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Muste JC, Kim S, Dinicu A, Wang PR, Muir M, Sorrell M, Bollini M, Petkovsek D, Phelan MP. Emergency department evaluation of nurse triage questions about safe-at-home and abuse or neglect in traumatic ocular injuries. CANADIAN JOURNAL OF OPHTHALMOLOGY 2024; 59:e453-e460. [PMID: 38008128 DOI: 10.1016/j.jcjo.2023.10.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Revised: 10/05/2023] [Accepted: 10/28/2023] [Indexed: 11/28/2023]
Abstract
OBJECTIVES Approximately 10 million Americans experience acts of physical violence by an intimate partner (IPV). Ocular injuries can present as a symptom of IPV in the emergency department, but IPV remains underreported in the literature. Understanding the incidence and trends in IPV-associated ocular injuries in the emergency department could increase the detection of at-risk patients otherwise overlooked. DESIGN Retrospective chart review. PARTICIPANTS Emergency department patients evaluated for traumatic ocular injuries between January 2018 and April 2023 at a large tertiary care health system. METHODS The study population was identified by ICD-10 code and their responses to being screened at triage for home safety and any nursing concerns for abuse or neglect. Patient screening consisted of a 2-part questionnaire inquiring first about whether the patient feels safe at home ("Yes" or "No") and second regarding nurses' concerns for abuse, neglect, domestic violence, sexual assault, or human trafficking. RESULTS There were 2,653,993 emergency department visits and 16,737 traumatic ocular injuries in the study period. Of them, 1.1% of patients (154 of 14,457) responded "No" to feeling safe at home. In only 0.6% of patients (82 of 14,457), a nursing concern was documented. Patients responding "No" to feeling safe at home presented with more severe ocular injuries such as maxillary fractures. On regression analysis, married, divorced, and widowed patients as well as patients on private insurance were less likely to report feeling unsafe at home than single patients on public insurance (p < 0.05). CONCLUSION Traumatic ocular injuries in emergency departments should raise concerns about IPV. Opportunity exists to improve education, screening, and management of these patients.
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Affiliation(s)
| | - Suzie Kim
- Cleveland Clinic Lerner College of Medicine, Cleveland, OH
| | - Andreea Dinicu
- Department of Obstetrics and Gynecology, Cleveland Clinic, Cleveland, OH
| | - Philip R Wang
- Cleveland Clinic Lerner College of Medicine, Cleveland, OH
| | - McKinsey Muir
- Department of Emergency Medicine, Cleveland Clinic, Cleveland, OH
| | - Michele Sorrell
- Department of Emergency Medicine, Cleveland Clinic, Cleveland, OH
| | - Mouli Bollini
- Department of Emergency Medicine, Cleveland Clinic, Cleveland, OH
| | | | - Michael P Phelan
- Department of Emergency Medicine, Cleveland Clinic, Cleveland, OH.
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Cunha A, Gonçalves M, Matos M. Understanding the Dynamics of Domestic Violence During the First Year of the Pandemic: An Integrative Review. TRAUMA, VIOLENCE & ABUSE 2024:15248380241277788. [PMID: 39315677 DOI: 10.1177/15248380241277788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/25/2024]
Abstract
This integrative review aims to analyze and synthesize existing literature to inform our understanding of the multifaceted dimensions of domestic violence during the first year of the COVID-19 pandemic, using a holistic and ecological framework. Utilizing the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) study design, searches were conducted on six databases, yielding a final sample of 58 articles. The study comprehensively overviews North America, South America, Asia, Europe, Africa, and worldwide research. The literature reveals an alarming increase in domestic violence victimization during the pandemic in most regions and studies, exacerbating pre-existing vulnerabilities. The increase in domestic violence during the pandemic is linked to ecological factors such as lower physical and mental health, rising substance use, and financial stress, which heightened individuals' vulnerability. Lockdowns exacerbated these issues by increasing confinement in homes, disrupting support services, and limiting victims' access to help. Barriers to help-seeking and amplified personal and professional stressors at the care level are identified. Advocacy for improved awareness, cooperation, and inclusive national and institutional policies emerges. This study underscores the urgency of empirical research to generate reliable data on the pandemic's impact on domestic violence. The findings of this study highlight the importance of understanding unique factors affecting specific groups, as well as informing prevention efforts and targeted interventions. Recognizing the mutual benefit of research-practice partnerships is crucial in addressing and preventing domestic violence. This research contributes to a deeper understanding of domestic violence during the pandemic's first year, guiding empirically informed interventions and policy changes.
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Affiliation(s)
- Ana Cunha
- Center of Investigation in Psychology, School of Psychology, University of Minho, Braga, Portugal
| | - Mariana Gonçalves
- Center of Investigation in Psychology, School of Psychology, University of Minho, Braga, Portugal
| | - Marlene Matos
- Center of Investigation in Psychology, School of Psychology, University of Minho, Braga, Portugal
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Martins N, Soares D, Gusmao C, Nunes M, Abrantes L, Valadares D, Marcal S, Mali M, Alves L, Martins J, da Silva V, Ward PR, Fauk NK. A qualitative exploration of the impact of the COVID-19 pandemic on gender-based violence against women living with HIV or tuberculosis in Timor Leste. PLoS One 2024; 19:e0306106. [PMID: 39133682 PMCID: PMC11318865 DOI: 10.1371/journal.pone.0306106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Accepted: 06/10/2024] [Indexed: 08/15/2024] Open
Abstract
Violence against women or gender-based violence (GBV) is a significant public health issue facing women and girls in different settings. It is reported to have worsened globally during the COVID-19 pandemic. Despite the impact of the COVID-19 pandemic on increased violence against women in general, which has been reported in many settings globally, there is a paucity of evidence of its impact on violence against highly vulnerable women living with HIV or tuberculosis (TB). Using a qualitative design, this study aimed to explore the views and experiences of women living with HIV (n = 19) or TB (n = 23) in Timor Leste regarding the GBV they faced during the COVID-19 pandemic. They were recruited using the snowballing sampling technique. Data were collected using one-on-one, in-depth interviews and focus group discussions. The five steps of qualitative data analysis suggested in Ritchie and Spencer's analysis framework were employed to guide the analysis of the findings. Findings indicated that women in this study experienced intensified physical, verbal, sexual and psychological violence by their partners, spouses, in-laws, and parents or other family members during the COVID-19 pandemic. Several prominent risk factors that worsened violence against women during the pandemic were (i) HIV or TB-positive status, (ii) traditional gender roles or responsibilities and expectations, (iii) economic and financial difficulties reflected in the loss of jobs and incomes due to the pandemic, and (iv) individual factors such as jealousy and increased alcohol drinking developed during the lockdowns. The women's experience of GBV during the pandemic also led to various negative psychological impacts. The findings underscore the urgent need for multifaceted interventions to address GBV, which should encompass challenging traditional gender norms, addressing economic inequalities, and targeting individual-level risk factors. The findings also indicate the need for the development of robust monitoring and evaluation systems to assess the effectiveness of policies and interventions addressing GBV where the results can inform future improvement. The findings also indicate the need to include GBV in the protocol or guidelines for HIV and TB management. Future large-scale quantitative studies to capture the magnitude and specific drivers of GBV against women living with HIV and TB during the pandemic are recommended.
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Affiliation(s)
- Nelson Martins
- Daslo Research and Development, Timor Leste
- Universidade da Paz (UNPAZ), Timor Leste
- Menzies School of Health Research, Darwin, NT, Australia
| | - Domingos Soares
- Instituto Nacional de Saúde Publica Timor-Leste (INSP-TL), Ministry of Health Timor-Leste
- Instituto Superior Cristal, Timor Leste
| | - Caetano Gusmao
- Instituto Nacional de Saúde Publica Timor-Leste (INSP-TL), Ministry of Health Timor-Leste
| | | | | | | | | | | | - Luis Alves
- Daslo Research and Development, Timor Leste
| | | | - Valente da Silva
- Daslo Research and Development, Timor Leste
- Universidade da Paz (UNPAZ), Timor Leste
| | - Paul Russell Ward
- Centre for Public Health, Equity and Human Flourishing, Torrens University Australia, Melbourne, Australia
| | - Nelsensius Klau Fauk
- Centre for Public Health, Equity and Human Flourishing, Torrens University Australia, Melbourne, Australia
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Côrtes MTF, Alves ÂC, Teixeira AL, Alabarse OP, Dos Santos Júnior A, Dos Santos Fernandes AM, de Azevedo RCS. Profile of female survivors of sexual violence in the first 6 months of the COVID-19 quarantine in the city of Campinas, Brazil: A cross-sectional retrospective study. Int J Gynaecol Obstet 2024. [PMID: 39072771 DOI: 10.1002/ijgo.15809] [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: 10/30/2023] [Revised: 06/10/2024] [Accepted: 07/08/2024] [Indexed: 07/30/2024]
Abstract
OBJECTIVES Describe the characteristics and changes in the profile of women who sought care after experiencing sexual violence (SV) during the first six months of the COVID-19 pandemic in a Brazilian city. METHODS This is a cross-sectional retrospective study. Data from emergency care and legal abortion requests of women assisted at the Women's Health Care Center Hospital (School of Medical Sciences, University of Campinas, Brazil) due to SV experienced between March 23 and August 23, 2020 (Quarantine Group, QG), were collected and compared with data from the same period of the previous biennium (Comparison Group, CG). χ2 and Fisher's exact tests were used to compare groups; the significance level was 5%. RESULTS Data for 236 women were analyzed; 70 women were included in the QG and 166 in the CG. In the QG, there was a restriction in the area of origin of women, with a higher proportion of women who lived in Campinas (P = 0.0007) and a higher frequency of chronic SV (P = 0,035). There were no rapes associated with the use of social media or apps in the QG, but 9.8% of women in the CG experienced rape associated with the use of social media or apps. There were higher rates of domestic violence (P = 0.022) and intimidation through physical force (P = 0.011) in the first two months. CONCLUSION The COVID-19 quarantine affected the profile of women who sought care after experiencing SV. The quarantine resulted in changes in the area of origin of patients, hindering access to health services and leading to higher rates of chronic and domestic SV, particularly in the first 2 months of the pandemic.
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Affiliation(s)
| | - Ândria Cléia Alves
- Gynecological Division, Department of Obstetrics and Gynecology, School of Medical Sciences, University of Campinas (UNICAMP), Campinas, Brazil
| | - Ana Luiza Teixeira
- Gynecological Division, Department of Obstetrics and Gynecology, School of Medical Sciences, University of Campinas (UNICAMP), Campinas, Brazil
| | - Otávio Prado Alabarse
- Department of Psychiatry, School of Medical Sciences, University of Campinas (UNICAMP), Campinas, Brazil
| | - Amilton Dos Santos Júnior
- Department of Psychiatry, School of Medical Sciences, University of Campinas (UNICAMP), Campinas, Brazil
| | - Arlete Maria Dos Santos Fernandes
- Gynecological Division, Department of Obstetrics and Gynecology, School of Medical Sciences, University of Campinas (UNICAMP), Campinas, Brazil
| | - Renata Cruz Soares de Azevedo
- Department of Psychiatry, School of Medical Sciences, University of Campinas (UNICAMP), Campinas, Brazil
- Gynecological Division, Department of Obstetrics and Gynecology, School of Medical Sciences, University of Campinas (UNICAMP), Campinas, Brazil
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Lorei N, Banaag A, Perez Koehlmoos T. The Impact of the COVID-19 Pandemic on the Military Health System's Care of Military Sexual Assault. Mil Med 2024; 189:e1784-e1789. [PMID: 38035759 DOI: 10.1093/milmed/usad470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 11/03/2023] [Accepted: 11/23/2023] [Indexed: 12/02/2023] Open
Abstract
BACKGROUND Sexual assault remains a high priority challenge for leaders in the U.S. military. The COVID-19 pandemic further complicated the issue by disrupting work and lifestyles, potentially affecting reporting and care-seeking by victims. To date, there are no studies addressing the impact of changes in access to health services and reporting of sexual assault by active duty service members to inform medical and public health interventions in a post-COVID-19 era and during future public health emergencies. METHODS Using the Military Health System Data Repository (MDR), we identified a retrospective open cohort of active duty servicemembers receiving care in the Military Health System (MHS) from fiscal years 2018 to 2021. Through the use of ICD-10 diagnostic codes, all corresponding sexual assault care was identified for the cohort before (October 1, 2017-February 28, 2020; pre-pandemic period) and after (March 1, 2020-September 30, 2021; pandemic period) the institution of COVID-19 pandemic protective measures. Pre-pandemic and pandemic period rates of sexual assault associated encounters per 10,000 total health encounters were calculated by geographic location and compared using Wilcoxon's sign rank test. Multivariate log binomial regression models were performed to estimate associated risk of sexual assault among active duty servicemembers and compared across both periods. RESULTS The study identified 47,067,073 encounters for servicemembers in the pre-pandemic period, of which 7,813 (0.016%) were associated with sexual assault. During the pandemic period, 4,377 (0.015%) of 28,926,480 encounters were associated with sexual assault, indicating a 44% reduction in total encounters and a 9% reduction in the proportion of encounters associated with sexual assault. Eighteen installations within the MHS had statistically significant increases in rates of encounters. Most sexual assault encounters occurred in the 20-24 year age, Female, White, Junior Enlisted, Army, and Unmarried categories. During both time-frames, younger age and being female were associated with an increased risk of sexual assault encounters. Race, service branch, and marital status were also associated with the risk of encounters. CONCLUSION Contrary to reports indicating a modest increase in the number of sexual assaults reported within the DoD, we found a reduction in the frequency of healthcare encounters associated with sexual assault during the pandemic which may be related to reduced access to care. Men comprised approximately 22% of sexual assault encounters delivered through the MHS although the racial distribution of encounters approximates the estimates of the DoD-published demographic statistics. This study illustrates that COVID-19 measures appear to have reduced access to care for sexual assault within the MHS but did not demonstrably alter the demographics of servicemembers seeking care. These findings suggest that the MHS may require contingency plans for future disruptions to care and public health emergencies.
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Affiliation(s)
- Nathan Lorei
- General Preventive Medicine Residency Program, Preventive Medicine and Biostatistics Department, Uniformed Services University, Bethesda, MD 20814, USA
| | - Amanda Banaag
- Center for Health Services Research, Uniformed Services University, Bethesda, MD 20814, USA
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD 20817, USA
| | - Tracey Perez Koehlmoos
- Center for Health Services Research, Uniformed Services University, Bethesda, MD 20814, USA
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Giwa A, Kandemiri M, Tulli-Shah M, Sayadi G, Hurley N, Salami B. Impacts of COVID-19 on Intimate Partner Violence Service Provision. Violence Against Women 2024:10778012241257251. [PMID: 38803295 DOI: 10.1177/10778012241257251] [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: 05/29/2024]
Abstract
COVID-19 policies like stay-at-home orders impacted intimate partner violence (IPV) service provision in Alberta. Using intersectionality and qualitative semi-structured interviews, this article situates IPV and access to services and supports within multiple overlapping factors such as race, gender, class, and ethnic minority status. Two main themes were identified. First, the challenges within IPV service provision reflect the sectors' traditional and binary understanding and response to violence. Second, the move to virtual services brought challenges related to access to telecommunication facilities and zoom fatigue. Thematic analysis also shows the impact of the pandemic in a sector with existing structural/institutional challenges. We conclude by recommending a multi-level intersectional approach to IPV service provision in Alberta.
