Roots and resiliency for native American young people

Aim: The presentation shares traditional Native American knowledge about wellbeing and caring for a person's body, heart, connection to the Creator, ancestors, and the land Methods: Drawing upon community narratives and traditional ancestral knowledge themes pertinent to the topic will be presented. Narrative Review Results: Ancestral knowledge is essential to access and practice in? community care and healing. This knowledge is sacred to the lives wellbeing, and continuation of traditional ways for Confederated Tribes of Warm Springs (CTWS) people. CTWS young people play an important role in these practices for their community and elders. The practice of taking CTWS children from families was a pivotal moment that pushed forward the concept of mental health for the CTWS. The threat of climate change, and the COVID-19 pandemic's activation of memories of imposed isolation between our people and from traditional ways continues to impact our young people. The process of healing from historical and present-day traumas includes grieving those losses and healing from addictions, as well as physical and sexual abuse Conclusion(s): Rebuilding and strengthening connections to the land Chuush (water in Sahaptin language), food gathering, and being with each other, is central to our young people's, and community's, healing The path of returning to our traditional understanding of the knowledge of what the Creator has provided for the CTWS people will be shared. This knowledge is useful for the care of young people Native and non-Native alike.

Prevalence of Physical Violence in the Medical-Forensic Approach in the Years 2015-2020 in City and Neighboring Municipalities: Perspectives from Poland-Poznan Study.

Forensic medical opinions serve the appropriate classification of a crime against health. Violence, a multifaceted phenomenon, requires forensic medical examination in the case of causing damage to health. Due to the effects caused by the perpetrator, the damage to health is divided into severe, medium, and light. This study analyzed 7689 incidents of violence from 2015-2020, taking place in the area subordinate to the Provincial Police Headquarters in Poznan, based on anonymized documentation of forensic medical examinations performed at the Department of Forensic Medicine in Poznan at the request of the Police and privately. The analysis took into account: units ordering the test, type of exposure, medical help, sex and age of the victim, places of the incident, classification and localization of injury, manner of impact, attitude of the perpetrator to the victim, profession of the victim, gender of the perpetrator, and remarks. In Poland, statistics on violence victims are underestimated, resulting from the low reporting of crimes committed to law enforcement authorities. There is a need for programs to educate the perpetrator of violence on methods of conflict resolution and programs to prevent violence, covering events taking place in public spaces.

Travesty of Life Elders Abuse an Inquiry of Physical and Psychological Abuse.

Elder abuse is evil in human society. The present paper unveils this social issue from two major factors psychological and physical abuse. The study sensitizes the subject matter of study by examining the effects of demographic variables like gender and age on elders. For achieving the purpose of the study the research is a design by exploring and validating the factors of measuring elder abuse through the mix method approach, exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). To test the established hypotheses of the effects of the demographic variable on elders the two-way ANOVA was applied. The present study verdicts the development of a sound measurement scale with two influence factors. The separate and composite effect of aging and gender type on elder abuse was evidenced. These findings are crucial especially when the prevalence of elder abuse is higher during COVID-19. The limited novel understudied variable opens an avenue for further research in behavioral and demographic variables like marital status. The present study has practical insinuation for caring the elders in any human society like physical and psychological treatment of elders to avoid abusive situations. In addition, the study attempts to validate the novel issues like psychological and physical abuse of elders in the dimensions of demographic variables. Some rare studies in the Indian continent established the motivation of conducting the research on this dimension.

Social Isolation During the COVID-19 Pandemic Impacts the Link between Child Abuse and Adolescent Internalizing Problems.

Collective traumas have a notable impact on adolescent well-being. While some youth face increased risk for mental health problems (e.g., those with maltreatment histories), many demonstrate resilience following traumatic events. One contributing factor to well-being following trauma is the degree to which one isolates from others. Accordingly, we examined the association between maltreatment and internalizing problems during the COVID-19 pandemic as moderated by social isolation. Among adolescents reporting pre-pandemic emotional abuse, those experiencing less isolation reported the lowest levels of anxiety symptoms. Among adolescents reporting pre-pandemic physical abuse, those experiencing less isolation reported the greatest levels of anxiety and depressive symptoms. The findings highlight a public health-oriented approach to youth well-being during collective trauma that extends beyond mitigating disease transmission.

