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1.
Inj Prev ; 29(3): 207-212, 2023 06.
Article in English | MEDLINE | ID: covidwho-2322078

ABSTRACT

BACTERKGROUND: There is debate on whether cannabis affects road traffic injuries (RTIs) separately from the effects of alcohol. Our goals are to report the possible increase in risk of an RTI among alcohol and cannabis users by type of exposure (biological, self-reported and combined) and the possible interaction of alcohol and cannabis in patients with an RTI in an emergency department in Mexico City. METHODS: A case-crossover study with 433 cases of RTI (as a pedestrian, driver or passenger) during the period January-April 2022. A breath sample, an oral sample for cannabis detection and self-reported alcohol and cannabis use 6 hours prior to the RTI and in two control periods were used. We report ORs and 95% CIs from conditional logistic regressions for the case-crossover estimates. RESULTS: Alcohol alone increased the risk of an RTI (OR=6.02, 95% CI 3.29 to 10.99) for most RTIs, regardless of whether we used information from self-reports or a breath sample in the hazard period. Conversely, cannabis only increased the RTI when we added information in the hazard period from self-reports or oral samples. Nevertheless, this increase in risk disappeared (OR=2.06, 95% CI 0.90 to 4.70) among those who only used cannabis. We also found no evidence of interaction between alcohol and cannabis in the risk of an RTI. CONCLUSIONS: Alcohol is the most commonly used substance in Mexico and a high-risk factor for RTI in Mexico City. Although cannabis alone was not associated with an RTI, continuous monitoring of its effects is required.


Subject(s)
Cannabis , Wounds and Injuries , Humans , Accidents, Traffic/prevention & control , Cannabis/adverse effects , Mexico/epidemiology , Cross-Over Studies , Risk Factors , Wounds and Injuries/epidemiology
2.
Am J Emerg Med ; 68: 155-160, 2023 06.
Article in English | MEDLINE | ID: covidwho-2319448

ABSTRACT

INTRODUCTION: Children under the age of 5 years suffer from the highest rates of fall-related injuries. Caretakers often leave young children on sofas and beds, however, falling and rolling off these fixtures can lead to serious injury. We investigated the epidemiologic characteristics and trends of bed and sofa-related injuries among children aged <5 years treated in US emergency departments (EDs). METHODS: We conducted a retrospective analysis of data from the National Electronic Injury Surveillance System from 2007 through 2021 using sample weights to estimate national numbers and rates of bed and sofa-related injuries. Descriptive statistics and regression analyses were employed. RESULTS: An estimated 3,414,007 children aged <5 years were treated for bed and sofa-related injuries in emergency departments (EDs) in the United States from 2007 through 2021, averaging 115.2 injuries per 10,000 persons annually. Closed head injuries (30%) and lacerations (24%) comprised the majority of injuries. The primary location of injury was the head (71%) and upper extremity (17%). Children <1 year of age accounted for most injuries, with a 67% increase in incidence within the age group between 2007 and 2021 (p < 0.001). Falling, jumping, and rolling off beds and sofas were the primary mechanisms of injury. The proportion of jumping injuries increased with age. Approximately 4% of all injuries required hospitalization. Children <1 year of age were 1.58 times more likely to be hospitalized after injury than all other age groups (p < 0.001). CONCLUSION: Beds and sofas can be associated with injury among young children, especially infants. The annual rate of bed and sofa-related injuries among infants <1 year old is increasing, which underscores the need for increased prevention efforts, including parental education and improved safety design, to decrease these injuries.


Subject(s)
Lacerations , Wounds and Injuries , Infant , Child , Humans , United States/epidemiology , Child, Preschool , Retrospective Studies , Lacerations/epidemiology , Hospitalization , Emergency Service, Hospital , Wounds and Injuries/epidemiology , Wounds and Injuries/etiology , Wounds and Injuries/therapy
3.
preprints.org; 2023.
Preprint in English | PREPRINT-PREPRINTS.ORG | ID: ppzbmed-10.20944.preprints202305.1168.v1

ABSTRACT

The restrictions imposed by the Covid-19 pandemic left many older adults isolated and confined. Under active aging theory, self-management is crucial for well-being among older adults coping with aging. The current study examines how (a) initial self-management, and (b) changes in self-management due to independent physical training, affect psychological outcomes in a sample of care home residents following outbreak of the pandemic. 64 older adults (53 females, 11 males), mean age is 82.23, reported on their self-management abilities, then embarked on six months of training in chair exercises (one session per week). The training exercises were halted after 22 sessions due to the pandemic, but some residents continued to practice independently. Eight weeks after the outbreak of the pandemic, residents who had continued to practice at least once per week (n = 35) and those who had not continued to practice (n = 29) were questioned again about their self-management, and about five psychological outcomes: anxiety, traumatic stress, satis-faction, general mood, and post-traumatic growth (PTG). Self-management improved among older adults who independently practiced the exercises, and declined among those who did not. Pre-pandemic self-management significantly predicted post-outbreak traumatic stress symptoms, anxiety, general mood, and satisfaction with life, but not PTG. However, the difference in self-management between the pre-pandemic and post-outbreak measures was associated with PTG, and made a unique contribution to prediction of the other effects. Self-management abilities among older adults can be seen as a protective factor against adverse psychological outcomes at times of trauma. Further, the improvement in self-management among older adults who independently practiced physical excises made a unique contribution beyond initial self-management abilities.


