between the avoidant attachment dimension and shame/guilt. Avoidant attachment had a significant effect on shame/guilt in groups with a high level of problem-focused coping. In contrast, none of the coping strategies significantly moderated the relationship between anxious attachment and grief response. Conclusions: The results suggest that people with highly avoidant attachment might be overwhelmed by shame and guilt when they try to use problem-focused coping strategies. This finding suggests that grief interventions should be organized with consideration of individual differences in attachment representations.

Emerging evidence suggests that the loss of loved ones under traumatic circumstances is highly prevalent among refugees and asylum seekers. We evaluated the effects of traumatic and multiple losses of family members and friends on psychopathology, disability, and quality of life in Iraqi asylum seekers in the Netherlands, and investigated mediation of these effects through psychopathology. Respondents (N = 294) completed structured Arabic interviews. Data were analyzed using structural equation modeling. The loss of a loved one was reported by 87.6% of the sample. Traumatic and multiple losses of family members independently predicted psychopathology, taking the effects of other traumatic events, postmigration stressors, and sociodemographic characteristics into account. Effects of traumatic and multiple losses on quality of life and disability were either partially or fully mediated by psychopathology. These findings highlight the need to evaluate and treat the effects of the loss of loved ones when working with asylum seekers and refugees as well as to incorporate grief-related psychopathology in diagnostic classifications.

Adjustment of Israeli Arab Muslim widows to the traumatic loss of their husbands was examined by comparing their reported ways of coping with those of married women of their community by means of the Two-Track-Bereavement Model. Participants included 93 widows and 86 comparable married women who were mostly middle aged and of middle class. We hypothesized that widows will express concurrently greater suffering and higher resilience to adverse life events compared with married women. It was hypothesized further that positive and close relations to a deceased husband will be reported by Arab widows as well as Arab married women. However, positive relationships of married women will correlate with their own coping supporting attributes, whereas positive relations of widows to their deceased husband will not be associated with their individual characteristics. Results indicated a fourfold factor structure of the bereavement and coping scale which differed from those obtained by Israeli Jewish women and generally supported these hypotheses. It appears that traumatic loss of a husband may enhance widows’ resilience.

Traumatic loss of the whole talus is extremely rare, and its possible treatment options are limited. Our experience of treatment of a 30-year-old male suffering from traumatic loss of the whole talus with the insertion of an anatomical antibiotic-loaded talus cement spacer using 3-dimensional printing techniques as an interim measure was reviewed and reported. A young motorcyclist was brought to the emergency department after a road traffic accident. He sustained multiple injuries including traumatic loss of his left talus. Despite repeated surgeries of debridement and insertion of external fixator to his injured ankle, the patient had residual problem of ankle instability, ankle infection, and absence of his involved talus. With the help of computerized 3-dimensional printing techniques, an anatomical talus cement spacer was produced in the operating room and inserted into the patient's ankle 7 weeks after the initial trauma. The external fixator was kept for another 3 weeks before removal. At 14 months after the insertion of cement spacer, the patient could walk independently without any pain for 15 minutes with the help of a crutch occasionally. However, the range of motion of his left ankle was limited to 15° in the flexion-extension arc and minimal subtalar motion. The infection of the left ankle was under control.

Children and teens bereaved after death by suicide may have numerous and/or complex questions. Obviously, there may be more questions or concerns, depending on the significance of the deceased person to the child, such as a parent, sibling, other family member, friend, or some individual who was influential to that child. Most of the research on children and teens bereaved by suicide tends to focus on the bereavement responses of young people after parental suicide death, but parental suicides are not, regretfully, the only suicides children and teens might experience. The focus of this chapter is geared toward bereavement after parental suicide, but bereavement after the suicide death of a sibling, friend, acquaintance, or some other significant person will present similar challenges. Grief is a journey and a process of adjusting to life after a significant loss. But suicide as a traumatic loss brings additional circumstances that can make healing more difficult.

This review of Fill the Void (Lemale et ha'halal) explores the tensions between the opposites of life and death as portrayed in a traditional Orthodox Jewish family who suffer a traumatic loss. The concept of individuation, within a climate of intense collective pressure and in the intergenerational context as seen through the lineage of the female characters, is explored.