Skills Training in Affective and Interpersonal Regulation Narrative Therapy Delivered via Synchronous Telehealth: A Case Study of a Rural Woman Veteran With Complex Posttraumatic Stress Disorder

The International Classification of Diseases-11 th Revision (ICD-11) includes the diagnosis of complex posttraumatic stress disorder (CPTSD). Clinical practice guidelines support the use of phased care for individuals with CPTSD. This case study illustrates the use of synchronous telehealth to deliver phased treatment to a rural woman veteran with CPTSD. Mrs. A experienced sexual, physical, and emotional abuse throughout her life, perpetrated by family members, intimate partners, and military authority figures. She sought treatment for posttraumatic nightmares and body image issues;she also had pain related to fibromyalgia and chronic migraine headaches. Mrs. A participated in 19 sessions of Skills Training in Affective and Interpersonal Regulation (STAIR) Narrative therapy via synchronous telehealth. Trauma and eating disorder symptoms were assessed before and after treatment and the patient demonstrated clinically significant improvement on measures of these disorders. Patient-provider working alliance and quality of life were assessed post-treatment. Synchronous telehealth use drastically increased with the onset of COVID-19;however, little information on treating CPTSD via synchronous video teleconferencing is available. This case study illustrates an evidence-based, phased therapy for CPTSD while highlighting the feasibility and value of in-home delivery of psychotherapy for CPTSD via synchronous telehealth.Copyright © The Author(s) 2023.

The monthly incidence of abusive head trauma, inflicted skeletal trauma, and unexplained skin lesion in children in six French university hospitals during the COVID-19 pandemic.

INTRODUCTION: The COVID-19 pandemic was a stressful period. Lockdowns may have added to parental difficulty leading to an increase in violence. This study aimed to compare the monthly incidence of high suspicion of child physical abuse before and during the COVID-19 pandemic. MATERIAL: We have retrospectively reviewed imaging examinations of children having a skeletal X-ray examination in six university hospitals with high suspicion of abusive head traumatism (AHT), inflicted skeletal trauma (IST) and unexplained skin lesions (USL) between March 2020 and June 2021 and compared with the similar period from 2018 to 2019. The monthly incidence of the different physical maltreatment was analyzed using a QuasiPoisson regression model. RESULTS: We included 178 children (n = 127 boys, 71.3 %), 110 during the pandemic period, median age 5 months. AHT was diagnosed in 91 children, 55 had inflicted skeletal trauma (IST) and 46 had unexplained skin lesions (USL). Among the 91 patients with AHT, 86 had a subdural hematoma (95.6 %) and 40 had bridging veins thrombosis (44 %). The ophthalmological examination performed on 89 children (97.9 %) revealed retinal hemorrhages in 57 children (89.8 %). The incidence of AHT doubled during the months of COVID-19 lockdowns (rate ratio = 2; 95 % CI [1.1; 3.6], p = 0.03). No difference in monthly incidence was observed for IST and USL groups. CONCLUSION: A significant increase in AHT was observed during the months with lockdowns and curfews during the COVID-19 pandemic. This highlights the need for developing a national strategy to prevent physical abuse in children in this context.

Physical abuse in adolescents during the COVID-19 pandemic

Covid-19 has now spread to almost all parts of the world which has caused changes in the social order of life for humans. The spread of Covid-19 in Indonesia is relatively high, so the Indonesian government has adopted a policy using social distancing (large-scale social restrictions). Various pressures experienced by residents tend to result in exces-sive stress and emotions. This can have an impact on the occurrence of violence in families and generally the victims are ado-lescents. Physical abuse is an act that can cause physical pain such as slapping, stran-gling, hitting, kicking, stabbing, twisting the arm, threats with sharp weapons or weapons, and murder. The method used in this research is descriptive analytical method. The research sample was 192 people from various provinces in Indonesia aged 10-24 years. The results of this study revealed that some of the physical abuse behaviors were obtained by adolescents at elementary school age, namely in the age range of 10 years or more with details, including hard encouragement by others with a total of 48 (25.0%), getting hit with a hand with a total of 38 (52.8%), getting slapped by other people with a total of 43 (22.4%), getting hit with a hard object from another person with a total of 22 (11.5%), having been pushed and also being arrested with a total of 16 (8.4%), having been pelt-ed with something painfully from others with a total of 24 (12.5%), and had received treatment in the form of being bitten, punched, and kicked by another person with a total of 26 (13.5%). Physical abuse can have long-term effects, such as physical and psychological disturbances from the teenag-er, which can even lead to death. In addition, physical abuse can also cause adolescents to experience mental disorders such as depression and show traumatic symptoms. Copyright © the Author(s),2022 Licensee PAGEPress, Italy.

