Parental stress and burden following traumatic brain injury amongst children and adolescents

Primary objectives: to assess parental stress following paediatric traumatic brain injury (TBI) and examine the relationship between self-reported problems and parental stress and general health. Research design: controlled interview study Methods and procedures: Parents of ninety-seven children admitted with a TBI (49 mild, 19 moderate, 29 severe) were identified from a case register of all paediatric admissions from 1992-1998. Parents of 31 uninjured children acted as controls. Structured interviews were carried out with families, and parents assessed on the Parenting Stress Index (PSI/SF) and General Health Questionnaire (GHQ-12) at recruitment, and repeated 12 months later. Main outcomes and results: regardless of injury severity, parents of injured children suffered greater stress than control parents as measured by the PSI/SF (p = 0.001). There was a highly significant relationship between number of problems reported and level of parental stress (p = 0.001). Financial burden was related to severity of TBI. Conclusions: improved information, follow-up, and support is likely to reduce parental stress and family burden

Senior Recital: Julie Long, Flute

Kemp Recital Hall Sunday Evening November 15, 1992 6:00p.m

Outcomes following childhood head injury : a population study

Objectives: To identify outcomes following head injury (HI) amongst a population of children admitted to one hospital centre and compare outcomes between different severity groups. Methods:A postal follow-up of children admitted with HI to one NHS Trust, between 1992-1998, was carried out. Children were aged 5-15 years at injury (mean 9.8), followed-up at a mean of 2.2 years post-injury. Parents of 526 injured children (419 mild, 58 moderate, 49 severe) and 45 controls completed questionnaires. Outcomes were assessed using the King’s Outcome Scale for Childhood Head Injury (KOSCHI). Results:Frequent behavioural, emotional, memory and attentional problems were reported by one third of the severe group, one quarter of the moderate, and 10-18% of the mild. Personality change since HI was reported for 148 children (28%) (21% mild HI, 46% moderate, 69% severe). There was a significant relationship between injury severity and KOSCHI outcomes. Following the HI, 252(48%) had moderate disability (43% mild HI, 64% moderate, 69% severe), 270(51%) made a good recovery (57% mild HI, 36% moderate, 22% severe). There was a significant association between social deprivation and poor outcome (p=0.002). Only 30%(158) of children received hospital follow-up after the HI. All children with severe disability received appropriate follow-up, but 64% of children with moderate disability received none. No evidence was found to suggest a threshold of injury severity below which the risk of late sequelae could be safely discounted. Conclusions:Children admitted with mild HI may be at risk of poor outcomes, but often do not receive routine hospital follow-up. A postal questionnaire combined with the KOSCHI to assess outcomes after HI may be used to identify children who would benefit from clinical assessment. Further research is needed to identify factors which place children with mild HI at risk of late morbidity

Children's brain injury : a postal follow-up of 525 children from one health region in the UK

Primary objectives: to follow-up a population of children admitted to one Hospital Trust with traumatic brain injury (TBI), and compare outcomes following mild TBI with outcomes following moderate or severe TBI. Research design: population-based postal questionnaire survey. Methods and procedures: questionnaires were mailed to parents of all 974 surviving children on a register of paediatric TBI admissions, 525 completed questionnaires were returned (56.2%). Most children (419) had suffered mild TBI, 57 moderate, and 49 severe. Main outcomes and results: Thirty percent of parents received no information on post-injury symptoms, and clinical follow-up was limited. Statistically significant differences were observed between mild and moderate/severe groups for cognitive, social, emotional, and mobility problems. Nevertheless, approximately 20% of the mild group suffered from poor concentration, personality change, and educational problems post-injury. Few schools (20%) made special provision for children returning after injury. Conclusions: children can have long lasting and wide ranging sequelae following TBI. Information should be routinely given to parents and schools after brain injury

Prevalence of traumatic brain injury amongst children admitted to hospital in one health district : a population-based study

There is a dearth of information regarding the prevalence of brain injury, serious enough to require hospital admission, amongst children in the United Kingdom. In North Staffordshire a register of all children admitted with traumatic brain injury (TBI) has been maintained since 1992 presenting an opportunity to investigate the incidence of TBI within the region in terms of age, cause of injury, injury severity and social deprivation. The register contains details of 1553 children with TBI, two thirds of whom are male. This population-based study shows that TBI is most prevalent amongst children from families living in more deprived areas, however, social deprivation was not related to the cause of injury. Each year, 280 per 100,000 children are admitted for ≥24 hours with a TBI, of these 232 will have a mild brain injury, 25 moderate, 17 severe, and 2 will die. The incidence of moderate and severe injuries is higher than previous estimates. Children under 2 years old account for 18.5% of all TBIs, usually due to falls, being dropped or non-accidental injuries. Falls account for 60% of TBIs in the under 5s. In the 10-15 age group road traffic accidents were the most common cause (185, 36.7%). These findings will help to plan health services and target accident prevention initiatives more accurately

Questioning the Research on Early Career Teacher Attrition and Retention

In this paper, we consider scholarly work on early career teacher attrition, and retention, from 1999 to 2010. Much of the literature has framed attrition as either a problem associated with individual factors (e.g., burnout), or a problem associated with contextual factors (e.g., support and salary). Some recent conceptualizations consider early career teacher attrition as an identity- making process that involves a complex negotiation between individual and contextual factors. On the basis of our review, we suggest the need to shift the conversation from one focused only on retaining teachers, toward a conversation about sustaining teachers. This shift offers the possibility of new insights about teacher education and about the kinds of spaces needed on school landscapes to sustain and retain beginning teachers.Cet article porte sur les travaux académiques évoquant l'attrition et la rétention des enseignants en début de carrière entre 1999 et 2010. Une part importante de la littérature présente l'attrition comme un problème associé à des facteurs individuels (par ex. épuisement professionnel) ou bien à des facteurs contextuels (par ex. appui et salaire). Selon certaines conceptualisations récentes, l'attrition d'enseignants en début de carrière serait un processus de formation identitaire impliquant des négociations complexes entre l'individu et des facteurs contextuels. À partir de notre analyse, nous évoquons le besoin de s'éloigner des conversations portant exclusivement sur le besoin de retenir les enseignants pour discuter plutôt de soutien aux enseignants. D'un tel changement peuvent découler de nouvelles idées sur la formation des enseignants et le type de milieux scolaires nécessaires pour appuyer et retenir les enseignants en début de carrière

Becoming parents by adoption: a systematic review

BackgroundTransition to parenthood (TP) for biological parents has been extensively explored in research, shaping healthcare service provision from pre-conception, birth and beyond. Adoptive parents are in a unique position. Despite growing number of studies on this issue there remains a demonstrable evidence gap about the experiences of adoptive parents. There is an urgent need to bring existing work in this area of TP together and synthesize the key messages for research and practice. AimsTo identify and summarise papers concerning the experiences of adoptive parents, becoming parents for the first time, in order to inform future research and clinical practice. Methods A systematic review searched CINAHL, MEDLINE and PsycINFO. FindingsThe search identified 21 papers and 7 areas of interest.ConclusionSimilarities exist between new biological and new adoptive parents however new adoptive parents face unique experiences and challenges as a result of becoming parents through adoption, not biology