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Yari A, Fasih P, Bagheri A, Aryanezhad SS, Sani MK. Prevalence and pattern of maxillofacial injuries associated with domestic violence: A retrospective study at a major trauma center. Dent Traumatol 2024; 40 Suppl 2:61-68. [PMID: 37915285 DOI: 10.1111/edt.12903] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 10/09/2023] [Accepted: 10/10/2023] [Indexed: 11/03/2023]
Abstract
BACKGROUND/AIM This study aimed to analyze the frequency and pattern of maxillofacial injuries associated with domestic violence. MATERIALS AND METHODS Medical records of victims of domestic violence between May 2016 and May 2023 were scrutinized retrospectively. The following data were analyzed: gender and age, history of previous abuse, hospital admission, pregnancy, type of facial injuries, anatomical location of injuries, side of injuries, concomitant injuries, mechanism of impact, treatment modality, and history of drug and alcohol abuse. RESULTS Seventy-eight patients were included, comprising of 75 (96.2%) women and 3 (3.8%) men. Domestic violence was an etiology of 2.7% of all maxillofacial injuries. The mean age was 27.06 ± 5.5 years. 33.3% of cases had a history of previous domestic violence. The assailant was drug addicted in 47.4% of cases. The attacker was the current partner of the victim in 79.5% of the victims. Soft tissue injuries were found in 96.1% of cases. Maxillofacial fracture was observed in 52.6% of victims among which zygoma was the most common (16.7%) followed by the nose and mandible (15.4%). Isolated fracture was observed in 85.3% of patients and 71.8% of the injuries were observed on the left. Concomitant injuries were present in 51.3% of patients with arms/hands being the most frequent (48.7%). Punch (67.9%) constituted the majority of the mechanism of impact. Based on the statistical analysis, punches resulted in significantly higher soft tissue contusion (p = .046), and injuries that required no intervention were significantly higher in punched victims (p = .002). CONCLUSION Maxillofacial soft tissue injuries with or without isolated fracture on the left side of the zygoma, mandibular angle, or nose in association with arms/hands injuries in young adult women could be clues of domestic violence. Appropriate care such as preventive programs for drug or alcohol abuse should be implemented to reduce domestic violence, thereby reducing these injuries.
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Affiliation(s)
- Amir Yari
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Kashan University of Medical Sciences, Kashan, Iran
| | - Paniz Fasih
- Department of Prosthodontics, School of Dentistry, Kashan University of Medical Sciences, Kashan, Iran
| | - Abbas Bagheri
- Department of Endodontics, School of Dentistry, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | | | - Mohammad Khosousi Sani
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Naran-Ochir O, Narantsetseg T, Bayartsogt B, Batbileg B, Gan-Ochir B, Altannamar M, Batbayar EO. A cross-sectional study of the impact of the COVID-19 lockdown on domestic violence-related oral and maxillofacial injuries. Dent Traumatol 2024; 40 Suppl 2:74-81. [PMID: 38459665 DOI: 10.1111/edt.12944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 02/15/2024] [Accepted: 02/16/2024] [Indexed: 03/10/2024]
Abstract
BACKGROUND During the COVID-19 lockdown, more domestic violence-related traumas were reported. In this study, we investigated and compared the incidence of domestic violence-related injuries-in particular oral and maxillofacial injuries-in Ulaanbaatar, Mongolia, before and during the COVID-19 lockdown. MATERIALS AND METHODS We conducted a cross-sectional study based on 3974 domestic violence cases registered at the Public Health Department, National Traumatology and Orthopedics Research Center of Mongolia between 2018 and 2022. Descriptive and binary logistic regression analyses were conducted. The victims were categorized according to their age (child, adult, and elderly). RESULTS The mean age of the victims was children 9.7 ± 5.4 years, adults 34.8 ± 8.3 years, and elderly 64.3 ± 8.7 years. Binary logistic regression analysis (no/yes) showed that oral and maxillofacial injuries during the lockdown increased 1.3 times (OR = 1.3; CI 95% = 1.0-1.6; p = .003) in adults and 2.5 times in children (OR = 2.5; CI 95% = 1.7-3.9; p = .001). Additionally, injuries to upper limbs increased 4.6 times (OR = 4.6; CI 95% = 3.5-6.1; p = .001) in adults and 5.2 times in elderly patients (OR = 5.2; CI 95% = 1.8-16.2; p = .01). Additionally, thorax injury in children increased 3.1 times (OR = 3.1; CI 95% = 1.7-5.7; p = .001). CONCLUSIONS During the lockdown, injury to oral and maxillofacial regions increased in adult and child victims of domestic violence.
