Sexual Assault Is the Biggest Risk Factor for Violence against Women in Taiwan-A Nationwide Population Cohort Study from 2000 to 2015.

Objective: To understand the main types of risk of violence against women in Taiwan. Materials and methods: This study used the outpatient, emergency, and hospitalization data of 2 million people in the National Health Insurance sample from 2000 to 2015. The International Classification of Diseases, Ninth Revision diagnostic N-codes 995.

Retinal hemorrhage after pediatric neurosurgical procedures.

Background: Neurosurgical procedures may occur prior to eye examination in children with suspected abusive head trauma and raise questions by child abuse physicians and ophthalmologists regarding the contribution of neurosurgery to retinal hemorrhage found postoperatively. The purpose of this study was to determine the prevalence and patterns of retinal hemorrhage attributable to neurosurgical intervention in children.

Methods: We conducted a retrospective cohort study of children undergoing neurosurgery who had postoperative ophthalmoscopy.

Multiple giant retinal tears due to inflicted injury in a neonate.

Purpose: This case represents the longest follow-up period and youngest patient treated for multiple GRTs in the same eye associated with physical abuse.

Observations: A 4-week-old otherwise healthy male presented with a constellation of unexplained injuries. Examination of the left eye revealed a mild lens opacity and a shallow retinal detachment with two giant retinal tears (GRTs) and no retinal hemorrhages.

Nonaccidental trauma: bilateral corneal abrasions as only initial presentation.

We report a case of nonaccidental trauma in a child who presented emergently with bilateral corneal abrasions of unclear etiology. It was later discovered that these lesions were actually caused by the newborn's father, who had forcefully pressed his thumbs against the child's orbits. Although uncommon, such types of anterior segment pathology should raise suspicion of nonaccidental trauma.

Characteristics and age-related injury patterns of maxillofacial fractures in children and adolescents: A multicentric and prospective study.

Background/aims: Paediatric maxillofacial trauma accounts for 15% of all maxillofacial trauma but remains a leading cause of mortality. The aim of this prospective, multicentric epidemiological study was to analyse the characteristics of maxillofacial fractures in paediatric patients managed in 14 maxillofacial surgery departments on five continents over a 1-year period.

Methods: The following data were collected: age (preschool [0-6 years], school age [7-12 years], and adolescent [13-18 years]), cause and mechanism of the maxillofacial fracture, alcohol and/or drug abuse at the time of trauma, fracture site, Facial Injury Severity Scale score, associated injuries, day of the maxillofacial trauma, timing and type of treatment, and length of hospitalization.

The first winter of social distancing improved most of the health indexes in a paediatric emergency department.

Aim: We compared visits to a tertiary level paediatric emergency department (PED) in Italy, during winter 2020-2021, when COVID-19 social distancing measures were in place, with winter 2019-2020.

Methods: This was a retrospective analysis of an electronic database. We obtained the number of visits and the ages, main complaints, triage codes, discharge diagnoses and outcomes of patients who accessed the PED from the 1 October 2020 to 28 February 2021.

Multi-modality imaging characteristics of costochondral fractures, a highly specific rib fracture for child abuse.

Background: Rib fractures in young children are strongly associated with nonaccidental trauma (NAT). Costochondral junction (CCJ) fractures are unique with most being identified in the healing phase on radiographs. NAT-associated CCJ fractures, therefore, may be underdiagnosed.

Value of additional lateral radiographs in paediatric skeletal surveys for suspected physical abuse.

Aim: To determine the added value of lateral limb radiographs in suspected physical abuse (SPA), particularly with regard to fracture detection and reporter confidence.

Methods And Materials: A 3-year (October 2017 to November 2020) retrospective study was conducted. Two blinded paediatric radiologists independently reviewed the appendicular radiographs for the presence of fractures, first by reviewing just the frontal projections, then both frontal and lateral radiographs.

Period of Purple Crying Program for the Prevention of Abusive Head Trauma/Shaken Baby Syndrome.

The Period of PURPLE Crying Program is an educational program delivered to parents of newborn children that aims to reduce the incidence of abusive head trauma/shaken baby syndrome1. The program was developed by a research-based, non-profit organisation and has already been implemented in many countries around the world. It educates parents on what to expect during the first few months of their newborn infant's life, allowing parents to become more informed and better prepared to care for their child.

A systematic review of clinical and laboratory findings of lead poisoning: lessons from case reports.

Lead is one of the most toxic heavy metals in the environment. The present review aimed to highlight hazardous pollution sources, management, and review symptoms of lead poisonings in various parts of the world. The present study summarized the information available from case reports and case series studies from 2009 to March 2020 on the lead pollution sources and clinical symptoms.

Child abuse in children living with special guardians, a service evaluation of child protection medical examinations.

Objective: To determine difference in frequency of referral for child protection medical examination (CPME) in children subject to special guardianship order (SGO), subject to child protection plan (CPP) or neither.

Design: Service evaluation analysing data from CPME reports.

Setting: Acute and community healthcare providers in Birmingham UK, during 2018.

