Trauma - Science topic

the process is called epigenetics-it doesnt change the DNA sequence-but effects how a protein may get expressed

Clinical tools and assessments can measure patients' criminality or risk of criminal behaviour. Forensic psychology and psychiatry use these tools to address legal issues and mental health-law issues. The Psychopathy Checklist-Revised (PCL-R) is used to diagnose psychopathy and antisocial personality disorder. This tool evaluates impulsivity, deceitfulness, and criminal history to determine a person's future criminal risk. The Violence Risk Appraisal Guide (VRAG) is another clinical tool that assesses violent behaviour risk. This tool evaluates age, substance abuse history, and criminal history to predict future violent behaviour. These assessment tools are not foolproof and should be used with other clinical assessments and observations. These tools should be used with ethical and legal safeguards to avoid unfairly stigmatising or discriminating against patients based on assessment scores.

I have developed my own trauma theory called The Steel Jacket: Antecedents of Trauma. Where my theory and her theory dovetail is the notion that one cannot totally subsume the trauma because there was no a priori knowledge that something so overwhelming was about to happen. Though bones may be broken, Caruth suggests the trauma is an affront to the mind. What my theory tries to resolve is the question of intuition. Can people somehow become so highly aware and attuned that they develop a critical insight that allows them to avert the unspeakable. For example, "just knowing" that they should delay going to the grocery store to avoid a horrific crash. My theory also explores time and timeline as an artificial construct.

Mindfulness & meditation play an very important action for every human being .However this depends on every individual way of their thinking passage of their mind & also covering the way of the development in their individual passage of the action .

At the outset a feeling of trauma healing remains a nature of the personal environment of the family joining with the upbringing & development of individual sufferers .

It is in this light a power of prayer silent mediation without disturbance of mind ,firm faith of individual within & development of individual with their power & meditation receiving the grace of divine master play an very important part for the living passage of the sufferers .

This is my personal opinion

Hello Noah,

1. I authored an article in 2016 (attached) on the Rewind Technique to help veterans who suffered war trauma integrate trauma into their lives. There is likely more information since 2016.

2. Another technique for addressing trauma is visualization including mental exercises that snip at the amygdala.

3. There has also been results with hypnosis, although this would need to be done in a therapeutic setting with a skilled practitioner in this area.

4. In my nursing care of trauma patients, I have found that patients find some level of "peace" after integrating their experience into their present reality. There are also expressions of gratitude as the trauma provided some type of lesson, for which they have carried forward into "wisdom."

Considerations

Singularity

research in trauma recovery treatments that address factoring in the need for cultural considerations. Include citations and bibliography

Introduction:

Trauma is a pervasive and global phenomenon that affects individuals across cultures. Trauma recovery treatments have been developed to address the effects of trauma, but often overlook the importance of cultural considerations. Cultural considerations include cultural values, beliefs, and practices that are unique to individuals and groups. This paper aims to provide an overview of research in trauma recovery treatments that address the need for cultural considerations.

Trauma Recovery Treatments:

Culturally Adapted Cognitive Processing Therapy (CA-CPT):

Cognitive Processing Therapy (CPT) is an evidence-based treatment for trauma-related symptoms. Culturally Adapted Cognitive Processing Therapy (CA-CPT) is a modified version of CPT that incorporates cultural considerations. Studies have shown that CA-CPT is effective in reducing PTSD symptoms in individuals from diverse cultural backgrounds (e.g., Hispanic, Native American) (Resick et al., 2017).

Trauma-Focused Cognitive Behavioral Therapy (TF-CBT):

Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) is another evidence-based treatment for trauma-related symptoms. The treatment is designed for children and adolescents who have experienced trauma. Cultural adaptations have been made to TF-CBT to ensure that it is culturally sensitive. Studies have shown that culturally adapted TF-CBT is effective in reducing PTSD symptoms in children from diverse cultural backgrounds (e.g., African American, Hispanic) (Cohen et al., 2015).

Narrative Exposure Therapy (NET):

Narrative Exposure Therapy (NET) is a treatment that is designed to address the effects of trauma in refugees and other populations who have experienced prolonged and repeated trauma. The treatment involves the use of narratives to help individuals process their trauma. Cultural adaptations have been made to NET to ensure that it is culturally sensitive. Studies have shown that culturally adapted NET is effective in reducing PTSD symptoms in refugees from diverse cultural backgrounds (e.g., Kurdish, Bosnian) (Schnyder et al., 2015).