The impact of experiencing severe physical abuse in childhood on adolescent refugees' emotional distress and integration during the COVID-19 pandemic.

Background: Accumulating evidence highlights the importance of pre- and post- migration stressors on refugees' mental health and integration. In addition to migration-associated stressors, experiences earlier in life such as physical abuse in childhood as well as current life stress as produced by the COVID-19-pandemic may impair mental health and successful integration - yet evidence on these further risks is still limited. The present study explicitly focused on the impact of severe physical abuse in childhood during the COVID-19 pandemic and evaluated the impact of these additional stressors on emotional distress and integration of refugees in Germany. Methods: The sample included 80 refugees, 88.8% male, mean age 19.7 years. In a semi-structured interview, trained psychologists screened for emotional distress, using the Refugee Health Screener, and integration status, using the Integration Index. The experience of severe physical abuse in childhood was quantified as a yes/no response to the question: "Have you been hit so badly before the age of 15 that you had to go to hospital or needed medical attention?" Multiple hierarchical regression analyses further included gender, age, residence status, months since the start of the COVID-19 pandemic and length of stay in Germany to predict emotional distress and integration. Results: Two regression analyses determined significant predictors of (1) emotional distress (adjusted R 2 = 0.23): duration of being in the pandemic (ß = 0.38, p < 0.001) and severe physical abuse in childhood (ß = 0.31, p = 0.005), and significant predictors of (2) integration (adjusted R 2 = 0.53): length of stay in Germany (ß = 0.62, p < 0.001), severe physical abuse in childhood (ß = 0.21, p = 0.019) and emotional distress (ß = -0.28, p = 0.002). Conclusion: In addition to migration-associated stressors, severe physical abuse in childhood constitutes a pre-migration risk, which crucially affects the well-being, emotional distress and integration of refugees in Germany.

Abuse of Marginalized Older Adults during COVID-19: Proxy Findings from the Canadian Longitudinal Study on Aging

Child and spousal abuse rates tend to increase during various disasters. This study sought to determine the prevalence and determinants of older adults' experiences of increased verbal or physical conflict (+VPC) as a proxy for elder abuse during the COVID-19 pandemic. Data stem from the Canadian Longitudinal Study on Aging (CLSA), a prospective cohort study of 51,338 Canadians aged 45-85 at baseline. We analyzed the data of participants aged 55 or older at core follow-up 1 who also participated in a CLSA COVID-19 substudy (n = 24,306). Experiencing +VPC was the main outcome variable;explanatory variables included gender identity, sexual orientation, age group, race/ethnicity, educational attainment, marital status, household income, working status, living arrangement (alone vs. with others), social support availability, cohesion in the community, self-rated health, anxiety, depression, and previous history of elder abuse. The overall weighted prevalence of +VPC was 7.4%. Gay/bisexual men, 55-64 age group, living with others, low social support, poor social cohesion, low self-rated health, poor mental health, and history of psychological or physical abuse were each significantly associated with +VPC. Weighted multivariable logistic regression revealed that male gender, living with others, higher depression and anxiety scores, and a history of psychological abuse were independent predictors of +VPC. Implications for postpandemic recovery and prevention strategies during future disasters include targeted outreach programs for the most vulnerable group, which included males and younger older adults between 55 and 64 years as well as those with mental health issues and/or history of elder psychological abuse.

