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Domestic violence (DV) is a pattern of abusive behavior in any relationship that is used by one partner to gain or maintain power and control over another intimate partner or member of the domestic unit. DV can be physical, sexual, emotional, economic, or psychological actions, threat of actions or negligence that influence another person. This includes any behavior that intimidates, manipulates, humiliates, isolates, deprives, frightens, terrorizes, coerces, threatens, blames, hurts, injures, or wounds someone. The World Health Organization (WHO) reports that violence against woman and girls globally is dramatically under reported. Recently, incidents of DV increased during the COVID-19 pandemic potentially due to the stay-at-home/lockdown orders and increased stress. For professionals in a forensic field, it is important to have a good knowledge of the characteristics of DV to be able to understand the dynamics of the repeating violence, the risk assessment, and the importance of an optimal forensic investigation. This article includes instruments for the diagnosis of DV, such as screening methods or typical patterns of injuries, and presents recommendations for a complete and excellent forensic documentation. The effect of DV on children is discussed briefly. If you or someone you know has been the victim of Domestic Violence, contact your relevant national/state support. © 2023 Elsevier Ltd. All rights reserved.
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OBJECTIVES: With increased bicycle use during the COVID-19 pandemic and growing availability of bicycle-sharing programs in Montreal, we hypothesize helmet use has decreased. The aim of this study was to evaluate helmet use and proper fit among Montreal cyclists during the pandemic relative to historical data. METHODS: Nine observers collected data on bike type, gender, helmet use, and ethnicity using the iHelmet© app at 18 locations across the island of Montreal from June to September 2021. Proper helmet wear was assessed at one busy location. Multiple logistic regression was used to identify factors associated with helmet wear and results were compared to a historical study. RESULTS: Of the 2200 cyclists observed, 1109 (50.4%) wore a helmet. Males (OR = 0.78, 95%CI = 0.65-0.95), young adults (OR = 0.65, 95%CI = 0.51-0.84), visible minorities (OR = 0.38, 95%CI = 0.28-0.53), and bike-share users (OR = 0.21, 95%CI = 0.15-0.28) were less likely to be wearing a helmet, whereas children (OR = 3.92, 95%CI = 2.17-7.08) and cyclists using racing bicycles (OR = 3.84, 95%CI = 2.62-5.62) were more likely to be wearing a helmet. The majority (139/213; 65.3%) of assessed cyclists wore properly fitting helmets. Children had the lowest odds of having a properly fitted helmet (OR = 0.13, 95%CI = 0.04-0.41). Compared to 2011, helmet use during the pandemic increased significantly (1109/2200 (50.4%) vs. 2192/4789 (45.8%); p = 0.032). CONCLUSION: Helmet use among Montreal cyclists was associated with age, gender, ethnicity, and type of bicycle. Children were least likely to have a properly fitted helmet. The recent increase in popularity of cycling and expansion of bicycle-sharing programs reinforce the need for bicycle helmet awareness initiatives, legislation, and funding prioritization.
RéSUMé: OBJECTIF: Avec la popularité grandissante du vélo durant la pandémie COVID-19 et l'expansion du vélopartage à Montréal, nous croyons que le port du casque a diminué. L'objectif de cette étude était d'évaluer l'utilisation du casque et le port adéquat parmi les cyclistes montréalais et de comparer nos résultats avec des données historiques. MéTHODE: Neuf observateurs, stationnés à 18 emplacements, ont recueilli les informations suivantes en utilisant l'application mobile iHelmet© : type de vélo, sexe, origine ethnique et port du casque. Le port adéquat du casque a été observé à un endroit. L'association de chaque variable avec le port et le port adéquat a été fait par régression multivariable et comparé à des données historiques. RéSULTATS: Des 2 200 cyclistes observés, 1 109 (50,4 %) portaient un casque. Les enfants (OR = 3,92, IC95% = 2,177,08) et les cyclistes de performance (OR = 3,84, IC95% = 2,625,62) portaient le casque plus fréquemment tandis que les hommes (OR = 0,78, IC95% = 0,650,95), les jeunes adultes (OR = 0,65, IC95% = 0,510,84), les minorités visibles (OR = 0,38, IC95% = 0,280,53), et les utilisateurs de vélopartage (OR = 0,21, IC95% = 0,150,28) le portaient moins. La majorité (139/213; 65,3 %) des casques étaient portés adéquatement. Les enfants étaient plus à risque de porter un casque mal ajusté (OR = 0,13, IC95% = 0,040,41). L'utilisation d'un casque chez les cyclistes montréalais a augmenté significativement depuis 2011 (1 109/2 200 (50,4 %) c. 2 192/4 789 (45,8 %); p = 0,032). CONCLUSION: Le port du casque à vélo à Montréal est associé à l'âge, le sexe, l'origine ethnique et le type de vélo. Les enfants sont plus à risque de mal porter un casque. Des stratégies de promotion ainsi que la législation peuvent favoriser des comportements sécuritaires à vélo.