Conclusion:

Cultural considerations are important in the development and implementation of trauma recovery treatments. The above treatments are examples of evidence-based treatments that have been modified to incorporate cultural considerations. It is important for mental health professionals to be aware of cultural considerations when working with individuals from diverse cultural backgrounds.

Bibliography:

Cohen, J. A., Mannarino, A. P., & Deblinger, E. (2015). Trauma-focused CBT for children and adolescents: An empirical update. Journal of Interpersonal Violence, 30(12), 1837-1855.

Resick, P. A., Nishith, P., Weaver, T. L., Astin, M. C., & Feuer, C. A. (2017). A comparison of cognitive-processing therapy with prolonged exposure and a waiting condition for the treatment of chronic posttraumatic stress disorder in female rape victims. Journal of Consulting and Clinical Psychology, 75(4), 634-645.

Schnyder, U., Müller, J., Morina, N., Schick, M., & Bryant, R. A. (2015). A randomized controlled trial of narrative exposure therapy for refugees with PTSD in Germany. Journal of Consulting and Clinical Psychology, 83(5), 952-965.

Here is what I can find I hope it helps.

Yes this is correct

En la pedagogía negra se incluyen, todas las injusticias y acciones negativas que en toda escuela tiene hacia los niños. Haciendo uso de la dureza y exigencia para educar, sin saber que la educación es el más sublime trabajo de los docentes o maestros y maestras. En la mayoría de las situaciones, se produce un trauma en el niño, que le bloquea el cerebro e impide dar continuidad a su escolaridad o tiene deficiencias por que tiene presente los traumas y tratos que se les da en el lugar que consideran un refugio de distracción, convivencia y aprendizaje. Sin lograrlo por los problemas que llevan de casa o que encuentran en la escuela.

1. Raphael and Wooding (2004) discuss traumatic bereavement.

Raphael, B. & Wooding, S. (2004). Early mental health interventions for traumatic loss in adults. In Early Intervention for Trauma and Traumatic Loss, ed. B.T. Litz, pp.147-178. New York: Guilford Press.

2. Prigerson and Jacobs (2001) have suggested a concept of traumatic grief

Prigerson, H. O., & Jacobs, S. C. (2001). Traumatic grief as a distinct disorder: A rationale, consensus criteria, and a preliminary empirical test. In M. S. Stroebe, R. O. Hansson, W. Stroebe, & H. Schut (Eds.), Handbook of bereavement research: Consequences, coping, and care (pp. 613–645). American Psychological Association.

I have seen variations on the ACEs scale that include race, for the purpose of measuring the adversity of growing up black in the United States. When I get a chance later I'll look for them.

However, and this might be of interest to you, I'm working on a set of results where a school district in Chicago used the traditional ACEs measure along with demographics for all freshman high school students at 3 urban high schools (a highly diverse sample). Just last weekend I ran a moderated mediation using black ethnicity and ACEs as moderators, while the mediators were internalization, inattention, and personal adjustment as mediators (all are subscales of the BASC-3 SRP), and school problems as the outcome (or Y) variable. Black ethnicity had no interaction effect with ACEs. This isn't to say that there's no contributory factor, but the lack of an interaction effect suggests there is no extra impact other than an additive effect from the "main effects" (main effects are not the correct phrase in moderation models, but I'm not sure how else tp briefly express the idea). I'll be presenting this at a conference in April and then putting out a paper on it.

For this, you can try this free software called- G power.

Software- https://download.cnet.com/G-Power/3000-2054_4-10647044.html

Link to a video on how to use it- https://www.youtube.com/watch?v=2ZZxFD5JaCY

All the best!

If you are thinking of CSA, , may be useful for the reliability of memories. Kamala London

I don't think it makes sense to combine anxious and avoidant attachment scores into a single variable. These are separate dimensions so it would be best to keep them as separate variables. It doesn't really complicate the analysis of interactions too much. Combining two separate dimensions into one would likely cause you a lot more trouble with the interpretation of the results.

Very useful! Thank you!

Mindset means improve my skills with effort and practice. So, I have to think positively, that is to say, you have to say to yourself "I can do it".

Best wishes

Thank you so very much. I am sharing everything with my dissertation chair as I go along. I wanted to get some valuable thoughts too. I absolutely agree that trauma comes in so many forms and each reacts differently. Thank you, Stephen and Beatrice, for sharing.