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Affiliation(s)
- Aisha Giwa
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| | - Myra Kandemiri
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| | - Mia Tulli-Shah
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| | - Ghada Sayadi
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| | - Nat Hurley
- Department of English and Film Studies, University of Alberta, Edmonton, Alberta, Canada
| | - Bukola Salami
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
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7
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Tilahun BT, Tariku Z, Alemu MK, Dejene T, Natae LA, Mohammed H, Assegid DT, Tekle MH. Maternal and Child Health Services Utilization During COVID-19 in Eastern Ethiopia. Int J Public Health 2024; 69:1606626. [PMID: 38841538 PMCID: PMC11150649 DOI: 10.3389/ijph.2024.1606626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 04/29/2024] [Indexed: 06/07/2024] Open
Abstract
Objectives: This study aimed to describe the impact of COVID-19 on maternal and child health service utilization in the Eastern part of Ethiopia. Methods: Comparative analysis was used to examine 2 years of maternal and child health service utilization. Data were extracted from client registers. A traditional Expert Modeler and one-way Analysis of Variance were used to compare service utilization before and during the COVID-19 pandemic. Results: A total of 34,576 client records were reviewed, of which 17,100 (49.5%) and 17,476 (50.5%) had visited the MCH service before and during the COVID-19 pandemic, respectively. The total client visit has shown a 2% percentage point increase. However, postnatal care and child immunization services showed a decrease. Moreover, there was a significant difference between service visits before and during COVID-19 (f = 4.6, p < 0.04). Conclusion: Mothers and children have missed or unattended facility appointments due to protective impositions or fear of getting infected with COVID-19, which might suggest a higher proportion of MCH issues were not addressed during the pandemic. The health system should therefore improve its resilience and strengthen its access at the lowest health care inlets.
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Affiliation(s)
- Bereket Tefera Tilahun
- Department of Public Health, College of Medicine and Health Science, Dire Dawa University, Dire Dawa, Ethiopia
| | - Zerihun Tariku
- Department of Public Health, College of Medicine and Health Science, Dire Dawa University, Dire Dawa, Ethiopia
| | - Mesfin Kebede Alemu
- Department of Public Health, College of Medicine and Health Science, Dire Dawa University, Dire Dawa, Ethiopia
| | - Tafese Dejene
- School of Medicine, College of Medicine and Health Sciences, Dire Dawa University, Dire Dawa, Ethiopia
| | - Legesse Abera Natae
- Department of Public Health, College of Medicine and Health Science, Dire Dawa University, Dire Dawa, Ethiopia
| | - Hussen Mohammed
- Department of Public Health, College of Medicine and Health Science, Dire Dawa University, Dire Dawa, Ethiopia
| | - Daniel Tadesse Assegid
- Department of Midwifery, College of Medicine and Health Science, Dire Dawa University, Dire Dawa, Ethiopia
| | - Mickiale Hailu Tekle
- Department of Midwifery, College of Medicine and Health Science, Dire Dawa University, Dire Dawa, Ethiopia
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Asiama AA. "Pleasure to Pain?" The Impact of the COVID-19 Lockdown on Sexual Violence in Marriages: Experiences of Rural Ghanaian Women. Violence Against Women 2024:10778012241248460. [PMID: 38693843 DOI: 10.1177/10778012241248460] [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: 05/03/2024]
Abstract
In many parts of the world, particularly in rural areas, sexual violence remains a serious issue. However, cultural orientations urge women to be submissive and obedient sexual partners in marriages. Hence, during COVID-19 lockdowns, when women were thought to be sexually assaulted most, this study used a chain referral sample technique to recruit 20 married rural Ghanaian women to examine their lived experiences of sexual violence. The study established that rural culture denies women sexual autonomy in marriages and offers husbands unrestricted access to their wives' bodies. Sexual violence becomes predominant and unbearable for rural wives during lockdown.
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Affiliation(s)
- Aikins Amoako Asiama
- Department of Sociology, The Chinese University of Hong Kong, Sha Tin, Hong Kong
- School of Graduate Studies, Lingnan University, Tuen Mun, Hong Kong
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Semenza DC, Ziminski D, Anestis MD. Physical Intimate Partner Violence and Emotional Harm in Five U.S. States. JOURNAL OF INTERPERSONAL VIOLENCE 2024; 39:2344-2368. [PMID: 38158732 DOI: 10.1177/08862605231218219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2024]
Abstract
The purpose of this study was to assess the relationship between physical intimate partner violence (IPV) victimization and four related aspects of emotional well-being: threat sensitivity, intolerance of uncertainty, impulse control, and access to resources for emotional regulation. We draw on a transactional model of IPV and emotional regulation to theorize how invalidation and partner threats in relationships can generate harmful emotional outcomes. We used representative data collected for residents living in five U.S. states: Colorado, Minnesota, Mississippi, New Jersey, and Texas. Our analytic sample included individuals who reported having been in a romantic relationship in the past year (N = 2,501). Data were collected using a probability-based web panel, between April 29 and May 15, 2022. Following the presentation of descriptive statistics and bivariate correlations, we developed a series of four multivariate models (ordinary least squares [OLS], negative binomial) to analyze the association between IPV victimization and each emotional outcome. All models adjusted for pertinent demographic and geographic control measures. Physical IPV victimization was associated with increased intolerance of uncertainty and heightened threat sensitivity. IPV victimization also corresponded with poorer impulse control and fewer resources for emotional regulation. Overall, our results demonstrate that experiences of physical IPV victimization are linked to poorer emotional outcomes. These outcomes can be harmful to broader mental health and potentially impact long-term well-being. The findings underscore the importance of mental health screenings that extend beyond assessments of diagnostic-level functions and allocating resources toward alleviating other clinically relevant factors that might arise from or even prompt additional exposure to physical IPV.
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Affiliation(s)
- Daniel C Semenza
- Rutgers University, Camden, NJ, USA
- Rutgers University, New Brunswick, NJ, USA
| | - Devon Ziminski
- Rutgers University, Camden, NJ, USA
- Rutgers University, New Brunswick, NJ, USA
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10
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Kink A, Towns JM, Fairley CK, Phillips TR, Bradshaw CS, Chow EPF. Management of acute sexual assault presenting to a large Australian sexual health clinic in 2012-2021: a retrospective clinical audit. Sex Health 2024; 21:SH23175. [PMID: 38603545 DOI: 10.1071/sh23175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 03/21/2024] [Indexed: 04/13/2024]
Abstract
Background The incidence of sexual assault continues to rise in Australia. This study aimed to describe the nature of assault, HIV/STI positivity, and its management at a sexual health clinic. Methods We performed a chart review of 516 sexual assault cases presenting to Melbourne Sexual Health Centre between 2012 and 2021, collecting data on victim demographics, details of assault, HIV/STI testing and positivity, police involvement, and offer of counselling. Results We included 516 cases: 124 males (24.0%); 384 females (74.4%); and eight transgender (1.6%) victims. The proportion of assault cases presenting to Melbourne Sexual Health Centre increased from 0.1% (37/37,070) in 2012 to 0.2% (56/36,514) in 2021 (P trend =0.006). HIV post-exposure prophylaxis was prescribed for 64.5% (80/124) of males and 12.5% (48/384) of females. Among victims, 69.4% (358/516) were tested for HIV and no one tested positive, while 71.9% (371/516) were tested for syphilis, with 1.6% (6/371) positive. Gonorrhoea and chlamydia were tested at the oropharynx (44.8% [231/516] vs 28.7% [148/516]), genitals (83.7% [432/516] vs 92.4% [477/516]) and anorectum (35.3% [182/516] vs 35.3% [182/516]). Positivity for gonorrhoea and chlamydia were: 2.6% (6/231) vs 2.0% (3/148) at oropharynx, 1.4% (6/432) vs 2.9% (14/477) at genitals, and 5.5% (10/182) vs 7.1% (13/182) at anorectum. According to clinical records, 25.2% (130/516) of victims sought police involvement, and 71.7% (370/516) were offered counselling. Conclusions Sexual assault was an uncommon presentation at Melbourne Sexual Health Centre, with diverse circumstances surrounding assault; however, clinical documentation varied, indicating a need for a standard primary care protocol for clients presenting with acute sexual assault.
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Affiliation(s)
- Aleah Kink
- Melbourne Sexual Health Centre, Alfred Health, Melbourne, Vic., Australia; and Melbourne Medical School, The University of Melbourne, Melbourne, Vic., Australia
| | - Janet M Towns
- Melbourne Sexual Health Centre, Alfred Health, Melbourne, Vic., Australia; and School of Translational Medicine, Monash University, Melbourne, Vic., Australia
| | - Christopher K Fairley
- Melbourne Sexual Health Centre, Alfred Health, Melbourne, Vic., Australia; and School of Translational Medicine, Monash University, Melbourne, Vic., Australia
| | - Tiffany R Phillips
- Melbourne Sexual Health Centre, Alfred Health, Melbourne, Vic., Australia; and School of Translational Medicine, Monash University, Melbourne, Vic., Australia
| | - Catriona S Bradshaw
- Melbourne Sexual Health Centre, Alfred Health, Melbourne, Vic., Australia; and School of Translational Medicine, Monash University, Melbourne, Vic., Australia; and Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Vic., Australia
| | - Eric P F Chow
- Melbourne Sexual Health Centre, Alfred Health, Melbourne, Vic., Australia; and School of Translational Medicine, Monash University, Melbourne, Vic., Australia; and Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Vic., Australia
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11
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Brøcker CM, Hansen OI, Rohde MC. The impact of COVID-19 restrictions on sexual assault in Western Denmark. Forensic Sci Med Pathol 2024; 20:166-173. [PMID: 37505320 DOI: 10.1007/s12024-023-00682-7] [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] [Accepted: 07/18/2023] [Indexed: 07/29/2023]
Abstract
This study sets out to investigate whether the 15-month nationwide COVID-19 lockdown in Denmark had an impact on the victim demographics, location of sexual assaults, and relationship between victim and perpetrator in the Western part of Denmark compared to the 15 months prior to the lockdown initiatives. This study is a retrospective study including a total of 596 cases. Cases were identified in the database of the Department of Forensic Medicine Aarhus, including cases labeled "rape," "attempted rape," and "later reported." 315 cases were found between March 11th 2020 and June 10th 2021 (lockdown) and 281 cases were found between December 11th 2018 and March 10th 2020(pre-lockdown). Fewer victims were in the age group 15-24 during lockdown (58.4%) than pre-lockdown (71.7%). Fewer stranger rapes occurred during lockdown (11%) than pre-lockdown (19.7%). During lockdown, more sexual assault occurred at a private site (80.1%) than pre-lockdown (60%); correspondingly, fewer public sexual assaults occurred during lockdown (10.3%) than pre-lockdown (26%). No statistically significant difference was observed regarding police reporting of the assault or alcohol intake in the victim prior to assault. We found an overall change in demographics regarding sexual assaults during the lockdown period indicating the restrictions during the lockdown could have affected the patterns of sexual assault in Denmark.
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Affiliation(s)
- Cecilie Marie Brøcker
- Department of Forensic Medicine, Aarhus University, Palle Juul Jensens Boulevard 99, 8200, Aarhus N, Denmark.
| | - Ole Ingemann Hansen
- Department of Forensic Medicine, Aarhus University, Palle Juul Jensens Boulevard 99, 8200, Aarhus N, Denmark
| | - Marianne Cathrine Rohde
- Department of Forensic Medicine, Aarhus University, Palle Juul Jensens Boulevard 99, 8200, Aarhus N, Denmark
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12
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Mercier O, Parpia R, Presseau J, Muldoon KA, Sampsel K. Telemedicine and virtual healthcare for survivors of sexual assault and intimate partner violence: A qualitative study. WOMEN'S HEALTH (LONDON, ENGLAND) 2024; 20:17455057241252958. [PMID: 38783826 PMCID: PMC11119373 DOI: 10.1177/17455057241252958] [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: 01/19/2024] [Revised: 03/28/2024] [Accepted: 04/18/2024] [Indexed: 05/25/2024]
Abstract
BACKGROUND Survivors of sexual assault and intimate partner violence often face many challenges in seeking/receiving healthcare and are often lost to follow up. OBJECTIVES Our study objectives are to evaluate the feasibility, acceptability, and satisfaction of using telemedicine technology among sexual assault and intimate partner violence patients who present to a Canadian Emergency Department. DESIGN Qualitative research was conducted using a thematic approach. METHODS Patients were identified from a case registry of all sexual assault and intimate partner violence cases seen between 1 April 2020 and 31 March 2022 from an emergency department of a large Canadian hospital. Qualitative trauma-informed interviews were conducted with consenting participants. Thematic qualitative analyses were performed to investigate barriers and drivers of telemedicine for follow-up care. RESULTS Of the 1007 sexual assault and intimate partner violence patients seen during the study timeframe, 180 (8%) consented to be contacted for future research, and 10 completed an interview regarding telemedicine for follow-up care. All participants were cisgendered women, 5 (50%) experienced sexual assault, 6 (60%) physical assault, and 3 (30%) verbal assault. All knew their assailant, and 6 (60%) were assaulted by a current or former intimate partner. Three themes emerged as drivers of telemedicine use: increased comfort, increased convenience, and less time required for the appointment. Three thematic barriers to telemedicine use included lack of privacy from others, lack of safety from their assailant, and pressure to balance competing tasks during the appointment. CONCLUSION This study illustrated that telemedicine for sexual assault and intimate partner violence follow-up care is feasible, acceptable, and can improve patient satisfaction with follow-up care. Ensuring safety and privacy are key considerations when offering telemedicine as an appropriate option for survivors.
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Affiliation(s)
- Olivia Mercier
- Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
- Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Rabea Parpia
- Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Justin Presseau
- Ottawa Hospital Research Institute, Ottawa, ON, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
- School of Psychology, University of Ottawa, Ottawa, ON, Canada
| | - Katherine A Muldoon
- Ottawa Hospital Research Institute, Ottawa, ON, Canada
- Department of Obstetrics and Gynecology, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
- Better Outcomes Registry and Network Ontario, Children’s Hospital of Eastern Ontario, Ottawa, ON, Canada
| | - Kari Sampsel
- Ottawa Hospital Research Institute, Ottawa, ON, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
- Department of Emergency Medicine, Faculty of Medicine, The Ottawa Hospital, Ottawa, ON, Canada
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Mognetti B, Scipio FD, Abbadessa G, Carnino G, Canavese A, Castagna P, Romano F, Gino S, Berta GN. Sexual Violence and Alcohol Intake: A Population-Based Explorative Study in a Northwestern Italian Area. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:2098. [PMID: 38138201 PMCID: PMC10744939 DOI: 10.3390/medicina59122098] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Revised: 11/24/2023] [Accepted: 11/27/2023] [Indexed: 12/24/2023]
Abstract
Background and Objectives: Sexual violence (SV) is a major global public health concern. While socioeconomic factors and familial relationships have been widely reported to contribute to SV, the role of alcohol consumption should not be ignored. Indeed, alcohol can impair cognition, distort reality, increase aggression, and ease drug-facilitated sexual assault. This retrospective study aims to explore the relationship between alcohol consumption and SV by examining the prevalence, characteristics, and consequences of violence episodes. Materials and Methods: A total of 1481 women accessed the Rape Centre "Centro Soccorso Violenza Sessuale" in Turin, Italy between 2008 and 2019, with 223 reporting alcohol consumption before the assault. Results: The alcohol group had a younger age profile, predominantly within the 18-25-year-old category. SV incidents involving alcohol consumers were more likely to occur in public places or in someone else's home, while the non-alcohol-consuming group experienced more violence in their own homes. Acquaintances and unknown individuals were primarily responsible, whereas partners were the most common perpetrators of violence against non-alcohol-consuming women. Alcohol consumers sought medical attention sooner after the assault and exhibited more symptoms and injuries, particularly of neurological origin. Concurrent use of recreational drugs was higher among alcohol consumers. The logistic regression analysis revealed higher odds of injury for Italian women and those in the 18-35 age groups after consuming alcohol. Conclusions: This study contributes to the understanding of the relationship between alcohol consumption and SV. The prevalence of alcohol-related sexual aggression is lower compared to that shown in previous studies. Nationality, age, and assailant identity influence SV dynamics. These findings can guide well-targeted interventions and prevention strategies to address SV and inform communities facing similar challenges.