Elder abuse in the COVID-19 era based on calls to the National Center on Elder Abuse resource line.

BACKGROUND: The COVID-19 pandemic has exacerbated circumstances that place older adults at higher risk for abuse, neglect, and exploitation. Identifying characteristics of elder abuse during COVID-19 is critically important. This study characterized and compared elder abuse patterns across two time periods, a one-year period during the pandemic, and a corresponding one-year period prior to the start of the pandemic. METHODS: Contacts (including social media contacts, and email; all referred to as "calls" for expediency) made to the National Center on Elder Abuse (NCEA) resource line were examined for differences in types of reported elder abuse and characteristics of alleged perpetrators prior to the pandemic (Time 1; March 16, 2018 to March 15, 2019) and during the pandemic (Time 2; March 16, 2020 to March 15, 2021). Calls were examined for whether or not abuse was reported, the types of reported elder abuse, including financial, physical, sexual, emotional, and neglect, and characteristics of callers, victims, and alleged perpetrators. Chi-square tests of independence compared frequencies of elder abuse characteristics between time periods. RESULTS: In Time 1, 1401 calls were received, of which 795 calls (56.7%) described abuse. In Time 2, 1009 calls were received, of which 550 calls (54.5%) described abuse. The difference between time periods in frequency of abuse to non-abuse calls was not significant ([Formula: see text]). Time periods also did not significantly differ with regard to caller, victim, and perpetrator characteristics. Greater rates of physical abuse ([Formula: see text] and emotional abuse ([Formula: see text] were reported during Time 2 after adjustment for multiple comparisons. An increased frequency of multiple forms of abuse was also found in Time 2 compared to Time 1 ([Formula: see text]. CONCLUSIONS: Findings suggest differences in specific elder abuse subtypes and frequency of co-occurrence between subtypes between time periods, pointing to a potential increase in the severity of elder abuse during COVID-19.

DOMESTIC ABUSE AND/OR VIOLENCE (DA/V) REPORTING BY SERVICE USERS (SUS) OF A REGIONAL ONLINE SEXUALLY TRANSMITTED INFECTION (STI) TESTING SERVICE (E-SERVICE), DURING THE COVID-19 PANDEMIC

Introduction DA/V increased over the pandemic Our e-service widened access during the crisis and introduced three questions to adult SUs enquiring about DA/V. An analysis of SUs triggering these questions is provided. Method E-notes review of SUs who triggered question(s) about current DA/DV, whilst ordering a kit between 17.8.21- 28.2.22. SUs that trigger are automatically offered access to supportive online information. The e-service team don't directly contact these SUs unless there's another reason (e.g. relaying positive STI results). If safe to do so, the triggers are discussed during these calls and further support/counselling offered. Results 3846/231460(1.7%) SU triggered DA/V question(s) between 17.8.21-28.2.22. The first 202 SU e-notes were reviewed: median age 28yrs (18-73yrs);66%(134/202) female;72%(145/202) heterosexual;75%(152/202) UK born. 264 triggers were selected: 27%(55/202) physical/emotional abuse, 81%(164/202) coercive control, and 22%(45/202) sexual abuse. Ten (5%) SUs triggered three DA/V questions, 42(21%) two and 150(74%) one. STI positivity was 4%. 77%(156/202) engaged in high-risk activity. 26%(52/202) had never visited a clinic. Telephonic discussion with the e-service took place in 10%(20/202) SUs: 50%(10/20) received counselling/signposting;10%(2/20) referred to independent DA/V advocate, 30% (6/20) stated historic abuse, 10%(2/20) mistakenly triggered, 5%(1/10) declined support for current abuse and 5%(1/10) disengaged. Of 29%(58/202) SUs who ordered further e-kit(s) 38%(22/58) continued to trigger and 9%(5/58) disclosed sexual assault. Discussion 1.7% SUs reported current DA/V. After attempted contact a supportive DA/V discussion was accepted by 80% SUs. Despite providing online support 38% continued to disclose abuse. Efforts to explore/evaluate safe methods of engaging and supporting DA/V survivors using e-services are required.