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Affiliation(s)
- Ochbayar Naran-Ochir
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia
- Department of Oral and Maxillofacial Surgery, Central Military Hospital, Ulaanbaatar, Mongolia
| | - Tsetsegkhen Narantsetseg
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia
| | - Batzorig Bayartsogt
- Department of Epidemiology and Biostatistics, School of Public Health, Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia
| | - Batzorig Batbileg
- The National Traumatology and Orthopedics Research Center, Ulaanbaatar, Mongolia
| | - Batbold Gan-Ochir
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia
| | - Munkhdul Altannamar
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Ach Medical University, Ulaanbaatar, Mongolia
| | - Enkh-Orchlon Batbayar
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia
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de Souza Cantão ABC, da Silva Lima TC, Fernandes MIAP, Nagendrababu V, Bastos JV, Levin L. Prevalence of dental, oral, and maxillofacial traumatic injuries among domestic violence victims: A systematic review and meta-analysis. Dent Traumatol 2024; 40 Suppl 2:33-42. [PMID: 38214027 DOI: 10.1111/edt.12922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 12/10/2023] [Accepted: 01/02/2024] [Indexed: 01/13/2024]
Abstract
BACKGROUND/AIMS Domestic violence (DV) encompasses a series of abusive behaviors, perpetrated in a family environment, against individuals of all ages and genders. Injuries to the head, neck, and face are frequent findings among victims of abuse, negatively impacting their quality of life. Although oral and maxillofacial injuries (OMFI) and traumatic dental injuries (TDI) are commonly diagnosed among DV victims, their prevalence is still unknown. This systematic review was aimed to assess the prevalence of OMFI and TDI among victims of DV. METHODS The protocol of the review was registered in PROSPERO (CRD42023424235). Literature searches were performed in eight electronic databases, up to August 7th, 2023. Observational studies published in the Latin-roman alphabet and reporting the prevalence of OMFI and/or TDI were included. The Joanna Briggs Institute's critical appraisal tool, checklist for prevalence studies, was used for quality assessment. Results were presented as qualitative and quantitative syntheses. RESULTS Seventeen studies, totaling 12,375 victims of domestic violence, were included. Meta-analyses showed an overall prevalence of 29% (95% CI: 15%-48%, I2 = 99%) and 4% (95% CI: 1%-10%, I2 = 98%) for OMFI and TDI, respectively. Higher pooled prevalence for OMFI (41%, 95% CI: 13%-46%, I2 = 99%) was demonstrated in samples with only women. OMFI was less prevalent (20%) among DV victims under 18, while TDI was lower among adults (1%). Hospital samples presented higher pooled prevalence of OMFI (32%), and forensic data from fatal victims presented higher prevalence of TDI (8%). CONCLUSION The overall prevalence of OMFI and TDI in DV victims was 29% and 4%, respectively. Women victims of DV presented higher rates of OFMI (41%) and TDI (6%).
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Affiliation(s)
| | | | | | | | | | - Liran Levin
- Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
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Araujo SCS, de Souza AAB, Coelho LV, Ramos GV, Silveira RL, Amaral MBF. Did physical aggression in women increase during the novel coronavirus 2019 (COVID-19) pandemic? A perspective of facial trauma. Oral Maxillofac Surg 2024; 28:149-155. [PMID: 36190578 PMCID: PMC9527380 DOI: 10.1007/s10006-022-01118-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Accepted: 09/27/2022] [Indexed: 11/28/2022]
Abstract
PURPOSE The present study aimed to assess whether there was an increase in physical aggression in women treated in Belo Horizonte, Minas Gerais, through the mandatory quarantine. METHODS Data from a cross-sectional study were collected and analyzed, from March 1 to December 31, 2020. Additionally, data from the same period the previous year were collected for comparison. RESULTS Of the etiologies reviewed for 2020, physical aggression had the highest percentage increase (+ 4.9%) and was the only etiology that showed a significant difference (p = 0.045). The mean age of the included patients was 34.05 years in 2019 and 33.97 in 2020, and most of the women had facial fractures, with nasal fractures being the most frequent, followed by jaw fractures. There was a significant increase (p = 0.34) in the conservative treatment of fractures from 2019 (48.6%) to 2020 (71.7%) and a minor (p = 0.088) increase in aggression toward intimate partners (2019, 40.9%; 2020, 63.9%). CONCLUSION Physical aggression against women increased during the period of mandatory social isolation that resulted from the COVID-19 pandemic. Health professionals, including emergency services professionals, must be trained to identify victims and refer them to specialized care.