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Affiliation(s)
- Barbara Mognetti
- Department of Life Sciences and Systems Biology, University of Turin, Via Accademia Albertina 13, 10123 Turin, Italy;
| | - Federica Di Scipio
- Department of Clinical and Biological Sciences, University of Turin, Regione Gonzole 10, 10043 Orbassano (TO), Italy; (F.D.S.); (G.A.)
| | - Giuliana Abbadessa
- Department of Clinical and Biological Sciences, University of Turin, Regione Gonzole 10, 10043 Orbassano (TO), Italy; (F.D.S.); (G.A.)
| | - Giulia Carnino
- Corso di Laurea in Medicina e Chirurgia at Azienda Ospedaliera Universitaria San Luigi (Orbassano), University of Turin, v. Verdi 8, 10124 Turin, Italy;
| | - Antonella Canavese
- Centro Soccorso Violenza Sessuale, Presidio Ospedaliero Sant’Anna, Città della Salute e della Scienza, Corso Spezia 60, 10126 Turin, Italy; (A.C.); (P.C.)
- Department of Surgical Sciences, University of Turin, Corso Dogliotti 14, 10126 Turin, Italy
| | - Paola Castagna
- Centro Soccorso Violenza Sessuale, Presidio Ospedaliero Sant’Anna, Città della Salute e della Scienza, Corso Spezia 60, 10126 Turin, Italy; (A.C.); (P.C.)
| | - Federica Romano
- Section of Periodontology, C.I.R. Dental School, Department of Surgical Sciences, University of Turin, Via Nizza 230, 10126 Turin, Italy;
| | - Sarah Gino
- Department of Health Sciences, University of Eastern Piedmont, Via Solaroli 17, 28100 Novara, Italy;
| | - Giovanni N. Berta
- Department of Clinical and Biological Sciences, University of Turin, Regione Gonzole 10, 10043 Orbassano (TO), Italy; (F.D.S.); (G.A.)
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Ross AN, Duchesne E, Lewis J, Norman PA, Bartels SA, Walker M, Rocca N. Urgent care-seeking and injury severity for intimate partner violence during COVID-19: a Canadian retrospective chart review. BMC Public Health 2023; 23:2169. [PMID: 37932707 PMCID: PMC10626712 DOI: 10.1186/s12889-023-16991-z] [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: 12/14/2022] [Accepted: 10/13/2023] [Indexed: 11/08/2023] Open
Abstract
BACKGROUND Early reports raised alarms that intimate partner violence (IPV) increased during the COVID-19 pandemic, but initial studies showed that visits to emergency departments (EDs) decreased. This study assessed the impact of the prolonged pandemic and its associated restrictions on both rates of urgent care-seeking and injury severity for IPV. METHODS Data from the Kingston Health Sciences Centre's (KHSC) ED were utilized to compare IPV presentations during 'Pre-COVID' (December 17, 2018 - March 16, 2020) and 'COVID' (March 17, 2020 - June 16, 2021), as well as three periods of heightened local restrictions: 'Lockdown-1' (March 17 - June 12, 2020), 'Lockdown-2' (December 26, 2020 - February 10, 2021) and 'Lockdown-3' (April 8 - June 2, 2021). The primary outcomes were incidence rate of IPV visits and injury severity, which was assessed using the Clinical Injury Extent Score (CIES) and Injury Severity Score (ISS). RESULTS A total of 128 individuals were included. This sample had mean age of 34 years, was comprised of mostly women (97%), and represented a variety of intimate relationship types. Some individuals presented multiple times, resulting in a total of 139 acute IPV presentations. The frequency of IPV visits during COVID was similar to the Pre-COVID time period (67 vs. 72; p = 0.67). Incidence rate was 13% higher during COVID, though this difference was non-significant (6.66 vs. 5.90; p = 0.47). IPV visit frequency varied across lockdown periods (11 in Lockdown-1, 12 in Lockdown-2 and 6 in Lockdown-3), with the highest incidence rate during Lockdown-2 (12.71). There were more moderate and severe injuries during COVID compared to Pre-COVID, but mean CIES was not statistically significantly different (1.91 vs. 1.69; p = 0.29), nor was mean ISS (11.88 vs. 12.52; p = 0.73). CONCLUSIONS During the 15-months following the start of COVID-19, there were small, but non-significant increases in both incidence rate and severity of IPV presentations to the KHSC ED. This may reflect escalation of violence as pandemic restrictions persisted and requires further investigation.
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Affiliation(s)
- Alison N Ross
- Faculty of Health Sciences (School of Medicine), Queen's University, Kingston, ON, Canada.
- Kingston Health Sciences Centre, 76 Stuart St, Victory 3, Kingston, ON, K7L 2V7, Canada.
| | - Emma Duchesne
- Department of Emergency Medicine, Queen's University, Kingston, ON, Canada
| | - Jane Lewis
- Sexual Assault & Domestic Violence Program, Kingston Health Sciences Centre, Kingston, ON, Canada
| | - Patrick A Norman
- Kingston General Health Research Institute, Kingston, ON, Canada
- Department of Public Health Sciences, Queen's University, Kingston, ON, Canada
| | - Susan A Bartels
- Faculty of Health Sciences (School of Medicine), Queen's University, Kingston, ON, Canada
- Department of Emergency Medicine, Queen's University, Kingston, ON, Canada
- Department of Public Health Sciences, Queen's University, Kingston, ON, Canada
| | - Melanie Walker
- Faculty of Health Sciences (School of Medicine), Queen's University, Kingston, ON, Canada
- Department of Emergency Medicine, Queen's University, Kingston, ON, Canada
- Department of Public Health Sciences, Queen's University, Kingston, ON, Canada
| | - Nicole Rocca
- Faculty of Health Sciences (School of Medicine), Queen's University, Kingston, ON, Canada
- Department of Emergency Medicine, Queen's University, Kingston, ON, Canada
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Gary JC, Charles L, Mitchell S. Sexual Assault Nurse Examiner Education Needs in Texas. JOURNAL OF FORENSIC NURSING 2023; 19:E45-E52. [PMID: 36994994 DOI: 10.1097/jfn.0000000000000438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/19/2023]
Abstract
ABSTRACT Background: As with many areas of the nation, Texas lacks a robust sexual assault nurse examiner (SANE) workforce. A program in Texas offers courses to educate and expand SANE skills to better provide trauma-informed care to vulnerable populations. Methods: A survey to stakeholders of a SANE educational program, as part of a planned program evaluation, elicited not only barriers to providing care but also specific program needs to better expand access to sexual assault and domestic violence medical forensic examinations in Texas. Results: In January 2022, a total of 40 stakeholders, all registered nurses in the state of Texas, provided vital information on their current program. Analysis of written survey responses provided themes regarding barriers to providing SANE care and suggestions for expanded education. Discussion: The survey provided valuable feedback and comments on the perceptions of the current SANE program. Written responses offered direction for additional learning desires of SANEs associated with the program as well as areas for the program to expand to meet the needs of the learners. This stakeholder guidance has implications beyond this one SANE education program to enhance and expand other programs based on learner needs.
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Affiliation(s)
- Jodie C Gary
- Author Affiliations: School of Nursing, Texas A&M University
| | - Laurie Charles
- Center for Excellence in Forensic Nursing, School of Nursing, Texas A&M University
| | - Stacey Mitchell
- Center for Excellence in Forensic Nursing, School of Nursing, Texas A&M University
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van Gelder NE, Ligthart SA, van Rosmalen-Nooijens KAWL, Prins JB, Oertelt-Prigione S. Key Factors in Helpfulness and Use of the SAFE Intervention for Women Experiencing Intimate Partner Violence and Abuse: Qualitative Outcomes From a Randomized Controlled Trial and Process Evaluation. J Med Internet Res 2023; 25:e42647. [PMID: 37603391 PMCID: PMC10477920 DOI: 10.2196/42647] [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: 09/12/2022] [Revised: 05/18/2023] [Accepted: 06/30/2023] [Indexed: 08/22/2023] Open
Abstract
BACKGROUND Many women experience at least one type of intimate partner violence and abuse (IPVA), and although various support options are available, we still know relatively little about web-based interventions for IPVA survivors. We conducted a qualitative evaluation of the SAFE eHealth intervention for women experiencing IPVA in the Netherlands, complementing the quantitative evaluation of self-efficacy, depression, anxiety, and multiple feasibility aspects. OBJECTIVE This study assessed users' experiences and what, according to them, were useful and helpful aspects of the intervention. METHODS The intervention consisted of modules with information on relationships and IPVA, help options, physical and mental health, and social support. It also contained interactive elements such as exercises, stories from survivors, a chat, and a forum. A randomized controlled trial was conducted with an intervention arm receiving the complete version of the intervention and a control arm receiving only a static version with the modules on relationships and IPVA and help options. We gathered data through open questions from surveys (for both study arms; n=65) and semistructured interviews (for the intervention study arm; n=10), all conducted on the web, during the randomized controlled trial and process evaluation. Interview data were coded following the principles of open thematic coding, and all qualitative data were analyzed using qualitative content analysis. RESULTS Overall, most users positively rated the intervention regarding safety, content, and suiting their needs, especially participants from the intervention study arm. The intervention was helpful in the domains of acknowledgment, awareness, and support. However, participants also identified points for improvement: the availability of a simplified version for acute situations; more attention for survivors in the aftermath of ending an abusive relationship; and more information on certain topics, such as technological IPVA, support for children, and legal affairs. Furthermore, although participants expressed a prominent need for interactive contact options such as a chat or forum, the intervention study arm (the only group that had these features at their disposal) mainly used them in a passive way-reading instead of actively joining the conversation. The participants provided various reasons for this passive use. CONCLUSIONS The positive outcomes of this study are similar to those of other web-based interventions for IPVA survivors, and specific points for improvement were identified. The availability of interactive elements seems to be of added value even when they are used passively. This study provides in-depth insight into the experiences of female IPVA survivors with the SAFE eHealth intervention and makes suggestions for improvements to SAFE and comparable web-based interventions for IPVA as well as inspiring future research. Furthermore, this study shows the importance of a varied assessment of an intervention's effectiveness to understand the real-world impact on its users. TRIAL REGISTRATION Netherlands Trial Register NTR7313; https://tinyurl.com/3t7vwswz.
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Affiliation(s)
- Nicole E van Gelder
- Department of Primary and Community Care, Research Institute for Medical Innovation, Radboud University Medical Center, Nijmegen, Netherlands
| | - Suzanne A Ligthart
- Department of Primary and Community Care, Research Institute for Medical Innovation, Radboud University Medical Center, Nijmegen, Netherlands
| | - Karin A W L van Rosmalen-Nooijens
- Department of Primary and Community Care, Research Institute for Medical Innovation, Radboud University Medical Center, Nijmegen, Netherlands
| | - Judith B Prins
- Department of Medical Psychology, Research Institute for Medical Innovation, Radboud University Medical Center, Nijmegen, Netherlands
| | - Sabine Oertelt-Prigione
- Department of Primary and Community Care, Research Institute for Medical Innovation, Radboud University Medical Center, Nijmegen, Netherlands
- Arbeitsgruppe 10 Geschlechtersensible Medizin, Medical Faculty Ostwestfalen-Lippe, Bielefeld University, Bielefeld, Germany
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17
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Mulder J, Teunissen TAM, Peters VMJ, Moors ML, Lagro-Janssen ALM. Views on Interprofessional Collaboration in a Dutch Sexual Assault Center: A Qualitative Study Among Workers. J Multidiscip Healthc 2023; 16:2001-2012. [PMID: 37484817 PMCID: PMC10361082 DOI: 10.2147/jmdh.s416996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 06/29/2023] [Indexed: 07/25/2023] Open
Abstract
Purpose As the response to sexual assault victims proved to be shattered and substandard, sexual assault centers were set up to improve care by providing the victims with medical, psychosocial and legal care. The Dutch Centers for Sexual Assault were launched in 2012. We wished to examine the challenges in interprofessional collaboration experienced in a long-running Dutch Sexual Assault Center. Methods In this qualitative study, data was collected via semi-structured explorative interviews which were analyzed using thematic analysis in an iterative process. The semi-structured interviews were held with fifteen professionals from medical, psychosocial and legal disciplines. An interview guide was developed based on expert opinion and the Bronstein Index of Interprofessional Collaboration. Qualitative analyses were done using the method of thematic analysis in ATLAS.ti and were reported according to the COREQ criteria. The themes of the experienced challenges in interprofessional collaboration were further clarified using quotations. Results Participants mentioned three themes that challenged interprofessional collaboration: 1. discrepancies in professional involvement, 2. conflicting goals and 3. a lack of connection. Discrepancies in motivation and affinity to work with victims of sexual violence between professionals proved to be the most pivotal challenge to collaboration, leading to disturbing differences in professional involvement. A low caseload and time restraints complicated gaining expertise, affinity and motivation. Conflicting goals and confidentiality issues arose between the medical and legal disciplines due to their contrasting aims of caring for victims versus facilitating prosecution. Some professionals felt a lack of connection, particularly due to missing face-to-face personal contact, which hindered the sharing of complex or burdensome cases and gaining insight into the other discipline's competences. Conclusion Building collective ownership and equal professional involvement are crucial for interprofessional collaboration. Professional involvement should be increased by training courses to clarify conflicting goals and to improve reciprocal personal contact between professionals. Training courses should be facilitated with organizational financial support.
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Affiliation(s)
- Jasmijn Mulder
- Department of Primary and Community Care, Gender and Women’s Health, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Theodora Alberta Maria Teunissen
- Department of Primary and Community Care, Gender and Women’s Health, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Veranie Maria Johanna Peters
- Department of Primary and Community Care, Gender and Women’s Health, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Marie Louise Moors
- Emergency Department, Radboud University Medical Center, Nijmegen, the Netherlands
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18
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van Gelder NE, Ligthart SA, van Rosmalen-Nooijens KA, Prins JB, Oertelt-Prigione S. Effectiveness of the SAFE eHealth Intervention for Women Experiencing Intimate Partner Violence and Abuse: Randomized Controlled Trial, Quantitative Process Evaluation, and Open Feasibility Study. J Med Internet Res 2023; 25:e42641. [PMID: 37368485 DOI: 10.2196/42641] [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: 09/12/2022] [Revised: 03/27/2023] [Accepted: 04/20/2023] [Indexed: 06/28/2023] Open
Abstract
BACKGROUND Intimate partner violence and abuse (IPVA) is a pervasive societal issue that impacts many women globally. Web-based help options are becoming increasingly available and have the ability to eliminate certain barriers in help seeking for IPVA, especially in improving accessibility. OBJECTIVE This study focused on the quantitative evaluation of the SAFE eHealth intervention for women IPVA survivors. METHODS A total of 198 women who experienced IPVA participated in a randomized controlled trial and quantitative process evaluation. Participants were largely recruited on the internet and signed up through self-referral. They were allocated (blinded for the participants) to (1) the intervention group (N=99) with access to a complete version of a help website containing 4 modules on IPVA, support options, mental health, and social support, and with interactive components such as a chat, or (2) the limited-intervention control group (N=99). Data were gathered about self-efficacy, depression, anxiety, and multiple feasibility aspects. The primary outcome was self-efficacy at 6 months. The process evaluation focused on themes, such as ease of use and feeling helped. In an open feasibility study (OFS; N=170), we assessed demand, implementation, and practicality. All data for this study were collected through web-based self-report questionnaires and automatically registered web-based data such as page visits and amount of logins. RESULTS We found no significant difference over time between groups for self-efficacy, depression, anxiety, fear of partner, awareness, and perceived support. However, both study arms showed significantly decreased scores for anxiety and fear of partner. Most participants in both groups were satisfied, but the intervention group showed significantly higher scores for suitability and feeling helped. However, we encountered high attrition for the follow-up surveys. Furthermore, the intervention was positively evaluated on multiple feasibility aspects. The average amount of logins did not significantly differ between the study arms, but participants in the intervention arm did spend significantly more time on the website. An increase in registrations during the OFS (N=170) was identified: the mean amount of registrations per month was 13.2 during the randomized controlled trial and 56.7 during the OFS. CONCLUSIONS Our findings did not show a significant difference in outcomes between the extensive SAFE intervention and the limited-intervention control group. It is, however, difficult to quantify the real contribution of the interactive components, as the control group also had access to a limited version of the intervention for ethical reasons. Both groups were satisfied with the intervention they received, with the intervention study arm significantly more so than the control study arm. Integrated and multilayered approaches are needed to aptly quantify the impact of web-based IPVA interventions for survivors. TRIAL REGISTRATION Netherlands Trial Register NL7108 NTR7313; https://trialsearch.who.int/Trial2.aspx?TrialID=NTR7313.
