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Lee YY, Loo LMA, Oh E, Ang IWL, Menon RK. Pediatric trauma during the COVID-19 lockdown: caregiver abuse and self-harm in a vulnerable population. Pediatr Surg Int 2024; 40:228. [PMID: 39147909 DOI: 10.1007/s00383-024-05795-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/16/2024] [Indexed: 08/17/2024]
Abstract
PURPOSE This retrospective cohort study explores the impact of the COVID-19 pandemic on pediatric trauma cases in Singapore's National University Hospital from January 2015 to July 2021. The pandemic prompted unprecedented measures, altering societal dynamics. The study hypothesizes a reduction in major trauma incidents during the pandemic period. METHODS This is a single-center retrospective study including all pediatric patients presenting with trauma-related ICD-9 codes, and an Injury Severity Score (ISS) greater than 8. Patients were stratified into two time periods: pre-pandemic (January 2015 to March 2020) and pandemic (April 2020 to July 2021) periods. RESULTS Out of 254 pediatric trauma cases, 201 occurred pre-pandemic, and 53 during the pandemic. While overall trauma incidence remained similar, the pandemic period saw a shift in injury patterns. Home-based falls increased, vehicular accidents decreased, while deliberate self-harm and caregiver abuse rose significantly. The incidence of serious trauma attributed to non-accidental injury increased during the pandemic. CONCLUSION The study reveals changing trauma patterns, emphasizing the importance of understanding societal impacts during pandemics. Notably cases of deliberate self-harm and caregiver abuse surged, echoing global concerns highlighted in other studies during the pandemic. The study underscores the need to preempt physical and psychological stressors in vulnerable populations during future pandemics.
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Affiliation(s)
- Yang Yang Lee
- Department of Paediatric Surgery, Khoo Teck Puat-University Children's Medical Institute, National University Hospital, Singapore, Singapore.
| | - Lynette Mee Ann Loo
- Division of General Surgery and Trauma, Department of Surgery, National University Hospital, Singapore, Singapore
| | - Eileen Oh
- Khoo Teck Puat-National University Children's Medical Institute, National University Health System, Singapore, Singapore
| | - Ivy Wei Ling Ang
- Khoo Teck Puat-National University Children's Medical Institute, National University Health System, Singapore, Singapore
| | - Raj Kumar Menon
- Division of General Surgery and Trauma, Department of Surgery, National University Hospital, Singapore, Singapore
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McGoron L, Trentacosta CJ, Wargo Aikins J, Beeghly M, Beatty JR, Domoff SE, Towner EK, Ondersma SJ. Risk, Emotional Support, Child Abuse Potential, and Parenting During the First Year of the COVID-19 Pandemic. CHILD MALTREATMENT 2024; 29:463-473. [PMID: 37369628 PMCID: PMC10300627 DOI: 10.1177/10775595231186645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/29/2023]
Abstract
The COVID-19 pandemic and associated mitigation efforts created stress that threatened parent and child well-being. Conditions that increase stress within families heighten the likelihood of child abuse, but social support can mitigate the impact. This short-term investigation considered whether cumulative risk, COVID-19 specific risk, and emotional support (one aspect of social support), were associated with child abuse potential during the pandemic. Additionally, we investigated whether emotional support moderated the association between COVID-19 specific risk and child abuse potential, and associations between child abuse potential and emotionally positive and emotionally negative parenting. Participants included 89 parents, from a metropolitan area with a large number of economically distressed families, who completed online questionnaires. COVID-19 specific risk and emotional support each explained additional variance in child abuse potential beyond cumulative risk, but emotional support did not moderate the association between COVID-19 specific risk and child abuse potential. Consistent with expectations, child abuse potential was negatively associated with emotionally positive parenting and positively associated with emotionally negative parenting practices. Results highlight the importance of addressing both risks and supports at multiple levels for parents during times of stress.
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Affiliation(s)
- Lucy McGoron
- Merrill Palmer Skillman Institute for Child & Family Development, Wayne State University, Detroit, MI, USA
| | - Christopher J. Trentacosta
- Merrill Palmer Skillman Institute for Child & Family Development, Wayne State University, Detroit, MI, USA
- Department of Psychology, Wayne State University, Detroit, MI, USA
| | - Julie Wargo Aikins
- Merrill Palmer Skillman Institute for Child & Family Development, Wayne State University, Detroit, MI, USA
- Department of Psychiatry and Behavioral Neuroscience, Wayne State University, Detroit, MI, USA
| | - Marjorie Beeghly
- Merrill Palmer Skillman Institute for Child & Family Development, Wayne State University, Detroit, MI, USA
- Department of Psychology, Wayne State University, Detroit, MI, USA
| | - Jessica R. Beatty
- Merrill Palmer Skillman Institute for Child & Family Development, Wayne State University, Detroit, MI, USA
| | - Sarah E. Domoff
- Department of Family Medicine & Public Health Sciences, Wayne State University, Detroit, MI, USA
| | - Elizabeth K. Towner
- Merrill Palmer Skillman Institute for Child & Family Development, Wayne State University, Detroit, MI, USA
- Department of Public Health, Wayne State University, Detroit, MI, USA
| | - Steven J. Ondersma
- C.S. Mott Department of Public Health and Department of Obstetrics, Gynecology, and Reproductive Biology, Michigan State University, Flint, MI, USA
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Tsang JTW, Fung ACH, Wong HHT, Dai WC, Wong KKY. Epidemiological changes in the pattern of children's traumatic injuries at Hong Kong emergency departments during the COVID-19 pandemic: a retrospective, single-institutional, serial and comparative study. Pediatr Surg Int 2024; 40:192. [PMID: 39012503 PMCID: PMC11252212 DOI: 10.1007/s00383-024-05772-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/06/2024] [Indexed: 07/17/2024]
Abstract
INTRODUCTION Trauma is the leading cause of paediatric mortality and morbidity. Stay-home regulations for coronavirus disease 2019 (COVID-19) reportedly changed trauma severity, yet data from Hong Kong were lacking. This study examined Hong Kong's spectrum of paediatric trauma and addressed knowledge gaps concerning epidemiological changes during COVID-19. METHODS Children with traumatic injuries who attended a tertiary trauma centre from January 2010 to March 2022 were included in this retrospective, cross-sectional study. We analysed demographic and clinical data and conducted unadjusted bivariate analyses of injury patterns before and after the pandemic. RESULTS In total, 725 children attended the Accident and Emergency Department due to trauma, 585 before and 140 during COVID-19. The male-to-female ratio was 1.84:1. The 90-day trauma-related mortality was 0.7%. The overall Injury Severity Score was 3.52 ± 5.95. The paediatric trauma incidence was similar before and after social-distancing policies (both 5.8 cases monthly). Gender, ISS distribution, intensive care unit stay length, and hospital stay length values were similar (p > 0.05). Trauma call activation (8.4% vs. 5.7%, p = 0.002) and road traffic accidents (10.6% vs. 5.7%, p = 0.009) significantly decreased, yet younger-patient injuries (< 10 years old; 85.7% vs. 71%, p < 0.001), burns (28% vs. 45.7%, p < 0.001), and domestic injuries (65.5% vs. 85.7%, p < 0.001) significantly increased. No significant self-harm, assault, or abuse increases were found. CONCLUSIONS The paediatric trauma incidences were similar before and during the pandemic. However, domestic and burn injuries significantly increased, highlighting the importance of injury prevention.
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Affiliation(s)
- Jaime Tsz-Wing Tsang
- Department of Surgery, School of Clinical Medicine, The University of Hong Kong, Hong Kong, China
| | - Adrian Chi-Heng Fung
- Department of Surgery, School of Clinical Medicine, The University of Hong Kong, Hong Kong, China
| | | | - Wing Chiu Dai
- Department of Surgery, School of Clinical Medicine, The University of Hong Kong, Hong Kong, China
| | - Kenneth Kak-Yuen Wong
- Department of Surgery, School of Clinical Medicine, The University of Hong Kong, Hong Kong, China.
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4
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Brito AAMP, Pati S, Schreiber M. The effects of the COVID-19 pandemic blood shortage on trauma patients. Transfusion 2024; 64:1323-1330. [PMID: 38899841 DOI: 10.1111/trf.17925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 12/13/2023] [Accepted: 12/17/2023] [Indexed: 06/21/2024]
Affiliation(s)
- Alexandra Alex Marie Pawliuk Brito
- Donald D. Trunkey Center for Civilian and Combat Casualty Care, Oregon Health and Science University, Portland, Oregon, USA
- The Queen's Medical Center, Honolulu, Hawaii, USA
| | - Shibani Pati
- University of California San Francisco, San Francisco, California, USA
| | - Martin Schreiber
- Donald D. Trunkey Center for Civilian and Combat Casualty Care, Oregon Health and Science University, Portland, Oregon, USA
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5
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Kim RC, Aggarwal P, Kuhia R, Sochan AJ, Zhao Z, Fiore S, Chesler D, Alcalá HE, Hsieh H. Pediatric Traumatic Brain Injury Outcomes and Disparities During the COVID-19 Pandemic. J Pediatr Surg 2024; 59:893-899. [PMID: 38388283 DOI: 10.1016/j.jpedsurg.2024.01.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Accepted: 01/22/2024] [Indexed: 02/24/2024]
Abstract
BACKGROUND To study the impact of the COVID-19 pandemic on traumatic brain injury (TBI) patient demographic, clinical and trauma related characteristics, and outcomes. METHODS Retrospective chart review was conducted on pediatric TBI patients admitted to a Level I Pediatric Trauma Center between January 2015 and June 2022. The pre-COVID era was defined as January 1, 2015, through March 12, 2020. The COVID-19 era was defined as March 13, 2020, through June 30, 2022. Bivariate analysis and logistic regression were performed. RESULTS Four hundred-thirty patients were treated for pediatric TBI in the pre-COVID-19 period, and 166 patients during COVID-19. In bivariate analyses, the racial/ethnic makeup, age, and sex varied significantly across the two time periods (p < 0.05). Unwitnessed TBI events increased during the COVID-19 era. Logistic regression analyses also demonstrated significantly increased odds of death, severe disability, or vegetative state during COVID-19 (AOR 7.23; 95 % CI 1.43, 36.41). CONCLUSION During the COVID-19 pandemic, patients admitted with pediatric TBI had significantly different demographics with regards to age, sex, and race/ethnicity when compared to patients prior to the pandemic. There was an increase in unwitnessed events. In the COVID period, patients had a higher odds ratio of severe morbidity and mortality despite adjustment for confounding factors. LEVEL OF EVIDENCE AND STUDY TYPE Level II, Prognosis.
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Affiliation(s)
- Rachel C Kim
- Department of Pediatrics, University of California, San Francisco, San Francisco, CA 94143, USA
| | - Priya Aggarwal
- Renaissance School of Medicine, Stony Brook University, Stony Brook, NY 11794, USA
| | - Regina Kuhia
- Renaissance School of Medicine, Stony Brook University, Stony Brook, NY 11794, USA
| | - Anthony J Sochan
- Renaissance School of Medicine, Stony Brook University, Stony Brook, NY 11794, USA
| | - Zirun Zhao
- Department of Neurological Surgery, University of Washington, Seattle, WA 98195, USA
| | - Susan Fiore
- Department of Neurosurgery, Stony Brook Medicine, Stony Brook, NY 11794, USA
| | - David Chesler
- Department of Neurosurgery, Stony Brook Medicine, Stony Brook, NY 11794, USA
| | - Héctor E Alcalá
- Department of Behavioral and Community Health, University of Maryland, School of Public Health, College Park, MD 20742, USA; Program in Oncology, University of Maryland Marlene and Stewart Greenebaum Comprehensive Cancer Center, Baltimore, MD, USA
| | - Helen Hsieh
- Department of Surgery, Stony Brook Medicine, Stony Brook, NY 11794, USA.
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Delbrück H, Lambertz E, Migliorini F, Berger N, Hildebrand F. Influence of COVID-19 pandemic on hospitalisations at a paediatric traumatology department during 2020: a single-centre observational study and comprehensive literature review. Eur J Trauma Emerg Surg 2024; 50:591-601. [PMID: 38286949 PMCID: PMC11035450 DOI: 10.1007/s00068-024-02453-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2023] [Accepted: 01/14/2024] [Indexed: 01/31/2024]
Abstract
PURPOSE The study investigates changes in the injury characteristics of hospitalised children in a paediatric trauma centre during the COVID-19 pandemic. METHODS Data from injured children from the pre-pandemic year 2019 were compared to the pandemic year 2020 using Pearson's chi-squared test and the Mann-Whitney U test. The period of highly restrictive regulations (HRP) was evaluated separately. A comprehensive literature review with defined search terms resulted in a descriptive data synthesis. RESULTS Data from 865 patients indicated reductions in admissions of 5.6% and 54.4% during the HRP. In 2020, the hospitalisation time was longer (2.2 ± 2.7 days in 2019 vs. 2.4 ± 2.6 in 2020, p = 0.045); the proportions of wounds requiring surgical therapy (p = 0.008) and of observational treatments, primarily for mild brain injuries (p = 0.046), were higher; and conservative treatments, primarily for contusions, were lower (p = 0.005). There were no significant changes in age, location of lesions, or frequency of surgical therapy; nor were there differences in the HRP, except for fewer injuries in school and kindergarten (p < 0.001). The literature review summarises the main results of 79 studies. CONCLUSION Limited resources did not alter the indications for surgical therapy. Further studies should examine whether the more common injuries sustained at home were caused by excessive work/childcare demands on parents. Reduced inpatient conservative treatment implies that hospital resources possibly were overused previously. The literature offers answers to many detailed questions regarding childhood injuries during a pandemic and more efficient safe treatment. Registration Ethical committee of RWTH Aachen University EK 22-320; Center for Translational & Clinical Research RWTH Aachen University (CTC-A) 21-430.
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Affiliation(s)
- Heide Delbrück
- Department of Orthopaedics, Trauma and Reconstructive Surgery, University Hospital RWTH Aachen, Pauwelsstrasse 30, 52074, Aachen, Germany.
| | - Ellen Lambertz
- Department of Orthopaedics, Trauma and Reconstructive Surgery, University Hospital RWTH Aachen, Pauwelsstrasse 30, 52074, Aachen, Germany
| | - Filippo Migliorini
- Department of Orthopaedics, Trauma and Reconstructive Surgery, University Hospital RWTH Aachen, Pauwelsstrasse 30, 52074, Aachen, Germany
- Department of Orthopaedic and Trauma Surgery, Academic Hospital of Bolzano (SABES-ASDAA), Teaching Hospital of the Paracelsus Medical University, 39100, Bolzano, Italy
| | - Nina Berger
- Department of Neuromuscular and Paediatric Orthopaedics, Klinikum Dritter Orden München - Nymphenburg, Menzinger Strasse 44, 80638, München, Germany
| | - Frank Hildebrand
- Department of Orthopaedics, Trauma and Reconstructive Surgery, University Hospital RWTH Aachen, Pauwelsstrasse 30, 52074, Aachen, Germany
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7
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Sarli AC, Sang HI, Syverson DJ, Axtman B, Bjordahl P, Ahmeti M. Changes in Patterns of Trauma Injuries in the Dakotas Region During the COVID-19 Pandemic. Am Surg 2024:31348241241722. [PMID: 38520273 DOI: 10.1177/00031348241241722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/25/2024]
Abstract
BACKGROUND The aim of this study is to compare impact of COVID-19 on trauma volume and characteristics on a set of trauma centers with a rural catchment area. The COVID-19 pandemic has affected different parts of the country quite differently, both in case volume and in local responses. State-wide responses have varied considerably, including variations in local mask mandates, school closures, and social distancing measures. METHODS This was a retrospective trauma registry review of patients who were admitted to three of the tertiary care trauma centers in North and South Dakota between 2014 through 2022. RESULTS In the analysis of 36,397 patients, we found a significant increase in trauma patient volume during the COVID-19 pandemic, with an increased percentage of patients presenting with a mechanism of injury secondary to abuse or assault. This increase in patient volume continued to rise during 2021 and 2022. CONCLUSIONS Our study demonstrates how the COVID-19 pandemic impacted trauma center admissions in the rural and frontier Midwest differently from more urban areas, and the importance of including a variety of settings in trauma research.