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Affiliation(s)
- Stella Cristina Soares Araujo
- Oral and Maxillofacial Surgery Residency Program, Hospital João XXIII (FHEMIG), Av. Professor Alfredo Balena 400, Santa EfigêniaCEP: 30.130-100, Belo Horizonte, MG, Brazil.
| | - Adriano Augusto Bornachi de Souza
- Oral and Maxillofacial Surgery Residency Program, Hospital João XXIII (FHEMIG), Av. Professor Alfredo Balena 400, Santa EfigêniaCEP: 30.130-100, Belo Horizonte, MG, Brazil
| | - Luiza Vale Coelho
- Oral and Maxillofacial Surgery Residency Program, Hospital João XXIII (FHEMIG), Av. Professor Alfredo Balena 400, Santa EfigêniaCEP: 30.130-100, Belo Horizonte, MG, Brazil
| | - Guilherme Veloso Ramos
- Oral and Maxillofacial Surgery Residency Program, Hospital João XXIII (FHEMIG), Av. Professor Alfredo Balena 400, Santa EfigêniaCEP: 30.130-100, Belo Horizonte, MG, Brazil
| | - Roger Lanes Silveira
- Oral and Maxillofacial Surgery Residency Program, Hospital João XXIII (FHEMIG), Av. Professor Alfredo Balena 400, Santa EfigêniaCEP: 30.130-100, Belo Horizonte, MG, Brazil
- Otorhinolaryngology/Head and Neck Surgery Service, Santa Casa, Belo Horizonte, MG, Brazil
| | - Marcio Bruno Figueiredo Amaral
- Oral and Maxillofacial Surgery Residency Program, Hospital João XXIII (FHEMIG), Av. Professor Alfredo Balena 400, Santa EfigêniaCEP: 30.130-100, Belo Horizonte, MG, Brazil
- Residency Program Director of Oral and Maxillofacial Surgery Service, Hospital João XXIII (FHEMIG), Av. Professor Alfredo Balena 400, Santa Efigênia, Minas Gerais, Belo Horizonte, Brazil
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Adeleke AI, Hlongwa M, Makhunga S, Ginindza TG. Epidemiology of maxillofacial injury among adults in sub-Saharan Africa: a scoping review. Inj Epidemiol 2023; 10:58. [PMID: 37968736 PMCID: PMC10652446 DOI: 10.1186/s40621-023-00470-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 11/05/2023] [Indexed: 11/17/2023] Open
Abstract
BACKGROUND Injuries remain one of the leading causes of death globally. These disproportionately affect young adults and are particularly prevalent in sub-Saharan Africa (SSA). Maxillofacial injuries (MI) pose significant challenges to public health systems. However, much remains unknown regarding the epidemiology and extent of the financial burden in resource-limited areas, such as SSA, further necessitating more research and support. This scoping review aims to investigate the mechanism, distribution, and financial impact of MI in adults aged ≥ 18 years in SSA. MAIN BODY The scoping review was guided by the methodological frameworks of Arksey and O'Malley and Levac. An electronic literature search for English-published articles on maxillofacial injuries in adults ≥ 18 years was conducted in Scopus, Medline, PubMed, Science Direct, CINAHL, Health Source: Nursing/Academic Edition, and grey literature. The PRISMA chart was used to document database searches and screening outcomes while reporting was guided by PRISMA-ScR. The data extraction process revolved around the predefined study outcomes, which encompassed the study characteristics and epidemiological parameters. The review used a narrative approach to report findings and evaluate publication quality using the STROBE checklist. The database search yielded 8246 studies, of which 30 met the inclusion criteria. A total of 7317 participants were included, 79.3% of whom were males. The peak age range for incidence was between 18 and 40 years. Road traffic collision (RTC) was the leading cause of MI, 59% of which resulted from motorcycle collisions. Assault/interpersonal violence ranked as the second leading cause of MI. The mandible was MI's most frequently affected hard tissue, followed by the midface. Factors such as alcohol/illicit drug use, poor knowledge of traffic regulations, and non-observance of these regulations were associated with MI. In our study, the cost range for mandibular fractures was $200-$468.6, borne by victims and their families. CONCLUSIONS Maxillofacial injuries are predominantly caused by road traffic collisions and assaults in SSA. The findings can provide valuable insights into policy decisions and prevention strategies aimed at reducing injury burden. Further research is warranted to explore the psychological impact of MI, including PTSD, for tailored support and intervention. Scoping Review Registration The protocol has been registered on the Open Science Framework. Registration DOI: https://doi.org/10.17605/OSF.IO/BWVDK .
