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Trauma Care, Volume 3, Issue 2 (June 2023) – 5 articles

Cover Story (view full-size image): Up to 25% of children who are admitted to pediatric ICUs (PICUs) will develop PTSD that persists for at least 6 months post discharge. Although few medically related risk factors have been identified, aspects of medical treatment can interfere with children’s cognitive processing and memory of admission, which may increase their risk of distress.  This study aimed to identify predictors of PTSD symptoms in PICU patients aged 6–16 at a time point of 6 months post discharge, with a particular focus on cognitive processing and memory. Being administered ketamine in a PICU was the only medical risk factor. Peri-trauma affect (fear, panic, and sadness), cognitive processing (confusion, delusions), and trauma memory significantly predicted distress. Peri-trauma affect influenced PTSD symptoms only via disrupted cognitive processing. The implications of clinical intervention are discussed. View this paper
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15 pages, 606 KiB  
Article
“I Am Never Enough”: Factors Contributing to Secondary Traumatic Stress and Burnout among Black Student Services Professionals in Higher Education
by Portia Jackson Preston, Gregory Chris Brown, Tiffani Garnett, Delia Sanchez, Esther Fagbamila and Natalie Graham
Trauma Care 2023, 3(2), 93-107; https://doi.org/10.3390/traumacare3020010 - 17 Jun 2023
Viewed by 2172
Abstract
Black higher education professionals are more likely to be under-represented and experience racial discrimination and to be approached by students with whom they share identity characteristics for support, compared to white counterparts. This study explored experiences of stress potentially leading to secondary traumatic [...] Read more.
Black higher education professionals are more likely to be under-represented and experience racial discrimination and to be approached by students with whom they share identity characteristics for support, compared to white counterparts. This study explored experiences of stress potentially leading to secondary traumatic stress or burnout and coping efforts in Black-identifying staff (n = 35), who were a subset of a larger sample (n = 559) representing twenty-two U.S. regional universities. Compared to the larger sample, Black respondents were more likely to be in their roles for three years or less, potentially indicating higher rates of turnover. The Sort and Sift, Think and Shift Method was used to conduct a qualitative analysis of participant responses to open-ended questions regarding role-related stressors, efforts to cope, and desired institutional resources. Many staff reported role challenges consistent with experiences of secondary traumatic stress and burnout, which they coped with by engaging in a range of mindful self-care practices (e.g., sustaining supportive relationships, finding meaning in their work, promoting their physical health, setting boundaries). Participants highlighted the urgency of the need for change to institutional infrastructure, policies, and practices to support manageable workloads and treat staff with respect. It is critical for institutions to take an active and intentional role in mitigating stressors that contribute to secondary traumatic stress or burnout by addressing racial battle fatigue, providing adequate resources to meet the needs of under-represented students, protecting the capacity of staff to utilize wellness resources on campus, enhancing role clarity and autonomy, and fostering a sense of cultural pride, respect, and accomplishment, as well as other mechanisms, to create a culture that promotes and sustains the wellbeing of Black staff. Full article
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11 pages, 421 KiB  
Article
Cognitive Predictors of Posttraumatic Stress in Children 6 Months after Paediatric Intensive Care Unit Admission
by Belinda L. Dow, Justin A. Kenardy, Robyne M. Le Brocque and Debbie A. Long
Trauma Care 2023, 3(2), 82-92; https://doi.org/10.3390/traumacare3020009 - 24 May 2023
Viewed by 1413
Abstract
This study aimed to identify predictors, especially cognitive predictors, of posttraumatic stress symptoms (PTSS) and posttraumatic stress disorder (PTSD) in children 6 months after Paediatric Intensive Care Unit (PICU) admission. Participants were 55 children aged 6–16, admitted to PICU for at least 8 [...] Read more.
This study aimed to identify predictors, especially cognitive predictors, of posttraumatic stress symptoms (PTSS) and posttraumatic stress disorder (PTSD) in children 6 months after Paediatric Intensive Care Unit (PICU) admission. Participants were 55 children aged 6–16, admitted to PICU for at least 8 h. Medical data were collected from patient charts. Cognitive variables (peri-trauma affect, cognitive processing and trauma memory) were assessed by interview and self-report questionnaires 2–4 weeks and 6 months following PICU admission. Acute PTSS at 2–4 weeks were assessed by self-report questionnaire and PTSD at 6 months was assessed by clinical interview. Receiving ketamine in PICU was the only non-cognitive variable associated with PTSS at 6 months. Peri-trauma affect, cognitive processing, and trauma memory significantly and independently accounted for 21% of the variance in PTSS at 6 months even after controlling for acute PTSS (and ketamine). A mediation analysis showed that peri-trauma affect indirectly influenced PTSS at 6 months through its effect on cognitive processing. Conclusions: Cognitive variables significantly contribute to PTSS in children, following PICU admission. Peri-trauma affect influenced PTSS only via disrupted cognitive processing. Prevention or early intervention strategies aimed at helping children develop a complete, contextual trauma narrative may be effective in reducing persistent posttraumatic stress responses in children following PICU. Full article
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16 pages, 1348 KiB  
Article
Unsilencing the Echoes of Historical Trauma: A Comparative Analysis
by Lorinda Riley, Anamalia Suʻesuʻe and Meldrick Ravida
Trauma Care 2023, 3(2), 66-81; https://doi.org/10.3390/traumacare3020008 - 23 May 2023
Cited by 1 | Viewed by 2240
Abstract
Indigenous communities in North America have distinct colonial histories with their own story of how their ancestors were able to survive the mass effort to take their land, resources, language, culture, and sometimes even their lives. These stories have been passed down orally [...] Read more.