Summary In the literature on grief and loss, it is noticed that the quest or the reconstruction of meaning after a traumatic loss of significant others has a crucial impact on successfull coping with this traumatic experience. Many researches prove that traumatic loss strongly shatters the system of meaning of a trauma survivor, and thus it becomes harder to integrate this experience into the self structures or personal memory. This relation between quest or the reconstruction of meaninng and difficulties to cope with traumatic loss is a multidimensional process. Authors investigating it frequently get quite controversial results. However, it is necesary to combine and compare studies made in this field and to summarize the knowledge of quest or reconstruction of meaning having or not an impact on coping with traumatic loss. There, several problematic aspects emerge. One of the basic ones is that there are some attempts to generalize the process of grief after traumatic and other very different losses and the role of quest or reconstruction of meaning in this process. The problems may arise because different researchers have different attitudes and theoretical approaches to the meaning as such, use different concepts and definitions, e.g., if the concept finding meaning and quest of meaning means the same; regarding the problem of definitions, authors chose too distinct methods in their studies. During the last twenty years when attention to the quest or reconstruction of meaning after a traumatic loss is under investigation, there are quite a lot of results found, a huge variety of knowledge in this field; thus, it is needed to be able to generalize it. A more clear view to the quest or the reconstruction of meaning after a traumatic loss is important not only to scientists but also to practicians dealing with people surviving a traumatic loss of significant others as well. In this article, the main trends of researching the quest or reconstruction of meaning after a traumatic loss and the difficulties in comparing and generalizing the results of these different studies are discussed. Key words: grief, meaning reconstruction, finding meaning, meaning-making, traumatic loss.

����� ��� n a letter that appears in Bass Cathedral (2008), the fourth volume of Nathaniel Mackey’s ongoing series of epistolary fictions collectively titled From a Broken Bottle Traces of Perfume Still Emanate, the series’ protagonist, a jazz musician identified only by the letter N., pauses to ponder the title of “Melin,” the first song on Henry Threadgill’s album When Was That? (1982). N. asks, “What does that title mean?” and considers the possibility that it might be “a typo, a misspelling,” before musing, “Should it be ‘Melan,’ the root for ‘black’ in words like ‘melanin’ and ‘melancholy’?” (125). N. poses this question of homophony as if only in passing, but like so many of the puzzles that fill N.’s letters, the question echoes against the larger framework that N. has put in place. In this case, the association that N. makes on the level of the signifier between blackness and melancholy resonates with Mackey’s investigation of melancholy, loss, and trauma in the context of African American and wider African diasporic history throughout the series. In fact, over the course of the series to date— which, in addition to Bass Cathedral, comprises Bedouin Hornbook (1986), Djbot Baghostus’s Run (1993), and Atet A.D. (2001)—N.’s experiences of traumatic loss repeatedly point to an overarching sense of loss stemming from the legacy of the Middle Passage that echoes across generations. As the series proceeds, it becomes clear that, apropos of the critical ligature between trauma and repetition that

We comment on Smith, Duax, and Rauch’s (2013--this issue) explication of their approach to treating perpetration-related guilt and shame using prolonged exposure (PE) therapy, with the aim of promoting a discourse about the mechanisms, techniques, and assumptions that underlie the treatment of moral injury in veterans and service members. We first discuss the theoretical foundation underlying PE and consider the extent to which it accounts for the phenomenology of moral injury. We then examine the treatment strategies used in the PE approach and the mechanisms by which these techniques ameliorate perpetration-related guilt and shame. We also briefly highlight points of similarity and contrast between PE and adaptive disclosure , a brief cognitive behavioral intervention targeting combat-related moral injury and traumatic loss.

Depicting the fraught relationship between a gay man and his straight female best friend, Tom Ford's A Single Man (2009) offers a complex, and often contradictory, depiction of its leading female character, Charley. At once glamorous and troubled, stunning and damaged, Charley reproduces a number of problematic stereotypes regarding women, in general, and fag hags, in particular. At the center of these problems is the film's insinuation that Charley has a melancholic attachment to George, her gay male companion. At first glance, A Single Man reproduces Freudian constructs of melancholy as a pathological response to traumatic loss; this essay argues, however, that the film's many ambivalences also offer opportunities for critical consideration of melancholy as a tactical response to heteronormativity.

This qualitative study examined the experiences of 25 parents who were estranged from their adult children in later life. Most participants experienced estrangement as an unanticipated, unchosen, and chronic loss for which they felt ill prepared. Most described a traumatic loss, ambiguous because of its uncertainty and inconclusiveness, and disenfranchised by societal ideologies embedded in constructs of parenting and motherhood as essential, natural, and universal. Many participants said they were subjected to the social stigma associated with tainted or devalued parenthood. In many cases, the gendered stigma accompanying estrangement positioned the female participants precariously for social rejection.

The aim in this paper is to compare the answers on the Rorschach's inanimate motion (m) and blood content (Bl) between sexual abuse victims and non-victims. Among the protocols of 76 individuals between 10 and 14 years old, 29 were selected. Qualitative analysis showed that the victims presented: a) narratives with m responses, suggesting the presence of feelings of helplessness and powerlessness; b) replies with m or Bl associated with contents far more violent and destructive; c) images filled with morbid characteristics. The findings support evaluation practices, illustrate the traumatic effects of sexual abuse and ascertain the validity of Rorschach's test for the ideographic approach, derived from the responses' qualitative analysis, and also from the normothetic perspective derived from the structural summary.