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Affiliation(s)
- Adekunle I Adeleke
- Discipline of Public Health Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, Mazisi Kunene Road, Durban, 4041, South Africa.
| | - Mbuzeleni Hlongwa
- Discipline of Public Health Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, Mazisi Kunene Road, Durban, 4041, South Africa
- Public Health, Societies, and Belonging, Human Sciences Research Council, Pretoria, South Africa
| | - Sizwe Makhunga
- Discipline of Public Health Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, Mazisi Kunene Road, Durban, 4041, South Africa
| | - Themba G Ginindza
- Discipline of Public Health Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, Mazisi Kunene Road, Durban, 4041, South Africa
- Cancer and Infectious Diseases Epidemiology Research Unit (CIDERU), College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
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Mikhael V, Ghabi R, Belahmer A, Kadi R, Guirguis N, Gutzeit A, Froehlich JM, Ferreira E, Higgs T, Dufour MM, Theoret V, Hebert M, Turgeon J, Balcom MC, Khurana B, Matoori S. Intimate partner violence: Defining the pharmacist’s role. Can Pharm J (Ott) 2023; 156:63-70. [PMID: 36969310 PMCID: PMC10034523 DOI: 10.1177/17151635231152450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Accepted: 09/28/2022] [Indexed: 02/19/2023]
Affiliation(s)
| | | | | | | | | | - Andreas Gutzeit
- Department of Health Sciences and Medicine, University of Lucerne, and the Institute of Radiology and Nuclear Medicine and Breast Center St. Anna
| | - Johannes M. Froehlich
- Hirslanden Klinik St. Anna, Lucerne, Switzerland; the Clinical Research Group, Klus Lab Zurich, Zurich, Switzerland
| | - Ema Ferreira
- Faculté de Pharmacie
- Département de pharmacie, CHU Ste-Justine, Montreal, Quebec
| | | | | | - Valerie Theoret
- Département de sexologie, Université du Québec à Montréal, Montréal, Quebec
| | - Martine Hebert
- Département de sexologie, Université du Québec à Montréal, Montréal, Quebec
| | - Joane Turgeon
- Faculté de l’éducation permanente, Université de Montréal, Montreal, Quebec
| | | | - Bharti Khurana
- Department of Radiology, Brigham and Women’s Hospital, Boston, Massachusetts
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7
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Adeleke AI, Hlongwa M, Makhunga S, Ginindza TG. Mapping Evidence on the Epidemiology and Cost Associated with Maxillofacial Injury among Adults in Sub-Saharan Africa: A Scoping Review Protocol. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1531. [PMID: 36674286 PMCID: PMC9865531 DOI: 10.3390/ijerph20021531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Revised: 01/06/2023] [Accepted: 01/09/2023] [Indexed: 06/17/2023]
Abstract
(1) Background: Maxillofacial injury (MI) occurs universally, for it disregards preference for age, gender, and geographical region. The global incidence and prevalence of facial fractures rose by 39.45% and 54.39%, respectively, between the years 1990 to 2017. Projections indicate that the burden of injuries will persist in sub-Saharan Africa (SSA) in the next twenty years. This scoping review aims to map the literature on MI epidemiology and the economic burden on society in SSA. (2) Methods: The methodology presented by Arksey and O'Malley and extended by Levac and colleagues will be employed in the scoping review. The researcher will report the proposed review through the Preferred Reporting Items for Systematic Review, and Meta-Analysis extension for scoping reviews (PRISMA-ScR). The review will include studies encompassing MI in sub-Saharan African adults 18 years and above. (3) Results: This will be presented as a thematic analysis of the data extracted from the included studies, and the Nvivo version 12 will be employed. (4) Discussion: We anticipate searching for related literature on the prevalence, incidence, risk factors, mortality, and cost associated with MI in the adult population of SSA. The conclusion from the review will assist in ascertaining research gaps, informing policy, planning, authorizing upcoming research, and prioritizing funding for injury prevention and management.
