Responding to child abuse during a pandemic

During a pandemic, particularly a pandemic resulting in a quarantine, child abuse is likely to increase because of added stressors to a family, the isolation of children with their offenders, reduced interaction with mandated reporters, and the elimination or reduction of critical services. Using the COVID-19 pandemic as an illustration, the authors propose numerous recommendations to assist multidisciplinary teams (MDTs) responding to child abuse during a pandemic. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

Domestic Violence Knowledge and Attitudes Among Minnesota Dental Hygienists: A pilot study.

Purpose The prevalence of intimate partner domestic violence (DV) increased in frequency during the global COVID-19 pandemic. The purpose of this pilot study was to assess dental hygienists' knowledge, attitudes, and readiness to manage patients experiencing DV in the state of Minnesota.Methods A cross-sectional study design was used on a convenience sample of dental hygienists. The validated Physician Readiness to Manage Intimate Partner Violence Survey (PREMIS) was used to collect the data. Survey items included demographic variables and measured attitudes and knowledge regarding intimate partner DV. Paper surveys were distributed to attendees at the Minnesota Dental Hygienist Association Annual Meeting. ANOVA and linear regression models were used to assess associations between domestic violence knowledge scores and respondent demographics and attitudes.Results Eighty-eight surveys were distributed; 31 surveys were completed and met the inclusion criteria for data analysis. The overall mean knowledge score was 11.6 from a possible score of 17. No significant differences were found by age, degree type, or years in practice and domestic violence knowledge or attitudes. Most respondents (64.5%) indicated a lack of preparedness to ask appropriate questions regarding DV and only a little more than half knew how to respond to disclosures of DV (51.6%) or were aware of the state's legal requirements for reporting DV (58.0%).Conclusion Participants demonstrated moderate knowledge of DV and recognized the importance of identifying and providing support for DV victims. However, participants were unsure of current state-mandated guidelines for reporting DV. Future exploration of reporting mandates will better support dental hygienists in their professional obligations identifying victims of DV.

Relationship Between a State-Directed Lockdown on Non-COVID-19-related ICU Admissions and Mortality in a Multicenter Colorado Healthcare System.

Colorado issued a month long statewide lockdown on March 26, 2020, during the initial surge of the COVID-19 pandemic. The impact of this mandate on non-COVID-19 ICU admission rates and outcomes is unclear. DESIGN: We performed a retrospective analysis of all medical ICU admissions in the University of Colorado Health System in four predefined periods: 1) prepandemic (2 mo prior to lockdown period 1); 2) mandated lockdown from March 26 to April 26, 2020 (period 2); 3) between surges (period 3); and 4) nonmandated lockdown surge (between November 1, 2020, and March 31, 2021, period 4). SETTING: Nonsurgical ICU admissions at the University of Colorado Health Systems, including 10 hospitals throughout Colorado. SUBJECTS: All ICU admissions in four predefined time periods. MEASUREMENTS AND MAIN RESULTS: We included 13,787 patients who were admitted during the four study periods. The 28-day mortality rates for non-COVID-19 ICU admissions following index ICU admission were 13.6%, 18.0%, 13.5%, and 16.0% across periods 1-4, respectively. However, the increased odds in non-COVID-19 ICU mortality during the mandated lockdown period relative to prepandemic 1 (odds ratio [OR], 1.39; 95% CI, 1.11-1.72; p = 0.0.04) was attenuated and nonsignificant after adjustment for demographics, comorbidities, diagnosis flags, and severity (OR, 1.15; 95% CI, 0.89-1.48; p = 0.27). Similar results were found in time-to-event analyses. The most common diagnosis in each time period was acute respiratory failure (ARF), and we found it to have increased during lockdown (p < 0.001), whereas sepsis admissions increased during and decreased after lockdown (p = 0.004). Admissions for alcohol withdrawal syndrome (AWS) increased during lockdown and 6 months afterwards (p = 0.005). CONCLUSIONS: For non-COVID-19-related ICU admissions, mortality rate was similar before, during, and after Colorado's month long lockdown after confounder adjustment, including typical ICU admission flags. Primary admission diagnoses shifted throughout the predefined study periods with more admissions for severe critical diagnoses (i.e., ARF, sepsis, AWS) occurring during the mandated lockdown and nonmandated lockdown periods compared with the prepandemic and between surge period. This would suggest that the perceived increase in mortality during the lockdown for non-COVID-19 ICU admissions may be related to a shift inpatient demographics.