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Affiliation(s)
- Nicole E van Gelder
- Department of Primary and Community Care, Research Institute for Medical Innovation, Radboud University Medical Center, Nijmegen, Netherlands
| | - Suzanne A Ligthart
- Department of Primary and Community Care, Research Institute for Medical Innovation, Radboud University Medical Center, Nijmegen, Netherlands
| | - Karin Awl van Rosmalen-Nooijens
- Department of Primary and Community Care, Research Institute for Medical Innovation, Radboud University Medical Center, Nijmegen, Netherlands
| | - Judith B Prins
- Department of Medical Psychology, Research Institute for Medical Innovation, Radboud University Medical Center, Nijmegen, Netherlands
| | - Sabine Oertelt-Prigione
- Department of Primary and Community Care, Research Institute for Medical Innovation, Radboud University Medical Center, Nijmegen, Netherlands
- Arbeitsgruppe 10 Sex- and Gender-sensitive Medicine, Medical Faculty Ostwestfalen-Lippe, University of Bielefeld, Bielefeld, Germany
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Majeed-Ariss R, Smith DM, Mohamed L, Wood L, White C. The impact of COVID19 pandemic and government enforced lockdowns on levels of attendance and context of sexual assaults reported at Saint Marys Sexual Assault Referral Centre. J Forensic Leg Med 2023; 97:102550. [PMID: 37331248 DOI: 10.1016/j.jflm.2023.102550] [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: 03/16/2023] [Revised: 05/10/2023] [Accepted: 06/05/2023] [Indexed: 06/20/2023]
Abstract
Globally, government enforced lockdowns were one measure introduced to reduce the transmission of COVID-19. The impact of these social movement restrictions on victims of sexual assault and their access of sexual assault services needed clarity. This study aimed to understand the impact of COVID-19 pandemic lockdowns on: Sexual Assault Referral Centres (SARC) attendance; characteristics of clients; characteristics of alleged perpetrators and nature of sexual assaults. Routinely collected data from the Saint Mary's SARC in the North West of England over two financial years, April 2019-March 2020 (pre-COVID-19) and April 2020-March 2021 (during COVID-19), were analysed. Compared to the pre COVID-19 year, monthly SARC attendance for children and adults decreased during national lockdowns and increased as restrictions lifted. Ethnicity of clients was significantly different during COVID-19 with more South Asian adults and more bi-racial children attending. Attendance of adults aged over 57 years also significantly increased during COVID-19. A significant increase in adults meeting alleged perpetrators online and a significant decrease in alleged perpetrators being a sex worker client were also identified. Finally, a significant increase in not-recorded data for health characteristics of adult and child clients was noted. While this study has illuminated some changes in the vulnerability profile of clients attending SARC during COVID-19 and its associated lockdowns, it has also highlighted shortcomings in changes to usual care introduced in the challenging and changing context of a global pandemic. These findings in parallel usefully recommend areas in need of service improvement.
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Affiliation(s)
- Rabiya Majeed-Ariss
- Saint Mary's Sexual Assault Referral Centre, York Place, Oxford Road, Manchester, M13 9WL, UK.
| | - Debbie M Smith
- Faculty of Biology, Medicine and Health, School of Health Sciences, Manchester Centre for Health Psychology, University of Manchester, Manchester, UK
| | - Laila Mohamed
- Saint Mary's Sexual Assault Referral Centre, York Place, Oxford Road, Manchester, M13 9WL, UK
| | - Lauren Wood
- Faculty of Biology, Medicine and Health, School of Medical Sciences, University of Manchester, Manchester, UK
| | - Catherine White
- Saint Mary's Sexual Assault Referral Centre, York Place, Oxford Road, Manchester, M13 9WL, UK; Institute for Addressing Strangulation Sexual Offences, UK
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Choi Y, Lee DH. The Pattern of Injuries in the Emergency Room during the COVID-19 Pandemic. Healthcare (Basel) 2023; 11:healthcare11101483. [PMID: 37239769 DOI: 10.3390/healthcare11101483] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 05/12/2023] [Accepted: 05/17/2023] [Indexed: 05/28/2023] Open
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic has obviously caused a remarkable change in patients' emergency department (ED) visits; however, data from multicenter studies are lacking. We aimed to present a comprehensive analysis of injury-related ED visits in Republic of Korea before and during the COVID-19 pandemic. MATERIALS AND METHODS Data from 23 tertiary hospitals based on Emergency Department-based Injury In-depth Surveillance were used for this retrospective cross-sectional study. A total of 541,515 ED visits (age ≥ 20 years) between 1 January 2018 and 31 December 2020 were included, and the trend of injuries related to motor vehicular accidents, falls, self-harm and suicide, assault, and poisoning were compared between the pre-COVID-19 time period and during the COVID-19 pandemic. RESULTS In the first year of the COVID-19 period, a decline in the number of ED visits was observed (41,275, 21%) compared to the previous year. Injuries caused by motor vehicles (36,332 in 2019 vs. 27,144 in 2020), falls and slips (61,286 in 2019 vs. 49,156 in 2020), assaults (10,528 in 2019 vs. 8067 in 2020), and poisonings (7859 in 2019 vs. 7167 in 2020) decreased, whereas self-harm and suicide (8917 in 2019 vs. 8911 in 2020) remained unchanged. The hospitalization (16.6% in 2019 vs. 18.8% in 2020) and ED mortality rate (0.6% in 2019 vs. 0.8% in 2020) also increased. CONCLUSION The COVID-19 pandemic led to a decline in the overall number of trauma patients seeking medical care; however, the proportion of patients requiring hospitalization or intensive care unit admission increased, indicating more severe injuries among those who did seek care. Suicide attempt rates remained unchanged, highlighting the need for targeted care and support for vulnerable patients. During the pandemic, EDs had to continue to provide care to patients with medical emergencies unrelated to COVID-19, which requires a delicate and adaptable approach to ED operations. To manage the increased stress and workload caused by the pandemic, increased resources and support for healthcare workers were needed.
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Affiliation(s)
- Yunhyung Choi
- Department of Emergency Medicine, College of Medicine, Ewha Womans University, Seoul 07985, Republic of Korea
| | - Duk Hee Lee
- Department of Emergency Medicine, College of Medicine, Ewha Womans University, Seoul 07985, Republic of Korea
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21
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Díaz-Faes DA, Vidal-Codina F, Segura A, Aguilar R, Pereda N. How the COVID-19 pandemic hit crime in Barcelona: Analysis of variation in crime trends. EUROPEAN JOURNAL OF CRIMINOLOGY 2023; 20:792-816. [PMID: 38602935 PMCID: PMC10014451 DOI: 10.1177/14773708231156326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/13/2024]
Abstract
Objectives To compare the observed and forecasted crime trends in Barcelona, using crime statistics from January 2018 to March 2021. Methods We trained (seasonal) auto-regressive integrated moving average modelling (95% confidence intervals) using daily recorded crimes from January 2018 to February 2020. These models were then used to forecast crime data from March 2020 to March 2021 across four periods (lockdown, summer, fall and winter). Crime data were organized into two categories: property (burglary, theft) and violent crimes (robbery, assault, domestic violence and sexual offenses [rape, assault or abuse]). Results Overall, crime levels for property and violent crimes during lockdown declined sharply from the forecasted levels. Theft, burglary, assault, robbery and sexual offenses exhibited general decreases throughout the study period, with the same sharp declines during the lockdown, progressive recovery in the summer, and steady or slight reductions from fall to March 2021. Only domestic violence differed, reaching the forecasted levels for all periods and surpassing the forecast for summer 2020. Conclusions Our findings show how the pandemic has affected mid-term crime trends. They help to place the measures applied in the last year into context and to determine the most suitable policies to reduce crime during societal change.
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Affiliation(s)
- Diego A. Díaz-Faes
- Department of Clinical Psychology and
Psychobiology, Faculty of Psychology, Universitat de
Barcelona, Barcelona, Spain
- Institute of Neurosciences
(UBNeuro), Universitat de
Barcelona, Barcelona, Spain
| | - Ferran Vidal-Codina
- Department of Aeronautics and Astronautics, Massachusetts Institute of
Technology, Cambridge, MA, USA
| | - Anna Segura
- School of Social Work, Rutgers University, New Brunswick, NJ, USA
- Universitat de Vic – Universitat
Central de Catalunya, Vic, Spain
| | - Raúl Aguilar
- Mossos d’Esquadra, Catalan Police, Barcelona, Barcelona, Spain
| | - Noemí Pereda
- Department of Clinical Psychology and
Psychobiology, Faculty of Psychology, Universitat de
Barcelona, Barcelona, Spain
- Institute of Neurosciences
(UBNeuro), Universitat de
Barcelona, Barcelona, Spain
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22
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Lynch KR, Logan T. Rural and Urban/Suburban Victim Professionals' Perceptions of Gender-Based Violence, Victim Challenges, and Safety Advice During the COVID-19 Pandemic. Violence Against Women 2023; 29:1060-1084. [PMID: 35938486 PMCID: PMC9412151 DOI: 10.1177/10778012221099987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This study surveyed a national sample of victim service professionals (N = 222) and compared rural versus urban/suburban participants' perceptions of a variety of issues, such as the impact of the pandemic on gender-based violence victimization and safety advice for isolated victims. Increased interference with victim employment and the abuser monitoring of online activities were reported by participants across all communities. However, urban/suburban participants rated the magnitude of all victim challenges as greater, while more rural participants noted child abuse as a particular problem in their communities. The results highlight the importance of community context for improving coordinated responses to gender-based violence (n = 101).
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Affiliation(s)
- Kellie R. Lynch
- Department of Criminology &
Criminal Justice, College for Health, Community and Policy, University of Texas at San
Antonio, San Antonio, TX, USA
| | - T.K. Logan
- Center on Drug and Alcohol Research,
Department of Behavioral Science, University of Kentucky, Lexington, KY, USA
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23
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Akfırat S, Bayrak F, Üzümçeker E, Ergiyen T, Yurtbakan T, Uysal MS. The roles of social norms and leadership in health communication in the context of COVID-19. Soc Sci Med 2023; 323:115868. [PMID: 36963212 PMCID: PMC10030439 DOI: 10.1016/j.socscimed.2023.115868] [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: 05/18/2022] [Revised: 02/28/2023] [Accepted: 03/20/2023] [Indexed: 03/24/2023]
Abstract
The global struggle with the COVID-19 pandemic has lasted for almost three years. Although national and local leaders have often called on the public to comply with preventive measures through health communication, large sections of society sometimes violated precautions and did not adequately follow these calls. We propose that social norms and leaders' identity entrepreneurship characteristics could be essential in effective health communication. In line with this notion, we investigated the effects of social norm types and leadership on complying with preventive measures, the intention to be vaccinated, and prosocial behavioral tendency through a high-powered experiment that focused on three factors: leadership quality (presence/lack of entrepreneurship), descriptive norm (supportive/obstructive), and injunctive norm (supportive/obstructive). Results showed that when support for injunctive and descriptive norms was present, people tended to more readily adhere to preventive measures, get vaccinated, and engage in prosocial behavior. There was also a significant effect of the interaction between descriptive and injunctive norms on compliance with preventive measures. The compliance level was highest when both norm types were supportive and lowest when both were obstructive. The effect decreased in the discrepant norms condition, where one type of norm was supportive and the other obstructive. There is also a significant interaction between leadership and the descriptive norm, indicating that a combination of an entrepreneur leader and a supportive descriptive norm increases compliance with the preventive measure. We discussed the role of leadership and social norms in effective health communication.
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Affiliation(s)
- Serap Akfırat
- Dokuz Eylul University, Department of Psychology, Turkiye.
| | - Fatih Bayrak
- Baskent University, Department of Psychology, Turkiye
| | - Emir Üzümçeker
- Dokuz Eylul University, Department of Psychology, Turkiye
| | - Tolga Ergiyen
- Izmir University of Economics, Department of Psychology, Turkiye
| | | | - Mete Sefa Uysal
- Friedrich Schiller University Jena, Department of Social Psychology, Germany
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24
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Liu L, Pollock NJ, Contreras G, Tonmyr L, Thompson W. Pandemic-related impacts and suicidal ideation among adults in Canada: a population-based cross-sectional study. Health Promot Chronic Dis Prev Can 2023; 43:105-118. [PMID: 36630582 PMCID: PMC10101044 DOI: 10.24095/hpcdp.43.3.01] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
INTRODUCTION Recent evidence has suggested an increase in suicidal ideation during the COVID-19 pandemic. Our objectives were to estimate the likelihood of suicidal ideation among adults in Canada who experienced pandemic-related impacts and to determine if this likelihood changed during the pandemic. METHODS We analyzed pooled data for 18 936 adults 18 years or older who responded to two cycles of the Survey on COVID-19 and Mental Health collected from 11 September to 4 December 2020 and from 1 February to 7 May 2021. We estimated the prevalence of suicidal ideation since the pandemic began and conducted logistic regression to evaluate the likelihood of suicidal ideation by adults who experienced pandemic-related impacts, and by factors related to social risk, mental health status, positive mental health indicators and coping strategies. RESULTS Adults who had adverse pandemic-related experiences were significantly more likely to experience suicidal ideation; a dose-response relationship was evident. People who increased their alcohol or cannabis use, expressed concerns about violence in their home or who had moderate to severe symptoms of depression, anxiety or posttraumatic stress disorder also had significantly higher risk of suicidal ideation. The risk was significantly lower among people who reported high self-rated mental health, community belonging or life satisfaction, who exercised for their mental and/or physical health or who pursued hobbies. CONCLUSION The COVID-19 pandemic has influenced suicidal ideation in Canada. Our study provides evidence for targeted public health interventions related to suicide prevention.