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Affiliation(s)
- Adrian C Sarli
- Department of Surgery, University of North Dakota School of Medicine and Health Sciences, Grand Forks, ND, USA
| | | | | | - Benjamin Axtman
- Department of Surgery, University of North Dakota School of Medicine and Health Sciences, Grand Forks, ND, USA
- Sanford Medical Center Bismarck, Bismarck, ND, USA
| | | | - Mentor Ahmeti
- Department of Surgery, University of North Dakota School of Medicine and Health Sciences, Grand Forks, ND, USA
- Sanford Medical Center Fargo, Fargo, ND, USA
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Katz C, Attrash-Najjar A, Maguire-Jack K, Varela N, Priolo-Filho SR, Bérubé A, Chang OD, Collin-Vézina D, Fouché A, Jacobson M, Kaawa-Mafigiri D, Massarweh N, Munoz P, Tarabulsy GM, Tiwari A, Walker-Williams H, Werkele C. Experiences and responses of child protection professionals during COVID-19: Lessons learned from professionals around the globe. CHILD ABUSE & NEGLECT 2024:106688. [PMID: 38355365 DOI: 10.1016/j.chiabu.2024.106688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 12/10/2023] [Accepted: 01/31/2024] [Indexed: 02/16/2024]
Abstract
BACKGROUND COVID-19 significantly worsened already challenging circumstances for children and their families and globally increased the likelihood of child maltreatment. This risk heightened the urgency of child protection professionals in preventing child maltreatment and defending children's rights. The vast and growing body of research on protecting children from child maltreatment during COVID-19 has emphasized practitioners' tremendous difficulty in this arena. OBJECTIVE The current international study sought to identify the experiences and responses of child protection professionals to child maltreatment during COVID-19. PARTICIPANTS AND SETTING Five real-time, virtual focus groups were conducted among professionals who work with children from countries around the globe. METHOD Reflexive thematic analysis was employed to analyze the focus group transcripts. RESULTS The participants identified their experiences and challenges in performing their role of protecting children. Additionally, they shared context-adapted and innovative responses to child maltreatment, while emphasizing self-care and their mental health. CONCLUSIONS The results highlighted that child protection was significantly more challenging during the COVID-19 pandemic. Furthermore, they underlined the importance of establishing practices and policies for child protection in crisis times as well as ensuring both children's and professionals' well-being and mental health.
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Affiliation(s)
- Carmit Katz
- Bob Shapell School of Social Work, Tel Aviv University, Chaim Levanon 30, Tel Aviv 69978, Israel.
| | - Afnan Attrash-Najjar
- Bob Shapell School of Social Work, Tel Aviv University, Chaim Levanon 30, Tel Aviv 69978, Israel.
| | - Kathryn Maguire-Jack
- School of Social Work, University of Michigan, 1080 S. University Ave., Ann Arbor, MI 48109, USA.
| | - Natalia Varela
- Faculty of Social and Human Sciences, Externado University, Calle 12 No. 1-17 Este, Bogotá, Colombia.
| | - Sidnei Rinaldo Priolo-Filho
- Laboratório de Pesquisa, Prevenção e Intervenção em Psicologia Forense - Universidade Tuiuti do Paraná, Brazil
| | - Annie Bérubé
- The Department of Psychoeducation and Psychology, Université du Québec en Outaouais, Canada.
| | - Olivia D Chang
- School of Social Work, University of Michigan, 1080 S. University Ave., Ann Arbor, MI 48109, USA.
| | - Delphine Collin-Vézina
- The Centre for Research on Children and Families, McGill University, Suite 106, Wilson Hall, 3506 University Street, Montreal, Quebec H3A 2A7, Canada.
| | - Ansie Fouché
- Department of Social Wellbeing, United Arab Emirates University, P.O. Box 15551, Al Ain, Abu Dhabi, United Arab Emirates; North-West University, Vanderbijlpark Campus, COMPRES research entity, Gauteng, South Africa.
| | - Ma'ayan Jacobson
- Haruv Institute, The Hebrew University of Jerusalem, Mount Scopus, Jerusalem, Israel.
| | - David Kaawa-Mafigiri
- Department of Social Work and Social Administration, Makerere University, Uganda
| | - Nadia Massarweh
- The Al-Qasemi Academic College of Education, P.O. Box 124, Baqa-El-Gharbia 3010000, Israel
| | - Pablo Munoz
- Departamento de Psicología, Nacional Universidad de Colombia, Building 205 - Of. 117, Bogota, DC, Colombia.
| | - George M Tarabulsy
- Faculty of Social Sciences, Pavillon Charles-De Koninck 1030, Avenue des Sciences-Humaines Suite 3456, Laval University, Quebec, Quebec G1V 0A6, Canada.
| | - Ashwini Tiwari
- The Institute of Public and Preventive Health, Augusta University, 1120 15th St, Augusta, GA 30912, USA.
| | - Hayley Walker-Williams
- North-West University, Vanderbijlpark Campus, COMPRES research entity, Gauteng, South Africa.
| | - Christine Werkele
- The Offord Centre for Child Studies, McMaster University, 1280 Main St. W. - MIP 201A, Hamilton, ON L8S 4K1, Canada.
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Wang H, Yang YT, Lu QD, Liu CX, Bai HA, Wang JJ, Jie Q. Research hotspots for pediatric fractures from 2017 to 2022: A bibliometric and visual analysis via Citespace. J Child Orthop 2024; 18:40-48. [PMID: 38348436 PMCID: PMC10859118 DOI: 10.1177/18632521231217333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 11/11/2023] [Indexed: 02/15/2024] Open
Abstract
Objective This review provides guidance and ideas for researchers through a comprehensive and comparative analysis of the present state, trends, and hotspots in the pediatric fracture literature over the past 6 years. Methods We used Citespace 6.1.R6 software to explore the country/region distribution, institutions, journals, keyword analysis, and co-cited references of the literature from Web of Science core database. Results There are 6472 pieces of pediatric fracture-related literature, including 2962 from 2017 to 2019 and 3510 from 2020 to 2022. The country with the most papers is the United States, and US institutions and journals also have a pivotal position in this field. Research hotspots for pediatric fractures in 2017-2019: The topic with the most attention is bone mineral density leading to related bone diseases. Treatment for pediatric fractures, including supracondylar humeral fractures, Monteggia fractures, forearm fractures, knee fractures, and ankle fractures in children, is another topic of greater interest. Brain injuries and dental injuries in children due to abuse and trauma are also concerning issues. Research hotspots for pediatric fractures in 2020-2022: comparison with 2017-2019 revealed a relative decrease regarding ankle-related epiphyseal injuries, but there is a higher focus on the epidemiology of fractures in children, risk factors, and reasons for childhood trauma. We have confirmed through literature co-citations that the literature of high interest is also in these aspects. Conclusion Researchers and clinicians can quickly learn about topics of interest through authoritative journals and highly cited literature and rapidly master the current status and frontiers of the field through study, providing ideas for future work.
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Affiliation(s)
| | | | - Qing-da Lu
- Pediatric Orthopedic Hospital, Honghui Hospital, Xi’an Jiaotong University, Xi’an, China
| | - Chen-xin Liu
- Pediatric Orthopedic Hospital, Honghui Hospital, Xi’an Jiaotong University, Xi’an, China
| | - Huan-an Bai
- Pediatric Orthopedic Hospital, Honghui Hospital, Xi’an Jiaotong University, Xi’an, China
| | - Jia-ju Wang
- Pediatric Orthopedic Hospital, Honghui Hospital, Xi’an Jiaotong University, Xi’an, China
| | - Qiang Jie
- Pediatric Orthopedic Hospital, Honghui Hospital, Xi’an Jiaotong University, Xi’an, China
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10
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Steyn M, Brits D, Botha D, Holland S. Violence against children: A review of cases at a forensic anthropology unit, Johannesburg, South Africa. J Forensic Leg Med 2024; 101:102623. [PMID: 38043241 DOI: 10.1016/j.jflm.2023.102623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 11/13/2023] [Accepted: 11/16/2023] [Indexed: 12/05/2023]
Abstract
South Africa is experiencing a scourge of violence against women and children, with alarming levels of violence, and as such, juvenile cases are sometimes encountered in a forensic anthropological setting. The aim of this research was to assess the cases of juveniles (under 20 years) presenting at the Human Variation and Identification Research Unit (HVIRU) for a 6-year period (2016-2022), in order to assess patterns and types of cases referred. A total of 19 cases were assessed, of which 10 were 16-20 years old, 3 between the ages of 5 and 15 years and 6 less than 5 years old at the time of death. Of the 14 children with known sex, 12 were female with features suggesting that they fell prey to sexual violence. Many of the individuals were either known (and referred for trauma analysis) or identified following investigation. Of the 19 juveniles, 11 (58 %) had evidence of perimortem trauma (sharp and/or blunt), attesting to the violent nature of their deaths. Two cases had both sharp and blunt force trauma, of which one is a possible case of dismemberment. The remains of two individuals showed signs of perimortem burning, which may or may not be related to the cause of death. Three individuals had signs of antemortem (healed) trauma, which may suggest a longer period of abuse. Five of the individuals showed signs of disease - two had cribra orbitalia, while two others had various porous lesions indicative of chronic disease or malnutrition. One individual had advanced osteomyelitis, suggesting a natural cause of death. Some of these cases had unusual trauma and pathology, highlighting the contribution of forensic anthropologists.
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Affiliation(s)
- M Steyn
- Human Variation and Identification Research Unit, School of Anatomical Sciences, Faculty of Health Sciences, University of the Witwatersrand, South Africa.
| | - D Brits
- Human Variation and Identification Research Unit, School of Anatomical Sciences, Faculty of Health Sciences, University of the Witwatersrand, South Africa
| | - D Botha
- Human Variation and Identification Research Unit, School of Anatomical Sciences, Faculty of Health Sciences, University of the Witwatersrand, South Africa
| | - S Holland
- Department of Forensic Medicine, Faculty of Health Sciences, University of the Witwatersrand, South Africa
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11
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Garner JB, Self-Brown S, Emery V, Wootten K, Tiwari A. COVID-19 and Caregiver Risk Factors for Child Maltreatment: The Pandemic in Review. TRAUMA, VIOLENCE & ABUSE 2024; 25:613-629. [PMID: 36935570 PMCID: PMC10030880 DOI: 10.1177/15248380231158609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
The COVID-19 pandemic has fostered an environment for increased risk of child maltreatment (CM) as families experience increased psychosocial and financial burdens and spend unprecedented amounts of time together in the home. This narrative review aimed to summarize empirical findings on existing or new pandemic-related risk factors among caregivers. A combination of search terms related to CM and COVID-19 were used to identify articles published within five databases between February 2020 and July 2022. Literature searches produced 113 articles, of which 26 published across 12 countries met inclusion criteria. Four previously well-established risk factors for CM perpetration continued to persist during the pandemic, including stress, parental mental health, financial concerns, and parental substance use. Of note, inconsistent definitions and measures were used to capture these risk factors. Several additional emerging and understudied risk factors were also identified among limited articles, such as food insecurity and parental education. Findings emphasize the ongoing need for evidence-based interventions to address CM risk during the pandemic, including parent training programs. However, consolidated measures and consistent conceptualization of risk factors are needed to advance the study of CM. Going forward, practitioners and researchers should (a) strengthen the identification process for families at greatest risk for CM, and particularly those vulnerable to pandemic-related stressors; and (b) augment delivery of CM prevention strategies and evidence-based programs to fit the pandemic context.
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12
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Nation A, Pacella R, Monks C, Mathews B, Meinck F. Prevalence of violence against children in the United Kingdom: A systematic review and meta-analysis. CHILD ABUSE & NEGLECT 2023; 146:106518. [PMID: 37944361 DOI: 10.1016/j.chiabu.2023.106518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 10/10/2023] [Accepted: 10/16/2023] [Indexed: 11/12/2023]
Abstract
BACKGROUND Violence against children can have extensive, long-term, and far-reaching adverse impacts on survivors and society. There is currently little consensus in the United Kingdom around the prevalence of violence against children: maltreatment, intimate partner violence, sexual violence, bullying, and community violence, and most existing studies focus on only a single or a few forms of violence. This study aims to produce data to highlight the current magnitude of the problem in the UK, to inform policy, drive action and allow for monitoring of progress over time. OBJECTIVE To produce weighted prevalence estimates by violence type, as well as gender and age sub-categories, to give as full a picture as possible of the current prevalence of violence against children in the UK. PARTICIPANTS AND SETTING The prevalence of violence against children from 23 self-report studies conducted in the United Kingdom was gathered through a systematic review. METHODS Databases were searched from inception to 24th June 2022. Studies were reviewed systematically for appropriate data and meta-analyses were conducted to give pooled prevalence data based on a quality effects model. RESULTS The most prevalent self-reported experience of childhood violence was community violence at 27.33 % (95 % CI [9.84, 48.97]). Prevalence of bullying was also high at 22.75 % (95 % CI [13.25, 33.86]). The most prevalent forms of child maltreatment were domestic violence exposure at 11.9 % (95 % CI [6.34, 18.84]) and emotional maltreatment at 11.84 % (95 % CI [5.58, 19.89]). CONCLUSION National child maltreatment surveys are needed in the UK, using a comprehensive and conceptually robust approach, and valid and reliable instruments, to provide data for researchers and policymakers on the prevalence of all types of violence against children including exposure to multiple types. This allows monitoring of trends over time, can inform strategies for prevention, and can enable monitoring of future progress in reducing violence against children and its associated health and economic burden.
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Affiliation(s)
- Alexandra Nation
- Institute for Lifecourse Development, University of Greenwich, Park Row, Greenwich, London SE10 9LS, United Kingdom.
| | - Rosana Pacella
- Institute for Lifecourse Development, University of Greenwich, Park Row, Greenwich, London SE10 9LS, United Kingdom
| | - Claire Monks
- Institute for Lifecourse Development, University of Greenwich, Park Row, Greenwich, London SE10 9LS, United Kingdom
| | - Ben Mathews
- Australian Centre for Health Law Research, Queensland University of Technology, 130 Victoria Park Road, Brisbane, Queensland 4059, Australia; Johns Hopkins University, Bloomberg School of Public Health, 3400 N Charles Street, Baltimore, MD 21218, United States of America
| | - Franziska Meinck
- School of Social and Political Science, University of Edinburgh, EH8 9LD, United Kingdom; School of Public Health, University of the Witwatersrand, Johannesburg, South Africa; Optentia, North-West University, Vanderbijlpark, South Africa
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13
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Campbell KA, Wood JN, Berger RP. Child Abuse Prevention in a Pandemic-A Natural Experiment in Social Welfare Policy. JAMA Pediatr 2023; 177:1263-1265. [PMID: 37870864 DOI: 10.1001/jamapediatrics.2023.4525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2023]
Affiliation(s)
- Kristine A Campbell
- Department of Pediatrics, Center for Safe and Healthy Families, Primary Children's Hospital, The University of Utah, Salt Lake City
| | - Joanne N Wood
- Division of General Pediatrics, Clinical Futures, and PolicyLab, Roberts Center for Pediatric Research, Perelman School of Medicine at the University of Pennsylvania, Philadelphia
| | - Rachel P Berger
- Department of Pediatrics, University of Pittsburgh Medical Center Children's Hospital of Pittsburgh, Safar Center for Resuscitation Research, University of Pittsburgh, Pittsburgh, Pennsylvania
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14
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Andoh JE, Miguez S, Andoh SE, Mehta S, Mir TA, Chen EM, Jain S, Teng CC, Nwanyanwu K. Epidemiologic trends of domestic violence-related ocular injuries among pediatric patients: data from the Nationwide Emergency Department Sample 2008-2017. J AAPOS 2023; 27:335.e1-335.e8. [PMID: 37931837 PMCID: PMC10859911 DOI: 10.1016/j.jaapos.2023.09.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 09/05/2023] [Accepted: 09/26/2023] [Indexed: 11/08/2023]
Abstract
PURPOSE To study the epidemiology of all domestic violence (DV)-related ocular injuries among pediatric emergency department (ED) patients in the United States. METHODS This is a retrospective, cross-sectional study of isolated children (<18 years of age) with a diagnosis of DV and primary or secondary diagnosis of ocular injuries in the Nationwide Emergency Department Sample, 2008-2017. We calculated annual incidence of DV-related ocular injuries and prevalence by demographic variables, including age, sex, and income quartile. Median charges, median length of inpatient hospital stay, and factors associated with hospitalization were also measured. RESULTS From 2008 to 2017, there were 4,125 ED encounters, with an average incidence of 0.56 per 100,000 population (males, 50.0%; mean age [SE], 9.2 [0.3]). Patients in the lowest income quartile (42.6%) and with Medicaid insurance (63.2%) were the most prevalent. The most common known perpetrator was a family member (29.4%). Most ED encounters took place at southern regional (28.6%), metropolitan teaching (67.1%) and designated trauma hospitals (57.8%). Contusion of the eye/adnexa and being struck by or against an object were the most common ocular diagnosis and known mechanism of injury, respectively. An estimated 12.4% of patients were admitted with a median hospital stay of 4 (IQR, 2-6). Median charges during the study period were $27,415.10 (IQR, $13,142.70-$54,454.90). CONCLUSIONS DV-related ocular injuries were most prevalent among patients with a low socioeconomic status. Given the historical underreporting of DV, future studies are warranted to identify more specific social determinants of health that contribute to such presentations.
