Prevalence of children witnessed violence in a pediatric emergency department

Gender Violence During the Three Ages of Life and the Impact of the Covid-19 Pandemic: A Review

Children, women, and older people suffer different types of violence, which appears to have been exacerbated during the COVID-19 pandemic and the relative lockdown. The aim of this study is to analyze the literature about gender violence and abuse in the different ages of life and during the COVID-19 lockdown. Data were obtained from an electronic literature search using various online sources such as PubMed, Google Scholar, Science Direct and Web of Science. The terms "child abuse" were the most frequently used, followed in frequency by "gender violence," "femicide," and, lastly, "elderly abuse." The first studies considered gender-based violence as a purely physical problem, then, progressively, the analysis focused on the psychological point of view of the issue. There was a greater number of studies in 2020 about violence in comparison with previous years. The social and scientific attention to gender-based violence appeared to be very poor, especially in the case of older people abuse. It is necessary to increase general attention to the topic to correctly identify each form of abuse and to be able to take care of the subjects most at risk.

Exposure to maternal experiences of IPV in early childhood and sleep health in adolescence

BACKGROUND

Half of US women will experience intimate partner violence (IPV), and nearly all children in families experiencing such violence will be exposed. The negative effects of IPV exposure on children's mental and physical health are well-documented; however, less is known about effects on children's sleep health, a key marker of well-being.

OBJECTIVE

This study examines the associations of early childhood exposure to maternal experiences of IPV with sleep health in adolescence, focusing on multiple dimensions of sleep health and differences by child sex.

PARTICIPANTS AND SETTING

We rely on data from the Future of Families and Child Wellbeing Study, a population-based study following 5000 children in large US cities, from birth to age 15. Analyses are based on 2687 adolescents interviewed at the year-15 follow-up.

METHODS

Early childhood exposure to IPV is based on mothers' reports of her experiences of IPV from the child's birth to age 5. Adolescent sleep health is measured using 6 items approximating the BEARS sleep problem scale, at age 15. We estimate multivariate linear regression models to examine associations of early childhood IPV exposure with adolescent sleep health and stratify models by child sex.

RESULTS

Early childhood IPV exposure is associated with worse overall sleep health (β = 0.08; p < 0.001) and multiple dimensions of poor sleep health in adolescence. Associations are notably stronger among girls than boys.

CONCLUSIONS

The strong and lasting associations of early childhood exposure to IPV with adolescents' sleep health, particularly among girls, has important consequences for addressing adolescent health disparities.

Impact of the COVID-19 Pandemic On Violence Against Children: A Narrative Review

PURPOSE OF REVIEW

The goal of this paper was to explore the different ways the COVID-19 pandemic has affected violence against children (VAC).

RECENT FINDINGS

Recent research of peer-reviewed articles using operational or survey data revealed the pandemic's impact in terms of institutional responses, risk and mediating factors, changes in VAC dynamics, and a likely increase in child marriage. Findings include a decrease in institutional responses, activities, and prevention case openings; an increased incidence of interparental intimate partner violence (IPV) witnessing cases, hospital admissions for suspected Abusive Head Trauma (AHT), other pediatric injuries, and sexual violence; a change in family conflict dynamics; and an estimated increase in child marriages. It also revealed mediating factors between the relationship of the pandemic and VAC (such as parental stress and mental health symptoms), as well as risk factors observed by service providers, which include the risk of mental health symptoms of both parents and children. Post-pandemic VAC research can be improved by utilizing operational or survey data in a meaningful way to be able to derive sound intervention approaches to diminish the pandemic's impact on VAC and child marriage. We also propose for researchers to integrate child marriage into the definition of VAC.

Screening and intervention for intimate partner violence at trauma centers and emergency departments: an evidence-based systematic review from the Eastern Association for the Surgery of Trauma

Background

Intimate partner violence (IPV) is a serious public health issue with a substantial burden on society. Screening and intervention practices vary widely and there are no standard guidelines. Our objective was to review research on current practices for IPV prevention in emergency departments and trauma centers in the USA and provide evidenced-based recommendations.

Methods

An evidence-based systematic review of the literature was conducted to address screening and intervention for IPV in adult trauma and emergency department patients. The Grading of Recommendations, Assessment, Development and Evaluations methodology was used to determine the quality of evidence. Studies were included if they addressed our prespecified population, intervention, control, and outcomes questions. Case reports, editorials, and abstracts were excluded from review.

Results

Seven studies met inclusion criteria. All seven were centered around screening for IPV; none addressed interventions when abuse was identified. Screening instruments varied across studies. Although it is unclear if one tool is more accurate than others, significantly more victims were identified when screening protocols were implemented compared with non-standardized approaches to identifying IPV victims.

Conclusion

Overall, there were very limited data addressing the topic of IPV screening and intervention in emergency medical settings, and the quality of the evidence was low. With likely low risk and a significant potential benefit, we conditionally recommend implementation of a screening protocol to identify victims of IPV in adults treated in the emergency department and trauma centers. Although the purpose of screening would ultimately be to provide resources for victims, no studies that assessed distinct interventions met our inclusion criteria. Therefore, we cannot make specific recommendations related to IPV interventions.

PROSPERO registration number

CRD42020219517.

Trend in 167 cases of minors witnessing violence: The role played by COVID-19 pandemic

BACKGROUND

There currently is no evidence that COVID-19 has had an impact on the rates of psychological abuses occurring when a minor witnesses interpersonal violence.

AIM

Our aim was to describe the accesses of the last four years to the Emergency Department of a tertiary hospital (Careggi University Hospital-Florence, Italy) due to this issue and then to evaluate whether the COVID-19 has had an impact on this trend.

METHODS

We collected data regarding cases of abuse in which at least a minor had reportedly witnessed the event. Medical records stored between January 1, 2018 to January 1, 2022 were analyzed, extracting sex, age and nationality of the victim; sex of the perpetrator and relationship with the victim; known previous episodes of abuse in the medical history of the victim; setting of the abuse (domestic vs. non-domestic); type of abuse (physical, psychological, sexual); whether the perpetrator was under the influence of alcohol/drugs; whether the victim was hospitalized; prognosis of the victim; number, relation with the victim and involvement in the abuse (as co-victim) of the minor(s) who witnessed the abuse.

RESULTS

A total of 167 eligible cases were registered. 69% of victims had previous episodes of abuse. The perpetrators were all known and mainly males (96%).The abuses were mainly domestic (79%). In 74% of the cases only a type of violence was perpetrated. In 12% of the cases, the minors were also victims of physical abuse. No statistically significant relationships were found between the start of the COVID-19 pandemic and the changes in the number of cases of domestic abuse (p = 0.07), physical abuse (p = 0.62), psychological abuse (p = 0.83) or sexual abuse (p = 0.88). However, during the institutional lockdown in Italy (March-May 2022) only two cases occurred - a number that did not allow period-specific statistical inference.

CONCLUSIONS

Empowering the hospital policies specifically aimed at identifying and protecting the victims of violence/witnessed violence remains a critical goal from both a public health and medico-legal point of view.