Subject(s)
Anxiety Disorders , Growth Disorders , Wounds and Injuries , Stress Disorders, Traumatic , COVID-19
4.
researchsquare; 2023.
Preprint in English | PREPRINT-RESEARCHSQUARE | ID: ppzbmed-10.21203.rs.3.rs-2906566.v1

ABSTRACT

Objectives: This study aimed to examine whether having adverse childhood experiences (ACEs) was associated with living in a deprived area in adulthood.  Methods: The cross-sectional study was conducted by using nationwide data in 2022 of the Japan COVID-19 and Society Internet Survey (JACSIS). Participants were community dwelling people 18 years or older. ACEs were assessed by Japanese version of 15-items ACE measurement tool (ACE-J). Living condition was measured by Area Deprived Index (ADI) and Densely Inhabited District (DID) based on zip code. Multivariable logistic regression to analyze the associations between ADI and ACE 4+ was conducted, controlling for individual-level factors, such as age, sex, marital status, and education, as an additional analysis.  Results: The total of 27,967 participants were included in the analysis. The prevalence of emotional neglect, childhood poverty, and school bullying were 34.5%, 21.9%, 20.0%, respectively. More than 70.1% of the population had one or more ACE(s). The number of ACEs was associated with significantly higher risk of living in deprived area in the adulthood (p<0.001). ACEs were not associated with living in density area. The association between ADI and ACEs 4+ was non-significant after controlling the individual-level factors.  Conclusion: People with higher number of ACEs tend to live in deprived areas in adulthood. Policy makers in highly deprived areas can apply the trauma-informed approach for the community care and support, which is critical to mitigating deficit perspectives and facilitating comprehensive support for those who experience ACEs.


Subject(s)
Wounds and Injuries , COVID-19
5.
Child Abuse Negl ; 140: 106186, 2023 06.
Article in English | MEDLINE | ID: covidwho-2293690

ABSTRACT

BACKGROUND: The possibility that child maltreatment was misclassified as unintentional injury during the COVID-19 pandemic has not been evaluated. OBJECTIVE: We assessed if child maltreatment hospitalizations changed during the pandemic, and if the change was accompanied by an increase in unintentional injuries. PARTICIPANTS AND SETTING: This study included children aged 0-4 years who were admitted for maltreatment or unintentional injuries between April 2006 and March 2021 in hospitals of Quebec, Canada. METHODS: We used interrupted time series regression to estimate the effect of the pandemic on hospitalization rates for maltreatment, compared with unintentional transport accidents, falls, and mechanical force injuries. We assessed if the change in maltreatment hospitalization was accompanied by an increase in specific types of unintentional injury. RESULTS: Hospitalizations for child maltreatment decreased from 16.3 per 100,000 (95 % CI 9.1-23.4) the year before the pandemic to 13.2 per 100,000 (95 % CI 6.7-19.7) during the first lockdown. Hospitalizations for most types of unintentional injury also decreased, but injuries due to falls involving another person increased from 9.0 to 16.5 per 100,000. Hospitalization rates for maltreatment and unintentional injury remained low during the second lockdown, but mechanical force injuries involving another person increased from 3.8 to 8.1 per 100,000. CONCLUSIONS: Hospitalizations for child maltreatment may have been misclassified as unintentional injuries involving another person during the pandemic. Children admitted for these types of unintentional injuries may benefit from closer assessment to rule out maltreatment.


Subject(s)
Accidental Injuries , COVID-19 , Child Abuse , Wounds and Injuries , Child , Humans , Infant , Pandemics , Accidents , COVID-19/epidemiology , Communicable Disease Control , Hospitalization , Wounds and Injuries/epidemiology
7.
researchsquare; 2023.
Preprint in English | PREPRINT-RESEARCHSQUARE | ID: ppzbmed-10.21203.rs.3.rs-2806617.v1

ABSTRACT

Systemic barriers contribute to attrition from K-12 education contexts and later involvement in adult education centers, especially among students from minoritized backgrounds. To assess the impact of stress-related risk factors, including trauma exposure and COVID-19-related stress, on ABE students and their barriers to academic and vocational success. Survey methods were used for data collection, and analysis of variance and structural equation modeling were used to test hypotheses. Results showed that past traumatic experiences were more common among ABE students who reported greater social or economic marginalization, especially those identifying as lesbian, gay, or bisexual or with a history of being unhoused. We observed that more traumatic experiences predicted higher COVID-19-related stress and alcohol misuse. Higher COVID-19-related stress, in turn, predicted lower job confidence. ABE students experiencing marginalization face compounded barriers to educational and vocational goals with trauma exposure and COVID-19-related stress. Based on findings, practice recommendations for ABE centers include targeted psychoeducational resources to offset systemic stressors and bolster academic and vocational attainment, such as on-site service delivery and using ABE centers as service system access points.