Loss of a sibling in mid-adolescence profoundly interrupts the progressive movement along a developmental path. The impact of a sibling's suicide for a first-generation Asian-American adolescent will be examined with respect to identity formation, and how cultural values and beliefs influenced clinical process. The author contends that an integrative treatment model was necessary for the work of mourning and for facilitating progression from one stage of adolescence to the next. This framework blended a psychoanalytic/developmental approach with a neuropsychological/somatic understanding of the synergistic relationship between mind and body. The clinical process utilized co-construction of experience (Stolorow & Atwood, 1992) and a multiple self-states model of the mind (Bromberg, 1998).

Traumatic loss of a thumb results in notable functional impairment. Multiple reconstructive procedures have been described to address these deficits. Compared with no reconstruction, any procedure is of benefit. However, each of the described methods offers subtle benefits and downsides and may be more applicable in certain situations. We present a review of current reconstructive options for traumatic thumb amputation in 2016.

The Persistence of the Human explores literary and cinematic works dealing with personal identity and consciousness. Escobar examines works in which traumatic loss challenges identity and the question of “the human” arises concluding that narrative is essential for the self.

The Persistence of the Human explores literary and cinematic works dealing with personal identity and consciousness. Escobar examines works in which traumatic loss challenges identity and the question of “the human” arises concluding that narrative is essential for the self.

The Persistence of the Human explores literary and cinematic works dealing with personal identity and consciousness. Escobar examines works in which traumatic loss challenges identity and the question of “the human” arises concluding that narrative is essential for the self.

Medical examiner/coroner's (ME/C) offices investigate sudden, violent, and unexpected deaths, leaving those close to the deceased suffering traumatic loss with little in terms of support and counseling. We investigated a grief services program (GSP) at the New Mexico Office of the Medical Investigator (OMI) to better understand the needs of bereaved individuals, identify the services provided, and propose our findings as a model for others. A total of 1085 contacts occurred over 1 year, with the majority occurring at OMI (60.5%), followed by telephone (23.1%). Support was primarily provided to those suffering a loss due to homicide (28.8%) and suicide (26.1%). The roles grief counselors play in the setting of a GSP and ME/C office are multiple. Given the frequent utilization of OMI's GSP and diverse reasons for visits, it is apparent there is a need for GSPs at ME/C offices, particularly given the traumatic nature of deaths investigated by ME/Cs.

There is little evidence to guide the use of psychotropic medications immediately following bereavement. This article presents a review of the relevant literature, followed by a case series on the use of psychotropic medication in traumatically bereaved individuals. Of 20 active subjects, nine had been prescribed psychotropic medication in the days and weeks following a traumatic loss. The amount, type, and timing of medication in this sample is explored and compared to the extant literature. Results suggest that clinical practice may not be guided by empirical research in this area.

The anterior maxillary incisor is the most traumatized region in the mouth and trauma is frequent between the ages of 8-10. Traumatic loss of teeth, can lead to many complications in children. Thus, as possible to keep traumatic teeth, but if you need extractions There may be. Complications occur and early tooth loss is frequent. Complications of early loss of central incisors are esthetic compromise, loss of vertical and horizontal width, height, contour of alveolar bone, tilting of adjacent teeth, arch length loss. Alveolar bone loss may affect normal function and stability, and results in esthetic problem for future prosthesis restoration. The 9-year-old girl and 6-year-old boy got early loss of upper central incisor. The amount of alveolar bone resorption was measured using cone beam computed tomograph and cast analysis.

In Am Beispiel meines Bruders Uwe Timm blends the pain of traumatic loss at the familial level with history writing in a narrative that suggests that trauma is endemic to all the writings and family stories that he employs. In order to elucidate Timm's distinctive approach to history the essay combines Cathy Caruth's disputed trauma-as-history equation with the notion of involution as a manner of interpreting culture. In an investigation of the past on simultaneous familial and national levels Timm embeds an intimate scene of his father sobbing. This scene serves as a prime instance of trauma-as-history and an illustration of how Timm's narrative involutes history back into the trauma that is endemic to its writing in the first place. Timm's work synthesizes both traumatic and historical elements, creating a narrative formula that precludes the dissociating effects of what Erich Santner calls "narrative fetishism." His work leads instead to a narrative with an embedded elaborating quality that instills active reflection and differentiating perspectives in the reader. Where past events are viewed through the trauma that they cause, history is involuted thus creating a paradigmatic rather than syntagmatic form in its conflation of national, familial and (auto) biographical history.