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Affiliation(s)
- Adekunle I. Adeleke
- Discipline of Public Health Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, Durban 4041, South Africa
| | - Mbuzeleni Hlongwa
- Discipline of Public Health Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, Durban 4041, South Africa
- Burden of Disease Research Unit, South African Medical Research Council, Cape Town 7925, South Africa
| | - Sizwe Makhunga
- Discipline of Public Health Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, Durban 4041, South Africa
| | - Themba G. Ginindza
- Discipline of Public Health Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, Durban 4041, South Africa
- Cancer & Infectious Diseases Epidemiology Research Unit (CIDERU), College of Health Sciences, University of KwaZulu-Natal, Durban 4041, South Africa
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Samieirad S, Bagheri Shirvan S, Grillo R, Shooshtari Z, Hosseini Abrishami M, Eshghpour M, Molaei M, Manafi A. The Effect of Covid-19-Related Social Distancing Restrictions on Maxillofacial Fractures Epidemiology. World J Plast Surg 2023; 12:73-82. [PMID: 38226200 PMCID: PMC10788111 DOI: 10.61186/wjps.12.3.73] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 10/11/2023] [Indexed: 01/17/2024] Open
Abstract
Background The purpose of the present study was to evaluate the changes in maxillofacial fracture epidemiology and etiology regarding Covid-19-related social distancing restrictions in an Iranian population. Methods A retrospective cross-sectional study was undertaken in six major trauma center hospitals in Iran in a period of two years (March 2018 until March 2020). The primary outcome variable was the maxillofacial fractures incidence. Patients' demographic data, date of injury as well as fracture characteristics, fracture etiology, type, and site were all recorded, compared, and analyzed in the control and experimental groups. Results The patients consisted of 520 (83.6%) males and 102 (16.4%) females. Patients sustaining maxillofacial fractures over this two-year period displayed a mean age of 31.24±14.44, with an age range of 2 to 88 years. The incidence of maxillofacial fractures significantly decreased in all age groups (p<0.001). After social distancing restrictions were placed; there was a significant drop in the number of subjects attending due to motorcycle collisions and road traffic accidents, whereas the number of fractures caused by assaults and domestic violence significantly increased (p<0.001 for each). Conclusion The investigators realized that social distancing restrictions were able to change the trends and patterns in maxillofacial fracture incidence and etiology.
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Affiliation(s)
- Sahand Samieirad
- Department of Oral & Maxillofacial Surgery, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Siavash Bagheri Shirvan
- Dental Research Center, Mashhad Dental School, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Ricardo Grillo
- Department of Oral & Maxillofacial Surgery, Traumatology and Prosthesis, University of São Paulo, São Paulo, Brazil
| | - Zahra Shooshtari
- Faculty of Dentistry, Mashhad Dental School, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Majid Hosseini Abrishami
- Department of Oral & Maxillofacial Surgery, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Majid Eshghpour
- Department of Oral & Maxillofacial Surgery, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Melika Molaei
- Dental Research Center, Faculty of Dentistry, Mazandaran University of Medical Sciences, Sari, Iran
| | - Ali Manafi
- Department of Plastic Surgery, Tehran University of Medical Sciences, Tehran, Iran
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Garbett H, Carter B, Gregory A, Cramer H, Lewis NV, Morgan K, Thompson J, Feder G, Braude P. Domestic violence and injuries: prevalence and patterns-a pilot database study to identify suspected cases in a UK major trauma centre. Inj Prev 2022; 28:injuryprev-2021-044481. [PMID: 35613902 DOI: 10.1136/injuryprev-2021-044481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Accepted: 03/18/2022] [Indexed: 11/05/2022]
Abstract
BACKGROUND Victim-survivors of domestic violence and abuse (DVA) present to secondary care with isolated injuries to the head, limb or face. In the UK, there are no published studies looking at the relationship of significant traumatic injuries in adults and the relationship to DVA.The primary objective was to assess the feasibility of using a tailored search method to identify cases of suspected DVA in the national audit database for trauma. The secondary objective was to assess the association of DVA with clinical characteristics. METHODS We undertook a single-centre retrospective observational cohort pilot study. Data were analysed from the local Trauma and Audit Research Network (TARN) database. The 'Scene Description' field in the database was searched using a tailored search strategy. Feasibility was evaluated with notes review and assessed by the PPV and prevalence. Secondary objectives used a logistic regression in Excel. RESULTS This method of identifying suspected cases of DVA from the TARN database is feasible. The PPV was 100%, and the prevalence of suspected DVA in the study period was 3.6 per 1000 trauma discharges. Of those who had experienced DVA, 52.7% were male, median age 43 (IQR: 33-52) and mortality 5.5%. Subgroup analysis of older people demonstrated longer hospital stay (p=0.17) and greater likelihood of admission to intensive care (OR 2.60, 95% CI 0.48 to 14.24). CONCLUSION We have created a feasible methodology to identify suspected DVA-related injuries within the TARN database. Future work is needed to further understand this relationship on a national level.