Subject(s)
Wounds and Injuries , COVID-19
8.
researchsquare; 2023.
Preprint in English | PREPRINT-RESEARCHSQUARE | ID: ppzbmed-10.21203.rs.3.rs-2800664.v1

ABSTRACT

Background Disparities in COVID-19 disease outcomes exist in Hispanic individuals, especially those with pre-existing health conditions. Infected individuals can develop “long COVID” with sustained impacts on overall quality of life. The goal of this study was to investigate the impact of COVID-19 infection and long COVID in Hispanic individuals and identify immune and endothelial factors that are associated with COVID-19 outcomes.Methods 112 participants in Riverside County, California, were recruited and categorized according to the following criteria: healthy control (n = 23), moderate infection (outpatient, n = 33), and severe infection (hospitalized, n = 33). Differences in outcomes between Hispanic and non-Hispanic individuals and presence/absence of comorbidities were evaluated. Circulating immune and vascular biomarkers and immune cell subsets were measured by ELISA, multiplex analyte assays, and flow cytometry. Follow-up assessments for long COVID, lung health, and immune and vascular changes were conducted (n = 23) including paired analyses of the same participants.Results Compared to uninfected controls, the severe infection group had a higher proportion of Hispanic individuals (n = 23, p = 0.012), but there was no difference between uninfected controls and those with moderate infection (n = 8, p = 0.550). Disease severity was associated with changes in innate monocytes and neutrophils and lymphopenia, disrupted cytokine production (increased IL-8 and IP-10/CXCL10 but reduced IFNλ2/3 and IFNγ), and increased endothelial injury (myoglobin, VCAM-1). In the severe infection group, integration of parameters through machine learning identified NGAL/LCN2, IL-6, and monocyte activation as parameters associated with fatality, whereas anti-coagulant therapy was linked to survival. Recovery from moderate COVID infection resulted in long-term immune changes including increased monocytes/lymphocytes and decreased neutrophils and endothelial markers. This group had a lower proportion of comorbidities (n = 8, p = 1.0) but still reported symptoms associated with long COVID despite recovered lung health.Conclusion This study indicates increased severity of COVID-19 infections in Hispanic individuals of Riverside County, California. Infection resulted in immunological and vascular changes and long COVID symptoms that were sustained for up to 11 months, however, lung function (volume and airflow resistance) was recovered. Given the behavioral and immune impacts of long COVID, the potential for increased susceptibility to infections and decreased quality of life, especially in high-risk populations, warrants further investigation.


Subject(s)
Wounds and Injuries , Lymphopenia , COVID-19
9.
medrxiv; 2023.
Preprint in English | medRxiv | ID: ppzbmed-10.1101.2023.03.17.23287413

ABSTRACT

Purpose Increases in pediatric firearm-related injuries during the COVID-19 pandemic may be due to changes in where children and adolescents spent their time. This paper examines changes in the frequency of pediatric firearm-related encounters as a function of schooling mode overall and by race/ethnicity and age group at a large trauma center through 2021. Methods We use data from a large pediatric and adult trauma center in Tennessee from January 2018 to December 2021 (N=211 encounters) and geographically linked schooling mode data. We use Poisson regressions to estimate smoothed monthly pediatric firearm-related encounters as a function of schooling mode overall and stratified by race and age. Results Compared to pre-pandemic, we find a 42% increase in pediatric encounters per month during March 2020 to August 2020, when schools were closed, and a 23% increase in encounters after schools returned to in-person instruction. Effects of schooling mode are heterogeneous by race. Encounters increased among non-Hispanic Black children and adolescents across all periods relative to pre-pandemic. Among non-Hispanic white children and adolescents, encounters increased during the closure period and decreased on return to in-person instruction. Effects of schooling mode are also heterogeneous by age. Relative to pre-pandemic, pediatric firearm-related encounters increased 205% for children aged 5 to 11 and 69% for adolescents aged 12 to 15 during the school closure period. Conclusion COVID-19-related changes to school instruction mode in 2020 and 2021 are associated with changes in the frequency and composition of pediatric firearm-related encounters at a major trauma center in Tennessee.


Subject(s)
Wounds and Injuries , COVID-19
11.
researchsquare; 2023.
Preprint in English | PREPRINT-RESEARCHSQUARE | ID: ppzbmed-10.21203.rs.3.rs-2693861.v1

ABSTRACT

There has been accumulating interest in the association of religion with mental status in adolescents. However, the impact of the interaction between religion and stress on adolescents remains unclear. This study aims to investigate the psychiatric symptoms among religious adolescents at the beginning of the COVID-19 epidemic in China. A total of 11,603 Chinese adolescents were recruited in this survey. The Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 Scale (GAD-7), the Connor-Davidson Resilience Scale (CD-RISC), and the Childhood Trauma Questionnaire (CTQ) were assessed for all adolescents. Of 11,069 valid questionnaires collected, 847 (7.7%) reported holding religious beliefs. Religious adolescents showed significantly more severe depressive and anxiety symptoms compared to non-religious adolescents. 249 (2.2%) reported exposure to COVID-19 and had more severe depressive and anxiety symptoms as compared to those without such exposure. Logistic regression analysis revealed that religiosity was a risk factor for the symptoms of depression (OR = 1.37, 95%CI: 1.16–1.61, p < 0.001) and anxiety (OR = 1.49, 95%CI: 1.23–1.79, p < 0.001). Our finding suggests that religious adolescents easily develop depressive and anxiety symptoms, compared to non-religious adolescents. Parents and education workers should regularly monitor adolescents with religious beliefs, especially those who had poor parent-child relationships and emotional or physical abuse.