Fibromyalgia syndrome: year in review

The aim of this review is to describe the most recent findings concerning the diagnosis, aetiopathogenesis and treatment of fibromyalgia syndrome (FM) that were published between January 2021 and January 2022 and appearing on PubMed database. Year 2021 saw the publication of many papers which tried to estimate the big COVID-19 impact on FM patient's lives, both from a physical and a mental point of view (1-3). Moreover, more and more attention has been put on juvenile fibromyalgia, which is surging as a distinct clinical entity which needs prompt diagnosis (4), and, as the adult counterpart, if it is comorbid with a rheumatic disease, it increases the perception of disease activity with respect to physician's evaluation. The most important publications last year were centered on the aetiopathogenesis of FM. One of the things that has to be kept in mind is the extreme importance of trauma in the life of these individuals. An interesting metaanalysis by Kaleycheva et al. (5) comprising nineteen studies confirms that there is a significant association between stressor exposure and adult FM, with the strongest associations observed for physical abuse (physical abuse (OR 3.23, 95% confidence interval 1.99-5.23) and total abuse (3.06, 1.71-5.46);intermediate for sexual abuse (2.65, 1.85-3.79) and smaller for medical trauma (1.80, 1.19-2.71), other lifetime stressors (1.70, 1.31-2.20), and emotional abuse (1.52, 1.27-1.81)). In addition, an autoantibody-centered theory is now developing. The most important recent study in this perspective comes from a study by Goebel et al. published on Journal of Clinical Investigation (6). Researchers found that mice treated with IgG from FM patients displayed increased sensitivity to noxious mechanical and cold stimulation, and nociceptive fibers in skin-nerve preparations from mice treated with FM IgG displayed an increased responsiveness to cold and mechanical stimulation. From the therapeutic point of view, few studies worth mentioning focused on the pharmacological treatment of FM;in particular, well-conducted clinical trials were about ketamine and low-dose naltrexone (7, 8). Most of 2021 studies focused on neurostimulation in FM patients, in particular on repetitive transcranial magnetic stimulation (rTMS) or direct current stimulation (DCS) (9, 10 etc.).

Prevalence of Child Maltreatment during the COVID-19 Pandemic: A Cross-sectional Survey of Rural Hubei, China

The prevalence of child maltreatment is quite high during the coronavirus disease 2019 pandemic in rural Hubei province, and children from vulnerable families are at greater risk of self-harm behaviours. The impact of lockdown measures in Wuhan, China during the coronavirus disease 2019 pandemic on child maltreatment remains unknown. The present study attempted to estimate the prevalence of child maltreatment during this period, to identify risk factors, and the influence of child maltreatment. A representative sample of 1,062 school-aged children in rural Hubei province was surveyed. Results indicated that the prevalence of family violence, physical violence, emotional abuse and neglect during the lockdown period were 13.9, 13.7, 20.2 and 7.3 percent, respectively, and that of lifetime prevalence were 17.0, 13.9, 14.6 and 6.9 percent, respectively. And most victims did not seek official help. Boys were more likely to experience physical violence. Children from separated/divorced families tended to report more emotional abuse. Those having family members with a history of drug abuse and mental illness were more likely to experience neglect during the lockdown period. All types of child maltreatment were positively associated with self-harm behaviours. These findings highlight the importance of identifying at-risk children immediately and implementing timely intervention programmes to prevent self-harm behaviours for social workers and health professionals.

Sleep reactivity as a potential pathway from childhood abuse to adult insomnia.