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Affiliation(s)
- Joana E Andoh
- Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland.
| | - Sofia Miguez
- Department of Ophthalmology and Visual Science, Yale School of Medicine, New Haven, Connecticut
| | - Sarah E Andoh
- University of Vermont, Larner College of Medicine, UVMMC, Burlington, Vermont
| | - Sumarth Mehta
- Department of Ophthalmology and Visual Science, Yale School of Medicine, New Haven, Connecticut
| | - Tahreem A Mir
- Department of Ophthalmology and Visual Sciences, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Evan M Chen
- Department of Ophthalmology, School of Medicine, University of California, San Francisco, San Francisco, California
| | - Srimathy Jain
- Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland
| | - Christopher C Teng
- Department of Ophthalmology and Visual Science, Yale School of Medicine, New Haven, Connecticut
| | - Kristen Nwanyanwu
- Department of Ophthalmology and Visual Science, Yale School of Medicine, New Haven, Connecticut
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15
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Sullivan TM, Scheese D, Jain E, Milestone ZP, Haynes J, Boomer LA. Injury Patterns and Outcomes at a Single Pediatric Trauma Center During the Coronavirus Disease 19 Pandemic. J Surg Res 2023; 292:123-129. [PMID: 37619496 PMCID: PMC10285201 DOI: 10.1016/j.jss.2023.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 05/22/2023] [Accepted: 06/13/2023] [Indexed: 08/26/2023]
Abstract
INTRODUCTION The coronavirus disease 19 (COVID-19) pandemic is reported to have changed injury patterns, prevalence, and outcomes across multiple institutions in the United States. Interpretation of aggregate data is difficult because injury patterns vary between urban and rural hospitals and the implementation of locoregional public health policies and guidelines in response to COVID-19 differed. To prepare our trauma system for future societal shutdowns, we compared injury patterns and outcomes of injured children and adolescents at a single pediatric trauma center before and during the first 2 y of the COVID-19 pandemic. METHODS We abstracted demographic, injury, and outcome data for injured children and adolescents (age <15 y) who required admission using our hospital trauma registry and the electronic medical record. We compared differences prior to and during the COVID-19 pandemic using univariate analysis. To address confounding variables, we also analyzed in-hospital mortality using a multivariable regression. RESULTS We observed an increase in the number of injured children requiring admission during the first year of the COVID-19 pandemic compared to the prepandemic era. Among injury types sustained, we observed an increase in firearm and nonfirearm related penetrating injuries (P < 0.001) during the first year, but not the second year, of the COVID-19 pandemic. Controlling for several confounding variables, we also observed an increase in in-hospital mortality (P = 0.04) during the first year of the COVID-19 pandemic. CONCLUSIONS The psychosocial and socioeconomic burden of the COVID-19 pandemic may have contributed to the rise in penetrating injuries and the odds of in-hospital mortality among a cohort of children and adolescents who were admitted to our hospital following injury. This data may be used to prepare our trauma system for future societal shutdowns through data informed resource utilization.
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Affiliation(s)
- Travis M Sullivan
- Department of Surgery, Virginia Commonwealth University Health System, Richmond, Virginia
| | - Daniel Scheese
- Department of Surgery, Virginia Commonwealth University Health System, Richmond, Virginia
| | - Eisha Jain
- Virginia Commonwealth University School of Medicine, Richmond, Virginia
| | | | - Jeffrey Haynes
- Division of Pediatric Surgery, Children's Hospital of Richmond at Virginia Commonwealth University, Richmond, Virginia
| | - Laura A Boomer
- Division of Pediatric Surgery, Children's Hospital of Richmond at Virginia Commonwealth University, Richmond, Virginia.
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16
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Mashiloane N, Nell W, Truter E. A qualitative exploration of the drivers for the transfer of foster children in Gauteng, South Africa. CHILD ABUSE & NEGLECT 2023; 146:106472. [PMID: 37778284 DOI: 10.1016/j.chiabu.2023.106472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 07/17/2023] [Accepted: 09/14/2023] [Indexed: 10/03/2023]
Abstract
BACKGROUND Many children in South Africa are orphaned or subjected to maltreatment, leaving them in need of care and protection. Foster care is one form of alternative care for such children. Retention of foster parents, or foster care placement stability, is one of the many challenges related to foster care, globally and in South Africa. This instability can have an adverse impact on children, and although some research speaks to the problem, the experiences of South African role players regarding this problem have not been documented, to date. To improve foster care retention in South Africa, local, contextualized studies exploring the drivers of foster care placement instability are required. AIM The aim of this qualitative study was thus to explore designated social workers' (DSWs) and foster parents' experiences about the reasons prompting foster care transfers. PARTICIPANTS AND SETTING A purposively selected sample of ten foster parents and ten DSWs in the Gauteng province of South Africa took part in the study. METHODS A descriptive qualitative study was adopted as basis for this study, which entailed thematic analysis of 20 semi-structured interviews. RESULTS It was found that children's behavioural problems, a shortage of resources, a lack of parenting skills, problematic relationships between foster parents and foster children, and previous traumatic events, led to most foster care transfers. A key finding from this study, which appears not to be evident in previous studies, centres on the critical role played by money, or rather its absence, in contributing to foster care placement instability. CONCLUSIONS When considered in conjunction with findings emerging from previous studies, our findings underscore the importance of obtaining a contextualized understanding of local, cultural factors at play in foster care delivery. To improve foster care retention in South Africa, which is fraught with challenges not yet reported elsewhere, it is recommended that screening procedures for foster parents be revised, and that allocation of resources to DSWs be prioritized.
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Affiliation(s)
- Nomlinda Mashiloane
- South African Council of Social Service Profession (SACSSP) and the South African Association of Social Workers in Private Practice (SAASWIPP), South Africa
| | - Werner Nell
- Faculty of Humanities, Optentia Research Entity, North-West University, Vanderbijlpark, South Africa.
| | - Elmien Truter
- Faculty of Health Sciences, COMPRES Research Entity, North-West University, Vanderbijlpark, South Africa.
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17
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Maassel NL, Graetz E, Schneider EB, Asnes AG, Solomon DG, Leventhal JM. Hospital Admissions for Abusive Head Trauma Before and During the COVID-19 Pandemic. JAMA Pediatr 2023; 177:1342-1347. [PMID: 37870839 PMCID: PMC10594171 DOI: 10.1001/jamapediatrics.2023.4519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Accepted: 07/19/2023] [Indexed: 10/24/2023]
Abstract
Importance Several studies have demonstrated a decrease in the occurrence of child abuse in the US since the start of the COVID-19 pandemic. This finding has generated concern for missed cases due to the initial lockdowns and lack of childcare resources. Determining the association of the pandemic on hospitalizations for severe forms of abuse is essential to focus preventive efforts. Objective To examine trends in abusive head trauma (AHT) before and during the COVID-19 pandemic. Design, Setting, and Participants Retrospective, multicenter, repeated cross-sectional study, conducted January 1, 2016, through April 30, 2022, with data from tertiary care children's hospitals and contributors to the Pediatric Health Information System. Data were obtained for 2380 hospitalizations of children younger than 5 years with International Classification of Diseases, Tenth Revision, Clinical Modification codes for both abuse and head trauma. Main Outcomes and Measures Monthly hospitalizations were analyzed using interrupted time-series analysis. Hospitalization severity (eg, intensive care unit stay) and clinical characteristics (subdural hemorrhages and retinal hemorrhages) were compared before and after the start of the pandemic. Results We identified 2380 hospitalizations due to AHT (median age, 140 [IQR, 75.0-325.5] days) from 45 hospitals. The mean (SD) monthly incidence of AHT was 34.3 (5.8) before the COVID-19 pandemic compared with 25.6 (4.2) during COVID-19 (a 25.4% decrease). When the pre-COVID-19 and during COVID-19 periods were compared, there were no significant differences in severity or clinical characteristics. On interrupted time-series analysis, there was a significant decrease in the number of monthly hospitalizations (-8.1; 95% CI, -12.41 to -3.72; P < .001) in the first month of the pandemic. In the subgroup of children younger than 1 year, there was a significant decrease in monthly hospitalizations at the onset of the pandemic (-8.2; 95% CI, -12.02 to -4.43; P < .001) followed by a significant temporal increase across the COVID-19 period (P = .01). Conclusions and Relevance The findings of this cross-sectional study suggest there was a significant decrease in monthly hospitalizations for AHT following the start of the pandemic in March 2020. Although there was no corresponding increase in hospitalization severity, the decrease during the pandemic may have been transient, as monthly hospitalizations for children younger than 1 year increased significantly over time during COVID-19, after the initial decrease.
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Affiliation(s)
- Nathan L. Maassel
- Department of Surgery, Yale School of Medicine, New Haven, Connecticut
| | - Elena Graetz
- Department of Surgery, Surgery Health Services and Outcomes Research Center, Yale School of Medicine, New Haven, Connecticut
| | - Eric B. Schneider
- Department of Surgery, Surgery Health Services and Outcomes Research Center, Yale School of Medicine, New Haven, Connecticut
| | - Andrea G. Asnes
- Department of Pediatrics, Yale School of Medicine, New Haven, Connecticut
| | - Daniel G. Solomon
- Division of Pediatric Surgery, Department of Surgery, Yale School of Medicine, New Haven, Connecticut
| | - John M. Leventhal
- Department of Pediatrics, Yale School of Medicine, New Haven, Connecticut
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18
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Thierry KL, Hockett CW, Elliott AJ, Wosu AC, Chandran A, Blackwell CK, Margolis AE, Karagas MR, Vega CV, Duarte CS, Camargo CA, Lester BM, McGowan EC, Ferrara A, O'Connor TG, McEvoy CT, Hipwell AE, Leve LD, Ganiban JM, Comstock SS, Dabelea D. Associations between COVID-19-related family hardships/distress and children's Adverse Childhood Experiences during the pandemic: The Environmental influences on Child Health Outcomes (ECHO) program. CHILD ABUSE & NEGLECT 2023; 146:106510. [PMID: 37922614 PMCID: PMC11338313 DOI: 10.1016/j.chiabu.2023.106510] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 10/02/2023] [Accepted: 10/08/2023] [Indexed: 11/07/2023]
Abstract
BACKGROUND Economic hardships imposed by the pandemic could have implications for children's experiences of adversity in the home, or Adverse Childhood Experiences (ACEs). OBJECTIVE This observational cohort study examined associations between COVID-19-related hardships and distress (e.g., job loss, caregiver stress) and the cumulative number of child ACEs reported by caregivers during the pandemic (i.e., March 1, 2020-February 28, 2022). PARTICIPANTS AND SETTING The study included children (N = 4345; median age = 6.0 years, interquartile range = 4-9 years) and their parents/caregivers who participated in the NIH-funded Environmental influences in Child Health Outcomes (ECHO) Program. METHODS We described socio-demographic characteristics and pandemic-related family hardships/distress and cumulative child ACE scores reported during pre-pandemic and pandemic periods. We used negative binomial regression models to evaluate associations between pandemic-related family hardships and cumulative child ACE scores reported during the pandemic. RESULTS Each caregiver-reported hardship/distress was associated with higher child ACE scores reported during the pandemic. After accounting for pre-pandemic child ACE scores, moderate and severe symptoms of pandemic-related traumatic stress among caregivers were associated with 108 % and 141 % higher child ACE scores reported during the pandemic, respectively, compared with no or low caregiver symptoms. In addition, finance-related stress during the pandemic was associated with 47 % higher child ACE scores. After adjusting for pre-pandemic child experiences of neglect, most sources of stress remained significantly associated with higher child ACE scores reported during the pandemic, particularly severe/very severe symptoms of pandemic-related traumatic stress among caregivers. Findings held for children with no known pre-pandemic ACEs. CONCLUSIONS This research suggests that caregivers experiencing financial hardships and those with severe pandemic-related traumatic stress may require additional support systems during stressful events.
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Affiliation(s)
| | - Christine W Hockett
- Department of Pediatrics, University of South Dakota School of Medicine, Vermillion, SD, USA; Avera Research Institute, Sioux Falls, SD, USA
| | | | - Adaeze C Wosu
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Aruna Chandran
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Courtney K Blackwell
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Amy E Margolis
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
| | | | - Carmen Velez Vega
- Social Sciences Department, School of Public Health, University of Puerto Rico, San Juan, PR
| | - Cristiane S Duarte
- Columbia University Irving Medical Center - New York State Psychiatric Institute, New York, NY, USA
| | | | - Barry M Lester
- Department of Pediatrics, Brown University, Providence, RI, USA
| | | | - Assiamira Ferrara
- Kaiser Permanente Northern California Division of Research, Oakland, CA, USA
| | - Thomas G O'Connor
- Departments of Psychiatry, Psychology, Neuroscience and Obstetrics & Gynecology, University of Rochester, Rochester, NY, USA
| | - Cindy T McEvoy
- Department of Pediatrics, Oregon Health & Science University, Portland, OR, USA
| | - Alison E Hipwell
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Leslie D Leve
- Department of Education, University of Oregon, Eugene, OR, USA
| | - Jody M Ganiban
- Department of Psychological and Behavioral Sciences, The George Washington University, Washington, DC, USA
| | - Sarah S Comstock
- Department of Food Science and Human Nutrition, Michigan State University, East Lansing, MI, USA
| | - Dana Dabelea
- University of Colorado Anschutz Medical Campus, Aurora, CO, USA
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19
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Rebbe R, Reddy J, Kuelbs CL, Huang JS, Putnam-Hornstein E. The Impact of COVID-19 on Infant Maltreatment Emergency Department and Inpatient Medical Encounters. J Pediatr 2023; 262:113582. [PMID: 37353150 PMCID: PMC10284615 DOI: 10.1016/j.jpeds.2023.113582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 05/30/2023] [Accepted: 06/16/2023] [Indexed: 06/25/2023]
Abstract
OBJECTIVE To assess the counts of infant maltreatment-related medical encounters at a large medical system during a 21-month span of the COVID-19 pandemic. METHODS Retrospective data for this study came from all inpatient and emergency department medical encounters for infants from January 1, 2016, through November 30, 2021, at a single children's hospital system in California. Distributions of medical encounters were tabulated and plotted over time. Interrupted time series models were used to evaluate changes in child maltreatment medical encounters. RESULTS Medical encounters for infants with child maltreatment diagnoses increased following the onset of COVID-19. Monthly counts of encounters with indicated maltreatment trended upward following the start of the pandemic. Interrupted time series models showed that the count of maltreatment encounters increased 64% with the onset of COVID-19. CONCLUSIONS We found an increase in infant maltreatment medical encounters during a 21-month period following the onset of COVID-19. These findings suggest that the pandemic may have adversely affected the safety of infants and ongoing work is needed to understand better the pandemic impacts on child maltreatment.