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Affiliation(s)
- Hollie Garbett
- Department of Medicine for Older People, CLARITY (Collaborative Ageing Research) Group, North Bristol NHS Trust, Bristol, UK
- Centre for Academic Primary Care, University of Bristol, Bristol, UK
| | - Ben Carter
- Department of Medicine for Older People, CLARITY (Collaborative Ageing Research) Group, North Bristol NHS Trust, Bristol, UK
- Department of Biostatistics and Health Informatics, King's College London, London, UK
| | - Alison Gregory
- Centre for Academic Primary Care, University of Bristol, Bristol, UK
| | - Helen Cramer
- Centre for Academic Primary Care, University of Bristol, Bristol, UK
| | - Natalia V Lewis
- Centre for Academic Primary Care, University of Bristol, Bristol, UK
| | - Karen Morgan
- Centre for Academic Primary Care, University of Bristol, Bristol, UK
| | - Julian Thompson
- North Bristol NHS Trust, Severn Major Trauma Network, Bristol, UK
| | - Gene Feder
- Centre for Academic Primary Care, University of Bristol, Bristol, UK
| | - Philip Braude
- Department of Medicine for Older People, CLARITY (Collaborative Ageing Research) Group, North Bristol NHS Trust, Bristol, UK
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Gujrathi R, Tang A, Thomas R, Park H, Gosangi B, Stoklosa HM, Lewis-O’Connor A, Seltzer SE, Boland GW, Rexrode KM, Orgill DP, Khurana B. Facial injury patterns in victims of intimate partner violence. Emerg Radiol 2022; 29:697-707. [PMID: 35505264 PMCID: PMC9064123 DOI: 10.1007/s10140-022-02052-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 04/22/2022] [Indexed: 01/21/2023]
Abstract
Purpose To evaluate the imaging findings of facial injuries in patients reporting intimate partner violence (IPV). Methods A retrospective review of radiology studies performed for 668 patients reporting IPV to our institution’s violence prevention support program identified 96 patients with 152 facial injuries. Demographics, imaging findings, and clinical data obtained from a review of the electronic medical records (EMR) were analyzed to categorize injury patterns. Results The study cohort consisted of 93 women and 3 men with a mean age of 35 years (range 19–76; median 32). At the time of presentation, 57 (59.3%) patients reported IPV as the mechanism of injury. The most frequent site of injury was the midface, seen in 65 (67.7%) patients. The most common fracture sites were the nasal bones (45/152, 29.6%), followed by the mandible (17/152, 11.1%), and orbits (16/152, 10.5%). Left-sided injuries were more common (90/152; 59.2%). A vast majority of fractures (94.5%) showed minimal or no displacement. Over one-third of injuries (60/152, 39.4%) demonstrated only soft tissue swelling or hematoma without fracture. Associated injuries were seen most frequently in the upper extremity, occurring synchronously in 11 (11.4%) patients, and preceding the index facial injury in 20 (21%) patients. Conclusion /advances in knowledge. The midface was the most frequent location of injury in victims of intimate partner violence, and the nasal bone was the most commonly fractured facial bone. Recognizing these injury patterns can help radiologists suspect IPV and prompt them to discuss the possibility of IPV with the clinical providers.
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Affiliation(s)
- Rahul Gujrathi
- Trauma Imaging Research and Innovation Center, Brigham and Women’s Hospital, Boston, MA USA
- Department of Radiology, Brigham and Women’s Hospital, Harvard Medical School, 75 Francis Street, Boston, MA 02115 USA
| | - Anji Tang
- Trauma Imaging Research and Innovation Center, Brigham and Women’s Hospital, Boston, MA USA
- Department of Radiology, Brigham and Women’s Hospital, Harvard Medical School, 75 Francis Street, Boston, MA 02115 USA
| | - Richard Thomas
- Trauma Imaging Research and Innovation Center, Brigham and Women’s Hospital, Boston, MA USA
- Department of Radiology, Brigham and Women’s Hospital, Harvard Medical School, 75 Francis Street, Boston, MA 02115 USA
| | - Hyesun Park
- Trauma Imaging Research and Innovation Center, Brigham and Women’s Hospital, Boston, MA USA
- Department of Radiology, Brigham and Women’s Hospital, Harvard Medical School, 75 Francis Street, Boston, MA 02115 USA
| | - Babina Gosangi
- Trauma Imaging Research and Innovation Center, Brigham and Women’s Hospital, Boston, MA USA
- Department of Radiology, Brigham and Women’s Hospital, Harvard Medical School, 75 Francis Street, Boston, MA 02115 USA
| | - Hanni M. Stoklosa
- Department of Emergency Medicine, Brigham and Women’s Hospital, Harvard Medical School, 75 Francis Street, Boston, MA USA
| | - Annie Lewis-O’Connor
- C.A.R.E. Clinic (Coordinated Approach to Resiliency & Empowerment), Brigham and Women’s Hospital, Boston, MA USA
| | - Steven E. Seltzer
- Department of Radiology, Brigham and Women’s Hospital, Harvard Medical School, 75 Francis Street, Boston, MA 02115 USA
| | - Giles W. Boland
- Department of Radiology, Brigham and Women’s Hospital, Harvard Medical School, 75 Francis Street, Boston, MA 02115 USA
- Brigham and Women’s Physicians Organization, Boston, USA
| | - Kathryn M. Rexrode
