Prevalence of traumatic psychological stress reactions in children and parents following paediatric surgery: a systematic review and meta-analysis

Background: Children undergoing surgery and their parents are at risk of developing post-traumatic stress reactions. We systematically reviewed the literature to understand the prevalence of this issue, as well as potential risk factors. Methods: We conducted a systematic review and meta-analysis, using PubMed, PsycInfo, Web of Science and Google Scholar, with searches conducted in February 2021. Papers were included if they measured post-traumatic stress in children and/or parents following paediatric surgery and were excluded if they did not use a validated measure of post-traumatic stress. Data were extracted from published reports. Findings: Our search yielded a total of 1672 papers, of which 16 met our inclusion criteria. In meta-analysis, pooled studies of children estimated an overall prevalence of 16% meeting criteria for post-traumatic stress disorder post surgery (N=187, 95% CI 5% to 31%, I2=80%). After pooling studies of parents, overall prevalence was estimated at 23% (N=1444, 95% CI 16% to 31%, I2=91%). Prevalence rates were higher than those reported in the general population. Risk factors reported within studies included length of stay, level of social support and parental mental health. Interpretation: There is consistent evidence of traumatic stress following surgery in childhood which warrants further investigation. Those delivering surgical care to children would benefit from a raised awareness of the potential for post-traumatic stress in their patients and their families, including offering screening and support

Cumulative risk exposure is associated with increased risk for PTSD but not depression or anxiety. Results from a UK clinical sample of children and adolescents

Background Childhood adversity can include traumatic experiences and exposure to other risk factors; consistently predicting poorer psychosocial outcomes in adulthood. Relatively little research has investigated the impact of cumulative risk exposure in childhood. Using data collected in a specialist clinical setting, we investigated the associations between risk exposure, psychopathology and psychosocial functioning. Method Participants were children attending the Attachment and Trauma service at Great Ormond Street Hospital in London (N = 132, M = 10.25, SD = 3.35). Data was collected via routine clinical practice during multi-disciplinary assessments. Data was collected on developmental and trauma history, psychopathology, and functioning (CGAS), using standardised measures, clinical interviews, and observations. Results All children had experienced at least one risk factor, with 78% reporting multiple exposures, including witnessing interpersonal violence (52%), neglect (48%), and physical abuse (42%). Other risk exposures included exposure to alcohol (17%) and substances (24%) in-utero, as well as social risk factors such as multiple foster placements in some cases. In this sample, 65% of children met criteria for at least one psychiatric diagnosis (Anxiety = 31%, PTSD = 28%, Depression = 8%). High levels of functional impairment were found, with 52% of children falling into the highest categories of ‘obvious’ or ‘severe’ problems. Multiple risk exposure significantly predicted PTSD (OR 9.64 (1.1, 83.7)), but did not predict anxiety, depression, or functional impairment. Conclusion This study highlights the rates of cumulative risk exposure in this clinical sample. The findings demonstrate the importance of detailed and accurate clinical assessments in ascertaining trauma histories in children with known histories of adversity and maltreatment. There are implications for assessment and treatment, such as the importance of clear guidelines on treating PTSD in children with complex trauma histories

Mindfulness, Compassion, and Self-Compassion as Moderator of Environmental Support on Competency in Mental Health Nursing

Abstract: This research explored the established relationship between environmental support and competency for Mental Health Nurses, intending to investigate whether the tendency to display higher levels of mindfulness, compassion, and self-compassion might buffer the effect of a poor environment on competency. One questionnaire was comprised of five pre-developed questionnaires, which included all items examining environmental support, competency, mindfulness, compassion, and self-compassion. Mental Health Nurses (n = 103) were recruited from online forums and social media group pages in the UK. The result showed environmental support related positively to competency. Furthermore, the positive relationship of competency with environmental support was moderated when controlling for compassion but did not with mindfulness and self-compassion, although subscales showed some further interactions. When poor environmental support influences the competency of mental health professionals, compassion and mindfulness-based interactions may have the potential to uphold competency

Some thoughts on modelling the effects of oxygen and particle concentration on the erosion-corrosion of steels in aqueous slurries

Advances in the understanding of slurry erosion-corrosion has gained momentum in recent years, due to the wide range of laboratory studies carried out in such environments. There are now new insights into the causes of ''synergistic'' effects in such environments for many particle/target/environment combinations. However, identifying such effects is difficult because in aqueous conditions, the corrosion and erosion variables are not independent of each other.In this work, some new developments on the modelling of slurry erosion-corrosion processes are described for steels. The effects of increases in flow velocity, and oxygen and particle concentration are considered. Theoretical erosion-corrosion maps are constructed showing the differences between the erosion-corrosion mechanisms as a function of these variables

Some recent advances in the development of theoretical approaches for the construction of erosion-corrosion maps in aqueous conditions

Significant progress has been made in the development of methodologies for the construction of erosion-corrosion maps for erosion by solid particles in aqueous conditions. Mathematical models for solid particle erosion have been combined with those for aqueous corrosion, enabling regime transitions to be identified as a function of the main process parameters. The effects of both erosion and corrosion variables have been identified on the maps. An important issue in such work has been the wide range of variables involved in the erosion-corrosion process. This has been addressed through combining such parameters into dimensionless groups. The results indicate that, although there are some limitations with such an approach, the technique does present some important advantages in dealing with the large number of variables associated with a single erosion-corrosion interaction. This paper describes some new developments on the above work, and indicates how the erosion-corrosion transitions, for pure metals and steels, can be described on a single map. Future directions of the work are also addressed

Development of a theoretical model to describe the erosion-corrosion wastage process under aqueous slurry conditions : Extended Abstract

"This Proceedings Volume consists of a collection of papers from the First International Symposium on Environmental Issues with Materials and Processes for the Electronics and Semiconductor Industries and from the companion Symposium titled Electrochemical and Photochemical Methods for Chemical Recycling and Pollution Abatemen