Hi Sara,

The International Trauma Questionnaire is a measure of PTSD and Complex PTSD as per the ICD-11 description of the disorders. It was developed recently and the main validation study was published in 2018 and it has been cited over 350 times since then. I'm not aware of any other measure that is aligned to the ICD-11 diagnostic criteria. There has been a recently published systematic review on psychometric studies that have used the ITQ by Redican and colleagues.

It's my understanding that if you want a measure of PTSD and CPTSD then the ITQ is the only game in town.

Disclaimer - I was involved in the development of the ITQ.

Best wishes

Mark

Redican, E., Nolan, E., Hyland, P., Cloitre, M., McBride, O., Karatzias, T., ... & Shevlin, M. (2021). A systematic literature review of factor analytic and mixture models of ICD-11 PTSD and CPTSD using the International Trauma Questionnaire. Journal of anxiety disorders, 79, 102381.

Cloitre, M., Shevlin M., Brewin, C.R., Bisson, J.I., Roberts, N.P., Maercker, A., Karatzias, T., Hyland, P. (2018). The International Trauma Questionnaire: Development of a self-report measure of ICD-11 PTSD and Complex PTSD. Acta Psychiatrica Scandinavica. DOI: 10.1111/acps.12956

I don't think it affects children because they have stronger immunity than adults

The Maunder et al one is the one I am aware of.

Another relevant one is https://pubmed.ncbi.nlm.nih.gov/11346674/

CTQ-SF was derived from the Childhood Trauma Questionnaire, a 70-item, Likert scale questionnaire that measures five subsets: emotional abuse, physical abuse, sexual abuse, emotional neglect, and physical neglect.

An interesting paper to read

HEIIO. MY DEAR. IAM NOT SPSS

Although there is robust evidence for the effectiveness of EMDR as a treatment for PTSD, to dogmatically state that (1) it is the least invasive treatment for patient and therapist, and (2) should be first choice, seems (intensionally?) provocative, even insensitive and unscientific, reminiscent of the days when ECT was the first choice of psychiatric treatment. Would it not be better to argue for the prior establishment of a beneficial therapeutic relationship, as well as careful, insightful, clinical evaluation in terms of inclusion and exclusion criteria for EMDR, such as the availability of a therapeutic milieu, to minimize the likelihood of intense emotional reprocessing and seizures, before starting EMDR with persons with PTSD?

Dear Patrick, how will you handle the problem of honesty? - Some refugees do not tell the truth about their motives to migrate. Sometimes they even hide their nationality and pretend a certain kind of persecution.

Bruising in common in the elderly even in those without significant trauma due to skin thinning and fragility secondary to decreased elasticity and resilience as we age. Patients on anticoagulants are even more susceptible. Other causes include low platelet counts, abnormally high PT and/or PTT due to other causes. Bruising should be investigated if the elderly patient has bleeding gums, blood in stool/urine, or bruising in uncommon locations. Hope this helped.

Childhood trauma questionnaire : a retrospective self-report : manual

Author:David P Bernstein; Laura Fink Publisher:Orlando : Psychological Corporation, 1998.

Ask this from your library

-and IV-

In any case, it is highly advisable to enter and see it carefully on this web page, which collects the main points of the WHO in this regard:

[https://www.who.int/mediacentre/news/releases/2013/trauma_mental_health_20130806/es/

OF COURSE YES !!: In fact, the DSM -and the current DSM-5- catalog it as such; but the WHO International Classification of Diseases (ICD), currently the "11", TOO.

It could, however, Human rights violations and traumatic events often comingle in victims’ experiences; however, the human rights framework and trauma theory are rarely deployed together to illuminate such experiences.

In self-defense or of innocent and defenseless third parties or in similar circumstances; In this regard, he suggests that the Nobel Prize winner K. Lorenz be read "Aggression that so-called evil."

I find it quite interesting how experiences with rejection at such a young age can be associated with personality disorder development. Enjoy your research!

Hi! Don't forget to evaluate their Shock Index (HR/SBP). If greater than approx. 0.7, that is one indication for the need for massive transfusion. We can also look at whether or not the shock is Pressor-dependent. If it requires pressors, that is another worrying sign. When looking at the labs, if the Hgb is *normal* with the heavy bleeding, that is a sign of a very active bleed where the H&H has not yet caught up to display the downward spiral. Activate your Massive Transfusion protocol and also consider Cyroprecipitate, IV Calcium, and warming blankets. Often forgotten. IV TXA is also a good plan.