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Affiliation(s)
- Li Liu
- Public Health Agency of Canada, Ottawa, Ontario, Canada
| | - Nathaniel J Pollock
- Public Health Agency of Canada, Ottawa, Ontario, Canada
- School of Arctic and Subarctic Studies, Memorial University, Newfoundland and Labrador, Canada
| | | | - Lil Tonmyr
- Public Health Agency of Canada, Ottawa, Ontario, Canada
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25
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Yang D, Cordone A, Sun WW, Gawel M, Sangal RB, Dodington J. Emergency department visits in Connecticut for survivors of sexual assault before and during the COVID-19 pandemic. Am J Emerg Med 2023; 67:97-99. [PMID: 36842427 PMCID: PMC9927790 DOI: 10.1016/j.ajem.2023.02.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 02/07/2023] [Accepted: 02/08/2023] [Indexed: 02/16/2023] Open
Abstract
STUDY OBJECTIVE We evaluate the impact of the COVID-19 pandemic on care for survivors of sexual assault in three urban Emergency Departments (ED) in the United States. METHODS A retrospective chart review was conducted on patients who presented after sexual assault to three EDs during 6-month intervals before and during the COVID-19 pandemic. We excluded individuals <18 years old. We performed a structured chart review to ascertain demographics, ED treatments, and adherence to guidelines for care of sexual assault survivors. RESULTS Of 105 patients who received care after a sexual assault, 57 presented during the COVID-19 pandemic. The majority were female, White/Caucasian, and presented within 120 h of sexual assault. There was an increase in ED presentations for sexual assault during the pandemic. While there was no difference in medical care, there were fewer sexual assault advocates called during the pandemic. In addition, there was an increase in non-White survivors in the first 3 months of the pandemic that did not remain at 6 months. CONCLUSION The care of survivors in the ED was disrupted by the COVID-19 pandemic. While medical care remained similar, fewer calls to sexual assault advocates, a key component of ED and long-term care of survivors, demonstrate a disruption in their care.
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Affiliation(s)
- David Yang
- Department of Emergency Medicine, Yale University School of Medicine, New Haven, CT, United States of America
| | - Alexis Cordone
- Department of Emergency Medicine, Yale University School of Medicine, New Haven, CT, United States of America
| | - Wendy W Sun
- Department of Emergency Medicine, Yale University School of Medicine, New Haven, CT, United States of America
| | - Marcie Gawel
- Center for Injury & Violence Prevention, Yale New Haven Hospital, New Haven, CT, United States of America
| | - Rohit B Sangal
- Department of Emergency Medicine, Yale University School of Medicine, New Haven, CT, United States of America
| | - James Dodington
- Department of Emergency Medicine, Yale University School of Medicine, New Haven, CT, United States of America; Center for Injury & Violence Prevention, Yale New Haven Hospital, New Haven, CT, United States of America; Department of Pediatrics, Yale University School of Medicine, New Haven, CT, United States of America
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26
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Sampsel K, Deutscher J, Duchesne E. Intimate Partner Violence and Human Trafficking. Emerg Med Clin North Am 2023; 41:101-116. [DOI: 10.1016/j.emc.2022.09.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Williamson L, Bayly M, Poncelet E, Lawson K. A Qualitative Exploration of Undergraduate Student Perspectives of Sexual Consent Within a Sexual Script Framework. THE CANADIAN JOURNAL OF HUMAN SEXUALITY 2023. [DOI: 10.3138/cjhs.2021-0069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
There appear to be widespread misunderstandings and disagreement regarding the definition and execution of sexual consent among postsecondary students. Without a clear understanding of what constitutes sexual consent, navigating consent-related situations can be challenging for individuals. Sexual script theory may explain gaps in consent knowledge by highlighting the social normative references, or sexual scripts, individuals may rely on when knowledge of consent is insufficient or challenging to apply. The goal of the current study was to qualitatively explore Canadian undergraduate students’ perceptions and experiences of sexual consent within the framework of sexual script theory. Using focus groups, N = 56 undergraduates discussed perceptions of sexual consent, under what circumstances they perceive it to be required, potential “grey areas” of sexual consent and how they are navigated, and how gender may intersect with sexual consent. Transcripts were analyzed within a framework of sexual script theory using inductive coding and thematic analysis. Although participants understood Canadian legally codified scripts well, they seemed to rely on socio-cultural and gendered sexual consent scripts when legal scripts were insufficient or challenging to apply, particularly in ambiguous consent scenarios. The findings suggest that beyond providing educational opportunities and interventions within formal school settings that encompass a wider range of sexual consent scenarios, there is a need to address socio-cultural norms/sexual scripts regarding consent within the broader population.
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Affiliation(s)
- Linzi Williamson
- Department of Psychology & Health Studies, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Melanie Bayly
- Canadian Centre for Health and Safety and Agriculture, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Evan Poncelet
- Department of Psychology & Health Studies, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Karen Lawson
- Department of Psychology & Health Studies, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
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28
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Pisl V, Vevera J, Štěpánek L, Volavka J. Changes in ambulance departures for assault calls during COVID-19 pandemic restrictions. Aggress Behav 2023; 49:76-84. [PMID: 36305480 PMCID: PMC9874533 DOI: 10.1002/ab.22055] [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: 09/04/2021] [Revised: 10/06/2022] [Accepted: 10/11/2022] [Indexed: 01/27/2023]
Abstract
Restrictions related to COVID-19 changed the daily behavior of people, including the expression of violence. Although an increased incidence of violent behavior, especially domestic violence, was expected during the pandemic, retrospective analyses have yielded mixed results. Records of ambulance departures to address injuries caused by assaults in the Pilsen region, Czech Republic, during the restrictive measures during the national state of emergency were compared to data from 3 previous years using general linear models. The number and severity of assaults were analyzed for the whole sample and separately for patients of either sex, for residential or nonresidential locations, and for domestic violence. Controlling for the seasonal effects, the number of assaults decreased by 39% during the pandemic restrictions compared to the 3 previous years. No difference was found between the effects of restrictions on assaults resulting in an injury of a male or female patient. The decrease was specifically pronounced in the sample of assaults in nonresidential locations, while no effect of restrictions was observed in assaults in residential locations and domestic assaults. Pandemic restrictions were associated with a decreased incidence of violent assaults that required ambulance services. Although the incidence decreased especially in those assaulted outside of their homes, we found no support for an increase in domestic violence or violence against women. Pandemic restrictions may have served as a protective rather than a risk factor for assaults severe enough to warrant a call for ambulance services.
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Affiliation(s)
- Vojtech Pisl
- Department of Psychiatry, Faculty of Medicine and University Hospital in PilsenCharles UniversityPlzeňCzech Republic
| | - Jan Vevera
- Department of Psychiatry, Faculty of Medicine and University Hospital in PilsenCharles UniversityPlzeňCzech Republic,Department of PsychiatryInstitute for Postgraduate Medical EducationPragueCzech Republic
| | - Lubomír Štěpánek
- Institute of Biophysics and Informatics, First Faculty of MedicineCharles UniversityPlzeňCzech Republic
| | - Jan Volavka
- Department of Psychiatry, Faculty of Medicine and University Hospital in PilsenCharles UniversityPlzeňCzech Republic,Department of Psychiatry, School of MedicineNew York University (Emeritus)New YorkNew YorkUSA
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29
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Elliott SA, Bardwell ES, Kamke K, Mullin TM, Goodman KL. Survivors' Concerns During the COVID-19 Pandemic: Qualitative Insights From the National Sexual Assault Online Hotline. JOURNAL OF INTERPERSONAL VIOLENCE 2023; 38:NP84-NP107. [PMID: 35341375 PMCID: PMC8960752 DOI: 10.1177/08862605221080936] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
With the onset of the COVID-19 pandemic and the implementation of stay-at-home orders in March 2020, experts warned of the possible threat of increased interpersonal violence among individuals isolated with abusers. Researchers have sought to understand how the pandemic impacted victims primarily through the analysis of administrative data sources, such as hospital and police records. However, the preponderance of this data shows a decrease in formal help-seeking among victims during the pandemic, speaking to an impaired access to services but limiting our understanding of other ways in which the pandemic has affected survivors. To overcome these limitations, we examined data collected about users of the National Sexual Assault Online Hotline (NSAOH). Information was collected through staff based on retrospective recall following one-on-one chat sessions with 470 victims of sexual violence who contacted the NSAOH in the first six months of the pandemic and discussed COVID-19-related concerns. We qualitatively examined open-ended descriptions of COVID-19-related concerns and identified the four most common: (1) mental health concerns, (2) creation or exacerbation of an unsafe living situation, (3) not being able to access services, and (4) not having access to a mandatory reporter or trusted adult. These findings demonstrate the myriad ways in which the pandemic affected the lives of victims of sexual violence and can inform practices for services and practitioners to best meet the needs of survivors moving forward. Specifically, these findings highlight the need for more accessible mental health services and funding for sexual assault service providers, as well as the importance of safety planning, particularly in times of crisis.
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Affiliation(s)
- Shannon A. Elliott
- Rape, Abuse & Incest National
Network, Research and Evaluation, Washington DC, USA
| | - Emma S. Bardwell
- Rape, Abuse & Incest National
Network, Research and Evaluation, Washington DC, USA
| | - Kristyn Kamke
- Rape, Abuse & Incest National
Network, Research and Evaluation, Washington DC, USA
| | - Tara M. Mullin
- Rape, Abuse & Incest National
Network, Research and Evaluation, Washington DC, USA
| | - Kimberly L. Goodman
- Rape, Abuse & Incest National
Network, Research and Evaluation, Washington DC, USA
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30
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Campbell R, Javorka M, Engleton J, Goodman-Williams R, Gregory K. Post-Assault Health Care for Sexual Assault Survivors During COVID-19: A Mixed Methods Analysis of Service Rates in a Predominately African American Community. JOURNAL OF INTERPERSONAL VIOLENCE 2023; 38:NP2112-NP2134. [PMID: 35532032 PMCID: PMC9082100 DOI: 10.1177/08862605221098963] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
This study examined how the COVID-19 pandemic affected sexual assault healthcare services in a predominately African American U.S. city. In mixed methods research design, we used quantitative interrupted time series modeling to evaluate changes in service rates for three core post-assault healthcare services-medical forensic exams (MFEs), medical advocacy MFE accompaniment, and counseling-from January 2019 through June 2021. We also conducted qualitative interviews with 12 sexual assault advocates to understand how their clients were impacted by COVID and how their agency adapted services to respond to the needs of their community. Both the quantitative and qualitative data revealed marked disruptions in service provision. The number of MFEs, medical advocacy accompaniments, and counseling sessions significantly decreased during the pandemic's initial surge, and survivors feared seeking hospital-based health care due to concerns that they might contract COVID-19 in hospital emergency departments. The number of MFEs performed by program staff did not return to pre-pandemic levels during this study's observation period, but the number of medical advocacy accompaniments and counseling sessions did significantly rebound. Counseling services eventually exceeded pre-pandemic levels as agency staff supported clients with both assault- and COVID-related trauma and loss. These results underscore the need for community-based sexual assault healthcare services, so that if public health emergencies limit the availability, accessibility, and safety of hospital emergency department care, sexual assault survivors have other settings for obtaining post-assault health care.
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Affiliation(s)
- Rebecca Campbell
- Department of Psychology, Michigan State
University, East Lansing, MI, USA
| | - McKenzie Javorka
- Department of Psychology, Michigan State
University, East Lansing, MI, USA
| | - Jasmine Engleton
- Department of Psychology, Michigan State
University, East Lansing, MI, USA
| | | | - Katie Gregory
- Department of Psychology, Michigan State
University, East Lansing, MI, USA
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31
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Babalola T, Couch T, Donahoe M, Kidman R, Hammock A, Monastero R, Hanes D, Meliker J. Domestic violence calls for police service in five US cities during the COVID-19 pandemic of 2020. BMC Public Health 2022; 22:2455. [PMID: 36581916 PMCID: PMC9800054 DOI: 10.1186/s12889-022-14901-3] [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: 05/26/2022] [Accepted: 12/19/2022] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND When COVID-19 stay-at-home orders were instituted, there were concerns that isolation may lead to increases in domestic violence (DV). Reports of increased rates of DV during the stay-at-home period have been suggestive of this but inconsistent across different locations. We sought to complement the existing studies by characterizing changes in DV trends in US cities of Chicago, Los Angeles (LA), New York City (NYC), Philadelphia, and Phoenix using police call volume data from January 1st, 2018, through Dec 31st, 2020. METHODS The stay-at-home orders were generally instituted for most US states in the second half of March 2020. We used the call volume for the pre-COVID-19 period (Jan. 2018 to Feb. 2020) to model a forecast against the stay-at-home order period (Mar. - May 2020) and the period after lifting the order (June - Dec. 2020) using the interrupted autoregressive integrated moving average (ARIMA) time series model. RESULTS During the stay-at-home order, increases in mean DV calls relative to pre-COVID-19 were observed in Chicago (47.8%), Phoenix (18.4%), NYC (3.5%), and LA (3.4%), but a decrease in Philadelphia (-4.9%). After lifting the stay-at-home order, changes in mean calls relative to pre-COVID-19 remained elevated in Chicago, slightly elevated in Phoenix, and returned to baseline in NYC and LA. CONCLUSION Results suggest that the stay-at-home orders may have contributed to an increase in DV calls in some cities (Phoenix, and to a smaller extent LA, NYC), but the increase seen in Chicago (and to some extent Phoenix) persisted beyond the stay-at-home order and therefore may not be attributable to the stay-at-home orders. Additional studies are needed to help explain why the association between stay-at-home orders and DV police call volume seems to only appear in some locations.
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Affiliation(s)
- Tesleem Babalola
- grid.36425.360000 0001 2216 9681Program in Public Health, Stony Brook University, Stony Brook, NY USA
| | - Tianna Couch
- grid.262007.10000 0001 2161 0463Pomona College, Claremont, CA USA
| | - Morgan Donahoe
- Westhampton Beach Senior High School, Westhampton Beach, NY USA
| | - Rachel Kidman
- grid.36425.360000 0001 2216 9681Program in Public Health, Stony Brook University, Stony Brook, NY USA
| | - Amy Hammock
- grid.36425.360000 0001 2216 9681Program in Public Health, Stony Brook University, Stony Brook, NY USA ,grid.36425.360000 0001 2216 9681School of Social Welfare, Stony Brook University, Stony Brook, NY USA
| | - Rebecca Monastero
- grid.36425.360000 0001 2216 9681School of Medicine, Stony Brook University, Stony Brook, NY USA
| | - Douglas Hanes
- grid.36425.360000 0001 2216 9681Program in Public Health, Stony Brook University, Stony Brook, NY USA ,grid.17063.330000 0001 2157 2938Centre for Gender and Sexual Minority Health, Dalla Lana School of Public Health, University of Toronto, Toronto ON, Canada
| | - Jaymie Meliker
- grid.36425.360000 0001 2216 9681Program in Public Health, Stony Brook University, Stony Brook, NY USA
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Domínguez D JF, Truong J, Burnett J, Satyen L, Akhlaghi H, Stella J, Rushworth N, Caeyenberghs K. Effects of the Response to the COVID-19 Pandemic on Assault-Related Head Injury in Melbourne: A Retrospective Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:63. [PMID: 36612383 PMCID: PMC9819794 DOI: 10.3390/ijerph20010063] [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: 09/15/2022] [Revised: 12/13/2022] [Accepted: 12/14/2022] [Indexed: 06/17/2023]
Abstract
Assault is the leading preventable cause of death, traumatic brain injury (TBI), and associated mental health problems. The COVID-19 pandemic has had a profound impact on patterns of interpersonal violence across the world. In this retrospective cross-sectional study, we analysed medical records of 1232 assault victims (domestic violence: 111, random assault: 900, prison assault: 221) with head injuries who presented to the emergency department (ED) at St Vincent's Hospital in Melbourne, Australia, a city with one of the longest and most severe COVID-19 restrictions worldwide. We examined changes in prevalence in the assault group overall and in domestic violence, random assault, and prison assault victims, comparing data from 19.5 months before and after the first day of COVID-19 restrictions in Melbourne. Moreover, we investigated differences driven by demographic factors (Who: age group, sex, and nationality) and clinical variables (Where: assault location, and When: time of arrival to the ED and time from moment of injury until presentation at ED). Descriptive statistics and chi-square analyses were performed. We found the COVID-19 pandemic significantly affected the Where of assault-related TBI, with a shift in the location of assaults from the street to the home, and the increase at home being driven by random assaults on middle-aged adults. Overall, we observed that 86% of the random assault cases were males, whereas 74% of the domestic assault cases were females. Meanwhile, nearly half (44%) of the random assault victims reported alcohol consumption versus a fifth (20%) of domestic violence victims. These findings will have direct implications for developing screening tools and better preventive and ameliorative interventions to manage the sequelae of assault TBI, particularly in the context of future large-scale health crises or emergencies.
