Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study

Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods: This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings: This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (74·0%) had emergency surgery and 280 (24·8%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (26·1%) patients. 30-day mortality was 23·8% (268 of 1128). Pulmonary complications occurred in 577 (51·2%) of 1128 patients; 30-day mortality in these patients was 38·0% (219 of 577), accounting for 81·7% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 1·75 [95% CI 1·28–2·40], p\textless0·0001), age 70 years or older versus younger than 70 years (2·30 [1·65–3·22], p\textless0·0001), American Society of Anesthesiologists grades 3–5 versus grades 1–2 (2·35 [1·57–3·53], p\textless0·0001), malignant versus benign or obstetric diagnosis (1·55 [1·01–2·39], p=0·046), emergency versus elective surgery (1·67 [1·06–2·63], p=0·026), and major versus minor surgery (1·52 [1·01–2·31], p=0·047). Interpretation: Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding: National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research

Interpersonal Problem Solving in Third and Fifth Graders: Sex, Grade, and Friendship Effects

Program year: 1994/1995Digitized from print original stored in HDRThis study examines the relationship between friendship and the types of problem solving strategies, emotional reactions, and the intensity of the emotional reaction to hypothetical dilemmas. Third and fifth grade children (n=78) were individually interviewed and read hypothetical dilemmas involving a conflict with either a friend or an acquaintance. Social competence as rated by the teachers and peers was assessed. Sex differences in problem solving strategies and emotional intensities were found as well as grade differences in the emotional response. Sex differences were found in the emotional intensity proposed for the scenarios. Friendship was also found to have a significant relationship cooperative and adult intervention problem solving strategies. Social competence as rated by teachers and peers was negatively correlated with aggressive and positively with verbal assertive strategies. There was also a correlation found with social competence and feeling sad and angry as rated by peers and emotional intensity was negatively correlated with social competence as rated by teachers

Consistency and Development of Prosocial Dispositions: A Longitudinal Study

The issue of whether there is consistency in prosocial dispositions was examined with a longitudinal data set extending from ages 4 to 5 years into early adulthood (N = 32). Spontaneous prosocial behaviors observed in the preschool classroom predicted actual prosocial behavior, other- and self-reported prosocial behavior, self-reported sympathy, and perspective taking in childhood to early adulthood. Prosocial behaviors that were not expected to refl ect an other-orientation (i.e., low cost helping and compliant prosocial behavior) generally did not predict later prosocial behavior or sympathy. Sympathy appeared to partially mediate the relation of early spontaneous sharing to later prosocial dispositions. The results support the view that there are stable individual differences in prosocial responding that have their origins in early childhood

Relations among mothers' expressivity, children's effortful control, and their problem behaviors: A four-year longitudinal study

Abstract Longitudinal relations between mothers' expressivity, children's effortful control, and their problem behaviors were examined when children (N = 181) were 6.5-10 years old (T2) and again 2 (T3) and 4 (T4) years later. Mothers reported on their expression of positive and negative dominant emotion. Mothers and teachers reported on children's effortful control and externalizing and internalizing problem behaviors. In structural equation models, variables exhibited consistency over time. Further, the relation between mothers' expressivity (positive minus negative dominant emotion) at T2 and children's externalizing problems at T4 was mediated by T3 effortful control. The same process of mediation was significant for teacher-but not mother-reported internalizing problems. The results provide one explanation for how emotion-related socializing behaviors influence children's problem behaviors

Prosocial Development in Early Adulthood: A Longitudinal Study

Consistency of measures of a prosocial personality and prosocial moral judgment over time, and the interrelations among them, were examined. Participants’ and friends’ reports of prosocial characteristics were obtained at ages 21– 22, 23–24, and 25–26 years. In addition, participants’ prosocial judgment was assessed with interviews and with an objective measure of prosocial moral reasoning at several ages. Reports of prosocial behavior and empathy-related responding in childhood and observations of prosocial behavior in preschool also were obtained. There was interindividual consistency in prosocial dispositions, and prosocial dispositions in adulthood related to empathy/sympathy and prosocial behavior at much younger ages. Interview and objective measures of moral reasoning were substantially interrelated in late adolescence/early adulthood and correlated with participants’ and friends’ reports of a prosocial disposition