Experiences of violence during the COVID-19 pandemic among people who use drugs in a Canadian setting: a gender-based cross-sectional study.

OBJECTIVES: People who use drugs (PWUD) experience disproportionately high rates of violent victimization. Emerging research has demonstrated that the COVID-19 pandemic has exacerbated violence against some priority populations (e.g., women), however there is limited research examining the impact of the pandemic on the experiences of violence of PWUD. METHODS: Using data collected between July and November 2020 from three prospective cohort studies of PWUD in Vancouver, Canada, we employed multivariable logistic regression stratified by gender to identify factors associated with recent experiences of violence, including the receipt of COVID-19 emergency income support. RESULTS: In total, 77 (17.3%) of 446 men, and 54 (18.8%) of 288 women experienced violence in the previous six months. Further, 33% of men and 48% of women who experienced violence reported that their experience of violence was intensified since the COVID-19 pandemic began. In the multivariable analyses, sex work (Adjusted Odds Ratio [AOR] = 2.15, 95% confidence interval [CI]: 1.06-4.35) and moderate to severe anxiety or depression (AOR = 3.00, 95% CI: 1.37-6.57) were associated with experiencing violence among women. Among men, drug dealing (AOR = 1.93, 95%CI: 1.10-3.38), street-based income sources (AOR = 1.93, 95%CI: 1.10-3.38), homelessness (AOR = 2.54, 95%CI: 1.40-4.62), and regular employment (AOR = 2.97, 95% CI: 1.75-5.04) were associated with experiencing violence. CONCLUSION: Our study results suggest economic conditions and gender were major factors associated with experiencing violence among our sample of PWUD during COVID-19. These findings highlight criminalization of drug use and widespread socioeconomic challenges as barriers to addressing violence among PWUD during periods of crisis.

Domestic violence towards children in Kenya and Zambia during the COVID-19 pandemic.

OBJECTIVES: Although research has demonstrated that the COVID-19 pandemic has increased the likelihood of children experiencing domestic abuse, few empirical studies have focused on the most vulnerable communities in developing countries. This study aimed to evaluate the impact of the COVID-19 pandemic on domestic violence towards children in Kenya and Zambia. STUDY DESIGN: In collaboration with an international non-governmental organisation (NGO), an original door-to-door survey of 842 children and their parents (or adult guardians) was conducted in Kenya and Zambia. The survey sites were carefully selected to target economically underprivileged communities with the presence of NGOs as well as those without. METHODS: Using multivariate regression analysis of child and parent survey responses, we attempted to identify how parents' experiences of COVID-19 affected children's exposure to domestic violence. Our analysis of domestic violence included both emotional (psychological) and physical violence. RESULTS: Children from households whose guardians perceived a strongly negative effect of COVID-19 were more likely to experience domestic violence. The correlation was statistically significant for both emotional and physical violence. In Kenya, children in communities with NGO presence were less likely to experience domestic violence. CONCLUSIONS: The COVID-19 pandemic has exposed children to an increased risk of experiencing domestic violence. Children from underprivileged communities in developing countries are particularly vulnerable to such risk, as they tend to lack social support from communities and governments. International organisations must pay more attention to these children during the pandemic.

Polytrauma patient with lateral thoracic spondyloptosis: case report and literature review

Background: Spondyloptosis is caused by high force trauma. The vast majority of cases occur in the sagittal plane and at transition points where ridged sections meet more flexible regions. Lateral thoracic spondyloptosis is extremely rare and there is no current consensus on the optimal treatment plan. Case Description: Here we present a case of a previously physically healthy 24-year-old polytrauma patient after he was struck as a pedestrian by a motor vehicle. Of note the patient was found to have lateral spondyloptosis between T9-10 with complete spinal cord transection. The patient also sustained multi-ligamentous left knee injury, pelvic fractures, open comminuted left tibia and fibular fracture, lacerated liver, bilateral renal lacerations, ischemic bowel, and an aortic arch pseudoaneurysm. Conclusion(s): Lateral thoracic spondyloptosis is a devastating injury with an extreme rate of persistent neurologic deficits. There is no unanimously accepted treatment because of the rarity if the injury and the poor outcomes that patients face. Additionally, patients who experience high level trauma often develop severe psychiatric illness, and the importance of identifying risk factors and implementing care early may improve patient outcomes.Copyright © AME Medical Journal.