Subject(s)
COVID-19 , Craniocerebral Trauma , Male , Child , Young Adult , Humans , Head Protective Devices , Bicycling , Cross-Sectional Studies , Pandemics , COVID-19/epidemiology , COVID-19/prevention & controlABSTRACT
George Winter provides an overview of recently published articles that may be of interest to practice nurses. Should you wish to look at any of the papers in more detail, a full reference is provided.
ABSTRACT
Domestic violence (DV) is a pattern of abusive behavior in any relationship that is used by one partner to gain or maintain power and control over another intimate partner or member of the domestic unit. DV can be physical, sexual, emotional, economic, or psychological actions, threat of actions or negligence that influence another person. This includes any behavior that intimidates, manipulates, humiliates, isolates, deprives, frightens, terrorizes, coerces, threatens, blames, hurts, injures, or wounds someone. The World Health Organization (WHO) reports that violence against woman and girls globally is dramatically under reported. Recently, incidents of DV increased during the COVID-19 pandemic potentially due to the stay-at-home/lockdown orders and increased stress. For professionals in a forensic field, it is important to have a good knowledge of the characteristics of DV to be able to understand the dynamics of the repeating violence, the risk assessment, and the importance of an optimal forensic investigation. This article includes instruments for the diagnosis of DV, such as screening methods or typical patterns of injuries, and presents recommendations for a complete and excellent forensic documentation. The effect of DV on children is discussed briefly. If you or someone you know has been the victim of Domestic Violence, contact your relevant national/state support.
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988 Table 1ConclusionThere were less medicals carried out in 2020, likely a reflection of the reduction in face to face contact with health professionals. The pandemic heightened risk factors for abuse which our data appear to reflect. 26% of infants with concerns for NAI following JPFME had head injuries on imaging and 20% had occult fractures on skeletal survey. This is higher than the average yield expected for this age group described in the literature. These audit findings at a local level, support findings published by a large centre for Paediatric abusive head trauma in the UK in 2020.This audit further provides evidence to consider the risk of occult injuries and support the existence of policies and protocols with a low threshold for information sharing and investigation. This also highlights the importance of training those working with families with young babies to support parents with keeping their babies safe and reducing the risk of non-accidental head injuries in the form of standardised training packages for example.
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Editor’s note: EMJ has partnered with the journals of multiple international emergency medicine societies to share from each a highlighted research study, as selected by their editors. This edition will feature an from each publication.
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In the form of a literary review, this work set itself the task of examining the professional literature published on this topic and selecting representative literary sources that document the interdisciplinary nature of this scientific discipline. Do této kategorie spadá mimo jiné publikace Ratio of serum pro BDNF to BDNF and its association with cognitive performance and brain morphometry in mild cognitive impairment, autorů Čechová a kol. (2020) Gray matter atrophy, but not vascular brain injury is related to cognitive impairment in patients with heart failure, článek Comparison of brain atrophy and cognitive performance in individuals with low and high cardiovascular riskautorů Restrepo a kol. (2020) publikovali v časopise Archives of clinical neuropsychology: the official journal of the National Academy of Neuropsychologists studii s názvem Return on Investment and Value Research in Neuropsychology: A Call to Arms.
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Objective: Dizziness and imbalance are common symptoms following head injury that can continue for months or years in some individuals. Chronic dizziness is a serious health concern that can lead to increased fall risk, emotional and psychological distress, as well as work disability. Multiple causes of post-concussive dizziness can present a challenge to diagnosis, and obstacle to treatment. The Departments of Veterans Affairs and Defense (VA/DoD) developed clinical practice guidelines that outline recommendations for managing individuals with post-concussive dizziness, but it is unclear how these recommendations impact treatment for post-concussion dizziness/imbalance. In addition, some Veterans may seek care outside the VA or use alternative approaches to manage their post-concussive dizziness. The purpose of this study is to determine factors that contribute to successful outcomes of patients with concussion/blast-related dizziness. Methodology: We will use VA and DoD health databases to identify and examine characteristics of Veterans with specific (for example, inner ear balance dysfunction) and non-specific diagnoses of post-concussion dizziness. Then, we will survey Veterans using questionnaires and access the VA electronic medical records to determine factors that impact long-term recovery of post-concussion dizziness. Specifically, we will examine the impact of factors such as type of treatment, the presence or absence of health conditions such as headache and anxiety, the severity of head injury, as well as age and gender. Findings: We have sent survey invitations to 2724 Veterans, and received 674, for a response rate of 25%. Due to COVID, our mailing schedule has been delayed and additional surveys will be mailed in FY21 to achieve our goal of 1050 completed surveys. Chart abstraction has been completed on 486 subjects.