BACKGROUND: Survivors of childhood abuse are prone to adult insomnia, but the mechanisms for this development are poorly understood. Abuse that occurs during sensitive developmental periods might affect risk for insomnia by impacting emerging stress regulatory processes. Sleep reactivity refers to the sensitivity of the sleep system to stress and is a robust risk factor for insomnia. Recent evidence shows stress exposure itself worsens sleep reactivity, thereby increasing insomnia vulnerability. In this preliminary study, we hypothesized the association between childhood abuse experiences and adult insomnia would be mediated through greater sleep reactivity. METHODS: Community adults were recruited from the United States during the COVID-19 pandemic between June 2020 and June 2021 (N = 241, 88% female, Mage = 39, SD = 13.40). Participants completed a cross-sectional survey that included the Childhood Trauma Questionnaire, Ford Insomnia Response to Stress Test, Insomnia Severity Index, and a measure of general COVID-19 stress. RESULTS: Reporting more frequent childhood emotional, physical, or sexual abuse was associated with more severe insomnia during the COVID-19 pandemic. Only childhood emotional and physical (but not sexual) abuse histories were associated with greater sleep reactivity, which exerted an indirect effect on the relationships between these two abuse types and insomnia symptoms. These findings were robust to the effects of gender, age, and stress about the COVID-19 pandemic. CONCLUSIONS: This preliminary study suggests recurrent emotional and physical abuse in childhood might promote later insomnia through heightened sleep reactivity. Stress management interventions could be important to prevent insomnia for abuse survivors by bolstering resilience of the sleep system.

Child maltreatment-related children's emergency department visits before and during the COVID-19 pandemic in Connecticut.

BACKGROUND: Previous studies of national emergency department (ED) data demonstrate a decrease in visits coded for physical abuse during the pandemic period. However, no study to date has examined the incidence of multiple child maltreatment types (physical abuse, sexual abuse, and neglect), within a single state while considering state-specific closure policies. Furthermore, no similar study has utilized detailed chart review to identify cases, nor compared hospital data to Child Protective Services (CPS) reports. OBJECTIVE: To determine the incidence of child maltreatment-related ED visits before and during the COVID-19 pandemic, including characterizing the type of maltreatment, severity, and CPS reporting. PARTICIPANTS AND SETTING: Children younger than 18 years old at two tertiary-care, academic children's hospitals in X state. METHODS: Maltreatment-related ED visits were identified by ICD-10-CM codes and keywords in chief concerns and provider notes. We conducted a cross-sectional retrospective review of ED visits and child abuse consultations during the pre-COVID (1/1/2019-3/15/2020) and COVID (3/16/2020-8/31/2020) periods, as well as state-level CPS reports for suspected maltreatment. RESULTS: Maltreatment-related ED visits decreased from 15.7/week in the matched pre-COVID period (n = 380 total) to 12.3/week (n = 296 total) in the COVID period (P < .01). However, ED visits (P < .05) and CPS reports (P < .001) for child neglect increased during this period. Provider notes identified 62.4% of child maltreatment ED visits, while ICD-10 codes identified only-CM captured 46.8%. CONCLUSION: ED visits for physical and sexual abuse declined, but neglect cases increased during the COVID-19 pandemic in X state.

The incidence and characteristics of inpatient child protection concern cases during the COVID-19 lockdown

Background: Known risk factors for child maltreatment, including parental unemployment and domestic violence (1, 2), were compounded by social isolation from school closures and restriction of home visitors during the COVID-19 lockdown. Data on the incidence of child maltreatment during the pandemic is limited. Aim: Our study aimed to compare the incidence of and characterize the types of child protection concerns among inpatients during the 2020 lockdown versus the same period in 2019. Methods: We carried out a retrospective chart review of inpatients at Children's Health Ireland (CHI) at Crumlin and CHI at Tallaght assessed for child protection concerns during the lockdown from March 13 to August 31, 2020, and the same timeframe in 2019. Results: Fewer patients with child protection concern were admitted in 2020 (n=86) compared to 2019 (n=163). Total admissions were also less in 2020 (n=4609) compared to 2019 (n=7728). Patients assessed for child protection concerns accounted for a smaller percentage of inpatients in 2020 (1.8% versus 2.1% in 2019 (p=0.35)). In 2020, there was a greater percentage of physical (52.3% versus 11% in 2019 (p<.001)) and emotional (6.9% versus 1.2% in 2019 (p=0.014)) abuse concern cases. There was also a greater percentage of neglect and sexual abuse concern cases and a lower percentage of welfare concern cases in 2020, but these differences were not statistically significant. The cases in 2020 were more complex, with 48.8% involving more than one concern type per case versus 13.4% in 2019 (p<.001). Child protection concerns increased steadily during the lockdown, peaking in July. In 2020, there were more unwitnessed injuries (34.8% versus 17.7% in 2019 (p=.002)) and parental use of physical discipline (6.9% versus 0.6% in 2019 (p=.003)). No statistically significant differences in delayed presentation and domestic violence were observed. Conclusions: While fewer inpatients were assessed for child protection concerns during the 2020 lockdown versus 2019, the 2020 cases were more complex. An increase in physical and emotional abuse concerns, unwitnessed injuries and physical disciplining highlights child protection issues specific to the pandemic.