Aggression, mini-aggression, and abuse against health care workers during the COVID-19 pandemic

Introduction: COVID-19 pandemic brought multiple negative consequences that go beyond the direct damage caused by the disease and that affect health systems as well. Complaints of attacks against health care workers became frequent and concerning. The objective of this survey was to characterize the frequency and type of violent behavior against front-line professionals in Latin America. Material(s) and Method(s): A cross-sectional electronic survey was carried out between January 11th to February 28th, 2022. Different health care workers from Latin America who have been delivering care at least from March 2020, regardless of whether they assist or not patients with COVID- 19 were included. A non-probabilistic snowball sampling was performed, and the survey was Results: The survey was responded by 3,544 participants from 19 countries (Figure 1);58.5% were women, and the mean age was 41.9+/-11 years. The 70.8% were doctors, 16% nurses, 3.4% physiotherapists, and the remaining 9.8% had other functions within the health team. About 85.1% of physicians were specialists: 33.9% were cardiologists, 14.4% were intensivists or emergency physicians, 10.9% had some surgical specialty, 7.7% were pediatricians or related subspecialties, and the remaining 33.1% had other specialties. The 36.3% and 28.8% worked in public and private practice respectively, the remaining worked in both. Direct and regular care to COVID-19 patients was provided by 74.7% of all contestants. Among the participants, 54.8% reported acts of violence: 95.6% suffered verbal violence, 11.1% physical violence, and 19.9% other types. 39.5% of respondents experienced it at least once a week. The acts of violence involved patients' relatives (32%), or patients together with their relatives (35.1%). The victims rated the stress level of these events with an average of 8.2+/-1.8 points (scale from 1 to 10). Approximately half of the health personnel who suffered an assault experienced psychosomatic symptoms after the traumatic event (Figure 2). Among the victims of violence, 56.2% considered changing their care tasks, and 33.6% abandoning their profession. However, only 23% of the health personnel attacked stated that they had made some type of legal action regarding these acts. In a logistic regression model, doctors (OR 1.95, p<0.01), nurses (OR 1.77, p=0.001), and administrative staff (OR 3.20, p<0.01) suffered more violence than other health workers. Women more frequently suffered violence (OR 1.56, p<0.01), as well as those who worked with patients with COVID-19 (OR 3.59, p<0.01). Conversely, a lower probability of violence was observed at older ages (OR 0.96, p<0.01). Conclusion(s): We detected a high prevalence of violence against health personnel in Latin America during the current pandemic. Those caring for COVID-19 patients, younger staff, and women were found to be more vulnerable. It is imperative to develop strategies to mitigate these acts and their repercussions on the health team. (Figure Presented) .

Violence Against Healthcare Workers During COVID-19 Pandemic In India

Purpose: The violence against healthcare workers is one of the world's serious public health and patient care challenges. This is often exacerbated during emergencies, and the same has been observed during COVID-19. Method(s): The study reported an analysis of media reports during the first and second waves of the COVID-19 pandemic from India. We searched and analysed violent incidents against healthcare workers reported in English & Hindi online media. Our media analysis also reported perpetrators and triggers to mitigate violence against healthcare workers. Finding(s): We studied 51 incidents of violence, during March 2020-August 2021, as per our inclusion criteria. The majority of this reported violence occurred from the government hospitals (45.1%), followed by the community (29.4%), private hospitals (19.6%), quarantine facilities (4.0%), and burial grounds (1.9%). Doctors were targeted in the majority (82.3%), followed by other hospital staff (security and support) (33.3%), nurses (9.8%), ANMs (3.9%), and ASHA (2.0%). The majority of reported incidents were related to physical violence (58.9%), followed by verbal and physical combined (23.5%), sexual harassment (9.8%), and verbal (7.8%). The preparators of violence were family members (53.0%), community (31.4%), police officials (7.8%), and patients (7.8%). Conclusion(s): The actions required to mitigate the violence against healthcare workers require a multipronged approach with the introduction of strict policy measures and their implementation. The mandatory training of healthcare workers in soft and communication skills, protection, and coping mechanisms to prevent and de-escalate such incidents.Copyright © 2022 Wolters Kluwer Medknow Publications. All rights reserved.

Parental stress and physical violence against children during the second year of the COVID-19 pandemic: results of a population-based survey in Germany.