Subject(s)
Anxiety Disorders , Mental Disorders , Depressive Disorder , Wounds and Injuries , COVID-19
12.
medrxiv; 2023.
Preprint in English | medRxiv | ID: ppzbmed-10.1101.2023.03.11.23287138

ABSTRACT

Objectives, the goal of this study was to investigate the correlation between SARS-CoV-2 infection and muscle injuries among a large sample of professional soccer players. Methods, A retrospective cohort study was conducted on professional soccer players from the Serie A and LaLiga leagues during the 2019-2020 and 2020-2021 football seasons. The players were divided into two groups based on whether they contracted the Sars-CoV-2 infection (C+) or not (C-) during the 2020/2021 season. Data collection was conducted using the Transfermarkt24 site. Results, In the 2019-2020 both championships showed non-significant differences in the average number of muscular injuries between the C+ group and the C- group (Serie A: p=0.194; 95%CI: -0.044 to 0.215, LaLiga p=0.915; 95%CI: -0.123 to 0.137). In the 2020-2021 the C+ group had a significantly higher number of muscular injuries compared to the C- group in both championships (Serie A: p<0.001; 95%CI 0.731 to 1.038; LaLiga: p<0.001; 95%CI: 0.773 to 1.054). Multiple linear regression analysis confirmed that belonging to C+ in the season 2020/2021 was the variable that most strongly influenced the probability of having a muscle injury in both championships. Survival analysis revealed a hazard ratio of 3.73 (95%CI 3.018 to 4.628) and of 5.14 (95% CI 3.200 to 8.254) for Serie A and LaLiga respectively. Conclusions This retrospective cohort study revealed a significant association between SARS-CoV-2 infection and increased risk of muscle injury, emphasizing the importance of carefully considering the infection in the decision-making process for determining athletes' readiness to return to sport.


Subject(s)
Wounds and Injuries , Muscular Diseases , COVID-19
13.
researchsquare; 2023.
Preprint in English | PREPRINT-RESEARCHSQUARE | ID: ppzbmed-10.21203.rs.3.rs-2679095.v1

ABSTRACT

Background: Understanding the epidemiology of ophthalmic presentations to emergency departments can help guide resource allocation, medical education programs, and optimize the patient experience. The purpose of this investigation was to summarize and assess the urgency of ophthalmic presentations in emergency departments (EDs) in Ontario, Canada over a 5-year period.  Methods: This was a multicentered retrospective review of all patient presentations to EDs in Ontario between January 1st, 2012, to December 31st, 2017. Presentations were included if patients had an ophthalmic related ICD-10 code as their primary problem prompting ED presentation. Patients under the age of 18 were excluded from this investigation. Results: A total of 774,057 patients patient presentations were included across the pediatric (149,679 patients) and adult (624,378 patients) cohorts. The mean (SD) age at presentation was 47.4 (17.9) years, and 6.54 (5.20) in the adult and pediatric cohorts respectively. Of the total presentations, 256,776 (33.1%) were due to a trauma related presentation. Problems pertaining to Cornea and External disease were the most common reason for presentation (51.0% of cases). Of all presentations, 34.1% were classified as either ‘emergent’ or ‘likely emergent’; the remaining presentations were either ‘non-emergent’ (39.5%) or the urgency ‘could not be determined’ (26.4%). The three most frequent presentations were due to conjunctivitis (121,175 cases or 15.7%), ocular foreign bodies (104,322 cases or 13.5%), and corneal / conjunctival abrasions (94,554 cases of 12.2%). Conclusions: This investigation summarizes all ophthalmic presentations to EDs in Ontario, Canada over a 5-year period. The results of this investigation can help guide ophthalmic related knowledge translation. Additionally, these results highlight that in Canadian EDs, a significant proportion of ophthalmic presentations are nonurgent; systems level efforts to improve access for eye-related complaints to healthcare professionals outside of the ED can help facilitate improved resource allocation. As we emerge from the COVID-19 pandemic, optimising the structure of patient care access is crucial to help alleviate the pressure from overburdened EDs while effectively meeting patient healthcare needs.