Adverse childhood experience and adult persistent pain and disability: protocol for a systematic review and meta-analysis.

BACKGROUND: A growing body of research highlights the pervasive harms of adverse childhood experiences (ACEs) on health throughout the life-course. However, findings from prior reviews and recent longitudinal studies investigating the association between types of ACEs and persistent pain have yielded inconsistent findings in the strength and direction of associations. The purpose of this review is to appraise and summarize evidence on the relationship between ACEs and persistent pain and disability outcomes in adulthood. The specific aims are (1) to determine whether there is a relationship between exposure to ACE and persistent pain and disability in adults and (2) to determine whether unique and cumulative ACEs exposures (number and type) increase the risk of developing persistent pain and disability in adulthood. METHOD: A systematic review and meta-analysis of observational studies will be conducted. Our eligibility criteria are defined following a PECOS approach: population, adults with persistent (≥ 3 months) musculoskeletal and somatoform painful disorders exposed to single or cumulative direct ACEs alone (i.e., physical, sexual, emotional abuse or neglect) or in combination to indirect types of ACE (e.g., parental death, exposure to domestic violence) in the first 18 years of life; comparators, unexposed individuals; outcomes, measurements for persistent pain (≥ 3 months) and disability using discrete and/or continuous measures; and settings, general population, primary care. A comprehensive search of MEDLINE (Ovid) and nine other pertinent databases was conducted from inception to 29 August 2019 using a combination of key words and MeSh terms (the search will be updated prior to conducting the analyses). Pairs of reviewers will independently screen records and full text articles, and a third reviewer will be consulted in cases of disagreement. Data will be extracted using Endnote and Covidence and a meta-analysis will be conducted using Review Manager (RevMan) Version 5.3. The Scottish Intercollegiate Guidelines Network (SIGN) and the Joanna Briggs Institute (JBI) checklists will be used to assess the quality of the included studies. If heterogeneity is high, the findings will be presented in narrative form. DISCUSSION: The present review will help consolidate knowledge on persistent pain and disability by evaluating whether frequency and type of adverse childhood experiences produces the most harm. Findings may help inform practitioners and policy-makers who endeavor to prevent and/or mitigate the consequences of ACEs and promote healthy development and well-being of children, youth, and families. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42020150230.

Evaluation of the impact of the COVID-19 pandemic on the reporting of maltreatment cases to the National Family Safety Program in Saudi Arabia.

INTRODUCTION: The COVID-19 pandemic represents a global and nationwide public health crisis. Although protective, socially restrictive measures may cause social isolation, which amounts to an increased ecological risk for mental health disturbance in vulnerable populations. Previous reports have suggested a significant association between the occurrence of public health crises and increased rates of multiple risk factors related to child mental health disturbances, domestic violence, and child-maltreatment. METHODOLOGY: We conducted a retrospective data review of reported child maltreatment cases from the National Family Safety Program during the period of September 2019 to September 2020. A descriptive analysis approach was used to compare rates before and during the COVID-19 pandemic. RESULTS: During COVID-19, abuse was significantly more reported by a family member than by the victims themselves or by a healthcare worker. However, before COVID-19, the offender was less often reported to be known to the victim; was both parents or the mother but was more often described as male, older, single, less educated; and currently unemployed with no significant change observed in their health status (p < 0.001). Interestingly, the predicted type of abuse also significantly differed and was more emotional or sexual than other types (p < 0.001). CONCLUSION: The types of abuse and the characteristics of both abused children and offenders saw significant changes during the COVID-19 pandemic. Sexual and emotional abuses were reported more frequently, and the male gender is considered to feature more commonly in reports prior to the pandemic era than during the pandemic.