BACKGROUND: Parents and caregivers belonged to those with the highest burdens during the COVID-pandemic. Considering the close link between parental stress and child maltreatment, identifying families with high parental stress is of utmost importance to prevent violence against children. Within this study, we thus aimed to investigate the interplay of parental stress, changes in parental stress, and physical violence against children during the second year of the COVID-pandemic on an exploratory level. METHODS: We conducted a cross-sectional, observational study in Germany from July to October 2021. By using different sampling steps, a representative probability sample of the German population was generated. A subsample of these participants with children under the age of 18 was included for analysis within this study (N = 453, 60.3% females, Mage = 40.08; SD = 8.53). RESULTS: Higher parental stress levels were associated with more physical violence against children, higher levels of own experiences of child maltreatment, and mental health symptoms. An increase in parental stress during the pandemic was associated with female sex, the use of physical violence against children, and parental experience of child maltreatment. Parents who have ever used physical violence against their children have been characterized by higher parental stress levels, a stronger increase in parental stress during the pandemic, own experience of child maltreatment, mental health symptoms and sociodemographic characteristics. Higher parental stress levels, a stronger increase of parental stress during the pandemic, having pre-existing psychiatric disorders, and parental experience of child maltreatment predicted an increased use of physical violence against children during the pandemic. CONCLUSIONS: Our results underscore the importance of parental stress for the risk of physical violence against children, more so in times of overall increased stress due to the pandemic and underline the need for low threshold support for families at risk in times of crises.

Level of depression in primary and secondary school adolescents after COVID 19 in the municipality of Pristina

As adolescence is the most sensitive period of human development, characterized by many physical, psychological, cognitive and emotional changes that affect all adolescents, some more to some less also not forgetting that in recent years we have faced a difficult situation caused by COVID 19, a period of dealing with many health problems, loss of loved ones, closing schools and switching to online learning, isolation social. Our study is focused on adolescence and specifically depression in adolescents of lower secondary schools and upper secondary schools in the municipality of Pristina to know more closely the consequences of COVID 19 in adolescents. Copyright © 2022 The Authors.

Intimate Partner Violence During COVID-19 Restrictions: A Study of 30 Countries From the I-SHARE Consortium.

Intimate partner violence (IPV) causes substantial physical and psychological trauma. Restrictions introduced in response to the COVID-19 pandemic, including lockdowns and movement restrictions, may exacerbate IPV risk and reduce access to IPV support services. This cross-sectional study examines IPV during COVID-19 restrictions in 30 countries from the International Sexual HeAlth and REproductive Health (I-SHARE) study conducted from July 20th, 2020, to February, 15th, 2021. IPV was a primary outcome measure adapted from a World Health Organization multicountry survey. Mixed-effects modeling was used to determine IPV correlates among participants stratified by cohabitation status. The sample included 23,067 participants from 30 countries. A total of 1,070/15,336 (7.0%) participants stated that they experienced IPV during COVID-19 restrictions. A total of 1,486/15,336 (9.2%) participants stated that they had experienced either physical or sexual partner violence before the restrictions, which then decreased to 1,070 (7.0%) after the restrictions. In general, identifying as a sexual minority and experiencing greater economic vulnerability were associated with higher odds of experiencing IPV during COVID-19 restrictions, which were accentuated among participants who were living with their partners. Greater stringency of COVID-19 restrictions and living in urban or semi-urban areas were associated with lower odds of experiencing IPV in some settings. The I-SHARE data suggest a substantial burden of IPV during COVID-19 restrictions. However, the restrictions were correlated with reduced IPV in some settings. There is a need for investing in specific support systems for survivors of IPV during the implementation of restrictions designed to contain infectious disease outbreaks.