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Affiliation(s)
- Juan F Domínguez D
- Cognitive Neuroscience Unit, School of Psychology, Deakin University, Geelong, VIC 3220, Australia
| | - Johnny Truong
- Cognitive Neuroscience Unit, School of Psychology, Deakin University, Geelong, VIC 3220, Australia
| | - Jake Burnett
- Cognitive Neuroscience Unit, School of Psychology, Deakin University, Geelong, VIC 3220, Australia
| | - Lata Satyen
- School of Psychology, Deakin University, Burwood, VIC 3125, Australia
| | - Hamed Akhlaghi
- Cognitive Neuroscience Unit, School of Psychology, Deakin University, Geelong, VIC 3220, Australia
- Department of Emergency Medicine, St. Vincent’s Hospital, Melbourne, VIC 3065, Australia
| | - Julian Stella
- Department of Emergency Medicine, Geelong Hospital, Geelong, VIC 3220, Australia
| | | | - Karen Caeyenberghs
- Cognitive Neuroscience Unit, School of Psychology, Deakin University, Geelong, VIC 3220, Australia
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Ochieng W, Sage EO, Achia T, Oluoch P, Kambona C, Njenga J, Bulterys M, Lor A. Sexual Violence Trends before and after Rollout of COVID-19 Mitigation Measures, Kenya. Emerg Infect Dis 2022; 28:S270-S276. [PMID: 36502433 DOI: 10.3201/eid2813.220394] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
COVID-19 mitigation measures such as curfews, lockdowns, and movement restrictions are effective in reducing the transmission of SARS-CoV-2; however, these measures can enable sexual violence. We used data from the Kenya Health Information System and different time-series approaches to model the unintended consequences of COVID-19 mitigation measures on sexual violence trends in Kenya. We found a model-dependent 73%-122% increase in reported sexual violence cases, mostly among persons 10-17 years of age, translating to 35,688 excess sexual violence cases above what would have been expected in the absence of COVID-19-related restrictions. In addition, during lockdown, the percentage of reported rape survivors receiving recommended HIV PEP decreased from 61% to 51% and STI treatment from 72% to 61%. Sexual violence mitigation measures might include establishing comprehensive national sexual violence surveillance systems, enhancing prevention efforts during school closures, and maintaining access to essential comprehensive services for all ages and sexes.
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Muldoon KA, Talarico R, Fell DB, Illingworth H, Sampsel K, Manuel DG. Population-Level Trends in Emergency Department Encounters for Sexual Assault Preceding and During the COVID-19 Pandemic Across Ontario, Canada. JAMA Netw Open 2022; 5:e2248972. [PMID: 36580330 PMCID: PMC9856789 DOI: 10.1001/jamanetworkopen.2022.48972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
IMPORTANCE Lockdown measures and the stress of the COVID-19 pandemic are factors associated with increased risk of violence, yet there is limited information on trends in emergency department (ED) encounters for sexual assault. OBJECTIVE To compare changes in ED encounters for sexual assault during the COVID-19 pandemic vs prepandemic estimates. DESIGN, SETTING, AND PARTICIPANTS This retrospective, population-based cohort study used linked health administrative data from 197 EDs across Ontario, Canada, representing more than 15 million residents. Participants included all patients who presented to an ED in Ontario from January 11, 2019, to September 10, 2021. Male and female individuals of all ages were included. Data analysis was performed from March to October 2022. EXPOSURES Sexual assault, defined through 27 International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, procedure and diagnoses codes. MAIN OUTCOMES AND MEASURES Ten bimonthly time periods were used to compare differences in the frequency and rates of ED encounters for sexual assault between 2020 to 2021 (during the pandemic) compared with baseline prepandemic rates in 2019. Rate differences (RDs) and age adjusted rate ratios (aRRs) and Wald 95% CIs were calculated using Poisson regression. RESULTS From January 11, 2019, to September 10, 2021, there were 14 476 656 ED encounters, including 10 523 for sexual assault (9304 [88.4%] among female individuals). The median (IQR) age was 23 (17-33) years for female individuals and 15 (4-29) years for male individuals. Two months before the pandemic, ED encounters increased for sexual assault among female individuals (8.4 vs 6.9 cases per 100 000; RD, 1.51 [95% CI, 1.06 to 1.96]; aRR, 1.22 [95% CI, 1.09 to 1.38]) and male individuals (1.2 vs 1.0 cases per 100 000; RD, 0.19 [95% CI, 0.05 to 0.36]; aRR, 1.19 [95% CI, 0.87 to 1.64]). During the first 2 months of the pandemic, the rates decreased for female individuals (4.2 vs 8.3 cases per 100 000; RD, -4.07 [95% CI, -4.48 to -3.67]; aRR, 0.51 [95% CI, 0.44 to 0.58]) and male individuals (0.5 vs 1.2 cases per 100 000; RD, -0.72 [95% CI, -0.86 to -0.57]; aRR, 0.39 [95% CI, 0.26 to 0.58]). For the remainder of the study period, the rates of sexual assault oscillated, returning to prepandemic levels during the summer months and between COVID-19 waves. CONCLUSIONS AND RELEVANCE These findings suggest that lockdown protocols should evaluate the impact of limited care for sexual assault. Survivors should still present to EDs, especially when clinical care or legal interventions are needed.
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Affiliation(s)
- Katherine A. Muldoon
- Ottawa Hospital Research Institute, Clinical Epidemiology Program, Ottawa, Ontario, Canada
- ICES, University of Ottawa, Ottawa, Ontario, Canada
- Department of Obstetrics and Gynecology, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Robert Talarico
- Ottawa Hospital Research Institute, Clinical Epidemiology Program, Ottawa, Ontario, Canada
- ICES, University of Ottawa, Ottawa, Ontario, Canada
| | - Deshayne B. Fell
- ICES, University of Ottawa, Ottawa, Ontario, Canada
- Children’s Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
| | | | - Kari Sampsel
- Ottawa Hospital Research Institute, Clinical Epidemiology Program, Ottawa, Ontario, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
- Department of Emergency Medicine, Faculty of Medicine, The Ottawa Hospital and University of Ottawa, Ottawa, Ontario, Canada
| | - Douglas G. Manuel
- Ottawa Hospital Research Institute, Clinical Epidemiology Program, Ottawa, Ontario, Canada
- ICES, University of Ottawa, Ottawa, Ontario, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
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Khatib N, Sampsel K. CAEP Position Statement Executive Summary : Where is the love? Intimate partner violence (IPV) in the Emergency Department (ED). CAN J EMERG MED 2022; 24:691-694. [PMID: 36255657 PMCID: PMC9579564 DOI: 10.1007/s43678-022-00386-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Accepted: 09/07/2022] [Indexed: 11/28/2022]
Affiliation(s)
- Nour Khatib
- Department of Emergency Medicine, Markham Stouffville Hospital, Lakeridge Health, University of Toronto, Toronto, ON, Canada.
| | - Kari Sampsel
- Department of Emergency Medicine, The Ottawa Hospital, University of Ottawa, Ottawa, ON, Canada.
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Brown SJ, Carter GJ, Halliwell G, Brown K, Caswell R, Howarth E, Feder G, O'Doherty L. Survivor, family and professional experiences of psychosocial interventions for sexual abuse and violence: a qualitative evidence synthesis. Cochrane Database Syst Rev 2022; 10:CD013648. [PMID: 36194890 PMCID: PMC9531960 DOI: 10.1002/14651858.cd013648.pub2] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND It is well-established that experiencing sexual abuse and violence can have a range of detrimental impacts; a wide variety of interventions exist to support survivors in the aftermath. Understanding the experiences and perspectives of survivors receiving such interventions, along with those of their family members, and the professionals who deliver them is important for informing decision making as to what to offer survivors, for developing new interventions, and enhancing their acceptability. OBJECTIVES This review sought to: 1. identify, appraise and synthesise qualitative studies exploring the experiences of child and adult survivors of sexual abuse and violence, and their caregivers, regarding psychosocial interventions aimed at supporting survivors and preventing negative health outcomes in terms of benefits, risks/harms and barriers; 2. identify, appraise and synthesise qualitative studies exploring the experiences of professionals who deliver psychosocial interventions for sexual abuse and violence in terms of perceived benefits, risks/harms and barriers for survivors and their families/caregivers; 3. develop a conceptual understanding of how different factors influence uptake, dropout or completion, and outcomes from psychosocial interventions for sexual abuse and violence; 4. develop a conceptual understanding of how features and types of interventions responded to the needs of different user/survivor groups (e.g. age groups; types of abuse exposure; migrant populations) and contexts (healthcare/therapeutic settings; low- and middle-income countries (LMICs)); 5. explore how the findings of this review can enhance our understanding of the findings from the linked and related reviews assessing the effectiveness of interventions aimed at supporting survivors and preventing negative health outcomes. SEARCH METHODS In August 2021 we searched MEDLINE, Embase, PsycINFO and nine other databases. We also searched for unpublished reports and qualitative reports of quantitative studies in a linked systematic review, together with reference checking, citation searches and contacting authors and other researchers to identify relevant studies. SELECTION CRITERIA We included qualitative and mixed-methods studies (with an identifiable qualitative component) that were linked to a psychosocial intervention aimed at supporting survivors of sexual abuse and violence. Eligible studies focused on at least one of three participant groups: survivors of any age, gender, sexuality, ethnicity or [dis]ability who had received a psychosocial intervention; their carers, family members or partners; and professionals delivering such interventions. We placed no restrictions in respect of settings, locations, intervention delivery formats or durations. DATA COLLECTION AND ANALYSIS Six review authors independently assessed the titles, abstracts and full texts identified. We extracted data using a form designed for this synthesis, then used this information and an appraisal of data richness and quality in order to stratify the studies using a maximum variation approach. We assessed the methodological limitations using the Critical Skills Appraisal Programme (CASP) tool. We coded directly onto the sampled papers using NVivo and synthesised data using a thematic synthesis methodology and used the GRADE-CERQual (Confidence in the Evidence from Reviews of Qualitative research) approach to assess our confidence in each finding. We used a narrative synthesis and matrix model to integrate our qualitative evidence synthesis (QES) findings with those of intervention review findings. MAIN RESULTS We identified 97 eligible studies and sampled 37 of them for our analysis. Most sampled studies were from high-income countries, with four from middle-income and two from low-income countries. In 27 sampled studies, the participants were survivors, in three they were intervention facilitators. Two included all three of our stakeholder groups, and five included two of our groups. The studies explored a wide range of psychosocial interventions, with only one type of intervention explored in more than one study. The review indicates that features associated with the context in which interventions were delivered had an impact on how individuals accessed and experienced interventions. This included organisational features, such as staff turnover, that could influence survivors' engagement with interventions; the setting or location in which interventions were delivered; and the characteristics associated with who delivered the interventions. Studies that assess the effectiveness of interventions typically assess their impact on mental health; however, as well as finding benefits to mental health, our QES found that study participants felt interventions also had positive impacts on their physical health, mood, understanding of trauma, interpersonal relationships and enabled them to re-engage with a wide range of areas in their lives. Participants explained that features of interventions and their contexts that best enabled them to benefit from interventions were also often things that could be a barrier to benefiting from interventions. For example, the relationship with the therapist, when open and warm was a benefit, but if such a relationship could not be achieved, it was a barrier. Survivors' levels of readiness and preparedness to both start and end interventions could have positive (if they were ready) or negative (if they were not) impacts. Study participants identified the potential risks and harms associated with completing interventions but felt that it was important to face and process trauma. Some elements of interventions were specific to the intervention type (e.g. faith-based interventions), or related to an experience of an intervention that held particular relevance to subgroups of survivors (e.g. minority groups); these issues could impact how individuals experienced delivering or receiving interventions. AUTHORS' CONCLUSIONS We had high or moderate confidence in all but one of our review findings. Further research in low- and middle-income settings, with male survivors of sexual abuse and violence and those from minority groups could strengthen the evidence for low and moderate confidence findings. We found that few interventions had published quantitative and qualitative evaluations. Since this QES has highlighted important aspects that could enable interventions to be more suitable for survivors, using a range of methodologies would provide valuable information that could enhance intervention uptake, completion and effectiveness. This study has shown that although survivors often found interventions difficult, they also appreciated that they needed to work through trauma, which they said resulted in a wide range of benefits. Therefore, listening to survivors and providing appropriate interventions, at the right time for them, can make a significant difference to their health and well-being.
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Affiliation(s)
- Sarah J Brown
- School of Law and Society, University of the Sunshine Coast, Sippy Downs, Australia
- Faculty of Health and Applied Sciences (HAS), University of the West of England (UWE), Bristol, UK
| | - Grace J Carter
- Institute for Health and Wellbeing, Coventry University, Coventry, UK
| | - Gemma Halliwell
- Centre for Academic Primary Care, Bristol Medical School, University of Bristol, Bristol, UK
| | - Katherine Brown
- Department of Psychology and Sports Science, University of Hertfordshire, Hatfield, UK
| | - Rachel Caswell
- Sexual Health and HIV Medicine, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Emma Howarth
- School of Psychology, University of East London, London, UK
| | - Gene Feder
- Centre for Academic Primary Care, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Lorna O'Doherty
- Institute for Health and Wellbeing, Coventry University, Coventry, UK
- Department of General Practice, The University of Melbourne, Melbourne, Australia
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VanBenschoten H, Kuganantham H, Larsson EC, Endler M, Thorson A, Gemzell-Danielsson K, Hanson C, Ganatra B, Ali M, Cleeve A. Impact of the COVID-19 pandemic on access to and utilisation of services for sexual and reproductive health: a scoping review. BMJ Glob Health 2022; 7:e009594. [PMID: 36202429 PMCID: PMC9539651 DOI: 10.1136/bmjgh-2022-009594] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 08/13/2022] [Indexed: 11/15/2022] Open
Abstract
INTRODUCTION The COVID-19 pandemic has negatively impacted health systems globally and widened preexisting disparities. We conducted a scoping review on the impact of the COVID-19 pandemic on women and girls' access to and utilisation of sexual and reproductive health (SRH) services for contraception, abortion, gender-based and intimate partner violence (GBV/IPV) and sexually transmitted infections (STIs). METHODS We systematically searched peer reviewed literature and quantitative reports, published between December 2019 and July 2021, focused on women and girls' (15-49 years old) access to and utilisation of selected SRH services during the COVID-19 pandemic. Included studies were grouped based on setting, SRH service area, study design, population and reported impact. Qualitative data were coded, organised thematically and grouped by major findings. RESULTS We included 83 of 3067 identified studies and found that access to contraception, in-person safe abortion services, in-person services for GBV/IPV and STI/HIV testing, prevention and treatment decreased. The geographical distribution of this body of research was uneven and significantly less representative of countries where COVID-19 restrictions were very strict. Access was limited by demand and supply side barriers including transportation disruptions, financial hardships, limited resources and legal restrictions. Few studies focused on marginalised groups with distinct SRH needs. CONCLUSION Reports indicated negative impacts on access to and utilisation of SRH services globally, especially for marginalised populations during the pandemic. Our findings call for strengthening of health systems preparedness and resilience to safeguard global access to essential SRH services in ongoing and future emergencies.