Using Computed Tomography skeletal surveys to evaluate for occult bony injury in suspected non-accidental injury cases - A preliminary experience.

Introduction: This case series summarises our institution's preliminary experience of using computed tomography skeletal surveys (CT-SS) for the assessment of infants with suspected non-accidental injury (NAI) who were unable to undergo radiographic skeletal surveys (SS). This paper describes our experience using CT-SS in terms of radiation doses achieved, occult bony injury detection and forensic utility.

Methods: Ten infants aged between two weeks and ten months underwent a CT-SS.

Increase in Mental Health Diagnoses Among Youth With Nonfatal Firearm Injuries.

Background And Objectives: Firearm injury is a leading cause of mortality for US youth. For every youth who dies from a firearm injury, at least 4 more survive. Little is known about the mental health consequences of non-fatal firearm injury in youth.

Preventing abusive head trauma: can educating parents reduce the incidence?

Abusive head trauma (AHT) is the most lethal form of child abuse; preventing AHT should be a national priority, but research into this area is woefully underfunded. Prevention programs have primarily focused on universal parent education during the neonatal period, a time when parents are a captive audience of the health care establishment whose focus is on the needs of their newborn infant, and who will soon be exposed to the frustration and anger of infant crying. Research has suggested a strong causal link between infant crying and AHT, and parents - particularly fathers and father figures - have been identified as the most common perpetrators of AHT.

Validation of a Clinical Decision Rule to Predict Abuse in Young Children Based on Bruising Characteristics.

Importance: Bruising caused by physical abuse is the most common antecedent injury to be overlooked or misdiagnosed as nonabusive before an abuse-related fatality or near-fatality in a young child. Bruising occurs from both nonabuse and abuse, but differences identified by a clinical decision rule may allow improved and earlier recognition of the abused child.

Objective: To refine and validate a previously derived bruising clinical decision rule (BCDR), the TEN-4 (bruising to torso, ear, or neck or any bruising on an infant <4.

An Evaluation of Pediatric Secondary Overtriage in the Pennsylvania Trauma System.

Background: We sought to determine the secondary overtriage rate of pediatric trauma patients admitted to pediatric trauma centers. We hypothesized that pediatric secondary overtriage (POT) would constitute a large percentage of admissions to PTC.

Materials And Methods: The Pennsylvania Trauma Outcome Study database was retrospectively queried from 2003 to 2017 for pediatric (age ≤ 18 y) trauma patients transferred to accredited pediatric trauma centers in Pennsylvania (n = 6).

COVID-19: Differences in sentinel injury and child abuse reporting during a pandemic.

Background And Objectives: There is widespread concern that the COVID-19 pandemic has increased the incidence of child maltreatment. However, reports in the scientific literature documenting rates of child maltreatment during this period are scarce. This study was designed to explore whether the incidence of child maltreatment among patients presenting to a pediatric emergency department has increased during the COVID-19 pandemic.

Evaluation of an Emergency Department High-risk Bruising Screening Protocol.

Objectives: The objective of this study was to describe the outcomes of implementing a high-risk bruise screening pathway in a pediatric emergency department (ED).

Methods: A retrospective observational study was performed of children aged 0 to <48 months who presented to the ED between December 1, 2016, and April 1, 2019, and had bruising that is high-risk for physical abuse on a nurse screening examination. A high-risk bruise was defined as any bruise if aged <6 months or a bruise to the torso, ears, or neck if aged 6 to <48 months.

Rib fractures in infancy, case-series and register case-control study from Sweden.

Objectives: To assess cases with rib fractures in infants under observation for or with an abuse diagnosis, and to compare risk factors with that in infants with fractures but no abuse diagnosis.

Methods: Design was case-series and register case-control of infants (aged <1 year) with rib fractures. Data was clinical records for the case-series (n = 26) and from national health registers for the case-controls (n = 28 and n = 31).

Accidental injury, self-injury, and assault among children of women with schizophrenia: a population-based cohort study.

Objective: We aimed to compare the risk for injury overall and by intent (accidental injury, self-injury, and assault) among children born to women with versus without schizophrenia.

Methods: Using health administrative data from Ontario, Canada, children born from 2003 to 2017 to mothers with (n = 3769) and without (n = 1,830,054) schizophrenia diagnosed prior to their birth were compared on their risk for child injury, captured via emergency department, hospitalization, and vital statistics databases up to age 15 years. Cox proportional hazard models generated hazard ratios for time to first injury event (overall and by intent), adjusted for potential confounders (aHR).

Association of State-Level Earned Income Tax Credits With Rates of Reported Child Maltreatment, 2004-2017.

Poverty is an important predictor of child maltreatment. Social policies that strengthen the economic security of low-income families, such as the Earned Income Tax Credit (EITC), may reduce child maltreatment by impeding the pathways through which poverty leads to it. We used variations in the presence and generosity of supplementary EITCs offered at the state level and administrative child maltreatment data from the National Child Abuse and Neglect Data System (NCANDS) to examine the effect of EITC policies on state-level rates of child maltreatment from 2004 through 2017.