- Department of Internal Medicine, Brigham and Women’s Hospital, Harvard Medical School, 75 Francis Street, Boston, USA
| | - Dennis P. Orgill
- Department of Plastic Surgery, Brigham and Women’s Hospital, Harvard Medical School, 75 Francis Street, Boston, USA
| | - Bharti Khurana
- Trauma Imaging Research and Innovation Center, Brigham and Women’s Hospital, Boston, MA USA
- Department of Radiology, Brigham and Women’s Hospital, Harvard Medical School, 75 Francis Street, Boston, MA 02115 USA
- Department of Plastic Surgery, Brigham and Women’s Hospital, Harvard Medical School, 75 Francis Street, Boston, USA
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11
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Bregulla JL, Hanisch M, Pfleiderer B. Dentists' Competence and Knowledge on Domestic Violence and How to Improve It-A Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19074361. [PMID: 35410043 PMCID: PMC8998579 DOI: 10.3390/ijerph19074361] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 03/31/2022] [Accepted: 04/01/2022] [Indexed: 11/16/2022]
Abstract
Domestic violence (DV) is an important public health topic with a high prevalence in society. Dentists are also frontline responders to DV, as they not only treat victims of DV with dental injuries, but they can also screen for the presence of DV because they see patients for regular check-ups. Using the WHO definition, which describes domestic violence as intimate partner violence, 17 papers could be included in our analyses. The results of this review clearly indicated that although dentists, as members of the health care sector, are important frontline responders to DV, they are neither trained adequately at medical school nor do most feel competent enough to ask victims about DV or support them as needed. DV is often not taught at dentistry schools at all. The aims of this review were to provide an overview of existing literature on dentists' knowledge and beliefs regarding DV, whether and how DV is taught in medical education and to give recommendations on how to improve the education of dentists on this topic. Based on our findings, we recommend that DV education should be mandatory at dentistry schools and in further training for dentists with a focus on communication with victims, how DV can be identified and how to support victims well.
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Affiliation(s)
- Jana Lauren Bregulla
- Department for Prosthodontics and Biomaterials, Albert-Schweitzer-Campus 1, University Hospital Muenster, Building W 30, 48149 Muenster, Germany;
- Clinic for Radiology, Albert-Schweitzer-Campus 1, University Hospital Muenster, Building A 16, Medical Faculty University of Muenster, 48129 Muenster, Germany
| | - Marcel Hanisch
- Research Unit Rare Diseases with Orofacial Manifestations, Department of Cranio-Maxillofacial Surgery, Albert-Schweitzer-Campus 1, University Hospital Muenster, Building W 30, 48149 Muenster, Germany;
| | - Bettina Pfleiderer
- Clinic for Radiology, Albert-Schweitzer-Campus 1, University Hospital Muenster, Building A 16, Medical Faculty University of Muenster, 48129 Muenster, Germany
- Correspondence:
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12
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Dentistry responding to domestic violence and abuse: a dental, practice-based intervention and a feasibility study for a cluster randomised trial. Br Dent J 2022; 233:949-955. [PMID: 36494544 PMCID: PMC9734034 DOI: 10.1038/s41415-022-5271-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Accepted: 06/24/2022] [Indexed: 12/13/2022]
Abstract
Objectives Assess the feasibility of using the Identification and Referral to Improve Safety (IRIS) intervention in a general dental practice setting and evaluating it using a cluster randomised trial design. IRIS is currently used in general medical practices to aid recognition and support referral into specialist support of adults presenting with injuries and other presenting factors that might have resulted from domestic violence and abuse. Also, to explore the feasibility of a cluster randomised trial design to evaluate the adapted IRIS.Design Feasibility study for a cluster randomised trial of a practice-based intervention.Setting Greater Manchester general dental practices.Results It was feasible to adapt the IRIS intervention used in general medical practices to general dental practices in terms of training the clinical team and establishing a direct referral pathway to a designated advocate educator. General dental practices were keen to adopt the intervention, discuss with patients when presented with the opportunity and utilise the referral pathway. However, we could not use practice IT software prompts and data collection as for general practitioners because there is no unified dental IT system and because coding in dentistry for diagnoses, procedures and outcomes is not developed in the UK.Conclusion While it was feasible to adapt elements of the IRIS intervention to general dental practice and there was general acceptability, we did not have enough empirical data to plan a definitive cluster randomised trial design to evaluate the IRIS-dentistry intervention within general dental practices.