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Affiliation(s)
- Rebecca Rebbe
- University of North Carolina at Chapel Hill School of Social Work, Chapel Hill, NC.
| | - Julia Reddy
- University of North Carolina at Chapel Hill Gillings School of Public Health, Chapel Hill, NC
| | - Cynthia L Kuelbs
- Rady Children's Hospital, San Diego, CA; Department of Pediatrics, University of San Diego, La Jolla, CA
| | - Jeannie S Huang
- Rady Children's Hospital, San Diego, CA; Department of Pediatrics, University of San Diego, La Jolla, CA
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20
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Sethuraman U, Kannikeswaran N, Singer A, Krouse CB, Cloutier D, Farooqi A, Donoghue L, Stankovic C. Trauma Visits to a Pediatric Emergency Department During the COVID-19 Quarantine and "Stay at Home" Period. Am Surg 2023; 89:4262-4270. [PMID: 34784788 DOI: 10.1177/00031348211047497] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Impact of social distancing on pediatric injuries is unknown. METHODS We retrospectively compared injury visits to a pediatric emergency department by individuals ≤21 years during "Stay at Home" (SHO) period to the same period in 2019 (non-SHO). Demographics, types, and outcomes of injuries were noted. RESULTS Although, there was a 35.6% reduction in trauma-related emergency department visits during SHO period (1226 vs 1904), the proportion of injury visits increased (15.5% vs 8.1%, P < .001) and mean age was lower (5.8 yrs ±4.5 vs 8.4 yrs ± 5.2, P < .001). There were significant increases in visits related to child physical abuse (CPA), firearms, and dog bites. Further, significant increases in trauma alerts (P < .01), injury severity (P < .01), critical care admissions (P < .001), and deaths (P < .01) occurred during the SHO period. CONCLUSIONS Although overall trauma-related visits decreased during SHO, the proportion of these visits and their severity increased. Trauma visits related to child physical abuse, dog bites, and firearms increased. Further studies are required to assess the long-term impact of pandemic on pediatric trauma epidemiology.
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Affiliation(s)
- Usha Sethuraman
- Division of Emergency Medicine, Department of Pediatrics, Children's Hospital of Michigan, Detroit, MI, USA
- Department of Pediatrics, Central Michigan University, Detroit, MI, USA
| | - Nirupama Kannikeswaran
- Division of Emergency Medicine, Department of Pediatrics, Children's Hospital of Michigan, Detroit, MI, USA
- Department of Pediatrics, Central Michigan University, Detroit, MI, USA
| | - Adam Singer
- Division of Emergency Medicine, Department of Pediatrics, Children's Hospital of Michigan, Detroit, MI, USA
- Department of Pediatrics, Central Michigan University, Detroit, MI, USA
| | | | - Dawn Cloutier
- Children's Hospital of Michigan, Trauma Program, MI, USA
| | - Ahmad Farooqi
- Division of Emergency Medicine, Department of Pediatrics, Children's Hospital of Michigan, Detroit, MI, USA
- Department of Pediatrics, Central Michigan University, Detroit, MI, USA
| | - Lydia Donoghue
- Children's Hospital of Michigan, Trauma Program, MI, USA
- Wayne State University, Detroit, MI, USA
| | - Curt Stankovic
- Division of Emergency Medicine, Department of Pediatrics, Children's Hospital of Michigan, Detroit, MI, USA
- Department of Pediatrics, Central Michigan University, Detroit, MI, USA
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21
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Liu C, Zhang M, Ma C, Fu M, Guo J, Zhen C, Zhang B. Childhood abuse as a mediator of the relationship between early family socio-economic status and geriatric depression: A population-based study in China. Heliyon 2023; 9:e22021. [PMID: 38034775 PMCID: PMC10682629 DOI: 10.1016/j.heliyon.2023.e22021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Revised: 11/01/2023] [Accepted: 11/02/2023] [Indexed: 12/02/2023] Open
Abstract
Previous studies have suggested that childhood socioeconomic status (SES) is linked to geriatric depressive symptoms in many developed countries. However, the potential pathways of the relationship between childhood SES and geriatric depressive symptoms need to be further explored. This study aimed to assess the mediating effect of being abused during childhood on the association between childhood SES and geriatric depressive symptoms, using evidence from a longitudinal study in China. The study cohort included 8137 individuals. Childhood abuse was defined as experiences related to parental violence, sibling abuse, school violence, community violence, and parental quarrel. Results indicated poor childhood SES was associated significantly with geriatric depressive symptoms. The indirect effect of poor childhood SES to high geriatric depressive risk through community violence, sibling abuse, school violence, and parental quarrel were 0.02, 0.01, 0.02, and 0.01, respectively. Our findings shed new light on the literature regarding the impact of childhood SES on elderly depressive symptoms. Furthermore, childhood SES demonstrated a significant correlation with geriatric depressive symptoms through bullying behaviors. The findings highlight the need to promote both childhood social welfare and psychological well-being within the elderly population.
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Affiliation(s)
- Chengcheng Liu
- The School of Social Development and Public Policy, Beijing Normal University, Beijing, 100875, PR China
| | - Mingyu Zhang
- School of Public Health, Peking University, Beijing, 100191, PR China
| | - Chongyue Ma
- School of Accounting, Henan University of Economics and Law, PR China
| | - Mingqi Fu
- School of Public Management, Central South University, Wuhan, 430079, PR China
| | - Jing Guo
- School of Public Health, Peking University, Beijing, 100191, PR China
- Health Policy and Technology Assessment Center, Peking University Health Science Center, Beijing, PR China
| | - Cheng Zhen
- Center For the History of Medicine, School of Health Humanities, Peking University Health Science Center, Beijing, PR China
| | - Bo Zhang
- Department of Neurology and ICCTR Biostatistics and Research Design Center, Boston Children's Hospital and Harvard Medical School, Boston, MA, USA
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22
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Ezeokoli EU, Pang LK, Loyd NG, Borici N, Bachim A, Vogel AM, Rosenfeld SB. Child traumatic physical abuse rates and comparisons during the COVID-19 pandemic: Retrospective paediatric single institution review in Texas. J Paediatr Child Health 2023; 59:1129-1134. [PMID: 37455617 DOI: 10.1111/jpc.16468] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 06/24/2023] [Accepted: 07/03/2023] [Indexed: 07/18/2023]
Abstract
AIM The COVID-19 pandemic drastically altered human behaviour and socialisation and may have created an environment that could lead to increased incidence of domestic abuse and non-accidental trauma, or child physical abuse (CPA). Initial reports about the effect of the COVID-19 pandemic on the rates of CPA have been mixed. The purpose of this study is to describe the effects of COVID-19 on rates of CPA in a large metropolitan paediatric hospital and level I paediatric trauma centre. METHODS We identified and compared all CPA admissions under 18 years from May 2019 to February 2020 and considered that to be the pre-COVID time frame. The ensuing 12-month period of March 2020 to February 2021 was considered to be the intra-COVID time frame. RESULTS There were 49 (0.32%) unique CPA patients pre-COVID and 83 (0.85%) unique CPA patients intra-COVID (P < 0.001) with lower total admissions for any reason during the intra-COVID time frame. Monthly CPA cases were increased (P < 0.03) during the intra-COVID time period (mean 6.9, 95% confidence interval: 5.8-12.7) compared to the pre-COVID time period (mean 4.9, 95% confidence interval: 3.3-8.2). CONCLUSION During the COVID-19 pandemic, there were decreased overall hospital admissions in the period of mandated shutdowns and isolation. However, we saw an increased rate of CPA admissions compared to the time period prior to the pandemic. Knowledge of such data, trends and circumstances will help keep health-care providers alert and vigilant in identifying children at risk for maltreatment, and may impact child abuse protocols and guidelines.
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Affiliation(s)
- Ekene U Ezeokoli
- Division of Pediatric Orthopedic Surgery, Texas Children's Hospital, Houston, Texas, United States
- Department of Orthopedic Surgery Baylor College of Medicine, Houston, Texas, United States
| | - Lon Kai Pang
- Department of Orthopedic Surgery Baylor College of Medicine, Houston, Texas, United States
| | - Nathaniel G Loyd
- Department of Orthopedic Surgery Baylor College of Medicine, Houston, Texas, United States
| | - Neritan Borici
- Division of Pediatric Orthopedic Surgery, Texas Children's Hospital, Houston, Texas, United States
- Department of Orthopedic Surgery Baylor College of Medicine, Houston, Texas, United States
| | - Angela Bachim
- Department of Pediatrics, Section of Public Health Pediatrics, Baylor College of Medicine, Texas Children's Hospital, Houston, Texas, United States
| | - Adam M Vogel
- Division of Pediatric Surgery, Department of Surgery Texas Children's Hospital and Baylor College of Medicine, Houston, Texas, United States
| | - Scott B Rosenfeld
- Division of Pediatric Orthopedic Surgery, Texas Children's Hospital, Houston, Texas, United States
- Department of Orthopedic Surgery Baylor College of Medicine, Houston, Texas, United States
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23
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Park H, Kang H, Yoon S, Jeong S, Lee S. The Effect of the COVID-19 Pandemic on Early Adolescent Fractures in the Republic of Korea. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1671. [PMID: 37763789 PMCID: PMC10537179 DOI: 10.3390/medicina59091671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Revised: 09/08/2023] [Accepted: 09/14/2023] [Indexed: 09/29/2023]
Abstract
Background and Objectives: Restrictions on daily activities to slow down the propagation of COVID-19 have changed the epidemiological pattern of pediatric fractures in many countries. However, the effect of the pandemic on pediatric fractures has not been fully studied. In this study, we investigated the impact of COVID-19 on early adolescent fractures in Korea. Materials and methods: We conducted a retrospective follow-up on a nationwide cohort of Korean early adolescents born between 2006 and 2009. The prevalence and incidence of pediatric fractures and the frequency of surgical treatment were compared between two different eras. Results: The prevalence and incidence of fractures during the pandemic have both shown a significant decrease: prevalence reduced from 34,626 to 24,789 (p < 0.001), while incidence decreased from 29,804 to 18,898 (p < 0.001). Considering sex, the shift in fracture prevalence was statistically significant (p = 0.020), whereas the incidence was not (p = 0.862). The decline in both fracture prevalence and incidence exhibited significant variation across birth year groups (prevalence, p < 0.001; incidence, p < 0.001), with a more pronounced reduction observed in the older age groups. While the proportion of patients who required surgeries has increased, the mean frequency of surgical treatment per patient remained at a similar level (by prevalence, p = 0.181; by incidence, p = 0.735). The decline in both fracture prevalence and incidence has shown significant variation in relation to fracture sites (prevalence, p < 0.001; incidence, p < 0.001), with a decrease in distal limb fractures and an increase in forearm and axial body fractures. Conclusions: The pediatric fracture pattern in Korea has been notably influenced by the COVID-19 pandemic, warranting further investigation into causal factors. Our findings should help predict epidemiology in the post-pandemic period and thus aid policymaking and patient management.
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Affiliation(s)
- HyunSeo Park
- CHA University School of Medicine, 120 Hyeryong-ro, Pocheon-si 11160, Gyeonggi-do, Republic of Korea; (H.P.); (H.K.)
| | - Hogyeong Kang
- CHA University School of Medicine, 120 Hyeryong-ro, Pocheon-si 11160, Gyeonggi-do, Republic of Korea; (H.P.); (H.K.)
| | - Siyeong Yoon
- Department of Orthopaedic Surgery, CHA Bundang Medical Center, CHA University School of Medicine, 335 Pangyo-ro, Bundang-gu, Seongnam-si 13488, Gyeonggi-do, Republic of Korea; (S.Y.); (S.J.)
| | - Simho Jeong
- Department of Orthopaedic Surgery, CHA Bundang Medical Center, CHA University School of Medicine, 335 Pangyo-ro, Bundang-gu, Seongnam-si 13488, Gyeonggi-do, Republic of Korea; (S.Y.); (S.J.)
| | - Soonchul Lee
- Department of Orthopaedic Surgery, CHA Bundang Medical Center, CHA University School of Medicine, 335 Pangyo-ro, Bundang-gu, Seongnam-si 13488, Gyeonggi-do, Republic of Korea; (S.Y.); (S.J.)
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24
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Nicoll G, Vincent J, Gajaria A, Zaheer J. A trauma-informed approach to suicide prevention for the COVID-19 pandemic. Psychiatry Res 2023; 327:115407. [PMID: 37579538 DOI: 10.1016/j.psychres.2023.115407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 07/31/2023] [Accepted: 08/05/2023] [Indexed: 08/16/2023]
Abstract
During the COVID-19 pandemic, researchers have questioned how the devastation of the pandemic might impact suicide rates. While initial evidence on suicide rates during the early stages of the pandemic is mixed, there are signs we should still remain vigilant. One way of conceptualizing the long-term effects of the pandemic is as a source of multiple traumatic events: the collective trauma of widespread illness and death and social upheaval, individual traumas from the virus itself (e.g., serious illness and disability, traumatic grief, vicarious trauma), traumas from the social and economic consequences (e.g., domestic violence, unemployment), and its intersections with pre-pandemic traumas and oppression. Given trauma is a well-established risk factor for suicide, this carries significant implications for suicide prevention in the wake of the pandemic. Yet access to trauma-informed care, education, and research remains limited. The pandemic presents a unique opportunity to address these gaps and implement a trauma-informed approach to suicide prevention. Building on existing frameworks, we describe how effective suicide prevention for the pandemic must incorporate trauma-informed and trauma-specific services, strategies, and policies; capacity building; collaborative research; and knowledge exchange. Attending to the traumatic effects of the pandemic may reduce the long-term impact on suicide rates.
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Affiliation(s)
- Gina Nicoll
- Department of Psychology, Faculty of Arts & Science, University of Toronto, Toronto, Ontario, Canada; Institute for Medical Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Jacqueline Vincent
- St. Michael's Hospital, Toronto, Ontario, Canada; Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Amy Gajaria
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Juveria Zaheer
- Institute for Medical Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
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25
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Katz C, Glucklich T, Attrash-Najjar A, Jacobson M, Cohen N, Varela N, Priolo-Filho SR, Bérubé A, Chang OD, Collin-Vézina D, Fouché A, Haffejee S, Katz I, Maguire-Jack K, Massarweh N, O'Reilly M, Tiwari A, Truter E, de Andrade Vieira RV, Walker-Williams H, Zibetti MR, Werkele C. The global impact of COVID-19 on child protection professionals: A scoping review and thematic analysis. CHILD ABUSE & NEGLECT 2023:106347. [PMID: 37479549 DOI: 10.1016/j.chiabu.2023.106347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Revised: 07/04/2023] [Accepted: 07/09/2023] [Indexed: 07/23/2023]
Abstract
BACKGROUND The COVID-19 pandemic triggered new risks for child maltreatment (CM) and exacerbated existing challenges for families and children, elevating the importance of child protection professionals (CPPs) while also adding barriers to their work. During the pandemic, many CPPs experienced increased workloads, a disrupted work environment, and personal pandemic-related hardships. However, the scope of how COVID-19 impacted CPPs globally, as well as their adopted coping strategies, have not been well explored. OBJECTIVE This study addresses these gaps in the research by conducting an international scoping review to explore and analyze these topics. METHOD The scoping review was performed in six languages: English, Hebrew, Arabic, French, Spanish, and Portuguese, across 16 databases. Sixteen manuscripts were included in the final thematic analysis of this review. RESULTS Two main themes were identified: 1) the impact of COVID-19 on CPPs, and 2) the coping and adaptation strategies employed by CPPs during COVID-19. This review revealed and emphasized the importance of CPPs' resilience during COVID-19, underpinned by the theoretical framework of the social ecology of resilience. CONCLUSIONS This study highlights the responsibility of social ecologies and organizational structures to create readiness for a rapid response in times of crisis as well as valuable evidence to inform how CPPs, children, and families may be better supported in the event of a future crisis.
