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

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

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

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

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 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