- Browse by Subject
Browsing by Subject "Child abuse"
Now showing 1 - 3 of 3
Results Per Page
Sort Options
Item Impact of “Stay-at-Home”orders on non-accidental trauma: A multi-institutional study(Elsevier, 2022) Collings, Amelia T.; Farazi, Manzur; Van Arendonk, Kyle; Fallat, Mary E.; Minneci, Peter C.; Sato, Thomas T.; Speck, K. Elizabeth; Deans, Katherine J.; Falcone, Richard A.; Foley, David S.; Fraser, Jason D.; Keller, Martin S.; Kotagal, Meera; Landman, Matthew P.; Leys, Charles M.; Markel, Troy; Rubalcava, Nathan; St. Peter, Shawn D.; Flynn-O’Brien, Katherine T.; Midwest Pediatric Surgery Consortium; Surgery, School of MedicineBackground: It is unclear how Stay-at-Home Orders (SHO) of the COVID-19 pandemic impacted the welfare of children and rates of non-accidental trauma (NAT). We hypothesized that NAT would initially decrease during the SHO as children did not have access to mandatory reporters, and then increase as physicians' offices and schools reopened. Methods: A multicenter study evaluating patients <18 years with ICD-10 Diagnosis and/or External Cause of Injury codes meeting criteria for NAT. "Historical" controls from an averaged period of March-September 2016-2019 were compared to patients injured March-September 2020, after the implementation of SHO ("COVID" cohort). An interrupted time series analysis was utilized to evaluate the effects of SHO implementation. Results: Nine Level I pediatric trauma centers contributed 2064 patients meeting NAT criteria. During initial SHO, NAT rates dropped below what was expected based on historical trends; however, thereafter the rate increased above the expected. The COVID cohort experienced a significant increase in the proportion of NAT patients age ≥5 years, minority children, and least resourced as determined by social vulnerability index (SVI). Conclusions: The COVID-19 pandemic affected the presentation of children with NAT to the hospital. In times of public health crisis, maintaining systems of protection for children remain essential.Item Intimate Partner Violence, Sexual Assault, and Child Abuse Resource Utilization During COVID-19(Department of Emergency Medicine, School of Medicine, University of California, Irvine, 2022-07-11) Pallansch, Jennifer; Milam, Claire; Ham, Kendra; Morgan, Patricia; Manning, John; Salzman, Jessica; Kopec, Kathryn; Lewis, Margaret; Emergency Medicine, School of MedicineIntroduction: Key measures in preventing spread of the virus that causes coronavirus disease 2019 (COVID-19) are social distancing and stay-at-home mandates. These measures along with other stressors have the potential to increase incidences of intimate partner violence (IPV), sexual assault, and child maltreatment. Methods: We performed a retrospective review of county police dispatches, emergency department (ED) visits, Sexual Assault Nurse Examiner (SANE) consults, Domestic Violence Healthcare Project (DVHP) team consults, and Child Protection Team consults at a large, tertiary, Level I trauma center. We queried International Classification of Diseases Revision 10 codes most specific to IPV, sexual assault, and child maltreatment from March-October 2020 compared to 2019. Similarly, the number of consults performed by SANE, DVHP, and our Child Protection Team were collected. We compared all ED visits and consultations to total ED visits for the reviewed time period. Finally, the total number of calls and referrals to a child advocacy center and resource call line for victims were recorded during this timeframe. Results: Police dispatches for IPV-related assaults increased by 266 reports from 2019 to 2020 (P = 0.015). Emergency department visits related to IPV increased from 0.11% of visits in 2019 to 0.15% in 2020 (P = 0.032), and DVHP consults increased from 0.31% in 2019 to 0.48% in 2020 of ED visits in the first three months (P < 0.001). Child maltreatment visits increased from 0.47% of visits in 2019 to 0.81% of visits in 2020 (P = 0.028), and a higher percentage of patients required Child Protection team consults from 1% in 2019 to 1.6% in 2020 (P = 0.004). Sexual assault-related visits and SANE consults both showed a small increase that was not statistically significant. Fewer calls and referrals were made to our child advocacy center and resource call line, decreasing by 99 referrals and 252 calls, respectively. Conclusion: Despite decreased ED volumes throughout the pandemic, we observed an increase in police dispatches, ED visits, and utilization of hospital consult services related to IPV and child maltreatment following the initiation of stay-at-home orders. However, use of community resources, such as the local child advocacy center, declined.Item Seeing the Forest in Family Violence Research: Moving to a Family-Centered Approach(Elsevier, 2020-08) Tiyyagura, Gunjan; Bloemen, Elizabeth M.; Berger, Rachel; Rosen, Tony; Harris, Tara; Jeter, Gloria; Lindberg, Daniel; Pediatrics, School of MedicineVictims of family violence are sorted into fragmented systems that fail to address the family as an integrated unit. Each system provides specialized care to each type of victim (child, older adult, adult, animal) and centers on the expertise of the medical and service providers involved. Similarly, researchers commonly study abuse from the frame of the victim, rather than looking at a broader frame-the family. We propose the following 5 steps to create a research paradigm to holistically address the response, recognition, and prevention of family violence.By developing an integrated research model to address family violence, and by using that model to support integrated systems of care, we propose a fundamental paradigm shift to improve the lives of families living with and suffering from violence.