A Snapshot of Adverse Childhood Experiences among International Medical Students and Their Impact on Holistic Health during the Covid-19 Pandemic

Aims Adverse Childhood Experiences (ACE's) are those potentially traumatic events occurring in an individual between birth and 17 years of age.1 The term was first used in the pioneering study published in 1998, which showed causational relationships between ten adverse childhood experiences and negative health outcomes. Since then, a multitude of further research has been conducted in the field. Scientific curiosity led me to research the link between early trauma and physical, mental, and social health. Having conducted and presented the results of a pilot study (pre-pandemic), my passion grew, leading to an in-depth literature review on the relating factors, mechanism and relationship between ACE's and physical and mental health, followed by an extensive undergraduate study, to ascertain the impact of ACE's on medical students, in particular focusing on emotional health, during this pandemic (2021). Methods A sample of 140 students attending the university of medicine and pharmacy 'Grigore T. Popa' were surveyed, collecting demographic, physical, mental, social, and emotional health data by means of an Google Forms questionnaire (including: the Pittsburgh sleep quality Index,2 and WHO ACE-IQ3). Correlations were made between different variables, such as: gender, nationality, self-rated physical health and 'binary ACE score'. Results 61.4% were female, with participants from across the globe. The average age was 23.13 years. A snapshot of the prevalence of ACE's was obtained, 29.3% had an ACE score of 4 or more. Of the categories of ACE's: a quarter having experienced sexual abuse, witnessing physical violence (without objects) in just under a third (31%), and threats or actual abandonment or exclusion from the house in just under 1 in 5 (19%). While data confirmed the findings of previous studies on the impact of ACE's on physical health, the most notable findings were in relation to emotional health. In the past year, 39.3% reported having felt deep sadness more than three times. 47.1% reported feelings of worthlessness more than three times in the past year. 27.1% reported excessive worry, 15% reported thoughts of self-harm. Positive correlations were observed between ACE score, and feelings of deep sadness, feelings of worthlessness, excessive worry, thoughts of self-harm, and suicidal thoughts (see figure 1). Conclusion These findings underline an important issue, equally affecting the future medical professionals. Findings reflect the generation and the world as a whole, with the compounded impact of the SARS-COV-2 pandemic on mental and emotional health. Results suggest, dealing with the effects of 'post-pandemic' stress and ACE will be an issue requiring particular attention. (Figure Presented).

Is gender-based violence a confluence of culture? Empirical evidence from social media.

Gender-based violence (GBV) has been plaguing our society for long back. The severity of GBV has spurred research around understanding the causes and factors leading to GBV. Understanding factors and causes leading to GBV is helpful in planning and executing efficient policies to curb GBV. Past researches have claimed a country's culture to be one of the driving reasons behind GBV. The culture of a country consists of cultural norms, societal rules, gender-based stereotypes, and social taboos which provoke GBV. These claims are supported by theoretical or small-scale survey-based research that suffers from under-representation and biases. With the advent of social media and, more importantly, location-tagged social media, huge ethnographic data are available, creating a platform for many sociological research. In this article, we also utilize huge social media data to verify the claim of confluence between GBV and the culture of a country. We first curate GBV content from different countries by collecting a large amount of data from Twitter. In order to explore the relationship between a country's culture and GBV content, we performed correlation analyses between a country's culture and its GBV content. The correlation results are further re-validated using graph-based methods. Through the findings of this research, we observed that countries with similar cultures also show similarity in GBV content, thus reconfirming the relationship between GBV and culture.

The global prevalence and its associated factors toward domestic violence against women and children during COVID-19 pandemic-"The shadow pandemic": A review of cross-sectional studies.

Globally, domestic violence affects women across their life span. Domestic violence against women and children during COVID-19 is a critical and substantial public health issue. This review article was aimed to determine the prevalence and its associated factors toward domestic violence against women and children during COVID-19. Several studies showed that the prevalence of domestic violence against women and children has been alarmingly enlarged during this COVID-19. Domestic violence is a significant and essential problem that is occurring all over the world for many years now, but this condition has been augmented during the lockdown situation because of this pandemic. Women and children of the worldwide are facing twin health emergencies that are COVID-19 and domestic violence. The pandemic was found as a threat to commit domestic violence against women and children. This is because, even though the measurements taken to avoid COVID-19 spread are supportive strategies and also the only opportunity to do so, reducing the risk of COVID-19 was found to raise the risk of domestic violence against women and children. Factors associated with domestic violence against women and children were; being housewives, age < 30 years, marriage, husband's age being between 31 and 40 years, physical victimization, and sexual victimization were factors associated with domestic violence. Depression, spending more time in close contact, job losses, financial insecurity, lockdowns, addiction (alcohol or drugs), control of wealth in the family, technology, and quarantine were factors considered as risk factors for domestic violence. This review will serve as a "call to action" to address this crisis effectively by coming together since this crisis is the global aspect. This is a shadow pandemic growing during this COVID-19 crisis and a global collective effort is needed to prevent it. The life of women and children moves from their needs to their rights during this pandemic. It is essential to undertake urgent actions to intervene in it.