Indigenous communities in North America have distinct colonial histories with their own story of how their ancestors were able to survive the mass effort to take their land, resources, language, culture, and sometimes even their lives. These stories have been passed down orally and through the DNA of the descendants of survivors via epigenetics. The Historical Loss Scale (HLS) and Historical Loss Associated Symptoms Scale (HLASS) are two validated scales that measure historical trauma among Native Americans. However, as different Indigenous communities have different colonial histories, it is critical to ensure that tools used to measure historical trauma are valid for that specific communities. When these scales are applied to Native Hawaiians, these measures may not provide an accurate picture of the historical trauma experienced by Native Hawaiians. As part of the effort to adapt the HLS for Native Hawaiians, we conducted a crosswalk analysis of the HLS and HLASS with a recent study on Native Hawaiian historical trauma (NHHT) to identify areas of overlap and divergence. We found that while there was significant overlap, several areas of divergence emerged likely stemming from the unique colonial histories of different Indigenous communities. Full article
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11 pages, 284 KiB  
Article
Identification and Characterization of Injuries during Competition in Wheelchair Basketball
by Karina Sá, M. Magno e Silva, José Gorla and Anselmo Costa e Silva
Trauma Care 2023, 3(2), 55-65; https://doi.org/10.3390/traumacare3020007 - 19 Apr 2023
Viewed by 1178
Abstract
Background: Knowledge and understanding of the most diverse aspects surrounding the emergence of sports injuries stand out as one of the pillars for sporting success. Methods: A total of 41 athletes answered an online form based on the Sports Injury Protocol in Paralympic [...] Read more.
Background: Knowledge and understanding of the most diverse aspects surrounding the emergence of sports injuries stand out as one of the pillars for sporting success. Methods: A total of 41 athletes answered an online form based on the Sports Injury Protocol in Paralympic Sports (PLEEP) in which data on sports injuries during competition in the first Brazilian wheelchair basketball division were collected. Results: The athletes who composed the sample perform a high volume of training. The majority did not present with injuries before the competition. There was a prevalence of 17.1% of injuries during the competition, an incidence of 0.17 injuries per athlete and an incidence rate of 0.03 injuries per athlete-hour or four injuries per one thousand athletes-days. The injuries that occurred during the competition were mostly in the shoulder region, characterized as traumatic, by indirect contact with other athletes, which occurred when propelling the wheelchair, and were of low severity. Conclusions: The wheelchair basketball athletes presented a low prevalence, incidence and incidence rate of injuries during the competition. The shoulder region was the most affected. Structuring training sessions with the prevention of injuries in the shoulder region in mind is essential for these athletes to perform optimally. Full article
(This article belongs to the Special Issue Exercise and Sport-Related Injuries: Rehab and Readapt)
9 pages, 1133 KiB  
Article
Changes in Paediatric Injury-Related Emergency Department Presentations during the COVID-19 Pandemic
by Reidar P. Lystad, Andrew Fyffe, Rhonda Orr and Gary Browne
Trauma Care 2023, 3(2), 46-54; https://doi.org/10.3390/traumacare3020006 - 03 Apr 2023
Viewed by 1496
Abstract
This study aimed to quantify changes in paediatric injury-related Emergency Department (ED) presentations at a large metropolitan paediatric hospital during the first two years of the COVID-19 pandemic (i.e., 2020 and 2021). This retrospective cohort study included children aged ≤15 years who presented [...] Read more.
This study aimed to quantify changes in paediatric injury-related Emergency Department (ED) presentations at a large metropolitan paediatric hospital during the first two years of the COVID-19 pandemic (i.e., 2020 and 2021). This retrospective cohort study included children aged ≤15 years who presented to the ED at the Children’s Hospital at Westmead, Sydney, New South Wales, Australia, with a principal diagnosis of injury during 1 January 2010 to 31 December 2021. Annual and monthly incidence of paediatric injury-related ED presentations from 2010 to 2019 were used to fit autoregressive integrated moving average models, from which forecast estimates with 95% prediction intervals were derived and compared against corresponding observed values to obtain estimates of absolute and relative forecast errors. The distributions of injuries by injury severity in 2020 and 2021 were compared against the 2010–2019 reference period. The annual incidence of paediatric injury-related ED presentations was 7.6% and 4.7% lower than forecasted in 2020 and 2021, respectively, equating to an estimated total of 1683 fewer paediatric injury-related ED presentations during the two-year period. The largest reductions in monthly incidence of paediatric injury-related ED presentations were observed during the periods of major societal restrictions (i.e., March–May 2020 and July–October 2021). Significant reductions in monthly incidence of injury-related ED presentations were observed for minor injuries only, with no discernable reductions in moderate and serious injuries. These findings highlight the impact of the COVID-19 pandemic on paediatric injury-related ED presentations and the need for future epidemiological studies examining secular trends in paediatric trauma volumes to account for the impact of the COVID-19 pandemic. Full article
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