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Affiliation(s)
- Hannah VanBenschoten
- Department of Bioengineering, University of Washington, Seattle, Washington, USA
| | | | - Elin C Larsson
- Department of Women's and Children's Health, Karolinska Institute, Stockholm, Sweden
- WHO Collaborating Center for Human Reproduction, Karolinska University Hospital, Stockholm, Sweden
| | - Margit Endler
- Department of Women and Children's Health, Karolinska Institutet, Stockholm, Sweden
- Department of Obsetrics and Gynecology, Stockholm South General Hospital, Stockholm, Sweden
| | - Anna Thorson
- Department of Sexual and Reproductive Health and Research, WHO, Geneve, Switzerland
- Department of Global Public Health, Karolinska Institute, Stockholm, Sweden
| | - Kristina Gemzell-Danielsson
- Department of Women's and Children's Health, Karolinska Institute, Stockholm, Sweden
- WHO Collaborating Center for Human Reproduction, Karolinska University Hospital, Stockholm, Sweden
| | - Claudia Hanson
- Department of Global Public Health, Karolinska Institute, Stockholm, Sweden
- Department of Disease Control, London School of Hygiene & Tropical Medicine Faculty of Infectious and Tropical Diseases, London, UK
| | - Bela Ganatra
- Department of Sexual and Reproductive Health and Research, WHO, Geneve, Switzerland
| | - Moazzam Ali
- Department of Sexual and Reproductive Health and Research, WHO, Geneve, Switzerland
| | - Amanda Cleeve
- Department of Women's and Children's Health, Karolinska Institute, Stockholm, Sweden
- Department of Obsetrics and Gynecology, Stockholm South General Hospital, Stockholm, Sweden
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Kiarie H, Temmerman M, Nyamai M, Liku N, Thuo W, Oramisi V, Nyaga L, Karimi J, Wamalwa P, Gatheca G, Mwenda V, Ombajo LA, Thumbi SM. The COVID-19 pandemic and disruptions to essential health services in Kenya: a retrospective time-series analysis. Lancet Glob Health 2022; 10:e1257-e1267. [PMID: 35961349 PMCID: PMC9363041 DOI: 10.1016/s2214-109x(22)00285-6] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 06/16/2022] [Accepted: 06/22/2022] [Indexed: 01/01/2023]
Abstract
BACKGROUND Public health emergencies can disrupt the provision of and access to essential health-care services, exacerbating health crises. We aimed to assess the effect of the COVID-19 pandemic on essential health-care services in Kenya. METHODS Using county-level data routinely collected from the health information system from health facilities across the country, we used a robust mixed-effect model to examine changes in 17 indicators of essential health services across four periods: the pre-pandemic period (from January, 2018 to February, 2020), two pandemic periods (from March to November 2020, and February to October, 2021), and the period during the COVID-19-associated health-care workers' strike (from December, 2020 to January, 2021). FINDINGS In the pre-pandemic period, we observed a positive trend for multiple indicators. The onset of the pandemic was associated with statistically significant decreases in multiple indicators, including outpatient visits (28·7%; 95% CI 16·0-43·5%), cervical cancer screening (49·8%; 20·6-57·9%), number of HIV tests conducted (45·3%; 23·9-63·0%), patients tested for malaria (31·9%; 16·7-46·7%), number of notified tuberculosis cases (26·6%; 14·7-45·1%), hypertension cases (10·4%; 6·0-39·4%), vitamin A supplements (8·7%; 7·9-10·5%), and three doses of the diphtheria, tetanus toxoid, and pertussis vaccine administered (0·9%; 0·5-1·3%). Pneumonia cases reduced by 50·6% (31·3-67·3%), diarrhoea by 39·7% (24·8-62·7%), and children attending welfare clinics by 39·6% (23·5-47·1%). Cases of sexual violence increased by 8·0% (4·3-25·0%). Skilled deliveries, antenatal care, people with HIV infection newly started on antiretroviral therapy, confirmed cases of malaria, and diabetes cases detected were not significantly affected negatively. Although most of the health indicators began to recover during the pandemic, the health-care workers' strike resulted in nearly all indicators falling to numbers lower than those observed at the onset or during the pre-strike pandemic period. INTERPRETATION The COVID-19 pandemic and the associated health-care workers' strike in Kenya have been associated with a substantial disruption of essential health services, with the use of outpatient visits, screening and diagnostic services, and child immunisation adversely affected. Efforts to maintain the provision of these essential health services during a health-care crisis should target the susceptible services to prevent the exacerbation of associated disease burdens during such health crises. FUNDING Bill & Melinda Gates Foundation.
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Affiliation(s)
- Helen Kiarie
- Division of Monitoring and Evaluation, Ministry of Health, Nairobi, Kenya
| | - Marleen Temmerman
- Centre of Excellence in Women and Child Health, Aga Khan University, Nairobi, Kenya
| | - Mutono Nyamai
- Centre for Epidemiological Modelling and Analysis, University of Nairobi, Nairobi, Kenya; Paul G Allen School for Global Health, Washington State University, Pullman, WA, USA
| | - Nzisa Liku
- Division of Monitoring and Evaluation, Ministry of Health, Nairobi, Kenya; Paul G Allen School for Global Health, Washington State University, Pullman, WA, USA
| | - Wangari Thuo
- Centre for Epidemiological Modelling and Analysis, University of Nairobi, Nairobi, Kenya
| | - Violet Oramisi
- National AIDS and STIs Control Programme, Ministry of Health, Nairobi, Kenya
| | - Lilly Nyaga
- Division of Monitoring and Evaluation, Ministry of Health, Nairobi, Kenya
| | - Janette Karimi
- Division of Monitoring and Evaluation, Ministry of Health, Nairobi, Kenya
| | | | - Gladwell Gatheca
- Division of Monitoring and Evaluation, Ministry of Health, Nairobi, Kenya
| | - Valerian Mwenda
- Division of Monitoring and Evaluation, Ministry of Health, Nairobi, Kenya
| | - Loice Achieng Ombajo
- Centre for Epidemiological Modelling and Analysis, University of Nairobi, Nairobi, Kenya; Department of Clinical Medicine and Therapeutics, College of Health Sciences, University of Nairobi, Nairobi, Kenya
| | - S M Thumbi
- Centre for Epidemiological Modelling and Analysis, University of Nairobi, Nairobi, Kenya; Institute of Tropical and Infectious Diseases, University of Nairobi, Nairobi, Kenya; Paul G Allen School for Global Health, Washington State University, Pullman, WA, USA; Institute of Immunology and Infection Research, School of Biological Sciences, University of Edinburgh, Edinburgh, UK.
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Engleton J, Goodman‐Williams R, Javorka M, Gregory K, Campbell R. Sexual assault survivors' engagement with advocacy services during the COVID-19 pandemic. JOURNAL OF COMMUNITY PSYCHOLOGY 2022; 50:2644-2658. [PMID: 35150008 PMCID: PMC9088241 DOI: 10.1002/jcop.22819] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 12/17/2021] [Accepted: 02/02/2022] [Indexed: 05/09/2023]
Abstract
Sexual assault advocates provide support to survivors as they navigate medical, legal, housing, and other complex systems. However, social distancing measures enacted in response to coronavirus disease 2019 (COVID-19) forced changes to traditional advocacy services. The current study aimed to understand how the COVID-19 pandemic transformed survivors' engagement with sexual assault advocacy services. Semi-structured interviews were conducted with 12 sexual assault advocates from a community-based advocacy organization in Detroit. Thematic analysis was employed to uncover emergent themes reflecting COVID-19's impact on survivors' engagement with advocacy services. Three themes were identified: (1) Disruption to advocacy services; (2) difficulty obtaining tangible resources; and (3) desire for COVID-related support, information, and resources. This study highlights the needs of sexual assault survivors during the COVID-19 pandemic and explores how public health emergencies have the potential to exacerbate the needs of this vulnerable population. Implications and future directions for service provision and research are considered.
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Affiliation(s)
- Jasmine Engleton
- Department of PsychologyMichigan State UniversityEast LansingMichiganUSA
| | | | - McKenzie Javorka
- Department of PsychologyMichigan State UniversityEast LansingMichiganUSA
| | - Katie Gregory
- Department of PsychologyMichigan State UniversityEast LansingMichiganUSA
| | - Rebecca Campbell
- Department of PsychologyMichigan State UniversityEast LansingMichiganUSA
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Elvey R, Mason T, Whittaker W. A hospital-based independent domestic violence advisor service: demand and response during the Covid-19 pandemic. BMC Health Serv Res 2022; 22:865. [PMID: 35790985 PMCID: PMC9254421 DOI: 10.1186/s12913-022-08183-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 05/20/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background and aim
Recent UK policy has focussed on improving support for victims of domestic violence and abuse (DVA), in healthcare settings. DVA victims attending hospital are often at highest risk of harm, yet DVA support in hospitals has been inadequate. A targeted service supporting high risk DVA victims, was implemented at a hospital Trust in North West England. The service was provided by Independent Domestic Violence Advisors (IDVAs). This paper assesses the activity in the hospital-based IDVA service during the COVID-19 pandemicand addresses the research questions: What was the demand for the service? How did the service respond? What facilitated this response?
Methods
A mixed-methods study was undertaken. Quantitative data on referrals to the service were examined using simple descriptive statistics and compared to other DVA services. Semi-structured interviews were undertaken with IDVAs and other hospital staff involved with the service and the data subjected to thematic analysis.
Results
The quantitative analysis showed that referrals dropped at the start of lockdown, then increased and continued to rise; the qualitative findings reiterated this pattern. Referrals came from a range of departments across the Trust, with the majority from A&E. Pre-pandemic, the population supported by the service included higher proportions of males and people aged 40 and over than at other IDVA services; this continued during the pandemic. The qualitative findings indicated a flexible response during the pandemic, enabled by strong working relationships and by using workarounds.
Conclusions
The hospital-based IDVAs provided an efficient, flexible serviceduring the COVID-19 pandemic. Referrals increased during the first lockdown and subsequent relaxing of restrictions. Locating the IDVAs within a team working across the organisation, and building good working relationships facilitated an effective disclosure and referral route, which endured through social restrictions. The IDVAs supported high-risk victims who may otherwise not have been identified in traditional community-based DVA settings during the pandemic. Hospital-based IDVA services can broaden access by supporting vulnerable, at risk populations whose needs may not be identified at other services.
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Moore G, Buckley K, Howarth E, Burn AM, Copeland L, Evans R, Ware L. Police referrals for domestic abuse before and during the first COVID-19 lockdown: An analysis of routine data from one specialist service in South Wales. J Public Health (Oxf) 2022; 44:e252-e259. [PMID: 34568944 PMCID: PMC8500039 DOI: 10.1093/pubmed/fdab343] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND COVID-19 lockdown measures may have led to more, and increasingly severe, domestic abuse. This study examines police referrals to a specialist domestic abuse service in Wales, UK before and during the first lockdown. METHODS Routine data relating to 2292 police referrals for female adult victim-survivors from December 2019 until July 2020 were analysed and presented in the form of descriptive statistics to monitor changes in referral rates and the profile of those referrals. RESULTS There was little increase in the overall volume of police referrals during lockdown, but the proportion assessed as high risk increased, and children became the primary source of third-party referrals, with a higher proportion of reports made by other third parties as restrictions eased. Police reports for cases of Child/Adolescent to Parent Violence (C/APV) occurred almost exclusively during lockdown. CONCLUSIONS The increase in risk level despite less clear increase in volume may suggest unmet need, with victims less likely to seek help during lockdown other than for more severe instances. Increased reports by children suggest increased exposure of children to domestic abuse during school closure. Unmet need for women and children may have been made visible to services, and acquaintances, as measures began to ease.
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Affiliation(s)
- Graham Moore
- Centre for Development, Evaluation, Complexity and Implementation in Public Health Improvement, School of Social Sciences, Cardiff University, Cardiff CF10 3BD, UK
- Wolfson Centre for Young People’s Mental Health, Cardiff University, Cardiff CF24 4HD, UK
| | - Kelly Buckley
- Centre for Development, Evaluation, Complexity and Implementation in Public Health Improvement, School of Social Sciences, Cardiff University, Cardiff CF10 3BD, UK
| | - Emma Howarth
- School of Psychology, University of East London, London E16 2RD, UK
| | - Anne-Marie Burn
- Department of Psychiatry, University of Cambridge, Cambridge CB2 0SZ, UK
| | - Lauren Copeland
- Centre for Development, Evaluation, Complexity and Implementation in Public Health Improvement, School of Social Sciences, Cardiff University, Cardiff CF10 3BD, UK
| | - Rhiannon Evans
- Centre for Development, Evaluation, Complexity and Implementation in Public Health Improvement, School of Social Sciences, Cardiff University, Cardiff CF10 3BD, UK
| | - Lisa Ware
- Cardiff Women’s Aid, Cardiff CF24 0EJ, UK
- RISE Cardiff, Cardiff CF24 0JT, UK
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Liu CH, Chen PC, Chen JH, Yeh CC. Changes in self-harm- and violence-related urgent psychiatric consultation in the emergency department during the different stages of the COVID-19 pandemic. BMC Psychiatry 2022; 22:384. [PMID: 35672738 PMCID: PMC9171742 DOI: 10.1186/s12888-022-04029-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Accepted: 05/31/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND The coronavirus disease 2019 pandemic significantly affected emergency department (ED) visits and urgent psychiatric consultation (UPC) seeking behavior in EDs. Our study explored the changes in UPCs during and after the pandemic peak. METHODS This retrospective observational study evaluated UPCs in the ED of a referral medical center in Taiwan, where treated both physical and psychiatric complaints. We defined the COVID-19 pandemic peak period as calendar week 4-18, 2020. The corresponding baseline as calendar week 4-18, 2019, and the slack period as week 4-18, 2021. The total number of UPCs, patient demographic data such as sex and age of the patients seen, the referral system (whether police or emergency medical service [EMS] or other sources), and the chief complaint (self-harm or violence) were recorded. RESULTS Compared with the baseline period, a significant decline in UPCs was observed in the pandemic peak period, and a rebound was observed in the slack period, with the median [IQR] Q1, Q3 values of 22 [18, 26], 12 [10, 17]), and 16 [15, 23], respectively. We observed significantly few men (34.9% vs 45.2%) and less violence (10.2% vs 17.6%) in the peak period compared with in the baseline period, but no significant difference was found compared with the slack period. Throughout the pandemic, younger patients (41.8 ± 17.4 in 2019, 39.2 ± 18.5 [p = 0.121] in 2020, and 35.6 ± 17.2 [p < 0.001] in 2021), higher proportions of police/EMS referral (38.7% in 2019, 41.9% [p = 0.473] in 2020, and 51.9% [p = 0.001] in 2021) and self-harm-related complaints (57% in 2019, 62.4% [p = 0.233] in 2020, and 64.9% [p = 0.049] in 2021) was noted among UPC seekers during the pandemic. However, the proportion of violence-related UPCs (17.6% in 2019, 10.2% [p = 0.023] in 2020, and 12.3% [p = 0.072] in 2021) declined. CONCLUSIONS This study found that UPCs changed throughout the pandemic. This result raises the concern that mental health needs are masked during the pandemic.
