Historicizing historical trauma theory: troubling the trans-generational transmission paradigm.

The premise that "trauma" is transmitted across generations is central to the historical trauma discourse currently circulating in indigenous communities and professional networks in Canada. Historical trauma may be understood as the offspring of two older and apparently antithetical discourses: Native healing, and colonial professional critiques of indigenous family life. While the former has maintained a therapeutic focus on restoring intergenerational social relations, the latter has pathologized indigenous parenting and child-rearing practices. The emergence of historical trauma marks a global shift in the moral economy by which victimhood status, acquired through individual experiences of physical and especially sexual abuse, has come to wield greater currency than collective struggles against colonialism. Providers of contemporary indigenous healing programmes are drawing simultaneously on trauma discourse, which is seen to legitimate individual social suffering, and older therapeutic forms centred on sharing local social histories to restore intergenerational continuities and collective identity. But these invocations of historical trauma may continue the colonial discourse of mental health and social welfare professionals, who blamed indigenous parenting practices for children's social problems and failure to assimilate. Some contemporary mental health and child development professionals have invoked parents' and grandparents' transmission of historical trauma in ways which construct indigenous families as pathological, promote an oversimplified, universalizing understanding of Canadian colonialism, and divert attention from the contemporary continuation of colonial structures and relations.

A comparison of thyroxine- and polyamine-mediated enhancement of rat facial nerve regeneration.

Thyroid hormones and spermidine, a motor neuron trophic polyamine (PA), have been shown to enhance peripheral motor nerve regeneration; however, the mechanism by which these treatment modalities exert their effect is unknown. Similarities in treatment outcome suggest that these molecules may be working via a common mechanism. Such an explanation is plausible since thyroid hormone is a potent inducer of ornithine decarboxylase (ODC), which is the rate-limiting enzyme involved in polyamine synthesis. This study was designed to morphologically evaluate the effects of exogenous thyroxine and spermidine on the regeneration of the rat facial nerve. Myelinated fiber density, axonal size, and degree of myelination were assayed by light and electron microscopy 21 days following facial nerve crush. Strikingly, the two treatment modalities had identical effects on all parameters tested. Each significantly enhanced the density of myelinated axons in regenerating nerves relative to the vehicle control. In addition, relative to the control treatment, both thyroxine and spermidine significantly increased the cross-sectional area of regenerating axons (P < 0.05). Interestingly, neither of the drug treatments had any effect on remyelination at the position where this parameter was analyzed. The concurrent administration of both thyroxine and spermidine did not synergistically enhance motor neuron regeneration. These data support the hypothesis that thyroxine and spermidine enhance neural regeneration by a common mechanism.

The findings of a London wide needs assessment for sickle cell dis orders

The size of the population in London with Sickle cell disorders has increased markedly in the past 20 years and it is now one of the commonest reasons for admission of children to hospital in inner London. This paper presents the findings of a London Wide Needs assessment for sickle cell disorders.It reviews Health and Local Authorities response to the needs of their populations in terms of the development of strategy and services. It also considers reasons for the failures to develop appropriate services[AU]

A Comprehensive approach to needs assessment of sickle cell services: The value of seeking service users' views

The recent `Fair Shares for London' study used multiple methods to carry out a needs assessment of services for sickle cell disorders in Greater London. This paper reported on one of these, a series of focus group discussions with users of services for sickle cell disorders. The aims of the focus groups were as follows: 1. To investigate and record service users' experiences, perceptions and opinions about current service provision for people with sickle cell disorders. 2. To structure the discussions so as to cover the same range of services investigated by the questionnaire surveys. Three focus groups, each consisting of 6-8 people, were conducted at different locations in London. The results of the focus groups reflect those of the questionnaire survey, indicating that service users recognise some recent improvements in service delivery, but that many aspects of services for sickle cell disorders in Greater London remain inadequate. Improvements most often mentioned included ambulance services and some aspects of acute care. Significant problems persist in the delivery of community services and education, housing and social services. Some examples of good practice in primary care were highlighted. However the majority of participants made little or no use of GP services due to previous negative experiences. The Fair Shares for London study shows how the use of qualitative methods in needs assessment can enhance and validate results. The focus group discussions made an important contribution to the overall findings, complementing and elucidating the results of the questionnaire survey of purchasers and providers, as well as identifying areas for further research.(AU)