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Affiliation(s)
- Carmit Katz
- Bob Shapell School of Social Work, Tel Aviv University, Chaim Levanon 30, Tel Aviv 69978, Israel.
| | - Talia Glucklich
- Bob Shapell School of Social Work, Tel Aviv University, Chaim Levanon 30, Tel Aviv 69978, Israel
| | - Afnan Attrash-Najjar
- Bob Shapell School of Social Work, Tel Aviv University, Chaim Levanon 30, Tel Aviv 69978, Israel
| | - Ma'ayan Jacobson
- Haruv Institute, The Hebrew University of Jerusalem, Mount Scopus, Jerusalem, Israel.
| | - Noa Cohen
- Bob Shapell School of Social Work, Tel Aviv University, Chaim Levanon 30, Tel Aviv 69978, Israel
| | - Natalia Varela
- Faculty of Social and Human Sciences, Externado University, Calle 12 No. 1-17 Este, Bogotá, Colombia.
| | - Sidnei Rinaldo Priolo-Filho
- Laboratório de Pesquisa, Prevenção e Intervenção em Psicologia Forense - Universidade Tuiuti do Paraná, Brazil
| | - Annie Bérubé
- The Department of Psychoeducation and Psychology, Université du Québec en Outaouais, Canada.
| | - Olivia D Chang
- School of Social Work, University of Michigan, 1080 S. University Ave., Ann Arbor, MI 48109, USA.
| | - Delphine Collin-Vézina
- The Centre for Research on Children and Families, McGill University, Suite 106, Wilson Hall, 3506 University Street, Montreal, Quebec H3A 2A7, Canada.
| | - Ansie Fouché
- Department of Social Wellbeing, United Arab Emirates University, P.O. Box 15551, Al Ain, Abu Dhabi, United Arab Emirates; North-West University, Vanderbijlpark Campus, COMPRES Research Entity, Gauteng, South Africa.
| | - Sadiyya Haffejee
- Centre for Social Development in Africa, University of Johannesburg, South Africa.
| | - Ilan Katz
- Social Policy Research Centre (SPRC), University of New South Wales, Sydney, NSW 2052, Australia.
| | - Kathryn Maguire-Jack
- School of Social Work, University of Michigan, 1080 S. University Ave., Ann Arbor, MI 48109, USA.
| | - Nadia Massarweh
- The Al-Qasemi Academic College of Education, P.O. Box 124, Baqa-El-Gharbia 3010000, Israel
| | - Michelle O'Reilly
- School of Media, Communication, and Sociology, University of Leicester and Leicestershire Partnership NHS Trust, UK.
| | - Ashwini Tiwari
- The Institute of Public and Preventive Health, Augusta University, 1120 15th St, Augusta, GA 30912, USA.
| | - Elmien Truter
- North-West University, Vanderbijlpark Campus, COMPRES Research Entity, Gauteng, South Africa.
| | | | - Hayley Walker-Williams
- North-West University, Vanderbijlpark Campus, COMPRES Research Entity, Gauteng, South Africa.
| | | | - Christine Werkele
- The Offord Centre for Child Studies, McMaster University, 1280 Main St. W. - MIP 201A, Hamilton, ON L8S 4K1, Canada.
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26
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Perron-Tremblay R, Clément MÈ, Dubois-Comtois K. Fear of COVID-19 and parental violence: The mediating role of parental burnout and child perceived as difficult. CHILD ABUSE & NEGLECT 2023; 143:106284. [PMID: 37352648 PMCID: PMC10267501 DOI: 10.1016/j.chiabu.2023.106284] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 05/27/2023] [Accepted: 06/11/2023] [Indexed: 06/25/2023]
Abstract
BACKGROUND Since the beginning of the COVID-19 pandemic, there has been a worldwide increase in the incidence of child abuse. Studies show that the pandemic context contributes to exacerbate several risk factors usually associated with the use of violent disciplinary practices. OBJECTIVE This study aims to better understand the role of parental burnout and child perceived as difficult as a parental stressor in the link between fear of COVID-19 and the use of parental violence (minor and severe physical violence and repeated psychological aggression). PARTICIPANTS The sample includes 467 mothers living in Québec (Canada) with a child aged 5 or less. METHOD An online questionnaire, administered one year after the beginning of the COVID-19 pandemic in Québec (March to May 2021), was used to measure parental violence, parental burnout, parental stress related to the perception of the child as difficult and fear of COVID-19. Serial mediation analyses were performed. RESULTS The main analyses confirmed the indirect association between fear of COVID-19 and the three forms of parental violence studied, through parental burnout and the child perceived as difficult. Unlike physical violence (minor and severe), the association between fear of COVID-19 and repeated psychological aggression is explained only by parental burnout. CONCLUSIONS This study has identified new mechanisms that allow a better understanding of processes underlying parental violence during the pandemic. It also shows that parental violence can also occur in low-risk families. It is crucial to develop strategies to prevent the use of violent disciplinary practices in future socio-health crises such as the COVID-19 pandemic.
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Affiliation(s)
- Roxanne Perron-Tremblay
- Département de psychologie, Université du Québec à Trois-Rivières, 3351, boul. des Forges, C.P. 500, Trois-Rivières, Québec, G9A 5H7, Canada
| | - Marie-Ève Clément
- Université du Québec en Outaouais, Saint-Jérôme, Québec, J7Z 0B7, Canada
| | - Karine Dubois-Comtois
- Département de psychologie, Université du Québec à Trois-Rivières, 3351, boul. des Forges, C.P. 500, Trois-Rivières, Québec, G9A 5H7, Canada; Hôpital en santé mentale Albert-Prévost, CIUSSS du Nord-de-l'Île-de-Montréal, Canada.
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27
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Kliem S, von Thadden A, Lohmann A, Kröger C, Baier D. The Effect of the Covid-19 Pandemic on Domestic Violence in Germany: A Comparison of Three Representative Population Surveys. JOURNAL OF INTERPERSONAL VIOLENCE 2023; 38:7296-7314. [PMID: 36636865 PMCID: PMC9849116 DOI: 10.1177/08862605221143194] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
The COVID-19 pandemic has had profound societal and economic effects. Concerns were raised that domestic violence might increase because of the enacted infection control measures. Previous findings on this issue have been contradictory. Since existing studies mainly rely on official reports, administrative data, helpline calls, or retrospective measures, their findings are likely to prove unreliable. Few population-based surveys include pre-pandemic data, limiting their ability to test for causality regarding increasing violence. Therefore, the aim of this study was to compare findings from population-representative surveys on the prevalence of intimate partner violence (IPV) and violence against children (VAC) before and during the COVID-19 pandemic. Based on the data of N = 3,639 individuals living with a romantic partner and N = 1,313 parents living with at least one of their children from three German representative population surveys, we estimated average marginal effects for the temporal trends (i.e., pre vs. post infection control measures) of domestic violence separately for males and females. To minimize bias across survey waves, inverse probability weighting was used. Results show no statistically significant increase in either physical or psychological forms of IPV or VAC as a result of the implementation of COVID measures. On the contrary, the 1-year prevalence was decreasing for certain forms of violence. Our findings suggest that the assessment of the consequences of infection control measures needs an empirical basis. Further research should be conducted using high-quality data sources. Therefore, the present study should be considered a stepping stone for ongoing research efforts to examine the consequences of pandemic-related infection control measures on the general population.
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Affiliation(s)
- Sören Kliem
- University of Applied Science, Jena,
Germany
- Sören Kliem, Ernst-Abbe-Hochschule Jena,
University of Applied Science, Carl-Zeiss Promenade 2, Jena 07745, Germany.
| | | | | | | | - Dirk Baier
- ZHAW Zurich University of Applied
Sciences, Zurich, Switzerland
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28
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Côté-Corriveau G, Luu TM, Lewin A, Brousseau É, Ayoub A, Blaser C, Auger N. Hospitalization for child maltreatment and other types of injury during the COVID-19 pandemic. CHILD ABUSE & NEGLECT 2023; 140:106186. [PMID: 37060690 PMCID: PMC10080276 DOI: 10.1016/j.chiabu.2023.106186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 03/13/2023] [Accepted: 03/31/2023] [Indexed: 05/06/2023]
Abstract
BACKGROUND The possibility that child maltreatment was misclassified as unintentional injury during the COVID-19 pandemic has not been evaluated. OBJECTIVE We assessed if child maltreatment hospitalizations changed during the pandemic, and if the change was accompanied by an increase in unintentional injuries. PARTICIPANTS AND SETTING This study included children aged 0-4 years who were admitted for maltreatment or unintentional injuries between April 2006 and March 2021 in hospitals of Quebec, Canada. METHODS We used interrupted time series regression to estimate the effect of the pandemic on hospitalization rates for maltreatment, compared with unintentional transport accidents, falls, and mechanical force injuries. We assessed if the change in maltreatment hospitalization was accompanied by an increase in specific types of unintentional injury. RESULTS Hospitalizations for child maltreatment decreased from 16.3 per 100,000 (95 % CI 9.1-23.4) the year before the pandemic to 13.2 per 100,000 (95 % CI 6.7-19.7) during the first lockdown. Hospitalizations for most types of unintentional injury also decreased, but injuries due to falls involving another person increased from 9.0 to 16.5 per 100,000. Hospitalization rates for maltreatment and unintentional injury remained low during the second lockdown, but mechanical force injuries involving another person increased from 3.8 to 8.1 per 100,000. CONCLUSIONS Hospitalizations for child maltreatment may have been misclassified as unintentional injuries involving another person during the pandemic. Children admitted for these types of unintentional injuries may benefit from closer assessment to rule out maltreatment.
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Affiliation(s)
- Gabriel Côté-Corriveau
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada; Institut national de santé publique du Québec, Montreal, Quebec, Canada; Department of Pediatrics, Sainte-Justine Hospital Research Centre, University of Montreal, Montreal, Quebec, Canada; University of Montreal Hospital Research Centre, Montreal, Quebec, Canada
| | - Thuy Mai Luu
- Department of Pediatrics, Sainte-Justine Hospital Research Centre, University of Montreal, Montreal, Quebec, Canada
| | - Antoine Lewin
- Medical Affairs and Innovation, Hema-Quebec, Saint-Laurent, Quebec, Canada; Department of Obstetrics and Gynecology, University of Sherbrooke, Sherbrooke, Quebec, Canada
| | - Émilie Brousseau
- Institut national de santé publique du Québec, Montreal, Quebec, Canada; University of Montreal Hospital Research Centre, Montreal, Quebec, Canada
| | - Aimina Ayoub
- Institut national de santé publique du Québec, Montreal, Quebec, Canada; University of Montreal Hospital Research Centre, Montreal, Quebec, Canada
| | - Christine Blaser
- Department of Social and Preventive Medicine, School of Public Health, University of Montreal, Montreal, Quebec, Canada
| | - Nathalie Auger
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada; Institut national de santé publique du Québec, Montreal, Quebec, Canada; University of Montreal Hospital Research Centre, Montreal, Quebec, Canada; Department of Social and Preventive Medicine, School of Public Health, University of Montreal, Montreal, Quebec, Canada.
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29
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Marmor A, Cohen N, Katz C. Child Maltreatment During COVID-19: Key Conclusions and Future Directions Based on a Systematic Literature Review. TRAUMA, VIOLENCE & ABUSE 2023; 24:760-775. [PMID: 34488521 PMCID: PMC10011920 DOI: 10.1177/15248380211043818] [Citation(s) in RCA: 23] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
The COVID-19 pandemic has had a far-ranging impact. As societies struggled to minimize infection, questions arose regarding the consequences for children. Initial research reported the urgent need for child protective services worldwide to adapt existing policies and practices to protect children from maltreatment during this time, which is the rationale for the current systematic literature review. This review examined studies published in peer-reviewed journals from March 2020 to October 2020 on child maltreatment (CM) in the context of COVID-19. Twenty-five manuscripts met the inclusion criteria and were predominantly from the United States, with three international studies. The majority of the studies included CM reports during COVID-19 based on official data. The results clearly demonstrated an increased risk for children alongside a worrisome international decrease in CM reports. Only two studies addressed interventions during the pandemic. The current review highlights that, along with the obligation of scholars to advance the protection of children during COVID-19, there is much that is unknown. Future studies should examine the impact of the pandemic on children and their surrounding systems as well as child protective services' responses, which face enormous challenges during a pandemic. An additional conclusion is that, since children were not identified as a health risk group during the pandemic, their protection rights may have been jeopardized. Furthermore, the variance identified in the policies of different countries pinpoints the urgent need to establish an international protocol for protecting children from maltreatment during COVID-19, a protocol that will hopefully be a basis for policymakers worldwide.
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Affiliation(s)
- Amitai Marmor
- Paul Baerwald School of Social Work and Social Welfare, Hebrew University of Jerusalem, Israel
- Amitai Marmor, Paul Baerwald School of Social Work and Social Welfare, Hebrew University of Jerusalem, Jerusalem 91905, Israel.
| | - Noa Cohen
- Bob Shapell School of Social Work, Tel-Aviv University, Israel
| | - Carmit Katz
- Bob Shapell School of Social Work, Tel-Aviv University, Israel
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30
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Obry S, Roman E, Tavernier E, Boutry N, Delval A, Blouet M, Tanase A, De Milly MN, Alison M, Vial J, Saint Martin P, Adamsbaum C, Morel B. The monthly incidence of abusive head trauma, inflicted skeletal trauma, and unexplained skin lesion in children in six French university hospitals during the COVID-19 pandemic. CHILD ABUSE & NEGLECT 2023; 138:106063. [PMID: 36758374 PMCID: PMC9884623 DOI: 10.1016/j.chiabu.2023.106063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 01/17/2023] [Accepted: 01/23/2023] [Indexed: 06/18/2023]
Abstract
INTRODUCTION The COVID-19 pandemic was a stressful period. Lockdowns may have added to parental difficulty leading to an increase in violence. This study aimed to compare the monthly incidence of high suspicion of child physical abuse before and during the COVID-19 pandemic. MATERIAL We have retrospectively reviewed imaging examinations of children having a skeletal X-ray examination in six university hospitals with high suspicion of abusive head traumatism (AHT), inflicted skeletal trauma (IST) and unexplained skin lesions (USL) between March 2020 and June 2021 and compared with the similar period from 2018 to 2019. The monthly incidence of the different physical maltreatment was analyzed using a QuasiPoisson regression model. RESULTS We included 178 children (n = 127 boys, 71.3 %), 110 during the pandemic period, median age 5 months. AHT was diagnosed in 91 children, 55 had inflicted skeletal trauma (IST) and 46 had unexplained skin lesions (USL). Among the 91 patients with AHT, 86 had a subdural hematoma (95.6 %) and 40 had bridging veins thrombosis (44 %). The ophthalmological examination performed on 89 children (97.9 %) revealed retinal hemorrhages in 57 children (89.8 %). The incidence of AHT doubled during the months of COVID-19 lockdowns (rate ratio = 2; 95 % CI [1.1; 3.6], p = 0.03). No difference in monthly incidence was observed for IST and USL groups. CONCLUSION A significant increase in AHT was observed during the months with lockdowns and curfews during the COVID-19 pandemic. This highlights the need for developing a national strategy to prevent physical abuse in children in this context.
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Affiliation(s)
- Sandra Obry
- UMR 1253, iBrain, Université de Tours, Inserm, Tours, France
| | - Elodie Roman
- Department of Pediatric Radiology, Jeanne de Flandre Hospital, CHU, Lille, France
| | - Elsa Tavernier
- INSERM, SPHERE, UMR1246, Université de Tours et Nantes, Tours, France
| | - Nathalie Boutry
- Department of Pediatric Radiology, Jeanne de Flandre Hospital, CHU, Lille, France
| | | | - Marie Blouet
- Department of Pediatric Imaging, Fondation Lenval Children's Hospital, Nice, France
| | - Anca Tanase
- Department of Pediatric Imaging, Robert Debré Hospital, APHP (Assistance Publique-Hôpitaux de Paris), Paris, France
| | - Marie Noelle De Milly
- Department of Pediatric Imaging, Robert Debré Hospital, APHP (Assistance Publique-Hôpitaux de Paris), Paris, France
| | - Marianne Alison
- Department of Pediatric Imaging, Robert Debré Hospital, APHP (Assistance Publique-Hôpitaux de Paris), Paris, France
| | - Julie Vial
- Department of Pediatric Radiology, Children's Hospital, CHU, Toulouse, France
| | | | - Catherine Adamsbaum
- Pediatric Radiology Department, AP-HP, Bicêtre Hospital, Le Kremlin Bicêtre, France
| | - Baptiste Morel
- UMR 1253, iBrain, Université de Tours, Inserm, Tours, France.