Teachers' Perspectives on Teaching and Learning during the Pandemic in the United States

Background/purpose - As COVID-19 spread around the globe, learning was greatly impacted, with teachers having to pivot to remote delivery. This study documented teachers' perceptions on the transition to online teaching and learning. Materials/methods - The phenomenological approach was used to gather and analyze responses to open-ended survey questions that solicited teachers' reflections on the benefits and challenges of instructing online, the quality of interactions with families, and the support provided by the leadership in school districts. Results - Two themes emerged from the data, teachers' challenges adjusting to new circumstances, and the complexities of meeting students' needs remotely while maintaining high academic expectations in pedagogy, instructional content, student outcomes and engagement, and parental involvement. Conclusion - Student engagement during remote learning indicate the need for educators and technology designers to begin to consider the future of learning in online formats among younger children. Copyright © 2022 by the author(s). This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License (CC-BY-4.0), where it is permissible to download and share the work provided it is properly cited.

Effect of Human Behavior on the Evolution of Viral Strains During an Epidemic.

It is well known in the literature that human behavior can change as a reaction to disease observed in others, and that such behavioral changes can be an important factor in the spread of an epidemic. It has been noted that human behavioral traits in disease avoidance are under selection in the presence of infectious diseases. Here, we explore a complementary trend: the pathogen itself might experience a force of selection to become less "visible," or less "symptomatic," in the presence of such human behavioral trends. Using a stochastic SIR agent-based model, we investigated the co-evolution of two viral strains with cross-immunity, where the resident strain is symptomatic while the mutant strain is asymptomatic. We assumed that individuals exercised self-regulated social distancing (SD) behavior if one of their neighbors was infected with a symptomatic strain. We observed that the proportion of asymptomatic carriers increased over time with a stronger effect corresponding to higher levels of self-regulated SD. Adding mandated SD made the effect more significant, while the existence of a time-delay between the onset of infection and the change of behavior reduced the advantage of the asymptomatic strain. These results were consistent under random geometric networks, scale-free networks, and a synthetic network that represented the social behavior of the residents of New Orleans.

Early mandated social distancing is a strong predictor of reduction in peak daily new COVID-19 cases.

OBJECTIVES: Mandated social distancing has been applied globally to reduce the spread of coronavirus disease 2019 (COVID-19). However, the beneficial effects of this community-based intervention have not been proven or quantified for the COVID-19 pandemic. STUDY DESIGN: This is a regional population-level observational study. METHODS: Using publicly available data, we examined the effect of timing of mandated social distancing on the rate of COVID-19 cases in 119 geographic regions, derived from 41 states within the United States and 78 other countries. The highest number of new COVID-19 cases per day recorded within a geographic unit was the primary outcome. The total number of COVID-19 cases in regions where case numbers had reached the tail end of the outbreak was an exploratory outcome. RESULTS: We found that the highest number of new COVID-19 cases per day per million persons was significantly associated with the total number of COVID-19 cases per million persons on the day before mandated social distancing (ß = 0.66, P < 0.0001). These findings suggest that if mandated social distancing is not initiated until the number of existing COVID-19 cases has doubled, the eventual peak would result in 58% more COVID-19 cases per day. Subgroup analysis on those regions where the highest number of new COVID-19 cases per day has peaked showed increase in ß values to 0.85 (P < 0.0001). The total number of cases during the outbreak in a region was strongly predicted by the total number of COVID-19 cases on the day before mandated social distancing (ß = 0.97, P < 0.0001). CONCLUSIONS: Initiating mandated social distancing when the numbers of COVID-19 cases are low within a region significantly reduces the number of new daily COVID-19 cases and perhaps also reduces the total number of cases in the region.