Subject(s)
Corneal Injuries , Wounds and Injuries , Conjunctivitis , COVID-19
14.
medrxiv; 2023.
Preprint in English | medRxiv | ID: ppzbmed-10.1101.2023.02.15.23286011

ABSTRACT

Background: Poverty, racism, discrimination, inadequate access to healthcare, and personal, everyday stressors lead to poor health outcomes, especially in African American families in the south. There is limited data on how these stressors are absorbed between the mother and child dyad. Objective: To assess the effects of racism, everyday stressors (i.e. motherhood), and the COVID pandemic on African American/Black mothers and their children. Methods: Utilizing the Health Belief Model, a survey was developed to assess mother-child stressors relating to three different constructs: racism/discrimination, pandemic/covid-19, and parenting. We interviewed seven black mothers and their children (aged 4-10yo). The families were recruited from a pediatric office in the rural city of Alexander City, Alabama. Interviews took place in an intimate setting and lasted for 1.5-2 hours. Medical students conducted, recorded, and transcribed each interview. The interview assessed the association between the COVID-19 pandemic, personal traumatic events, and racism and discrimination in their everyday lives. Results: Through qualitative analysis; racism, daily activities, and the COVID-19 pandemic were demonstrated to be significant stressors for the mothers. Knowledge, school/work, actions, emotions, and seriousness/susceptibility displayed stressors not only in the mom as one would expect, but in the children as well. Using the resilience model, we assessed adversity, coping strategies, and self-efficacy. As one might expect, each situation caused a different level of anxiety; however, the coping strategies varied. Some moms took to smoking to cope with it while others chose suppression. The childrens coping ranged from inconsolable crying and using outlets such as phones to cope. Conclusion: Ultimately, our qualitative approach saw an association between the pandemic and discrimination. Mothers often felt the need to shield children from the emotions attached to discrimination, and ultimately were unable to. There is a need to explore resilience and assess these stressors and changes in perception over time.


Subject(s)
Wounds and Injuries , Anxiety Disorders , COVID-19
15.
Am J Emerg Med ; 67: 56-62, 2023 05.
Article in English | MEDLINE | ID: covidwho-2230203

ABSTRACT

INTRODUCTION: The use of all-terrain vehicles (ATVs) carries significant risk of permanent injury and death, disproportionately affecting children. These injuries commonly affect the head and are especially severe among children as they are often unhelmeted and more likely than adults to experience rollover injuries. Many studies examining patients with ATV-related injuries are single-center cohort studies, with few focusing specifically on head injuries. In the present study, we aimed to characterize the annual incidence of ATV-related head injuries between 2012 and 2021, classify and compare head injury types, and identify descriptive characteristics of ATV-related head injury victims. METHODS: Using the US Consumer Product Safety Commission's National Electronic Injury Surveillance System (NEISS) database, we queried all head injuries associated with operating or riding an ATV in children under 18 years-old from over 100 emergency departments (EDs). Patient information regarding age, race, sex, location of incident, diagnoses, and sequelae were analyzed. We also collected the estimated number of ATV-related head injuries from all US EDs using the NEISS algorithm provided by the database. RESULTS: Using the NEISS algorithm we identified 67,957 (95% CI: 43,608 - 92,305) total pediatric ATV-related head injuries between 2012 and 2021. The annual incidence of ATV-related head injury was similar throughout this study period except for a 20% increase during the COVID-19 pandemic period of 2019-2021 (2019: 6382 injuries, 2020: 6757 injuries, 2021: 7600 injuries). A subset of 1890 cases from approximately 100 EDs were then analyzed. Unspecified closed head injuries were the prevailing type of injury (38%, 900/1890), followed by concussions (27%, 510/1890). More severe injuries included intracranial hemorrhages in 91 children (3.8%, 91/1890). Injuries of all types were predominantly seen in 14-17 year-old's (780/1890, 41%) and in males (64.1%, 1211/1890). In addition, ATV-associated injuries were significantly more common in those coded as white (58.0%, 1096/1890) than any other racial group. ATV-associated accidents among children younger than 9 more commonly occurred at the home compared to accidents involving children older than 9 (57% vs. 32%, p < 0.0001). CONCLUSION: ATV-related head injuries cause a significant annual burden among children, with growing incidence in recent years. Further research may wish to explore potential benefits of helmet use and supervision of younger children in possible prevention of these accidents and their associated economic and non-economic costs.


Subject(s)
COVID-19 , Craniocerebral Trauma , Off-Road Motor Vehicles , Wounds and Injuries , Male , Adult , Humans , Child , Adolescent , Pandemics , COVID-19/epidemiology , Craniocerebral Trauma/epidemiology , Craniocerebral Trauma/etiology , Accidents , Head Protective Devices , Wounds and Injuries/epidemiology , Accidents, Traffic/prevention & control , Retrospective Studies
16.
J Surg Res ; 283: 999-1004, 2023 03.
Article in English | MEDLINE | ID: covidwho-2237456