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31
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Evaluating the regional differences in pediatric injury patterns during the COVID-19 pandemic. J Surg Res 2023; 289:61-68. [PMID: 37086597 PMCID: PMC10033255 DOI: 10.1016/j.jss.2023.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 02/18/2023] [Accepted: 03/08/2023] [Indexed: 03/25/2023]
Abstract
Background Reports of pediatric injury patterns during the COVID-19 pandemic are conflicting and lack the granularity to explore differences across regions. We hypothesized there would be considerable variation in injury patterns across Pediatric Trauma Centers (PTCs) in the United States. Materials and Methods A multicenter, retrospective study evaluating patients <18-years-old with traumatic injuries meeting National Trauma Data Bank criteria was performed. Patients injured after Stay-at-Home Orders through September 2020 (“COVID” cohort) were compared to “Historical” controls from an averaged period of equivalent dates in 2016–2019. Differences in injury type, intent, and mechanism were explored at the site level. Results 47,385 pediatric trauma patients were included. Overall trauma volume increased during the COVID cohort compared to the Historical (COVID 7,068 patients vs. Historical 5,891 patients); however, some sites demonstrated a decrease in overall trauma of 25% while others had an increase over 33%. Bicycle injuries increased at every site, with a range in percent change from 24% to 135% increase. Although the greatest net increase was due to blunt injuries, there was a greater relative increase in penetrating injuries at 7/9 sites, with a range in percent change from 110% increase to a 69% decrease. Conclusions There was considerable discrepancy in pediatric injury patterns at the individual site level, perhaps suggesting a variable impact of the specific sociopolitical climate and pandemic policies of each catchment area. Investigation of the unique response of the community during times of stress at PTCs is warranted to be better prepared for future environmental stressors.
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Impact of the COVID-19 pandemic on the well-being of preschoolers: A parental guide. Heliyon 2023; 9:e14332. [PMID: 36974319 PMCID: PMC10028354 DOI: 10.1016/j.heliyon.2023.e14332] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 02/13/2023] [Accepted: 02/28/2023] [Indexed: 03/24/2023] Open
Abstract
Unexpected changes brought about by the coronavirus disease 2019 (COVID-19) have affected humans worldwide. This review attempts to address major parental concerns about the development of preschool-aged children during the pandemic from the perspectives of neuropsychology, consultation, and motor development for preschoolers aged 2–5 years. Methods A total of 273 articles including original data, review articles, national and regional perspectives, government websites, and commentaries were considered in this review, of which 117 manuscripts were excluded because they were unrelated to children, adolescents, or COVID -19 pandemic/upper respiratory infections. A total of 156 manuscripts were included after reading the abstract and entire article. Results Telehealth could be an effective tool for addressing cognitive and emotional challenges that arise during the pandemic. Online consultations are highlighted for nutritional guidelines and to overcome problems that parents face when caring for children in difficult times. Outdoor activities using sanitisers, proper cleanliness, and following standard operating procedures are recommended. Parental preoccupation with media should be avoided. Interpretation: Many preschoolers show delays in reaching their developmental milestones, and the pandemic has increased parents' concerns, as access to practitioners is limited. Therefore, parents should be encouraged to undergo neuropsychological consultations whenever necessary. This study emphasises important strategies to ensure that children's development is minimally affected while staying in the confined environment of their homes. This study serves as a new guide for parents, as they raise young children in the new normal. Parents should undergo basic yearly physical, neuropsychological, nutritional, and speech checkups.
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Ikeda AK, Ettinger RE, Susarla SM, Lu GN. The Effect of COVID-19 Shelter-in-Place Orders on Pediatric Craniofacial Trauma. Facial Plast Surg Aesthet Med 2023; 25:141-144. [PMID: 36315194 DOI: 10.1089/fpsam.2022.0174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Objectives: To investigate the impacts of the shelter-in-place orders on the injury patterns among children with craniofacial trauma. Materials and Methods: Pediatric (<18 years old) craniofacial trauma cases presenting to a regional level I trauma center 1 year before and after the initiation of Washington's shelter-in-place order were retrospectively reviewed. Demographic and injury-related variables were recorded, and bivariate and logistic regression analyses were computed. Results: One hundred nineteen children were evaluated over 2-year period (46 pre- and 73 post-shelter-in-place and were comparable in age, gender, and ethnicity (p ≥ 0.17)). The distribution of injury mechanisms between pre- and post-shelter-in-place were significantly different (p = 0.02), with the largest proportional increase in falls (10.5%) and had higher rates of associated brain injury (p ≤ 0.02). After adjusting for effect modifiers and confounders, children presenting during the post-shelter-in-place period were more likely to have associated brain injuries (odds ratio 3.4, 95% confidence interval: 1.11-10.6, p = 0.03). Conclusions: Among pediatric craniofacial injury cases, the shelter-in-place order was associated with a higher likelihood of brain injury and significant changes in injury mechanisms, with a higher proportion of falls.
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Affiliation(s)
- Allison K Ikeda
- Department of Otolaryngology-Head and Neck Surgery, University of Washington, Seattle, Washington, USA
| | - Russell E Ettinger
- Division of Plastic Surgery, Department of Surgery, University of Washington, Seattle, Washington, USA
| | - Srinivas M Susarla
- Division of Plastic Surgery, Department of Surgery, University of Washington, Seattle, Washington, USA.,Department of Oral and Maxillofacial Surgery, University of Washington, Seattle, Washington, USA
| | - G Nina Lu
- Department of Otolaryngology-Head and Neck Surgery, University of Washington, Seattle, Washington, USA
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Walter C, Miller M, Jones V, Ryan LM. Emergency Department-Attended Injuries Resulting from School-Based Violence in Baltimore Adolescents, 2019-2020. THE JOURNAL OF SCHOOL HEALTH 2023; 93:219-225. [PMID: 36426581 DOI: 10.1111/josh.13288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 09/29/2022] [Accepted: 11/02/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Our objective is to describe violence-related injuries to early adolescents that occurred at school, resulting in emergency department (ED) evaluation. METHODS This retrospective cohort study at an urban academic pediatric ED in Baltimore, MD, identified patients 10-15 years old who presented with an injury from intentional, interpersonal violence that occurred at school between January 2019-December 2020. Descriptive statistics were used to summarize patient and event characteristics. RESULTS Of 819 youth 10-15 years of age evaluated for a violence-related injury, school was the location in 115 cases (14.0%). All events occurred prior to the statewide stay at home order (March 30, 2020). School-injured youth had a mean age of 12.7 ± 1.7 years and were predominantly male (64.3%). Of the 115 cases, 75 (65.2%) involved an altercation with a peer, 26 (22.6%) involved a teacher or school staff, 6 (5.2%) involved a family member, 1 (0.9%) involved police, 6 (5.2%) involved an unknown party, and 1 (0.9%) involved an unrelated but known adult. All injured youth were discharged from the ED. CONCLUSIONS School-based violence is a well-recognized cause of traumatic injuries to adolescents and may involve peers, teachers, or school staff.
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Affiliation(s)
- Creason Walter
- Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Mattea Miller
- Johns Hopkins University School of Medicine, Baltimore, MD
| | - Vanya Jones
- Health, Behavior, & Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Leticia Manning Ryan
- Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
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Miller M, Jones V, Walter C, Manning Ryan L. Epidemiology of Injuries to Early Adolescents from Family Violence Evaluated in an Urban Pediatric Emergency Department. Pediatr Emerg Care 2023; 39:113-119. [PMID: 36728739 DOI: 10.1097/pec.0000000000002891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND Exposure to family violence during childhood and adolescence increases the risk for experiencing or perpetrating future violence. Social distancing protocols combined with reduction in access to youth/family services during the COVID-19 pandemic may have intensified the risk of exposure to familial violence. OBJECTIVES This study describes the epidemiology of violence-related injuries to 10- to 15-year-old children from family violence, including child maltreatment and physical fighting, resulting in emergency department (ED) evaluation. METHODS This retrospective cohort study located in an urban academic pediatric ED in the mid-Atlantic region is a review of electronic medical records between January 2019 and March 2020 (prepandemic period) and March to December 2020 (pandemic period). This review focused on visits for youth aged 10 to 15 years who presented for evaluation of an injury due to a violent event involving a family member. Demographic and clinical data were abstracted, including circumstances of the event. Descriptive statistics were used to summarize data and compare prepandemic to postpandemic proportions. RESULTS Of 819 youth aged 10 to 15 years evaluated for a violence-related injury, 448 (54.7%) involved a family member. Of these, most involved parents/guardians, 343 (76.6%), and occurred at home (83.9%). Most patients were girls (54.0%), Black/African American (84.4%), and were enrolled in a public insurance plan (71.2%). Most youth were transported to the hospital by police (66.7%). Overall, alcohol, drugs, and weapons were involved in 10.0%, 6.5%, and 10.7% of events, respectively, and their involvement significantly increased during the pandemic period to 18.8%, 14.9%, and 23.8% ( P < 0.001). Most patients (98.7%) were discharged from the ED. CONCLUSIONS More than half of violence-related injuries treated in the ED in this population resulted from family violence. Family violence is a prevalent and possibly underrecognized cause of injuries during adolescence. Further research should explore the potential of the ED as a setting for preventive interventions.
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Affiliation(s)
- Mattea Miller
- From the Johns Hopkins University School of Medicine
| | - Vanya Jones
- Health, Behavior, & Society, Johns Hopkins Bloomberg School of Public Health
| | - Creason Walter
- Department of Pediatrics, Johns Hopkins University School of Medicine
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Penna AL, de Aquino CM, Pinheiro MSN, do Nascimento RLF, Farias-Antúnez S, Araújo DABS, Mita C, Machado MMT, Castro MC. Impact of the COVID-19 pandemic on maternal mental health, early childhood development, and parental practices: a global scoping review. BMC Public Health 2023; 23:388. [PMID: 36823592 PMCID: PMC9950022 DOI: 10.1186/s12889-023-15003-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 01/05/2023] [Indexed: 02/25/2023] Open
Abstract
BACKGROUND In March 2020, the COVID-19 outbreak was declared a pandemic by the World Health Organization (WHO), generating stark economic and social repercussions that directly or indirectly affected families' wellbeing and health status. AIMS This review aims at mapping the existing evidence on the impact of the COVID-19 pandemic on maternal mental health, early childhood development, and parental practices, worldwide, to identify evidence gaps and better inform future delivery of care and health policy measures. METHODS Following the protocol defined by PRISMA-ScR, this scoping review has searched for relevant studies published between January 2020 and June 2021, selecting evidence sources based on pre-established criteria. From a total of 2,308 articles, data were extracted from 537 publications from 35 countries on all three health domains. RESULTS The combined stressors brought forth by the pandemic have exerted a heavy burden on the mental health of mothers and the development of young children, partly mediated by its impact on parental practices. CONCLUSIONS Despite remaining gaps, we have identified sufficient evidence pointing to an urgent need for more concerted global research efforts and rapid policy responses to timely address severe and pervasive negative impacts to the mental health of mothers and children at a key developmental stage.
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Affiliation(s)
- Ana Luiza Penna
- Department of Global Health and Population, Harvard T. H. Chan School of Public Health, Boston, USA.
| | - Camila Machado de Aquino
- grid.8395.70000 0001 2160 0329Department of Community Health, Federal University of Ceará, Fortaleza, Brazil
| | | | | | - Simone Farias-Antúnez
- grid.411237.20000 0001 2188 7235Department of Health Sciences, Federal University of Santa Catarina, Araranguá, Brazil
| | | | - Carol Mita
- grid.38142.3c000000041936754XCountway Library, Harvard Medical School, Boston, USA
| | | | - Marcia C. Castro
- grid.38142.3c000000041936754XDepartment of Global Health and Population, Harvard T. H. Chan School of Public Health, Boston, USA
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Li H. I'm Offering You My Pain: Priming COVID-19 Salience Increases Everyday Sadism. Psychol Rep 2023:332941231159611. [PMID: 36823028 PMCID: PMC9950809 DOI: 10.1177/00332941231159611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
Abstract
The COVID-19 pandemic and its link to the emergence of everyday sadism is a matter of public concern worldwide. However, previous studies are nearly silent regarding the causal relationship between the two variables. We address this gap by theorizing that exposure to information about coronavirus can increase sadistic behavior by inducing state boredom. We conducted three complementary controlled experiments, which comprised multiple participants populations (N = 784, student and community samples) and measurement techniques of sadism, to test our theoretical perspective. Based on self-report measures, Study 1 found that Chinese university students who were exposed to a reminder of COVID-19 exhibited a higher level of everyday sadism than participants in the control condition. Study 2 replicated this finding in a more generalized population. Additionally, results revealed that state boredom mediated this effect. Moving beyond subjective self-report data in Studies 1 and 2, Study 3 assessed a different behavioral operationalization of sadistic tendencies, namely, shredding worms. As expected, priming COVID-19 salience has an immediate, statistically significant influence on sadistic behavior in impactful real-world contexts. Overall, these findings suggest that the COVID-19 pandemic not only has grave effects on economy and society, but has implications for the malevolent side of human nature.
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Affiliation(s)
- Heng Li
- Sichuan International Studies University, Chongqing, China
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Geprägs A, Bürgin D, Fegert JM, Brähler E, Clemens V. Parental stress and physical violence against children during the second year of the COVID-19 pandemic: results of a population-based survey in Germany. Child Adolesc Psychiatry Ment Health 2023; 17:25. [PMID: 36804027 PMCID: PMC9940081 DOI: 10.1186/s13034-023-00571-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 02/01/2023] [Indexed: 02/22/2023] Open
Abstract
BACKGROUND Parents and caregivers belonged to those with the highest burdens during the COVID-pandemic. Considering the close link between parental stress and child maltreatment, identifying families with high parental stress is of utmost importance to prevent violence against children. Within this study, we thus aimed to investigate the interplay of parental stress, changes in parental stress, and physical violence against children during the second year of the COVID-pandemic on an exploratory level. METHODS We conducted a cross-sectional, observational study in Germany from July to October 2021. By using different sampling steps, a representative probability sample of the German population was generated. A subsample of these participants with children under the age of 18 was included for analysis within this study (N = 453, 60.3% females, Mage = 40.08; SD = 8.53). RESULTS Higher parental stress levels were associated with more physical violence against children, higher levels of own experiences of child maltreatment, and mental health symptoms. An increase in parental stress during the pandemic was associated with female sex, the use of physical violence against children, and parental experience of child maltreatment. Parents who have ever used physical violence against their children have been characterized by higher parental stress levels, a stronger increase in parental stress during the pandemic, own experience of child maltreatment, mental health symptoms and sociodemographic characteristics. Higher parental stress levels, a stronger increase of parental stress during the pandemic, having pre-existing psychiatric disorders, and parental experience of child maltreatment predicted an increased use of physical violence against children during the pandemic. CONCLUSIONS Our results underscore the importance of parental stress for the risk of physical violence against children, more so in times of overall increased stress due to the pandemic and underline the need for low threshold support for families at risk in times of crises.
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Affiliation(s)
- Alina Geprägs
- grid.6582.90000 0004 1936 9748Hospital of Child and Adolescent Psychiatry/Psychotherapy, University of Ulm, Ulm, Germany
| | - David Bürgin
- grid.6582.90000 0004 1936 9748Hospital of Child and Adolescent Psychiatry/Psychotherapy, University of Ulm, Ulm, Germany ,grid.6612.30000 0004 1937 0642Child and Adolescent Psychiatric Research Department (UPKKJ), Psychiatric University Hospitals, University of Basel, Basel, Switzerland
| | - Jörg M. Fegert
- grid.6582.90000 0004 1936 9748Hospital of Child and Adolescent Psychiatry/Psychotherapy, University of Ulm, Ulm, Germany
| | - Elmar Brähler
- grid.410607.4Department for Psychosomatic Medicine and Psychotherapy, University Medical Center of Johannes Gutenberg University of Mainz, Mainz, Germany ,grid.9647.c0000 0004 7669 9786Integrated Research and Treatment Center Adiposity Diseases, Behavioral Medicine Unit, Department of Psychosomatic Medicine and Psychotherapy, Leipzig University Medical Center, Leipzig, Germany
| | - Vera Clemens
- Hospital of Child and Adolescent Psychiatry/Psychotherapy, University of Ulm, Ulm, Germany.