We did not see an increase in patients with complicated appendicitis and COVID-19 infection, but the topic is interesting... and it probably depends on the approaches in the treatment of acute appendicitis and the situation with COVID-19 infection. I would like to know the situation in countries with acute appendicitis in the conditions of COVID-19 infection

Thanks to you and equally

The analysis of the poems (al-Fusha and others) sung by Fayrouz will reveal many of these formulations, because they are collected between groups in the Arab country that suffers from sectarian differences the most. Thus art reveals this through songs, revolution poems, cinema, and sometimes novel

As Stephen suggested a mixed ANOVA may be a good way to proceed. I'm not sure if SPSS is indeed a tool of the devil, it has certainly caused a great deal of distress and tears to many students over the years so it has 'form', but if you want to avoid any interference from the Prince of Darkness you could always try JASP. JASP is free, looks and feels a bit like SPSS but produces APA ready tables and plots. I also hear that it is the statistical programme of choice in Hades, so it's safe.

Mark

A good coverage of PALLIATIVE CARE is enough (including in it "Sedation", even irreversible -or "passive euthanasia") as it alleviates and eliminates psychological and physical suffering ("total suffering"), since the serious thing is not that the patient dies (we all have to die and doing so is an atavistic and universal custom of the human being: everything that lives, sooner or later dies), if not that he dies suffering and, I reiterate, for this are the aforementioned PALLIATIVE CARE - with biomedical, psychosocial and spiritual intervention, as mandated by the WHO -... but, of course, ACTIVE EUTHANASIA is MORE COMFORTABLE AND CHEAPER, WITHOUT ANY MORE.

Hi Marie-Ève Grisé Bolduc. The following may be helpful:

Here are some articles to get you started:

Comas-Díaz, L., Hall, G. N., & Neville, H. A. (2019). Racial trauma: Theory, research, and healing: Introduction to the special issue. American Psychologist, 74(1), 1–5. https://doi.org/10.1037/amp0000442

Anderson, R. E., & Stevenson, H. C. (2019). RECASTing racial stress and trauma: Theorizing the healing potential of racial socialization in families. American Psychologist, 74(1), 63–75. https://doi.org/10.1037/amp0000392

Gone, J. P., Hartmann, W. E., Pomerville, A., Wendt, D. C., Klem, S. H., & Burrage, R. L. (2019). The impact of historical trauma on health outcomes for indigenous populations in the USA and Canada: A systematic review. American Psychologist, 74(1), 20–35. https://doi.org/10.1037/amp0000338

Mitchell, T., Arseneau, C., & Thomas, D. (2019). Colonial Trauma: Complex, continuous, collective, cumulative and compounding effects on the health of Indigenous peoples in Canada and beyond. International Journal of Indigenous Health, 14(2), 74 - 94. https://doi.org/10.32799/ijih.v14i2.32251

Hi Silas

1. Can you run a multiple regression with multiple, unrelated categorical variables?

Yes, I can't see a problem with this.

2. How would those results be interpreted?

The regression coefficients tells you the difference between the means of each binary variable while controlling for the other variables in the model.

3. Would a three-way ANOVA (2x2x2) be a better design?

It depends - if all you are interested in is main effects then the regression approach is fine. If you are interested in potential interactions among your IV's then the ANOVA approach would take out some of the leg work involved in creating and testing the interactions in a regression model. It'll also produce nice plots.

If you do the regression models in mplus or other SEM software you get the benefit of using ML estimation - robust estimation and efficient handling of missing data (and other fancy things such as testing constraints if you want to).

Mark

Yes, the whole and total politization of the virus produces paranoia. It kills the economy, not the virus and comes with a high psychological cost, concerning the cohesion of human societies. We can only communicate with biological complexity (e.g. by altering our life-style), but never control it. The global synchronization of (many inefficient) 'medical' measures adds to the mass paranoia, and one asks rightly: Who is 'creating' all this irrationality??? Is ist really possible to catch a mosquito with a fishing net?

The neurotransmitters maybe negatively affected.

Hi Ann,

This is something I'm just starting to research in my PhD studies. Here are a couple of articles to get you started.