ABSTRACT

INTRODUCTION: Since the implementation of national stay-at-home orders during the COVID-19 pandemic, there has been rising concerns regarding prolonged social isolation that many individuals face. Given the link between increased stress and alcohol and drug use, our study investigated admission trends and patterns of alcohol and drug use in trauma patients. METHODS: This was a single center, retrospective cohort study comparing trauma patients admitted before the pandemic and during the first wave. We compared patient demographics, injury characteristics, and outcomes of substance screen negative, positive, and unscreened patients admitted. Patients screened positive if they had a positive urine drug screen (UDS) and/or a blood alcohol concentration (BAC) ≥10 mg/dL. RESULTS: There were 3906 trauma admissions in the year prior to and 3469 patients in the first year of the pandemic. No significant demographic differences were presented across time periods. Rates of UDS and BAC screening remained consistent. Equivalent rates of alcohol and drug positivity occurred (34% versus 33%, 17% versus 18%, P = 0.49). The total prevalence of alcohol use disorders (4% versus 5%, P < 0.001) and psychiatric disorders (6% versus 7%, P = 0.02) increased during the pandemic. CONCLUSIONS: The prevalence of diagnosed alcohol use and psychiatric disorders in trauma patients increased during the COVID-19 pandemic while rates of acute alcohol and drug screen positivity remained the same. These observations suggest a possible link between pandemic stressors and exacerbation of alcohol use and psychiatric conditions in trauma patients. During a changing pandemic landscape, it remains pertinent to increased screening for these conditions regardless of substance screen positivity upon admission.


Subject(s)
Alcoholism , COVID-19 , Wounds and Injuries , Humans , Pandemics , Blood Alcohol Content , Retrospective Studies , Trauma Centers , COVID-19/epidemiology , Ethanol , Wounds and Injuries/epidemiology
17.
Arq. ciências saúde UNIPAR ; 26(3)set-dez. 2022.
Article in Portuguese | WHO COVID, LILACS (Americas) | ID: covidwho-2205389

ABSTRACT

Introdução: A violência contra à mulher é caracterizada especialmente pela desigualdade de gênero, diferença hierárquica, subordinação e pela agressividade do parceiro ou ex-parceiro. Entre os principais subtipos, cita-se; a violência física, psicológica, sexual, patrimonial e moral. Com o surgimento da pandemia de coronavírus em 2020 na tentativa de contenção da doença, medidas protetivas como o isolamento social aumentaram o convívio familiar. Dessa forma, as vítimas de violência passaram a ficar ainda mais tempo expostas aos seus agressores e consequentemente com maiores dificuldades para denunciar os abusos sofridos, pois a prestação dos serviços públicos, instituições de segurança e judiciais também foram restringidas. Objetivo: Caracterizar os casos de violência contra a mulher em tempos de pandemia de coronavírus em um município do Sudoeste do Paraná. Materiais e métodos: Trata-se de um estudo descritivo, documental e transversal com abordagem quantitativa realizada em um município do Sudoeste do Paraná a partir da coleta de dados, por meio das fichas de notificação de violência contra a mulher entre 2019 e 2021. Resultados e discussão: O estudo demonstrou prevalência de notificações no ano de 2019 em mulheres com idade de 12 a 18 anos (27,2%), brancas (71,3%), com ensino médio (21,9%), sendo ainda estudantes (23,1%) ou desempregadas (17,2%), sem companheiro (52,4%), residentes da área urbana (74%), heterossexuais (50,6%), sem possuir algum tipo de deficiência (51,8%). Ao verificar a tipologia da agressão com maior incidência, observou-se a lesão autoprovocada (53,6%) por meio da intoxicação /envenenamento (41,4%). Quanto a violência interpessoal, notou-se que a maioria das agressões foram ocasionadas pelo próprio cônjuge da vítima (12,4%), utilizando da força física (29,3%), salienta-se que o álcool não estava presente na maior parte das agressões. Conclusão: Evidencia-se a prevalência de violência autoprovocada (53,6%), em adolescentes com ensino médio, brancas, sem companheiro, residentes da área urbana, agredidas em ambiente domiciliar, motivadas por conflitos geracionais, sendo as violências mais incidentes a física por meio de envenenamento/intoxicação. Diante do exposto é importante abordar o fato de que é necessário realizar capacitações com os profissionais de saúde referente a ficha de notificação e orientá-los da importância de preenchê-la de forma correta, para haja a tomada de providências de acordo com cada necessidade.


Introduction: Introduction: Violence against women is characterized especially by gender inequality, hierarchical difference, subordination and aggressiveness of the partner or ex partner. Among the main subtypes are physical, psychological, sexual, patrimonial and moral violence. With the emergence of the COVID-19 pandemic in 2020 in an attempt to contain the disease, protective measures such as social isolation increased family coexistence. As a result, the victims of violence have been exposed to their aggressors for even longer and consequently find it more difficult to report the abuse they have suffered, since the provision of public services, security and judicial institutions have also been restricted. Objective: To characterize the cases of violence against women during the COVID-19 pandemic in a municipality in the southwest of Paraná. Materals and methods: This is a descriptive, documentary, and cross-sectional study with a quantitative approach carried out in a municipality in the Southwest of Paraná from data collection performed through the notification forms of violence against women notified between 2019 and 2021. Results and discussion: The study showed a prevalence of notifications in the year 2019 in women aged 12 to 18 years (27.2%), white (71.3%), with high school education (21.9%), being still students (23.1%) or unemployed (17.2%), without a partner (52.4%), residents of the urban area (74%), more specifically the Padre Ulrico neighborhood (12.4%), heterosexual (50.6%), without having any type of disability (51.8%). When checking the type of aggression with the highest incidence, we observed self-harm (53.6%) through intoxication/ poisoning (41.4%). As for interpersonal violence, it was noted that most aggressions were caused by the victim's own spouse (12.4%), using physical force (29.3%), and alcohol was not present in most aggressions. Conclusion: The prevalence of self- inflicted violence (53.6%) is evident in adolescents with high school education, white, without a partner, urban residents, assaulted in the home environment, motivated by generational conflicts, with the most incident violence being physical violence through poisoning/intoxication. Given the above, it is important to address the fact that it is necessary to conduct training with health professionals regarding the notification form and guide them on the importance of filling it out correctly, so that there is taking action according to each need.