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Gum AM, Goldsworthy M, Guerra L, Salloum A, Grau M, Gottstein S, Horvath C, Fields A, Crowder J, Holley R, Ruth LJ, Hanna K. Trauma-informed patient and public-engaged research: Development and evaluation of an online training programme. Health Expect 2023; 26:388-398. [PMID: 36345789 PMCID: PMC9854293 DOI: 10.1111/hex.13668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 10/17/2022] [Accepted: 11/06/2022] [Indexed: 11/11/2022] Open
Abstract
INTRODUCTION As patients, members of the public, and professional stakeholders engage in co-producing health-related research, an important issue to consider is trauma. Trauma is very common and associated with a wide range of physical and behavioural health conditions. Thus, it may benefit research partnerships to consider its impact on their stakeholders as well as its relevance to the health condition under study. The aims of this article are to describe the development and evaluation of a training programme that applied principles of trauma-informed care (TIC) to patient- and public-engaged research. METHODS A research partnership focused on addressing trauma in primary care patients ('myPATH') explicitly incorporated TIC into its formation, governance document and collaborative processes, and developed and evaluated a free 3-credit continuing education online training. The training was presented by 11 partners (5 professionals, 6 patients) and included academic content and lived experiences. RESULTS Training participants (N = 46) positively rated achievement of learning objectives and speakers' performance (ranging from 4.39 to 4.74 on a 5-point scale). The most salient themes from open-ended comments were that training was informative (n = 12) and that lived experiences shared by patient partners were impactful (n = 10). Suggestions were primarily technical or logistical. CONCLUSION This preliminary evaluation indicates that it is possible to incorporate TIC principles into a research partnership's collaborative processes and training about these topics is well-received. Learning about trauma and TIC may benefit research partnerships that involve patients and public stakeholders studying a wide range of health conditions, potentially improving how stakeholders engage in co-producing research as well as producing research that addresses how trauma relates to their health condition under study. PATIENT OR PUBLIC CONTRIBUTION The myPATH Partnership includes 22 individuals with professional and lived experiences related to trauma (https://www.usf.edu/cbcs/mhlp/centers/mypath/); nine partners were engaged due to personal experiences with trauma; other partners are community-based providers and researchers. All partners contributed ideas that led to trauma-informed research strategies and training. Eleven partners (5 professionals, 6 patients) presented the training, and 12 partners (8 professionals, 4 patients) contributed to this article and chose to be named as authors.
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Affiliation(s)
- Amber M. Gum
- myPATH PartnershipUniversity of South FloridaTampaFloridaUSA
- Department of Mental Health Law & PolicyUniversity of South FloridaTampaFloridaUSA
- Department of Internal MedicineUniversity of South FloridaTampaFloridaUSA
| | - Mary Goldsworthy
- myPATH PartnershipUniversity of South FloridaTampaFloridaUSA
- Department of Mental Health Law & PolicyUniversity of South FloridaTampaFloridaUSA
| | - Lucy Guerra
- myPATH PartnershipUniversity of South FloridaTampaFloridaUSA
- Department of Internal MedicineUniversity of South FloridaTampaFloridaUSA
| | - Alison Salloum
- myPATH PartnershipUniversity of South FloridaTampaFloridaUSA
- School of Social WorkUniversity of South FloridaTampaFloridaUSA
| | - Meredith Grau
- myPATH PartnershipUniversity of South FloridaTampaFloridaUSA
- Crisis Center of Tampa BayTampaFloridaUSA
| | - Sheri Gottstein
- myPATH PartnershipUniversity of South FloridaTampaFloridaUSA
| | - Carol Horvath
- myPATH PartnershipUniversity of South FloridaTampaFloridaUSA
| | - Annanora Fields
- myPATH PartnershipUniversity of South FloridaTampaFloridaUSA
| | - Johnny Crowder
- myPATH PartnershipUniversity of South FloridaTampaFloridaUSA
| | - Robb Holley
- myPATH PartnershipUniversity of South FloridaTampaFloridaUSA
- Department of Mental Health Law & PolicyUniversity of South FloridaTampaFloridaUSA
| | - Leigh J. Ruth
- myPATH PartnershipUniversity of South FloridaTampaFloridaUSA
- Department of Psychiatry and Behavioral NeurosciencesUniversity of South FloridaTampaFloridaUSA
| | - Karim Hanna
- myPATH PartnershipUniversity of South FloridaTampaFloridaUSA
- Department of Family MedicineUniversity of South FloridaTampaFloridaUSA
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Puppi M, Rota L, Scotti L, Rabbone I, Gino S. Clinical and Forensic Aspects of the Management of Child Abuse: The Experience of the Paediatric Emergency Department in Novara, North-West Italy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2028. [PMID: 36767394 PMCID: PMC9916143 DOI: 10.3390/ijerph20032028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 01/15/2023] [Accepted: 01/17/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Child abuse is an endemic phenomenon that refers to any form of violence aimed at children and adolescents. The Emergency Room is often the entry point to healthcare for the abused child. METHODS This is a cross-sectional study including minors, aged 0-18 years, of all genders, who experienced any form of violence examined at the Paediatric Emergency Department of the 'Maggiore della Carità' Hospital in Novara (North-West Italy) between 1 January 2017 to 31 December 2021. Data were extrapolated by looking at the diagnosis at discharge. A comparison of the different variables collected was made between the pre-COVID-19 period and the COVID era. RESULTS 120 minors presented to the paediatric emergency room seeking help for violence. The average age was 10 years, 55% of the victims were male and 75% of them were Italian. In the pre-COVID period, the number of presentations for abuse was 62, while in the COVID period it was 58 with an increase of peer violence (from 38.71% to 62.07%) and with a statistically significant impact of the pandemic on the phenomenon (p-value < 0.00001). In general, peer violence accounts for 50% of the cases reviewed and resulted in fewer reports to the judicial authority and requests for forensic advice. CONCLUSION The SARS-CoV-2-related pandemic has had an impact on total emergency room admissions and the types of abuse perpetrated.
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Affiliation(s)
- Micol Puppi
- School of Medicine, University of Eastern Piedmont, Via Solaroli 17, 28100 Novara, Italy
| | - Linda Rota
- Division of Paediatrics, Department of Health Sciences, University of Eastern Piedmont, Via Solaroli 17, 28100 Novara, Italy
| | - Lorenza Scotti
- Department of Translational Medicine, University of Eastern Piedmont, Via Solaroli 17, 28100 Novara, Italy
| | - Ivana Rabbone
- Division of Paediatrics, Department of Health Sciences, University of Eastern Piedmont, Via Solaroli 17, 28100 Novara, Italy
| | - Sarah Gino
- Department of Health Sciences, University of Eastern Piedmont, Via Solaroli 17, 28100 Novara, Italy
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McKinlay AR, Simon YR, May T, Fancourt D, Burton A. How did UK social distancing restrictions affect the lives of women experiencing intimate partner violence during the COVID-19 pandemic? A qualitative exploration of survivor views. BMC Public Health 2023; 23:123. [PMID: 36653799 PMCID: PMC9845821 DOI: 10.1186/s12889-023-14987-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 01/04/2023] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Increased numbers of domestic abuse cases were reported at the start of the COVID-19 pandemic. Many people experiencing abuse faced barriers to seeking support with service closures affecting the sector. Available evidence suggests women are overrepresented in the reported cases of intimate partner violence (IPV) and we aimed to learn more about how their lives were impacted by social distancing restrictions. METHODS We conducted an online qualitative interview study, using reflexive thematic analysis. Interviews were conducted between April 2021 and March 2022. 18 women in the UK with past experiences of IPV provided informed consent and participated in this study. RESULTS During the analysis, we identified five themes relating to the impact of lockdown restrictions on participants' lives, including: (1) Lockdown meant being confined to a place where abuse was escalating, (2) Barriers to accessing support, including "cancelled" services and missed opportunities to intervene during interactions in lockdown with frontline workers. (3) Increased feelings of fear, isolation, and loss of control, particularly during the early stages of the pandemic from the combination of abuse and pandemic-related changes to daily life. (4) Some forms of support were more accessible during the pandemic, such as provision of online psychological support and social groups. Participants also accessed new forms of support for the first time during the pandemic, in some cases sparked by posts and content on social media about abuse awareness. (5) For some, psychosocial wellbeing transformed during the pandemic, with several participants using the word "freedom" when reflecting on their experience of simultaneously escaping abuse and living through the COVID-19 pandemic. CONCLUSIONS In this study, we explored the views of female survivors of IPV in the UK during the COVID-19 pandemic. Our results highlight the importance of combined public awareness campaigns and community intervention points for victims to safely seek help during social distancing restrictions. Having the time and space to reflect on healing after escaping abuse was described by women in our study as a benefit from their lives in lockdown, which is a factor that could be incorporated into future initiatives developed to support people subjected to violence and abuse.
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Affiliation(s)
- A. R. McKinlay
- grid.83440.3b0000000121901201Research Department of Behavioural Science and Health, Institute of Epidemiology & Health Care, University College London, 1-19 Torrington Place, London, WC1E 7HB UK
| | - Y. R. Simon
- grid.83440.3b0000000121901201Research Department of Behavioural Science and Health, Institute of Epidemiology & Health Care, University College London, 1-19 Torrington Place, London, WC1E 7HB UK
| | - T. May
- grid.83440.3b0000000121901201Research Department of Behavioural Science and Health, Institute of Epidemiology & Health Care, University College London, 1-19 Torrington Place, London, WC1E 7HB UK
| | - D. Fancourt
- grid.83440.3b0000000121901201Research Department of Behavioural Science and Health, Institute of Epidemiology & Health Care, University College London, 1-19 Torrington Place, London, WC1E 7HB UK
| | - A. Burton
- grid.83440.3b0000000121901201Research Department of Behavioural Science and Health, Institute of Epidemiology & Health Care, University College London, 1-19 Torrington Place, London, WC1E 7HB UK
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Huang N, Yang F, Liu X, Bai Y, Guo J, Riem MME. The prevalences, changes, and related factors of child maltreatment during the COVID-19 pandemic: A systematic review. CHILD ABUSE & NEGLECT 2023; 135:105992. [PMID: 36549089 PMCID: PMC9755012 DOI: 10.1016/j.chiabu.2022.105992] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Revised: 10/09/2022] [Accepted: 12/07/2022] [Indexed: 05/04/2023]
Abstract
BACKGROUND The impact of the COVID-19 pandemic has been extensive and drastic during the twenty-first century. The increasing phenomenon of child maltreatment during the pandemic is a significant public health concern. OBJECTIVE This study is the first systematic review to analyze and summarize the prevalence rates, risk factors, and protective factors related to child maltreatment during the COVID-19 pandemic. METHODS Four electronic databases (PubMed, Web of Science, Scopus, Embase) were systematically searched. Some potential studies were also identified from the reference lists of previously included articles. The quality of the included studies was assessed by the National Institutes of Health (NIH) Quality Assessment Tool and Critical Appraisal Skills Program (CASP) Quality Assessment Tool. RESULTS A total of 35 articles were included in the analysis, with 16 having prevalence information and 22 having factor information. Sixteen studies were conducted in the US, the other 17 studies were from 12 countries, and only two studies contained mixed countries. The prevalences of child maltreatment during the pandemic varied widely in different types and measurements. The pandemic rates of physical abuse, psychological abuse, neglect, and sexual abuse were 0.1 %-71.2 %, and 4.9 %-61.8 %, 7.3 %-40 % and 1.4 %-19.5 %, respectively. There was a decline in allegations of child maltreatment and an increase in severe cases of child maltreatment during the COVID-19 pandemic. Lockdown measures and their side effects were the main risk factors contributing to child maltreatment. CONCLUSIONS This review calls for targeted measures to prevent child maltreatment during the COVID-19 pandemic and current and future lockdowns and more future replication studies conducted in countries other than the US.
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Affiliation(s)
- Ning Huang
- Department of Health Policy and Management, School of Public Health, Peking University, Beijing 100191, China
| | - Fan Yang
- Department of Health Policy and Management, School of Public Health, Peking University, Beijing 100191, China
| | - Xiaohan Liu
- Department of Health Policy and Management, School of Public Health, Peking University, Beijing 100191, China
| | - Yashuang Bai
- Department of Health Policy and Management, School of Public Health, Peking University, Beijing 100191, China
| | - Jing Guo
- Department of Health Policy and Management, School of Public Health, Peking University, Beijing 100191, China.
| | - Madelon M E Riem
- Behavioral Science Institute, Radboud University, the Netherlands; Clinical Child & Family Studies, Faculty of Behavioral and Movement Sciences, Vrije Universiteit, Amsterdam, the Netherlands
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Dagi AF, Parry GJ, Labow BI, Taghinia AH. Trends in Pediatric Head and Facial Trauma During the COVID-19 Pandemic. J Craniofac Surg 2023; 34:e1-e6. [PMID: 35864579 PMCID: PMC9793995 DOI: 10.1097/scs.0000000000008776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2021] [Accepted: 04/11/2022] [Indexed: 01/11/2023] Open
Abstract
INTRODUCTION The effect of physical-distancing policies and school closures on pediatric health has been a topic of major concern in the United States during the coronavirus disease 2019 (COVID-19) pandemic. The objective of this study was to assess the immediate impact of these public policies on patterns of head and facial trauma in the pediatric population. MATERIALS AND METHOD The Pediatric Health Information System (PHIS) was queried to identify patient encounters at 46 children's hospitals across the United States in 2016-2020. Encounters were included if resultant in ICD-10 diagnosis for head or facial trauma in a child under 18 between April 1 and June 30 in 2020 (first COVID-19 school closures) and during the same period in the previous 4 years (for comparison). RESULTS A total of 170,832 patient encounters for pediatric head and facial trauma were recorded during the study period, including 28,030 (16.4%) in 2020 and 142,802 (83.6%) in 2016-2019. Patient encounters declined significantly in 2020 among children of all age groups relative to previous years. Relative reductions were greatest in children aged 11 to 17 (middle/high school) and 6 to 10 (elementary school), at -34.6% (95% confidence interval: -23.6%, -44%; P <0.001) and -27.7% (95% confidence interval: -18.4%, -36%; P <0.001). Variation in relative reductions by race/ethnicity, sex, and rural/urban status were not statistically significant. CONCLUSIONS Physical-distancing policies and school closures at the start of the COVID-19 pandemic correlated with significant reductions in pediatric head and facial trauma patient encounters. As in-person activities resume, reductions in head and facial trauma during the pandemic may indicate a range of possible preventable injuries in the future.
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Cercone DJ, Berger RP, Manole MD, Soung JK, Coombs CM, Noorbakhsh KA. Increased severity of abusive head trauma during the first year of the COVID-19 pandemic. CHILD ABUSE & NEGLECT 2023; 135:105971. [PMID: 36427395 PMCID: PMC9676164 DOI: 10.1016/j.chiabu.2022.105971] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/21/2022] [Revised: 11/12/2022] [Accepted: 11/16/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Abusive head trauma (AHT) is the leading cause of death from physical abuse in children. Reports regarding the impact of the COVID-19 pandemic on rates and severity of AHT are limited and with conflicting results. OBJECTIVE To determine the number and clinical characteristics of AHT cases presenting to a pediatric tertiary care center during the first year of the COVID-19 pandemic compared to the two prior years. PARTICIPANTS AND SETTING We performed a retrospective cohort study of patients <5 years old diagnosed with AHT at a single pediatric tertiary care center over a three-year period. METHODS Data were obtained for the pandemic year and two years before, including demographics, length of stay, physical and retinal examination findings, radiologic studies, electroencephalogram results, and mortality. RESULTS There were 27 cases of AHT during the first year of the pandemic and 55 during the two pre-pandemic years. Length of stay was similar for the two cohorts. The mortality rate was higher during the pandemic (29.6 % vs. 3.6 %; p < .01), as were the proportion of patients with retinal hemorrhages (84.6 % vs. 41.5 %; p < .01) and abnormal cervical spine imaging (52.6 % vs. 21.2 %; p = .02). There were no differences in age, sex, race, abnormalities on dermatological exam, skeletal surveys, and electroencephalograms. CONCLUSIONS We did not observe an increase in the number of patients with AHT during the pandemic but did see an increase in mortality, patients with retinal hemorrhages, and patients with abnormalities on cervical spine imaging. These data suggest a higher severity of AHT presenting to a pediatric tertiary care center during the pandemic.