Physical and psychological violence in dating with stress among adolescents during the COVID-19 pandemic

Currently, the juvenile delinquency trend is still very high. Dating violence (DV) is one of the delinquencies that teenagers often commit. DV has negative impacts in the form of physical and psychological impacts. Physical impacts can include bruises, fractures. Meanwhile, the psychological impact can be a the form of depression, stress, anxiety, and sleep problems. This study aimed to analyze the relationship between physical and psychological violence in dating stress adolescents. This study used a cross-sectional design. Sample of this study was 314 students (15-19 years) in Bantul chosen through a purposive sampling technique. Data analysis was using multiple logistic regressions. The results showed that there was a significant relationship towards stress, namely gender (p-value=0.050), physical violence (p-value=0.000), and psychological violence (p-value=0.000). Age (p-value=0.653) and parents' income (p-value=0.100) had no significant relationship to stress. Psychological violence variable (p-value=0.000;OR=6.285, 95%;CI=3.683-10.726) was the most dominant in triggering stress in adolescents. So, there were relationships between gender, physical and psychological violence in dating with the incidence of stress among adolescents in Bantul Regency, Yogyakarta, Indonesia during the COVID-19 pandemic. © 2021, Institute of Advanced Engineering and Science. All rights reserved.

Prevalence and associated factors of intimate partner violence (IPV) against women in Bangladesh amid COVID-19 pandemic.

BACKGROUND: Intimate Partner Violence (IPV) is a serious violation of women's human rights and a dominant chronic global public health problem. Although it is suspected that epidemic-induced economic downturns have fueled the IPV, enough empirical literature are not available to make a consensus. Against this backdrop, the present study has attempted to explore the prevalence and associated factors of IPV amid the COVID-19 pandemic. METHODS: The study has included Bangladesh as the study area and collected data from married women who lived with her intimate partner. Total of 605 women were reached and 84.30% (510) women, aged 16-45 with mean age 30.12 (±6.27) years, provided their consent and required information. The study has employed the translated version of WHO multi-country study tools to screen the IPV. RESULTS: This cross-sectional study has found the prevalence of IPV about 45.29%, where 44.12% are emotionally abused, 15.29% physically, 10.59% sexually, and 19.22% are abused either physically or sexually. The study has found that types of marriage, area of residence, women's employment status, husband's age and level of education, family income status, and pandemic induced economic downturns were the associated factors of intimate partner violence amid the pandemic. LIMITATIONS: Self-reported cross-sectional study has some methodological limitations, and the present study is not free from them. CONCLUSIONS: The study contributes to the existing literature by highlighting the associated factors of IPV amid the pandemic, which will help to make preventive policy.

Modelling the effect of the COVID-19 pandemic on violent discipline against children.

BACKGROUND: The COVID-19 pandemic could increase violence against children at home. However, collecting empirical data on violence is challenging due to ethical, safety, and data quality concerns. OBJECTIVE: This study estimated the anticipated effect of COVID-19 on violent discipline at home using multivariable predictive regression models. PARTICIPANTS: Children aged 1-14 years and household members from the Multiple Indicator Cluster Surveys (MICS) conducted in Nigeria, Mongolia, and Suriname before the COVID-19 pandemic were included. METHODS: A conceptual model of how the COVID-19 pandemic could affect risk factors for violent discipline was developed. Country specific multivariable linear models were used to estimate the association between selected variables from MICS and a violent discipline score which captured the average combination of violent disciplinary methods used in the home. A review of the literature informed the development of quantitative assumptions about how COVID-19 would impact the selected variables under a "high restrictions" pandemic scenario, approximating conditions expected during a period of intense response measures, and a "lower restrictions" scenario with easing of COVID-19 restrictions but with sustained economic impacts. These assumptions were used to estimate changes in violent discipline scores. RESULTS: Under a "high restrictions" scenario there would be a 35%-46% increase in violent discipline scores in Nigeria, Mongolia and Suriname, and under a "lower restrictions" scenario there would be between a 4%-6% increase in violent discipline scores in these countries. CONCLUSION: Policy makers need to plan for increases in violent discipline during successive waves of lockdowns.