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Affiliation(s)
- Chun-Hao Liu
- Department of Child Psychiatry, Chang Gung Memorial Hospital at Linkou, Taoyuan city, Taiwan.,College of Medicine, Chang Gung University, Taoyuan city, Taiwan
| | - Po-Cheng Chen
- College of Medicine, Chang Gung University, Taoyuan city, Taiwan.,Department of Rehabilitation Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung city, Taiwan
| | - Jian-Hong Chen
- College of Medicine, Chang Gung University, Taoyuan city, Taiwan.,Department of Psychiatry, Chang Gung Memorial Hospital at Keelung, Keelung city, Taiwan.,National Taiwan Sport University, Taoyuan city, Taiwan
| | - Chung-Cheng Yeh
- Department of Emergency Medicine, Chang Gung Memorial Hospital at Keelung, Keelung city, Taiwan.
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43
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Yan E, Lai DWL, Lee VWP, Bai X, K L Ng H. Abuse and Discrimination Experienced by Older Women in the Era of COVID-19: A Two-Wave Representative Community Survey in Hong Kong. Violence Against Women 2022; 28:1750-1772. [PMID: 35475662 PMCID: PMC9047603 DOI: 10.1177/10778012221085998] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Although there is a growing volume of research on violence against women, violence against older women has received little attention to date. Little is known about the experience of elder abuse, discrimination, loneliness, and health among older women, in particular in the era of COVID-19 when our lives have been changed drastically. Using two waves of survey data (N = 1,498), this study compared the estimates of elder abuse and age discrimination before and during the COVID-19 pandemic, examined their associations with physical and mental health, and explored the mediating effects of loneliness on the associations in two independent samples of older women in Hong Kong. Reductions in some forms of abuse and discrimination against older women during the pandemic were observed. Findings from regression analyses show that elder abuse and age discrimination were associated with poorer health, and these associations were mediated by loneliness.
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Affiliation(s)
- Elsie Yan
- 26680Hong Kong Polytechnic University, Hong Kong SAR, China
| | | | | | - Xue Bai
- 26680Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Haze K L Ng
- 26680Hong Kong Polytechnic University, Hong Kong SAR, China
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44
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Campbell LS, Masquillier C, Knight L, Delport A, Sematlane N, Dube LT, Wouters E. Stay-at-Home: The Impact of the COVID-19 Lockdown on Household Functioning and ART Adherence for People Living with HIV in Three Sub-districts of Cape Town, South Africa. AIDS Behav 2022; 26:1905-1922. [PMID: 34977957 PMCID: PMC8720535 DOI: 10.1007/s10461-021-03541-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/22/2021] [Indexed: 11/30/2022]
Abstract
In March 2020, the South African government imposed a lockdown to control COVID-19 transmission. Lockdown may affect people living with HIV's (PLWH) antiretroviral therapy (ART) adherence. Data from a cluster randomised control trial was collected from 152 PLWH in Cape Town sub-districts from October 2019-March 2020 when the lockdown halted collection. Subsequently, 83 PLWH were followed-up in June-July 2020. Random effects models were used to analyse: (1) changes between baseline and follow-up and (2) correlates of adherence during lockdown. At follow-up, there was an increase in the odds of being below the poverty line and the odds of experiencing violence decreased. Measures for well-being, household functioning, stigma and HIV competency improved. Violence, depression, food insecurity, and stigma were associated with poorer ART adherence; higher well-being scores were associated with better adherence. During lockdown, governments need to ensure financial support, access to (mental) health services, and services for those experiencing violence.Clinical Trial Number: Pan African Clinical Trial Registry, PACTR201906476052236. Registered on 24 June 2019.
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Affiliation(s)
- Linda S. Campbell
- Centre for Population, Family and Health, University of Antwerp, Prinsstraat 13, 2000 Antwerpen, Belgium
| | - Caroline Masquillier
- Centre for Population, Family and Health, University of Antwerp, Prinsstraat 13, 2000 Antwerpen, Belgium
| | - Lucia Knight
- Division of Social and Behavioural Sciences, School of Public Health and Family Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
- School of Public Health, Community and Health Sciences, University of the Western Cape, Cape Town, South Africa
| | - Anton Delport
- School of Public Health, Community and Health Sciences, University of the Western Cape, Cape Town, South Africa
| | - Neo Sematlane
- Centre for Population, Family and Health, University of Antwerp, Prinsstraat 13, 2000 Antwerpen, Belgium
- School of Public Health, Community and Health Sciences, University of the Western Cape, Cape Town, South Africa
| | - Lorraine Tanyaradzwa Dube
- School of Public Health, Community and Health Sciences, University of the Western Cape, Cape Town, South Africa
| | - Edwin Wouters
- Centre for Population, Family and Health, University of Antwerp, Prinsstraat 13, 2000 Antwerpen, Belgium
- Centre for Health Systems Research & Development, University of the Free State, Bloemfontein, South Africa
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45
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Khan S, Mishra J, Ahmed N, Onyige CD, Lin KE, Siew R, Lim BH. Risk communication and community engagement during COVID-19. INTERNATIONAL JOURNAL OF DISASTER RISK REDUCTION : IJDRR 2022; 74:102903. [PMID: 35313476 PMCID: PMC8925315 DOI: 10.1016/j.ijdrr.2022.102903] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 01/24/2022] [Accepted: 03/08/2022] [Indexed: 05/20/2023]
Abstract
In today's information age, both excess and lack of information can cause a disaster. COVID-19 pandemic not only highlighted the significance of risk communication but also pointed out several unintended and distressing consequences due to information gaps and miscommunications. Despite facing a common threat, the local communities suffered differential impacts during the pandemic. This paper classifies the nature of risk communications experienced across different countries into three categories, namely: inadequate, ideal, and infodemic risk communication that influenced the local perceptions and responses. It further argues that inadequately planned risk communications tend to create new risks and compromise the efforts towards managing a disaster. As global risks are responded locally, there is a need for more inclusive and engaging risk communication that involves communities as responsible stakeholders who understand, plan, and respond to risks to increase their propensity for resilience during disasters and crisis situations.
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46
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Di Stefano R, Di Pietro A, Talevi D, Rossi A, Socci V, Pacitti F, Rossi R. Personality disorders (PD) and interpersonal violence (IV) during COVID-19 pandemic: a systematic review. Ann Gen Psychiatry 2022; 21:11. [PMID: 35397587 PMCID: PMC8994418 DOI: 10.1186/s12991-022-00388-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Accepted: 02/03/2022] [Indexed: 11/10/2022] Open
Abstract
Not only did the ongoing CoronaVIrus Disease-19 (COVID-19) pandemic cause a massive number of casualties, but also there is growing concern that the burden of its psychological aftermaths will only show up years down the road. This systematic review summarises the existing literature reporting the impact of COVID-19 on personality disorders (PDs)-related violence. MEDLINE and APA PsycINFO were independently searched for relevant studies by two authors. Eligible studies had to be identifiable through database searching, published and fully accessible. This systematic review was conducted according to Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines. An initial pool of 241 studies were found, out of which 69 met the selection criteria and were, therefore, included. The majority reported a worse Mental Health Outcome (MHO) during the pandemic as related to dysfunctional personality and positive personality traits predicting a better outcome. Furthermore, increased levels of interpersonal violence (IV) and self-directed violence were reported. Further research should be conducted on the reciprocal interaction of PDs and IV during the time of pandemic. Nevertheless, the dramatic impact of restrictive measures on PDs has still to be appropriately addressed.
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Affiliation(s)
- Ramona Di Stefano
- Department of Biotechnological and Applied Clinical Sciences (DISCAB), University of L'Aquila, Via Vetoio, Coppito, 67100, L'Aquila, Italy.
| | - Angelica Di Pietro
- Department of Biotechnological and Applied Clinical Sciences (DISCAB), University of L'Aquila, Via Vetoio, Coppito, 67100, L'Aquila, Italy
| | - Dalila Talevi
- Department of Biotechnological and Applied Clinical Sciences (DISCAB), University of L'Aquila, Via Vetoio, Coppito, 67100, L'Aquila, Italy
| | - Alessandro Rossi
- Department of Biotechnological and Applied Clinical Sciences (DISCAB), University of L'Aquila, Via Vetoio, Coppito, 67100, L'Aquila, Italy
| | - Valentina Socci
- Department of Biotechnological and Applied Clinical Sciences (DISCAB), University of L'Aquila, Via Vetoio, Coppito, 67100, L'Aquila, Italy
| | - Francesca Pacitti
- Department of Biotechnological and Applied Clinical Sciences (DISCAB), University of L'Aquila, Via Vetoio, Coppito, 67100, L'Aquila, Italy
| | - Rodolfo Rossi
- Department of Systems Medicine, University of Rome Tor Vergata, Via Montpellier, 1, 00133, Rome, Italy
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Ford K, Bellis MA, Hill R, Hughes K. An evaluation of a short film promoting kindness in Wales during COVID-19 restrictions #TimeToBeKind. BMC Public Health 2022; 22:583. [PMID: 35331188 PMCID: PMC8944183 DOI: 10.1186/s12889-022-12876-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Accepted: 02/25/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In response to successive COVID-19 restrictions in Wales, the Welsh ACE Support Hub launched the #TimeToBeKind campaign in March 2021. The campaign used a short film broadcast on national television and promoted on social media to encourage behaviour change for kindness. We evaluated the #TimeToBeKind campaign film to identify whether watching the film would result in increased intention to act in ways that promote kindness to others and if intentions were associated with being emotionally affected by the film. METHODS A mixed methods evaluation was employed, using a short online survey and interaction with the film on the Twitter social media platform. The online survey measured public (n = 390) attitudes towards the film including feelings invoked, and behavioural intentions for acts of kindness as a result of viewing the film. Tweets which interacted with the film (n = 59; likes, re-tweets or comments), and tweet sentiment (positive, negative, or neutral) towards the film were also explored. RESULTS The majority of participants reported positive attitudes to the film and agreed that they understood the campaign message (91.8%). 67.9% reported that the film made them feel upset or sad and for 22.6% the film resonated with their lockdown experience. As a result of seeing the film, 63.6% reported intentions to be kinder to others, 65.6% intended to try and help other members of their community, and 70.5% were more likely to check in on friends, family and neighbours. A higher proportion of individuals who were emotionally affected by the film (e.g. upset or sad, hopeful or encouraged, gained something positive) and those for whom the film resonated with their lockdown experience reported increased kindness behavioural intentions as a result of seeing the film. CONCLUSIONS Film can be an effective tool to promote behaviour change for kindness. Films that provoke strong emotional reactions can still be perceived positively and lead to behaviour change. With the COVID-19 pandemic accelerating a move online for many, the findings of the present evaluation are relevant to how public health messaging can adapt and utilise this space to target individuals and promote behaviour change.
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Affiliation(s)
- Kat Ford
- Public Health Collaborating Unit, College of Human Sciences, Bangor University, LL13 7YP, Wrexham, UK.
| | - Mark A Bellis
- Public Health Collaborating Unit, College of Human Sciences, Bangor University, LL13 7YP, Wrexham, UK
- World Health Organization Collaborating Centre on Investment for Health and Well-being, Policy and International Health, Public Health Wales, LL13 7YP, Wrexham, UK
| | - Rebecca Hill
- World Health Organization Collaborating Centre on Investment for Health and Well-being, Policy and International Health, Public Health Wales, CF10 4BZ, Cardiff, UK
| | - Karen Hughes
- Public Health Collaborating Unit, College of Human Sciences, Bangor University, LL13 7YP, Wrexham, UK
- World Health Organization Collaborating Centre on Investment for Health and Well-being, Policy and International Health, Public Health Wales, LL13 7YP, Wrexham, UK
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48
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Lavine K, Hardy E. Emergency department visits and helpline calls in Rhode Island for acute sexual assault before and during the COVID-19 pandemic. Acad Emerg Med 2022; 29:905-907. [PMID: 35257438 PMCID: PMC9111162 DOI: 10.1111/acem.14479] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 02/25/2022] [Accepted: 02/28/2022] [Indexed: 11/28/2022]
Affiliation(s)
- Katya Lavine
- Warren Alpert Medical School of Brown University Providence Rhode Island USA
| | - Erica Hardy
- Warren Alpert Medical School of Brown University Providence Rhode Island USA
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49
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Thomas T, Nobrega JC, Britton-Susino S. Challenges and Collaborations: A Case Study for Successful Sexual Assault Nurse Examiner Education in Rural Communities During the COVID-19 Pandemic. JOURNAL OF FORENSIC NURSING 2022; 18:59-63. [PMID: 35045043 PMCID: PMC8852357 DOI: 10.1097/jfn.0000000000000364] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Accepted: 11/19/2021] [Indexed: 06/14/2023]
Abstract
Challenges can often only be overcome with collaboration. In this case report of a Health Resources and Services Administration-funded program for Advancing Nurse Education - Sexual Assault Nurse Examiner, we describe the unique challenges and collaborations that have taken place in rural communities as we continued to train nurses during the COVID-19 pandemic. Geography and lack of availability of sexual assault nurse examiner (SANE) trainees brought many challenges as we prepared them to successfully pass the SANE certification examination and recruit new cohorts to expand SANE education.During the implementation of this program, we found that our process model, community collaboration, and commitment to these rural counties were the keys to our success before and during the COVID-19 pandemic.SANE trainee process and outcome measures were collected through quantitative and qualitative data collection. These data from the first cohort, along with the strategies implemented as all partners navigated the challenges of COVID-19, helped to strengthen our collaboration and expand the program. Details of these strategies and outcomes to date will be discussed.
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50
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Xie Y, Kulpanowski D, Ong J, Nikolova E, Tran NM. Predicting Covid-19 emergency medical service incidents from daily hospitalisation trends. Int J Clin Pract 2021; 75:e14920. [PMID: 34569674 DOI: 10.1111/ijcp.14920] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Accepted: 09/23/2021] [Indexed: 12/01/2022] Open
Abstract
INTRODUCTION The aim of our retrospective study was to quantify the impact of Covid-19 on the temporal distribution of emergency medical services (EMS) demand in Travis County, Austin, Texas and propose a robust model to forecast Covid-19 EMS incidents. METHODS We analysed the temporal distribution of EMS calls in the Austin-Travis County area between 1 January 2019 and 31 December 2020. Change point detection was performed to identify the critical dates marking changes in EMS call distributions, and time series regression was applied for forecasting Covid-19 EMS incidents. RESULTS Two critical dates marked the impact of Covid-19 on the distribution of EMS calls: March 17th, when the daily number of non-pandemic EMS incidents dropped significantly, and 13 May, by which the daily number of EMS calls climbed back to 75% of the number in pre-Covid-19 time. The new daily count of the hospitalisation of Covid-19 patients alone proves a powerful predictor of the number of pandemic EMS calls, with an r2 value equal to 0.85. In particular, for every 2.5 cases, where EMS takes a Covid-19 patient to a hospital, one person is admitted. CONCLUSION The mean daily number of non-pandemic EMS demand was significantly less than the period before the Covid-19 pandemic. The number of EMS calls for Covid-19 symptoms can be predicted from the daily new hospitalisation of Covid-19 patients. These findings may be of interest to EMS departments as they plan for future pandemics, including the ability to predict pandemic-related calls in an effort to adjust a targeted response.
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Affiliation(s)
- Yangxinyu Xie
- Department of Computer Science, University of Texas at Austin, Austin, Texas, USA
| | - David Kulpanowski
- Department of Emergency Medical Services, City of Austin, Austin, Texas, USA
| | - Joshua Ong
- Department of Electrical and Computer Engineering, University of Texas at Austin, Austin, Texas, USA
| | - Evdokia Nikolova
- Department of Electrical and Computer Engineering, University of Texas at Austin, Austin, Texas, USA
| | - Ngoc M Tran
- Department of Mathematics, University of Texas at Austin, Austin, Texas, USA
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