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Affiliation(s)
- Dominic J Cercone
- Division of Emergency Medicine, Department of Pediatrics, University of Pittsburgh Medical Center, 4401 Penn Avenue, Pittsburgh, PA 15224, United States.
| | - Rachel P Berger
- Division of Child Advocacy, Department of Pediatrics, University of Pittsburgh Medical Center, 4401 Penn Avenue, Pittsburgh, PA 15224, United States.
| | - Mioara D Manole
- Division of Emergency Medicine, Department of Pediatrics, University of Pittsburgh Medical Center, 4401 Penn Avenue, Pittsburgh, PA 15224, United States.
| | - Jane K Soung
- Division of Emergency Medicine, Department of Pediatrics, University of Pittsburgh Medical Center, 4401 Penn Avenue, Pittsburgh, PA 15224, United States.
| | - Carmen M Coombs
- Division of Emergency Medicine, Department of Pediatrics, University of Pittsburgh Medical Center, 4401 Penn Avenue, Pittsburgh, PA 15224, United States; Division of Child Advocacy, Department of Pediatrics, University of Pittsburgh Medical Center, 4401 Penn Avenue, Pittsburgh, PA 15224, United States.
| | - Kathleen A Noorbakhsh
- Division of Emergency Medicine, Department of Pediatrics, University of Pittsburgh Medical Center, 4401 Penn Avenue, Pittsburgh, PA 15224, United States.
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Loiseau M, Cottenet J, Gilard-Pioc S, François-Purssell I, Mikaeloff Y, Quantin C. [Child maltreatment and Covid-19: A crisis within a crisis]. Med Sci (Paris) 2023; 39:64-67. [PMID: 36692322 DOI: 10.1051/medsci/2022201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
The fight against the SARS-CoV-2 pandemic was carried out through strong restrictive measures, including general population lockdown, which allowed the convergence of risk factors for child abuse. During this period, the French national hotline for children in danger recorded a 56% increase in calls. Calls followed by an alert to departmental child protection services increased by 30%. Through an algorithm created by our team, we showed a 50% increase in the relative frequency of hospitalizations for physical abuse in children aged 0-5 years during the lockdown. This has fueled thinking about subsequent health measures to protect the youngest children. Our goal is now to use this algorithm for epidemiological purposes as a barometer of abuse or in daily practice to help the diagnosis of physical abuse in young children.
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Affiliation(s)
- Mélanie Loiseau
- Service de médecine légale, Centre hospitalier universitaire (CHU) Dijon Bourgogne, France - Inserm UMR 1231, Lipides nutrition cancer, CHU Dijon Bourgogne, France
| | - Jonathan Cottenet
- Biostatistique et information médicale (DIM), CHU Dijon Bourgogne, France
| | | | | | - Yann Mikaeloff
- Centre de protection de l'enfant et de l'adolescent (CPEA), DMU Santé de l'enfant et de l'adolescent (SEA), Hôpital Bicêtre, AP-HP : équipe « Psychiatrie du développement », CESP, Inserm, université Paris-Saclay, France
| | - Catherine Quantin
- Biostatistique et information médicale (DIM), CHU Dijon Bourgogne, France - Inserm, CIC 1432, CHU Dijon Bourgogne, Centre d'investigation clinique, Dijon, France - Université Paris-Saclay, Université de Versailles-Saint-Quentin-en-Yvelines, Université Paris-Sud, Inserm, High-dimensional biostatistics for drug safety and genomics, CESP, Villejuif, France
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46
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Masler IV, Shah N, Duerring SA, Monroe KR. Effects of the COVID-19 pandemic on the pediatric emergency department: a single institution experience. Inj Epidemiol 2022; 9:34. [PMID: 36544193 PMCID: PMC9768778 DOI: 10.1186/s40621-022-00401-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic resulted in drastic decreases in volume for most pediatric emergency departments (ED). Injuries have persisted and there is concern that injuries may have increased during the pandemic. This study evaluates the impact of the COVID-19 pandemic on ED patient trends at a freestanding children's hospital. RESULTS Despite an average annual increase of 1100 patients per year between 2017 and 2019, this ED saw a decrease of over 25,000 patients in 2020. The number of trauma alerts increased from 341 in 2017 to 571 in 2020 and those numbers remained stable (568-571) in 2020 compared to 2019. The percent of total volume accounted for by trauma alerts increased from 0.65 to 1.2% between 2019 and 2020 (following the trend of 0.48% in 2017 to 0.56% in 2018). Historically, motor vehicle crashes account for the majority of the trauma alerts, though the number of trauma alerts from firearm-related injuries increased from 36 per year in 2018 to 44 in 2019 to 66 (12% of total trauma alerts) in 2020. CONCLUSIONS While total volumes of patients being seen decreased, the number of trauma alerts remained stable resulting in an increased percentage of trauma alert patients. This indicates that severe injuries requiring trauma alert activation did not diminish during the pandemic. These trends have implications for prevention as well as implications for ED staffing. Changing trends in types of severe injuries are noted.
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Affiliation(s)
- Isabella V. Masler
- grid.265892.20000000106344187Department of Pediatrics, University of Alabama at Birmingham, Birmingham, AL 35223 USA
| | - Nipam Shah
- grid.265892.20000000106344187Division of Pediatric Emergency Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham, AL 35223 USA
| | - Shea A. Duerring
- grid.265892.20000000106344187Division of Pediatric Emergency Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham, AL 35223 USA
| | - Kathy R. Monroe
- grid.265892.20000000106344187Division of Pediatric Emergency Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham, AL 35223 USA
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Emery CR, Abdullah A, Thapa S, Do MH, Jordan L, Huang YT, Men VY, Wekerle C. Invasive Exploitation and the Multiplicative Hypothesis: Polyvictimization and Adolescent Depression Symptoms in Nepal. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:NP22428-NP22452. [PMID: 35184579 DOI: 10.1177/08862605211072164] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Adverse effects of childhood maltreatment experience and adolescent depression symptoms are theorized to be more profound for adolescents who have suffered multiple maltreatments (polyvictimization). New theoretical insights into the study of polyvictimization suggest that it must be studied using a multiplicative logic, particularly when maltreatment is characterized by invasive exploitation. This study, for the first time, examined the concept of invasive exploitation in the context of polyvictimization and its association with adolescent depression symptoms. The study used a random, three stage probability proportional to size (PPS) cluster sample of 565 mother-adolescent dyads in Kathmandu, Nepal, and also examined the protective effects of maternal empathy. We hypothesized that (a) singly, the empirical categories of maltreatment (neglect, physical abuse, and child sexual abuse) would associate positively with adolescent depressive symptoms and (b) main effects held constant, the interaction effects of a child sexual abuse X neglect and a child sexual abuse X physical abuse would be positive. Regression with clustering corrections found that neglect (B = 3.17, p < .01) and sexual abuse (B = 3.48, p < .05) positively associated with adolescent depression symptoms. Results support the multiplicative invasive exploitation polyvictimization hypothesis (child sexual abuse X neglect interaction; B = 6.14, p < .05). The positive neglect X sexual abuse interaction is consistent with the theory that sexual abuse is distinct as invasive exploitation, and demonstrates that the multiplicative hypothesis can be fruitfully applied to the study of polyvictimization. Interventions targeting polyvictims with experience of invasive exploitation and studies aiming to provide deeper insights into sexual abuse as invasive exploitation are needed.
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Affiliation(s)
- Clifton R Emery
- Department of Social Work and Social Administration, 25809The University of Hong Kong, Hong Kong
| | - Alhassan Abdullah
- Department of Social Work and Social Administration, 25809The University of Hong Kong, Hong Kong
| | | | - Mi-Hyang Do
- Department of Child Welfare Studies, 65374Namseoul University, South Korea
| | - Lucy Jordan
- Department of Social Work and Social Administration, 25809The University of Hong Kong, Hong Kong
| | - Yu-Te Huang
- Department of Social Work and Social Administration, 25809The University of Hong Kong, Hong Kong
| | - Vera Yu Men
- Department of Social Work and Social Administration, 25809The University of Hong Kong, Hong Kong
| | - Christine Wekerle
- Department of Pediatrics, 3710McMaster University, Hamilton, ON, Canada
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Shusterman GR, Fluke JD, Nunez JJ, Fettig NB, Kebede BK. Child maltreatment reporting during the initial weeks of COVID-19 in the US: Findings from NCANDS. CHILD ABUSE & NEGLECT 2022; 134:105929. [PMID: 36270070 PMCID: PMC9556910 DOI: 10.1016/j.chiabu.2022.105929] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 09/16/2022] [Accepted: 10/10/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND After the national COVID-19 emergency declaration in the U.S. in March 2020, child welfare agencies observed large reductions in maltreatment reporting. OBJECTIVE To quantify the impact of the COVID-19 pandemic on child maltreatment reporting nationally to inform policy for future emergencies. PARTICIPANTS AND SETTING Administrative data from the National Child Abuse and Neglect Data System (NCANDS) for 48 states for federal fiscal years (FFYs) 2017 through 2020. METHODS Analyses focused on reports to child protective services (CPS) between weeks 12 and 24 of calendar years 2017 through 2020 (mid-March through mid-June). Report sources of screened in and substantiated reports were compared with those during the prior year. Likelihood of a report being substantiated in 2020 compared with 2019 based on report source was calculated using odds ratios. RESULTS In 2020, CPS screened in 39 % fewer reports than during the same period in 2019 and the proportion of reports substantiated increased from 18 to 22 %. Reports from all report sources decreased, especially from education personnel (90 % decrease) and child daycare providers (65 % decrease). The odds for substantiation were significantly higher during 2020 than in 2019 for reports from all but three sources. CONCLUSION During the initial weeks following the national COVID-19 emergency declaration, the number of reports to CPS declined sharply at the national level and across all states, primarily in association with a large reduction in referrals from education sentinels. Explanations for the increase in percent of substantiation in the context of reduction of reports are considered.
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Affiliation(s)
| | - John D Fluke
- Kempe Center, Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO, USA
| | - Juan J Nunez
- WRMA, Inc., a Trimetrix Company, Rockville, MD, USA; Department of Social Welfare, Luskin School of Public Affairs, University of California, Los Angeles, CA, USA
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Boutin S, Elder J, Sothilingam N, Davis P, Oyedokun T. Epidemiology and outcomes for level 1 and 2 traumas during the first wave of COVID19 in a Canadian centre. Sci Rep 2022; 12:20345. [PMID: 36437249 PMCID: PMC9701679 DOI: 10.1038/s41598-022-23625-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 11/02/2022] [Indexed: 11/28/2022] Open
Abstract
To determine if lockdown measures imposed during the first wave of the COVID19 pandemic affected trauma patterns, volumes, and outcomes in a western Canadian level 1 trauma center, we performed a retrospective cohort study assessing level 1 and 2 trauma patients presenting to our center during the initial COVID19 "lockdown" period (March 15-June 14, 2020) compared to a similar cohort of patients presenting during a "control" period 1 year prior (March 15-June 14, 2019). Overall, we saw a 7.8% reduction in trauma volumes during the lockdown period, and this was associated with a shorter average ED length of stay (6.2 ± 4.7 h vs. 9.7 ± 11.8 h, p = 0.003), reduced time to computed tomography (88.5 ± 68.2 min vs. 105.1 ± 65.5 min, p < 0.001), a reduction in intensive care unit admissions (11.0 ± 4.9% vs. 20.0 ± 15.5%, p = 0.001), and higher injury severity score (6.5 ± 7.6 vs. 6.2 ± 9.5, p = 0.04). Our findings suggest that lockdown measures imposed during the first wave of the COVID19 pandemic had a significant impact on trauma patients.
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Affiliation(s)
- S. Boutin
- grid.412271.30000 0004 0462 8356Department of Emergency Medicine, Royal University Hospital, University of Saskatchewan, 103 Hospital Drive, Saskatoon, SK S7N 0W8 Canada
| | - J. Elder
- grid.412271.30000 0004 0462 8356Department of Emergency Medicine, Royal University Hospital, University of Saskatchewan, 103 Hospital Drive, Saskatoon, SK S7N 0W8 Canada
| | - N. Sothilingam
- grid.412271.30000 0004 0462 8356Department of Surgery, Royal University Hospital, University of Saskatchewan, 103 Hospital Drive, Saskatoon, SK S7N 0W8 Canada
| | - P. Davis
- grid.412271.30000 0004 0462 8356Department of Emergency Medicine, Royal University Hospital, University of Saskatchewan, 103 Hospital Drive, Saskatoon, SK S7N 0W8 Canada
| | - T. Oyedokun
- grid.412271.30000 0004 0462 8356Department of Emergency Medicine, Royal University Hospital, University of Saskatchewan, 103 Hospital Drive, Saskatoon, SK S7N 0W8 Canada
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Strassle PD, Kinlaw AC, Ko JS, Quintero SM, Bonilla J, Ponder M, Nápoles AM, Schiro SE. Effect of Stay-at-Home orders and other COVID-related policies on trauma hospitalization rates and disparities in the USA: a statewide time-series analysis. Inj Epidemiol 2022; 9:33. [PMID: 36414998 PMCID: PMC9680127 DOI: 10.1186/s40621-022-00409-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 11/06/2022] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND To combat the coronavirus pandemic, states implemented several public health policies to reduce infection and transmission. Increasing evidence suggests that these prevention strategies also have had a profound impact on non-COVID healthcare utilization. The goal of this study was to determine the impact of a statewide Stay-at-Home order and other COVID-related policies on trauma hospitalizations, stratified by race/ethnicity, age, and sex. METHODS We used the North Carolina Trauma Registry, a statewide registry of trauma hospitalizations for 18 hospitals across North Carolina, including all North Carolina trauma centers, to calculate weekly rates of assault, self-inflicted, unintentional motor vehicle collision (MVC), and other unintentional injury hospitalizations between January 1, 2019, and December 31, 2020. Interrupted time-series design and segmented linear regression were used to estimate changes in hospitalization rates after several COVID-related executive orders, overall and stratified by race/ethnicity, age, and sex. Changes in hospitalization rates were assessed after 1) USA declaration of a public health emergency; 2) North Carolina statewide Stay-at-Home order; 3) Stay-at-Home order lifted with restrictions (Phase 2: Safer-at-Home); and 4) further lifting of restrictions (Phase 2.5: Safer-at-Home). RESULTS There were 70,478 trauma hospitalizations in North Carolina, 2019-2020. In 2020, median age was 53 years old and 59% were male. Assault hospitalization rates (per 1,000,000 NC residents) increased after the Stay-at-Home order, but substantial increases were only observed among Black/African American residents (weekly trend change = 1.147, 95% CI = 0.634 to 1.662) and 18-44-year-old males (weekly trend change = 1.708, 95% CI = 0.870 to 2.545). After major restrictions were lifted, assault rates decreased but remained elevated compared to pre-COVID levels. Unintentional non-MVC injury hospitalizations decreased after the USA declared a public health emergency, especially among women ≥ 65 years old (weekly trend change = -4.010, 95% CI = -6.166 to -1.855), but returned to pre-pandemic levels within several months. CONCLUSIONS Statewide Stay-at-Home orders placed Black/African American residents at higher risk of assault hospitalizations, exacerbating pre-existing disparities. Males 18-44 years old were also at higher risk of assault hospitalization. Fear of COVID-19 may have led to decreases in unintentional non-MVC hospitalization rates, particularly among older females. Policy makers must anticipate policy-related harms that may disproportionately affect already disadvantaged communities and develop mitigation approaches.
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Affiliation(s)
- Paula D. Strassle
- grid.281076.a0000 0004 0533 8369Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD USA
| | - Alan C. Kinlaw
- grid.10698.360000000122483208Division of Pharmaceutical Outcomes and Policy, University of North Carolina School of Pharmacy, Chapel Hill, NC USA ,grid.10698.360000000122483208Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, NC USA
| | - Jamie S. Ko
- grid.281076.a0000 0004 0533 8369Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD USA
| | - Stephanie M. Quintero
- grid.281076.a0000 0004 0533 8369Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD USA
| | - Jackie Bonilla
- grid.189967.80000 0001 0941 6502Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA USA
| | - Madison Ponder
- grid.10698.360000000122483208Department of Epidemiology, Gillings School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC USA
| | - Anna María Nápoles
- grid.281076.a0000 0004 0533 8369Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD USA
| | - Sharon E. Schiro
- grid.10698.360000000122483208Division of General, Acute Care, and Trauma Surgery, Department of Surgery, University of North Carolina at Chapel Hill, Chapel Hill, NC USA
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