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The funding for study EP170034 was granted to LSU Health Sciences Center (LSUHSC (Shreveport on September 15th, 2018. The study protocol was approved by the U.S. Army Medical Research and Materiel Command (USAMRMC), Office of Research Protections (ORP), Human Research Protection Office (HRPO) on June 7th, 2019. Dr. Hai Sun accepted the job offer from Rutgers University. He resigned from LSUHSC effectively on August 31st and began serving as an Associate Professor in the Department of Neurosurgery at RWJMS at Rutgers University (RU) on September 9th, 2019. The DOD and CDMRP granted the permission to transfer the study from LSUHSC to RWJMS at RU. The transfer was completed in March, 2020. Then the COVID-19 pandemic has resulted the suspension of all research effort in March. Currently RU is undergoing Phase 3 reopening and the current regulation still prohibits any research study involving face-to-face interaction with human subjects. EP170034 falls in this category. In the meantime, the IRB committee at RWJMS at RU has approved our study protocol on July 8, 2020. This continuing review of this study protocol was submitted to the USAMRDC, ORP, and HRPO on July 15, 2020. We are waiting for the permission from RU to resume research studies involving face-to-face interaction with human subjects. We have necessary study infrastructure to begin subject recruitment as soon as the permission is granted.
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The primary objective of the Telephone Delivery of Cognitively Augmented Behavioral Activation (Tele-CABA) intervention with Veterans who have a history of traumatic brain injury (TBI) is to reduce their negative cognitive and psychiatric health outcomes and promote personal resilience. The long-term objective of this study is to develop an accessible and acceptable intervention that can be broadly disseminated to address the complex rehabilitation needs within this population of Veterans. Participants will be Veterans and Service members with a history of TBI enrolled for health services at any VA medical center or satellite program. A total of 192participants will be enrolled. Participants will be randomly assigned to either the treatment (Tele-CABA) or ausual-care control group (UC). Participants randomly assigned to the Tele-CABA group will receive the manualized intervention delivered by telephone over the course of 10 weekly, 90-minute sessions. Participants in the UC group will continue to receive their regular medical, psychiatric, and psychotherapeutic care. All participants will undergo evaluation at baseline, post-treatment, and 6-months following the completion of treatment. At baseline, participants will complete a diagnostic TBI interview, self-report questionnaires measuring cognitive and psychiatric symptom severity including the Neurobehavioral Symptom Inventory (NSI) and a brief cognitive screening battery. Self-report questionnaires and cognitive testing will be repeated at post-treatment and follow-up. We will evaluate the following primary outcomes: cognitive symptoms, psychiatric distress symptoms, utility of compensatory strategies, self-efficacy, adaptive functioning, quality of life, and treatment satisfaction.
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Persistent symptoms after mild traumatic brain injury (mTBI), including chronic pain and sensory disturbance, may be related to alterations at the level of neural oscillations. Studies in mTBI patients show disturbed sleep as a core component of symptoms. The purpose of this study is to evaluate a noninvasive, closed-loop, acoustic stimulation neurotechnology (HIRREM-SOP called Cereset Research, using non-invasive BrainEcho technology) as a novel treatment to enable both physiological and clinical recovery from mTBI, through auto-calibration of neural oscillations. The study is conducted as a single blind study at two sites USUHS/Walter Reed and WAMC. The hypothesis is that usage of Cereset Research neurotechnology (ten sessions, 90 minutes each), will entail greater reduction in persistent symptoms of mTBI, at three months, than exposure to non-specific random tones that are delivered in a comparable way. The participant enrollment has begun at both USUHS/Walter Reed and WAMC. Both sites progressed nicely until March of 2020 when COVID forced a complete shutdown of research interventions. IRB permissions were granted for the sites to do follow-up visits remotely, but no new clients were allowed to be enrolled or begin the intervention process. COVID restrictions have recently been lifted so the sites can again begin to advertise and enroll new participants. COVID caused this study to be delayed at least 4 to 6 months.