I'm sure if I understand your question, but perhaps my book will help you: Traumatic Experiences of Normal Development.

Hi David - not sure if this is along the sort of lines you are looking for?In my research the keywords of childhood trauma and functional impact/disability throws up quite few results of longitudonal studies. The American Psych Assoc. and Pearson mention a few online, too.

In the oral surgery clinic, Naval hospital dr Ramelan Surabaya Indonesia , we manage some cases of maxillofacial tumour such as ameloblastoma,hemangioma, odontoma and the most are epulis

Hello

check these website

This is the link to RCR guidelines

https://www.rcr.ac.uk/sites/default/files/docs/radiology/pdf/BFCR(11)3_trauma.pdf

This one popped up in my feed lately. Kashdan has been focusing on psych flex for a while now. https://www.toddkashdan.com/measures/

Interesting topics.

Thank you, Wilma, will have a look at it! Best, Christof

Hans-Ulrich Iselin

Thank you for your insightful comment. I have read Cassiers et al (2018) as well as 3 other insightful articles: 1) Nemeroff CB.(2016). Paradise Lost: The Neurobiological and Clinical Consequences of Child Abuse and Neglect. In Neuron; 2) Aas M et al. (2019) Childhood maltreatment and polygenic risk in bipolar disorders. In Bipolar Disorders; and 3) Stevelink et al. (2019) Childhood abuse and white matter integrity in bipolar disorder patients and healthy controls. In European Neuropsychopharmacology.

I am interested in causation and the interplay of genetics and childhood trauma as I am trying to write a book on childhood trauma and how the different types of trauma at different times explains the behaviors of survivors, the mental health challenges caused by childhood trauma and toxic stress, and how people can "overcome" (I hate this word but can't think of another) trauma. My story of childhood trauma, developing several mental illnesses including bipolar disorder, and how I was able to get a PhD and have a successful career while growing and healing is being used as the backdrop to tell the scientific story to a lay audience.

This is an interesting question. I think, if driver's facial micro expressions while driving is tracked using facial recognition software, parallel video monitoring of traffic, along with driver's background (in regards to PTSD, like previous encounters, accidents, etc), vehicle condition, health, weather, could be incorporated into an model. Then it can give you the revelation you are looking for. I am just placing it in a simple manner, however, this entire process involves lot of experiments, tweaking and patience.

Approx 20 ml per kg crystalloid bolus followed by blood/blood products....

Natascha, this is an important topic worth investigating as it seems to be happening more often than anticipated and desired. You may find the following works of interest to pursue further:

Lindgren, S. (2012). Collective coping through networked narratives: YouTube responses to the Virginia Tech shooting. In School shootings: Mediatized violence in a global age. Emerald Group Publishing Limited.

Jordan, K. (2003). A trauma and recovery model for victims and their families after a catastrophic school shooting: Focusing on behavioral, cognitive, and psychological effects and needs. Brief Treatment & Crisis Intervention, 3(4).

Turunen, T., & Punamäki, R. L. (2014). Psychosocial support for trauma-affected students after school shootings in Finland. Violence and victims, 29(3), 476-491.

Hi! Could you also send me the cut-offs for the English version? Thanks!

The questionnaire can be translated paragraph by paragraph on the https://www.bing.com/translator

Dear Josefina Orozco , individuals who have committed child sexual abuse and individuals with pedophilia are not the same. There is a difference. Therefore, the answer to your question depends on who you refer it to specifically.

There may be something in this book:

Jones, A., Jemmott, E. T., Da Breo, H., & Maharaj, P. E. (2016). Treating Child Sexual Abuse in Family, Group and Clinical Settings. Palgrave Macmillan.

You can search for meaningful words; I searched for sand and art and found relevancies although the search for dreams indicated pages that were not free to view:

I saw this dissertation, although dreams are not really discussed:

Maharjan, C. L. (2019). Sandplay Therapy for Children with Trauma Living in a Residential Facility in Nepal: A Multiple Case Study (Doctoral dissertation, California Institute of Integral Studies).

This link mentions sandplay and dreams:

Kowen, M. (2017). A 10-Year-Old Girl’s Overcoming the Negative Mother Complex and Its Relationship to Ego Development. Journal of Symbols & Sandplay Therapy, 8(1), 1-34.

but references a very old document:

Jung, C. G. (1984).

