Do young people who self-harm experience cognitions and emotions related to post-traumatic growth?

Background: Adolescent self-harm is a vast public health concern with self-harm rates increasing each year. Looked-after adolescents are a group at increased risk of self-harm owing to adverse life-events and attachment issues, giving rise to difficulties with problem solving and relationship difficulties (Ogundele, 2020). Whilst research into risk factors of self-harm is plentiful, fewer studies have explored what factors might facilitate self-harm recovery. This paper investigates whether looked-after adolescents with experience of self-harm can experience cognitions and emotions related to post-traumatic growth (PTG). Methods: Secondary Data Analysis was conducted on a primary qualitative data set from a study including twenty-four looked-after young people aged between 14 and 21 with experience of self-harm; 20 females and 4 males. An Interpretive Phenomenological Analysis was conducted. Results: Five themes were identified, four of which shared similarities to prior research into the recovery of self-harm and manifestations of PTG: 1) Self-Reflection, 2) Communication, 3) Embracing and Appreciating Support, 4) Better Management of feelings. The fifth theme suggested a potential barrier to experiencing PTG; 5) Reliance on Self-Harm. Findings revealed four relevant themes suggesting that individuals who self-harm can indeed experience cognitions and emotions relevant to PTG. Limitations: This study utilised a homogeneous sample, limiting the generalisability of the findings to other populations. Perhaps future research should consider other populations of individuals who self-harm. Conclusions: We suggest there is a need for interventions for self-harm to focus on protective factors to increase PTG within an individual, potentially moderating the risk of suicide.

Cold burn injuries in the United Kingdom: retain-->A 5-year cohort study of patients presenting to a regional burn unit.

AIMS: To assess the aetiology, management and outcomes of cold burn injuries presenting to a regional burn unit in the United Kingdom. METHODS: Retrospective cohort study of consecutive patients over a 5-year period (2018-2022). RESULTS: Sixty-two patients (M:F 34:38; median age 23.5 years) were identified. The most common aetiology was aerosol (n = 28, 45.2%). Seven (11.5%) injuries were sustained during a social media or peer 'challenge' and 19 (31.2%) were self-harm, of whom 5 (26.3%) were inpatients on a mental health ward at the time of injury. All 'challenge' and self-harm injuries were caused by aerosol. Patients with 'challenge' injury were younger than those with self-harm (p = .007) and non-intentional injuries (p < .001). A greater proportion of self-harm injuries were in female patients compared with non-intentional injuries (p < .001). Median total body surface area (TBSA) was 0.35% (IQR: 0.3). Most burns were superficial partial thickness (n = 35, 56.5%), followed by deep dermal (n = 18, 29.0%), full-thickness (n = 8, 12.9%), and superficial (n = 1, 1.6%). The upper limb was most frequently affected (n = 35, 56.5%). Aetiology and a non-intentional, 'challenge' or self-harm injury did not affect TBSA (p = 0.776 and p = 0.364) or depth (p = 0.353 and p = 0.381). Five (8.1%) patients underwent autografting. The median time to healing was 17 days (range: 7-45, IQR: 22.75). Follow-up ranged from 1 to 173 weeks. CONCLUSIONS: The incidence of cold burns has increased when compared with previous literature. A disproportionate number of cold burns are self-inflicted using aerosols, either as self-harm or because of social media or peer 'challenges'. Other emerging aetiologies include non-intentional skin contact with nitrous oxide containers during its recreational use.

Acute healing outcomes in paediatric partial thickness burns using Epiprotect® and Biobrane®: A retrospective comparative study.

AIM: To compare the acute healing outcomes of Biobrane® and Epiprotect® in paediatric partial thickness (PT) burns. METHODS: All paediatric patients (age <18 years) with PT burns managed using either Biobrane® or Epiprotect® over a 5-year period at our burns unit were included. The primary outcome was time to complete healing. Secondary outcomes included adherence, infection rates, length of hospital stay, duration of acute follow-up and return to the theatre. RESULTS: Among the 99 patients included, 38 received Epiprotect® and 61 received Biobrane®. The mean total body surface area (TBSA) was 6% (range 1%-15%) and median age was 21 months (range 5-169 months). Median time to healing in the Epiprotect® group was 19.5 days and 16 days in the Biobrane® group (P = .14). The median hospitalisation length was the same for both products (2 days, P = .85). Infection rate was lower in the Epiprotect® group (2.6% vs 16.4%, P = .048). There was no difference in adherence rate. These trends were preserved when depth sub-groups were analysed. Adherence and infection rates were not affected by post-operative antibiotics (P > .99 and P = .65, respectively) in either group. The rate of return to the theatre for further surgery was 13.2% for both products (P > .99). CONCLUSION: Our findings demonstrate that acute healing outcomes with Epiprotect® in paediatric PT burns are comparable to those with Biobrane®, with significantly lower infection rates for Epiprotect®. These results suggest that Epiprotect® is a viable alternative to Biobrane®. Nevertheless, further prospective randomised studies are required to investigate the short- and long-term outcomes.

Assessing the effect of the cost-of-living crisis on hot water bottle-related burns in the United Kingdom, a single-centre retrospective observational study.

Background: The cost-of-living crisis (CoLC) is an economic climate that the United Kingdom (UK) has been experiencing since late 2021, characterized by an increase in the price of essential goods faster than real-term incomes. Food and fuel poverty has ensued. This study aimed to assess whether the CoLC is associated with an increase in hot water bottle (HWB)-related burns as patients seek alternative heating sources to keep warm. Methods: Records of patients treated for HWB burns between December 2019 and March 2023 were reviewed for patient demographics, burn depth and surface area, patient comorbidities, and patient index of multiple deprivation (IMD). The incidence of admissions, IMD, and severity of injury were compared prior to and during the CoLC using either independent t-test or Kruskal-Wallis H test. Results: Between December 2019 and March 2023, 177 patients were treated for HWB burns, 79 prior to the CoLC, and 98 during. Of the patients, 55 patients were male and 122 females. An independent t-test comparing average monthly admissions prior and during the CoLC identified a significant difference (p = 0.042), with a mean increase of 1.85 cases (95% CI: 0.71-3.63). Additionally, a Kruskal-Wallis H test showed statistically significant difference in the number of patients treated for HWB burns between the seasons (p = 0.001). An independent t-test comparing average patient IMD prior and during the CoLC identified no difference (p = 0.33). Conclusion: The increase in HWB burns coincides with the increase in energy costs and general cost of living that has occurred in the UK since October 2021.