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Transient global amnesia is a clinical syndrome characterized by anterograde amnesia, mild retrograde amnesia, and confusion for up to 24 hours. It most commonly occurs in patients older than 50 years and results from the temporary impairment of short-term memory formation.
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The article presents the discussion on researchers examining data from 2011 through 2020 on injuries associated with a baby carrier in children up to five years of age reported to the National Electronic Injury Surveillance System.
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OBJECTIVE: The coronavirus disease 2019 (COVID-19) pandemic is affecting the characteristics of patients with head injuries. This study aimed to evaluate the effect of the COVID-19 pandemic on patients with head injuries at a regional emergency medical center in South Korea. METHODS: From April 2019 to November 2020, 350 patients with head injuries were admitted to our hospital. The study period was divided into the pre-COVID-19 (n=169) and COVID-19 (n=181) eras (10 months each). Patients with severe head injuries requiring surgery (n=74) were categorized into those who underwent surgery (n=41) and those who refused surgery (n=33). RESULTS: Head injuries in pediatric patients (<3 years) were more frequent in the COVID-19 era than in the pre-COVID-19 era (8.8% vs. 3.6%, p=0.048). More patients refused surgery in the COVID-19 era than in the pre-COVID-19 era (57.9% vs. 30.6%, p=0.021). Refusal of surgery was associated with old age (67.7±14.5 vs. 52.4±19.1, p<0.001), marital status (married, 84.8% vs. 61.0%, p=0.037), unemployment (42.4% vs. 68.3%, p=0.034), COVID-19 era (66.7% vs. 39.0%, p=0.021), and lower Glasgow coma scale scores (6.12±3.08 vs. 10.6±3.80, p<0.001). Multivariable logistic regression analysis revealed that refusal of surgery was independently associated with old age (adjusted odds ratio [OR], 1.084; 95% confidence interval [CI], 1.030-1.140; p=0.002), COVID-19 era (adjusted OR, 6.869; 95% CI, 1.624-29.054; p=0.009), and lower Glasgow coma scale scores (adjusted OR, 0.694; 95% CI, 0.568-0.848; p<0.001). CONCLUSION: We observed an increased prevalence of head injuries in pediatric patients (<3 years) during the COVID-19 pandemic. Additionally, among patients with severe head injuries requiring surgery, more patients refused to undergo surgery during the COVID-19 pandemic.
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Readers in need of escapism can ponder the lessons learnt from head injuries in nursery rhyme characters (doi:10.1136/bmj-2021-068256)3 or the health of ageing superheroes (doi:10.1136/bmj-2021-068001).4 Feast your eyes on a traditional Christmas table and spot the toxic seasonal botanicals (doi:10.1136/bmj-2021-066995),5 click the QR codes to hear what gout and other conditions might sound like (doi:10.1136/bmj-2021-068240),6 and read Greta Bauer’s wildly duplicitous scheme for publishing poor research (doi:10.1136/bmj-2021-067350).7 Her infographic might help you evaluate whether second to fourth finger digit ratio is associated with luck when playing poker (doi:10.1136/bmj-2021-067849)8 or whether the density of heavy metal bands in a population is correlated with death (doi:10.1136/bmj-2021-067633).9 Juan Franco and Santiago Esteban demystify chance findings and artificial intelligence (doi:10.1136/bmj.n2915).10 Behind data are people, and empathy is as important in clinical research as in medicine. Among some trial participants, hope is treasured (doi:10.1136/bmj-2021-066851),11 but Christmas cards from their trial organisers proved less so (doi:10.1136/bmj-2021-067742).12 We can provide better care if we put ourselves in colleagues’ shoes, as a GP and a consultant learnt when they traded places (doi:10.1136/bmj.n3005),13 as did other clinicians who reflect here on their “covid careers” (doi:10.1136/bmj.n2762).14 Those redeployed to intensive care might have found it a “smidge” easier to navigate using James Hodgetts and colleagues’ slang dictionary for new starters—a reminder that clear language can make medicine safer and more inclusive (doi:10.1136/bmj-2021-067900).15 Many clinicians want to change lives for the better, especially those working in Afghanistan with Médecins Sans Frontières, which is where your donations to The BMJ’s annual appeal will go this year (doi:10.1136/bmj.n3004).16 Sometimes you have to think outside the box to change the world. [...]few things are as simple, seasonal, or wonderful as giving and receiving thanks (doi:10.1136/bmj.n2816).20 Join our campaign on Twitter to thank the people who have been supportive through the pandemic (#bmjcovidthanks): this may be the seasonal boost healthcare professionals need most as they prepare for what 2022 will bring. 1 Robertson D Doshi P. The end of the pandemic will not be televised.