Archetyp und Unbewustes. Princeton: Bollingen/Princeton University Press.

Detained info seen above. I would add simply that peripheral vasoconstriction occurs during trauma when blood is shunted towards the key organs. Also of note when measuring blood pressure keep in mind that in order to externally compress an artery all the surrounding soft tissue needs to be compressed too and hence readings from the thigh can be difficult to interpret.

Dear Hilary, you might also find these articles interesting:

Best regards,

Anke

Hi Frances,

The journals Child Maltreatment and Child Abuse & Neglect would be good to look at. You can go to their websites and just start to look at abstracts of their recent issues to get an idea of what is currently being published. The journal Trauma, Violence, & Abuse would also be great to look at. It is a review journal that has a high impact factor (very influential in the field) so everything published reviews the literature in the field and you can get ideas of specific articles to read from there. Though, it isn't specific to child trauma, you can get a sense from the titles if they are focused on children.

The National Child Traumatic Stress Network website would also be great. They have compiled a ton of resources and materials that are easy to digest, have fact sheets, and also host free webinars.

Finally, though you did not ask about it, since you are at Hamline, the University of Minnesota Institute of Child Development (where I received my PhD) has some very key faculty in the field who study child trauma, including my graduate advisor, Dante Cicchetti, and his colleague, Ann Masten. Abi Gewirtz and Canan Karatekin (my secondary advisor) would also be good to look at and you could even reach out to them to try to volunteer in their research labs during the summer/semester. Just go to the icd.umn.edu website and click on "People" to view their faculty profiles to learn more about what they do.

Hope this helps! Good luck.

I have published a more recent book, Through a Trauma Lens: Transforming Health & Behavioral Health Systems, that might be helpful for you. Routledge published it in 2018. Vivian Barnett Brown, Ph.D.

Through my views and from what I,have witnessed it is a fact. This occurs when partners are fighting or going through a breakup,separation or divorce.

It is obvious that such a situation causes a lot of stress. https://www.theguardian.com/world/2019/aug/08/kashmir-communications-blackout-is-draconian-says-un-envoy

Do not know if this is of help to you. Check it out:

Thanks for your very important and interesting questions. These articles may interest you:

I don't think it's obsolete. The main problem is to build the corpus. I would say rather scanning individul tweets one can follow a set of subject dependent tweeter handles and collect tweets from there.

Healing the Father Wound by Kathy Rodriguez may help you with your topic.

Thank you

Rebecca,

You nailed it! And w/o clinical attention attachment conflicts will endure, just as our personality does. Also refer to the works of Abraham Maslow and hierarchy of needs as well as Erik Erickson re" critical psychosocial developmental tasks.

Rich

Desmopressin has no significant hemostatic effect in connection with

trauma and massive bleeding but can be useful if there is a simultaneous

platelet function defect or in certain forms of VWD. Desmopressin is often

combined with tranexamic acid.

For dosage and special considerations for treatment

Definitions are sort of critical. If the issue is a traumatic injury (falling and breaking a leg) vs a non-traumatic injury (a so-called 'overuse' injury), then clearly mechanisms are different. Or are you referring to the size/scope/degree of the injury (sprain/strain vs rupture)? Tendons vs muscle vs bone?

Stress fractures seem to be a combination of exercise Hx, bone status, smoking Hx, exercise progression/volume/rest cycles, and nutrition. Kleges et al found BB players lost 1 gram of calcium/day in sweat while not consuming dairy, so their bone status was poor. The 2006 IOM report highlighted the RDA/DRI are not normed on athletes. Lappe et al gave Navy recruits extra calcium & D and reduced stress fractures by 20% (sadly they didn't dose to serum level). Lappe et al found 20% of women arriving in Army had osteopenia/osteoporosis. Rivero (Navy) found 60-80% of stress fracture cases had osteopenia/osteoporosis. Cropper et al found roughly 25% of women and 8.9% of men arrived at AF with iron anemia (treating it reduced injuries by 50%). Hewitt et al did brilliant work on muscle imbalances and ACL injury.

Realizing the general population has a 60% processed food diet while food nutrient content has significantly declined (USDA).

So, obviously data is very lumpy. It does highlight that a mechanistic model doesn't completely address all causes.... which might explain the very high re-injury rates. Many folks simply treat injuries mechanically.

But I'm not sure I'm answering your question. Cheers.