Introducción: La violencia contra las mujeres se caracteriza especialmente por la desigualdad de género, la diferencia jerárquica, la subordinación y la agresividad de la pareja o ex pareja. Entre los principales subtipos, se menciona; la violencia física, psicológica, sexual, patrimonial y moral. Con la aparición de la pandemia de coronavirus en 2020 en un intento de contener la enfermedad, las medidas de protección como el aislamiento social han aumentado la convivencia familiar. Así, las víctimas de la violencia han quedado aún más expuestas a sus agresores y, en consecuencia, tienen mayores dificultades para denunciar los abusos sufridos, ya que también se ha restringido la prestación de servicios públicos, de seguridad y de instituciones judiciales. Objetivo: Caracterizar los casos de violencia contra la mujer en tiempos de pandemia de coronavirus en un municipio del sudoeste de Paraná. Materiales y métodos: Se trata de un estudio descriptivo, documental y transversal con enfoque cuantitativo realizado en un municipio del suroeste de Paraná a partir de la recolección de datos a través de las formas de notificación de la violencia contra las mujeres entre 2019 y 2021. Resultados y discusión: El estudio mostró una prevalencia de notificaciones en 2019 en mujeres de 12 a 18 años (27,2%), de raza blanca (71,3%), con estudios secundarios (21,9%), siendo aún estudiantes (23,1%) o desempleadas (17,2%), sin pareja (52,4%), residentes en el área urbana (74%), heterosexuales (50,6%), sin tener algún tipo de discapacidad (51,8%). Al verificar el tipo de agresión con mayor incidencia, se observó la lesión autoinfligida (53,6%) a través de la intoxicación / envenenamiento (41,4%). En cuanto a la violencia interpersonal, se observó que la mayoría de las agresiones fueron causadas por el propio cónyuge de la víctima (12,4%), utilizando la fuerza física (29,3%), se destaca que el alcohol no estuvo presente en la mayoría de las agresiones. Conclusión: Se evidencia la prevalencia de la violencia autoprovocada (53,6%), en adolescentes con educación médica, brancas, sin compañía, residentes del área urbana, agredidos en ambiente domiciliario, motivados por conflictos geracionales, siendo las violencias más incidentes a la física por medio de envenenamiento/intoxicación. Dado lo anterior es importante abordar el hecho de que es necesario realizar una capacitación con los profesionales de la salud respecto a la ficha de notificación y orientarlos sobre la importancia de llenarla correctamente, para que exista la toma de acciones de acuerdo a cada necesidad.


Subject(s)
Humans , Female , Pregnancy , Adolescent , Adult , Health Profile , Violence Against Women , Pandemics , COVID-19 , Poisoning , Social Isolation , Women , Wounds and Injuries , Cross-Sectional Studies/methods , Health Personnel , Health Personnel/education , Crime Victims/statistics & numerical data , Notification/statistics & numerical data , Aggression/psychology , Professional Training , Physical Abuse/statistics & numerical data
18.
Zhongguo Dang Dai Er Ke Za Zhi ; 24(12): 1295-1300, 2022 Dec 15.
Article in Chinese | MEDLINE | ID: covidwho-2203145

ABSTRACT

OBJECTIVES: To study the features of unintentional injury in children under the impact of coronavirus disease 2019 (COVID-19). METHODS: A retrospective analysis was performed on the medical data of 2 526 children with unintentional injury in Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from July 2019 to June 2022. The study period was divided into 5 stages: before the epidemic (July to December, 2019), the Wuhan epidemic period (January to April, 2020), the epidemic remission period in China (May 2020 to February 2022), the Shanghai epidemic period (March to May, 2022), and the epidemic remission period in Shanghai (June 2022). The incidences of unintentional injury in children at different time stages and different ages were compared. A questionnaire survey was conducted on 107 children of the 2 526 children to explore the features of unintentional injury. RESULTS: There were significant differences in gender composition, age, age distribution and proportion of many types of unintentional injuries among the five time stages (P<0.05). There was a reduction in the number of children who attended the emergency department due to unintentional injury during the Wuhan epidemic and the Shanghai epidemic. The proportion of children with trauma-related unintentional injuries in each stage reached more than 50%, and the proportion of children with trauma-related unintentional injuries reached 63.9% and 82.0%, respectively during the Wuhan epidemic and the Shanghai epidemic. Most children suffering from unintentional injury were mainly school-aged and preschool children (1 823 children, 72.17%). Compared with the same period of Shanghai epidemic in 2021, the age of children with unintentional injury was younger (median 7 years vs 11 years), and the proportion of children with trauma-related unintentional injuries increased (97% vs 69%) during the Shanghai epidemic (P<0.05). CONCLUSIONS: Under the COVID-19 epidemic, there is a reduction in the number of children with unintentional injury, while there is an increase in the proportion of children with trauma-related unintentional injuries. Unintentional injury is more common among school-aged and preschool children.