Reporting of child maltreatment during the SARS-CoV-2 pandemic in New York City from March to May 2020.

BACKGROUND: School closures and other public health responses have decreased the extent that children interact with mandated reporters and other professionals trained to detect child maltreatment. OBJECTIVE: To assess associations between the pandemic public health response and the number of allegations of child abuse or neglect. METHODS: This study analyzed monthly data from New York City of the number of child maltreatment allegations, stratified by reporter type (e.g., mandated reporter, education personnel, healthcare personnel), as well as the number of Child Protective Services (CPS) investigations warranting child welfare preventative services. SARIMA models were trained using data from January 2015 to February 2020 to predict expected values for March, April, and May 2020. Observed values were compared against predicted values at an alpha of .05. RESULTS: Substantially fewer allegations of child maltreatment were reported than expected in March (-28.8 %, deviation: 1848, 95 % CI: [1272, 2423]), April (-51.5 %, deviation: 2976, 95 % CI: [2382, 3570]), and May 2020 (-46.0 %, deviation: 2959, 95 % CI: [2347, 3571]). Significant decreases in child maltreatment reporting were also noted for all reporter subtypes examined for March, April, and May 2020. Fewer CPS investigations warranted preventative services than expected in March 2020 (-43.5 %, deviation: 303, 95 % CI: [132, 475]). CONCLUSIONS: Precipitous drops in child maltreatment reporting and child welfare interventions coincided with social distancing policies designed to mitigate COVID-19 transmission. In light of these findings, educators and healthcare providers must be especially vigilant when engaging online with children and their families for signs of child abuse and/or neglect.

Mandated societal lockdown and road traffic accidents.

BACKGROUND: The effect of mandated societal lockdown to reduce the transmission of coronavirus disease 2019 (COVID-19) on road traffic accidents is not known. For this reason, we performed an in-depth analysis using data from Statewide Traffic Accident Records System. MATERIALS AND METHODS: We reviewed data on total 2292 road traffic accident records in Missouri from January 1, 2020 through May 15, 2020. We treated March 23 as the first day of mandated societal lockdown and May 3 as the first day of re-opening. RESULTS: We have found that there was a significant reduction in road traffic accidents resulting in minor or no injuries (mean 14.5 versus 10.8, p < 0.0001) but not in accidents resulting in serious or fatal injuries (mean 3.4 versus 3.7, p = 0.42) after mandated societal lockdown. Furthermore, there was a significant reduction in road traffic accidents resulting in minor or no injuries after the mandated social lockdown (parameter estimate -5.9, p = 0.0028) in the time series analysis. There was an increase in road traffic accidents resulting in minor or no injuries after expiration of mandatory societal lockdown (mean 10.8 versus 13.7, p = 0.04). CONCLUSION: The mandated societal lockdown policies led to reduction in road traffic accidents resulting in non-serious or no injuries but not those resulting in serious or fatal injuries.

Employer-Sponsored Benefits in the United States: The Past, Present, and Future.

In early 2020, the COVID-19 virus caused a global pandemic, threatening the lives and livelihoods of millions across the globe. As of this writing, 40 million Americans had filed first-time unemployment claims U.S. Department of Labor (2020, March 26). Employment and Training Administration. https://www.dol.gov/newsroom/releases/eta. The United States, with its historical reliance upon employers to cover many basic benefits, must overcome unique challenges in its recovery from this global crisis. In this article, we briefly describe the initial federal response; we then present the history of US benefits along with recent yet prepandemic benefit trends, and we conclude by presenting a potential path forward that may allow for both employers and workers to recover in a postpandemic society.