Re-stor(y)ing Trauma Swartz, Ronnie
International Journal of Social Work Values and Ethics,
01/2022, Volume:
19, Issue:
1
Journal Article
Peer reviewed
Open access
Individualistic and disembodied trauma narratives that emerge effortlessly from dominant discourses like biochemistry and diagnostic nomenclature fail to address the effects of trauma in people’s ...lives. Trauma could also be understood as a challenge to personal narratives of living in the face of exceptional experiences that stand far outside what is known and familiar. This invites personal accounts of values, purposes, skills, and acts of resistance which offer more possibilities for addressing the negative effects of trauma than descriptions from the cultural canon.
Owing largely to the pioneering spirit of Sigmund Freud, social work's understanding of human behavior and development has supported individualist discourses that essentialize the self. ...Socio-cultural discourses present alternatives that strengthen the intentions of many social workers when they invoke the concept of human behavior in the social environment. In particular, Lev Vygotsky, Barbara Myerhoff, Jerome Bruner, and Ken Gergen offer compelling and salient accounts for genuinely regarding human behavior as embedded, even constituted by, social environments.
As a profession that places values and ethics squarely in the center of its mission, social work must struggle with the criticisms and suggestions emerging in the last few decades under the inelegant ...moniker of postmodernism. This article unpacks taken-for-granted ideas about the development and performance of values and offers a framework for thinking about and enacting social work grounded in a postmodern values orientation. Adapted from the source document.
This paper describes a three-campus collaborative, distributed learning program that delivers social work education to remote rural and desert communities in California via distance learning ...modalities. This "Pathway Program" provides accredited social work education for a career ladder beginning with advising and developing an academic plan and leading to BSW and MSW degrees. The paper offers assessment data on the Pathway Program and also suggests the potential for major changes in social work education. Questions about the nature of the university, the role of the faculty member, and the future of social work students in the twenty-first century are discussed.
Abstract Objectives Neonates with congenital heart disease are at risk for impaired neurodevelopment after cardiac surgery. We hypothesized that intraoperative EEG activity may provide insight into ...future neurodevelopmental outcomes. Methods Neonates requiring surgery had continuous intraoperative EEG and hemodynamic monitoring. The level of EEG suppression was classified as either: slow and continuous; moderate burst suppression; severe burst suppression; or isoelectric (no brain activity for >3 minutes). Follow-up neurodevelopmental outcomes were assessed using the Vineland Adaptive Behavior Scale II (Vineland-II). Results Twenty-one neonates requiring cardiac surgery developed a slow and continuous EEG pattern after general anesthesia. Ten neonates (48%) maintained continuous brain electrical activity with moderate burst suppression as the maximum level of EEG suppression. Eleven neonates (52%) developed severe burst suppression that progressed into an isoelectric state during the deep hypothermic period required for circulatory arrest. However, the duration of this state was significantly longer than circulatory arrest times (111.1 ± 50 vs 22.3 ± 17 minutes; P < .001). At a mean follow-up at 5.6 ± 1.0 years, compared with neonates with continuous brain electrical activity, neonates who developed an isoelectric state had lower Vineland-II scores in communication. There was an inverse relationship between composite Vineland-II scores and duration of isoelectric activity (R = −0.75, P = .01). Of neonates who experienced an isoelectric state, durations of >90 minutes were associated with the lowest Vineland-II scores (125.0 ± 2.6 vs 81.1 ± 12.7; P < .01). Conclusions The duration of cortical isoelectric states seems related to neurodevelopmental outcomes. Strategies using continuous EEG monitoring to minimize isoelectric states may be useful during complex congenital heart surgery.
Abstract Background During the surgical repair of infants with congenital cardiac defects, there can be periods of decreased cerebral blood flow, particularly during deep hypothermic circulatory ...arrest. As a result, these infants are at increased risk for seizures and long-term neurodevelopmental difficulties. Methods Thirty-two infants with congenital heart disease had continuous video-electroencephalographic (EEG) monitoring pre-, intra-, and postoperatively for 48 hours after surgery. Results For patients requiring deep hypothermic circulatory arrest (n = 17) the EEG pattern for all patients became suppressed and eventually isoelectric below 25°C. Two of the 32 infants had electrical seizures within the 48-hour monitoring period. Both required deep hypothermic circulatory arrest, and the burst pattern during recovery had rhythmic, sharp components that were high amplitude and often asynchronous between the hemispheres. The interval between the onset of seizure activity and initiation of the sharp burst pattern during surgery was 29 and 40 hours. This pattern was not observed during isoelectric recovery from infants who did not develop postoperative seizures. Conclusions The EEG in infants during deep hypothermic circulatory arrest displayed predictable changes. We identified an electroencephalographic pattern following the isoelectric period that may predict seizure development in the subsequent 48 hours.
The problem of violence against individuals with severe mental illness (SMI) has received relatively little notice, despite several studies suggesting an exceptionally high prevalence of ...victimization in this population. This paper describes the results of an investigation of the prevalence and correlates of past year physical and sexual assault among a large sample of women and men with SMI drawn from inpatient and outpatient settings across 4 states. Results confirmed preliminary findings of a high prevalence of victimization in this population (with sexual abuse more prevalent for women and physical abuse more prevalent for men), and indicated the existence of a range of correlates of recent victimization, including demographic factors and living circumstances, history of childhood abuse, and psychiatric illness severity and substance abuse. The research and clinical implications of these findings are discussed.
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