Subject(s)
COVID-19 , Epidemics , Wounds and Injuries , Child, Preschool , Humans , Child , COVID-19/epidemiology , Retrospective Studies , China/epidemiology , Schools , Wounds and Injuries/epidemiology , Wounds and Injuries/etiology
19.
J Trauma Nurs ; 30(1): 20-26, 2023.
Article in English | MEDLINE | ID: covidwho-2190960

ABSTRACT

BACKGROUND: COVID-19 challenged U.S. trauma centers to grapple with demands for expanded services with finite resources while also experiencing a concurrent increase in violent injuries. OBJECTIVE: The purpose of this study was to describe the impact of COVID-19 on the roles and duties of U.S. hospital-based injury prevention professionals. METHODS: This descriptive cross-sectional survey study of hospital-based injury prevention professionals was conducted between June 2021 and August 2021. Participants were recruited from six organizational members of the national Trauma Prevention Coalition, including the American Trauma Society, Emergency Nurses Association, Injury Free Coalition for Kids, Safe States Alliance, Society for Trauma Nurses, and Trauma Center Association of America. Results were analyzed using descriptive and inferential statistics. RESULTS: A total of 216 participants affiliated with 227 trauma centers responded. The following changes were reported during 2020: change in injury prevention position (range = 31%-88%); change in duties (range = 92%-100%); and change to hospital-based injury prevention programs (range = 75%-100%). Sixty-one (43%) single-center participants with a registered nurse license were reassigned to clinical duties compared with six (10%) nonlicensed participants (OR = 5.6; 95% CI [1.96, 13.57]; p < .001). Injury prevention programs at adult-only and combined adult and pediatric trauma centers had higher odds of suspension than pediatric-only trauma centers (OR = 3.6; 95% CI [1.26, 10.65]; p < .017). CONCLUSION: The COVID-19 response exposed the persistent inequity and limited prioritization of injury prevention programming as a key deliverable for trauma centers.


Subject(s)
COVID-19 , Wounds and Injuries , Adult , Child , Humans , United States/epidemiology , Cross-Sectional Studies , Trauma Centers , Surveys and Questionnaires , Hospitals , Wounds and Injuries/epidemiology , Wounds and Injuries/prevention & control
20.
preprints.org; 2023.
Preprint in English | PREPRINT-PREPRINTS.ORG | ID: ppzbmed-10.20944.preprints202301.0448.v1

ABSTRACT

The Impact of Event Scale-Revised (IES-R) is the most popular measure of post-traumatic stress disorder (PTSD), which has been recently validated in Arabic. This instrumental study aimed to determine optimal cutoff scores of the IES-R and its subscales in Arab samples of psychiatric patients (N = 168, 70.8% females) and healthy adults (N = 992, 62.7% females) from Saudi Arabia during the COVID-19 pandemic as an ongoing collective traumatic event. Based on a cutoff score of 14 of the Depression Anxiety Stress Scale 8-items (DASS-8), receiver operator curve (ROC) analysis revealed two optimal points of 39.5 and 30.5 for the IES-R in the samples (area under the curve (AUC) = 0.86 & 0.91, p values = 0.001, 95% CI: 0.80-0.92 & 0.87 to 0.94, sensitivity = 0.85 & 0.87, specificity = 0.73 & 0.83, Youden index = 0.58 & 0.70, respectively). Different cutoffs were detected for the six subscales of the IES-R, with numbing and avoidance expressing the lowest predictivity for distress. Meanwhile, hyperarousal followed by the irritability expressed stronger predictive capacity for distress than all subscales in both samples. In path analysis, pandemic-related irritability resulted from direct and indirect effects of key PTSD symptoms (intrusion, hyperarousal, and numbing). Irritability contributed to traumatic symptoms of sleep disturbance in both samples while the opposite was not true. The findings suggest usefulness of the IES-R at a score of 30.5 for detecting adults prone to trauma related distress, with higher scores needed for screening in psychiatric patients. Various PTSD symptoms may induce dysphoric mood, which represents a considerable burden that may induce circadian misalignment and more noxious psychiatric problems/ co-morbidities (sleep disturbance) in both healthy and diseased groups.


Subject(s)
Sleep Wake Disorders , Anxiety Disorders , Mental Disorders , Stress Disorders, Post-Traumatic , Wounds and Injuries , Mood Disorders , Stress Disorders, Traumatic , COVID-19
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