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13
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Saleem MN, Raja HZ, Shakoor A, Rashid H, Nasir H, Yusuf E. Knowledge, Attitude, and Practices of Dental Practitioners Regarding Domestic Violence in Pakistan. INQUIRY : A JOURNAL OF MEDICAL CARE ORGANIZATION, PROVISION AND FINANCING 2021; 58:469580211060799. [PMID: 34915749 PMCID: PMC8725044 DOI: 10.1177/00469580211060799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Domestic violence is a complex social issue worldwide that includes a wide range of physical, sexual, psychological, economic, or emotional trauma to a child or adult. A large proportion of domestic violence cases remain unreported or undocumented. Dentists can play an important role in identifying and reporting these cases, but no such local study is available assessing the dental practitioners' attitudes and knowledge of evaluating physical abuse in Pakistan. The objective of this study was to assess the knowledge and practices of dental practitioners of Pakistan about domestic violence. This cross-sectional study was carried out over 2 months, among 330 dentists across Pakistan, selected by convenience sampling technique. Data was collected via a pre-validated online questionnaire, filled anonymously after taking informed consent. The survey questionnaire collected data about dentists' demographics, awareness, and experiences about domestic violence cases via close-ended questions. Only 10.6% of participating dentists received formal training in the management of domestic violence cases. Approximately 55% of participants knew that physical abuse should be reported in all circumstances; however, half of them could not accurately identify the legal authorities where suspected cases should be reported. Only 20% of the participating dentists had ever suspected a case of physical abuse and 30% of those actually reported it to legal authorities. Participants characterized fear of anger from relatives as the most significant barrier toward reporting suspected cases. The analysis revealed that Pakistan's dentists lack adequate knowledge regarding domestic violence in terms of identification, relevant physical signs/symptoms, and social indicators. Dentists of Pakistan had insufficient knowledge about the identification, management, and reporting of domestic violence cases. However, formal training and dentists' qualification were positively associated with overall awareness and practices regarding domestic violence case management.
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Affiliation(s)
- Muhammad Nasir Saleem
- Professor of Operative Dentistry, 462516Institute of Dentistry CMH Lahore Medical College, NUMS, Lahore, Pakistan
| | - Hina Zafar Raja
- Professor Prosthodontics, 462516Institute of Dentistry CMH Lahore Medical College, NUMS, Lahore, Pakistan
| | - Asma Shakoor
- Associate Professor, 462516Institute of Dentistry CMH Lahore Medical College, NUMS, Lahore, Pakistan
| | - Haroon Rashid
- Vice President and Dy Chief Executive, 462516CMH Lahore Medical College, NUMS, Lahore, Pakistan
| | - Haiqa Nasir
- 462516Institute of Dentistry CMH Lahore Medical College, Lahore, Pakistan
| | - Elyon Yusuf
- Deceased, Former student 462516Institute of Dentistry CMH Lahore Medical College, Lahore, Pakistan
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14
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Alessandrino F, Keraliya A, Lebovic J, Mitchell Dyer GS, Harris MB, Tornetta P, Boland GWL, Seltzer SE, Khurana B. Intimate Partner Violence: A Primer for Radiologists to Make the "Invisible" Visible. Radiographics 2020; 40:2080-2097. [PMID: 33006922 DOI: 10.1148/rg.2020200010] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Intimate partner violence (IPV) is the physical, sexual, or emotional violence between current or former partners. It is a major public health issue that affects nearly one out of four women. Nonetheless, IPV is greatly underdiagnosed. Imaging has played a significant role in identifying cases of nonaccidental trauma in children, and similarly, it has the potential to enable the identification of injuries resulting from IPV. Radiologists have early access to the radiologic history of such victims and may be the first to diagnose IPV on the basis of the distribution and imaging appearance of the patient's currrent and past injuries. Radiologists must be familiar with the imaging findings that are suggestive of injuries resulting from IPV. Special attention should be given to cases in which there are multiple visits for injury care; coexistent fractures at different stages of healing, which may help differentiate injuries related to IPV from those caused by a stranger; and injuries in defensive locations and target areas such as the face and upper extremities. The authors provide an overview of current methods for diagnosing IPV and define the role of the radiologist in cases of IPV. They also describe a successful diagnostic imaging-based approach for helping to identify IPV, with a specific focus on the associated imaging findings and mechanisms of injuries. In addition, current needs and future perspectives for improving the diagnosis of this hidden epidemic are identified. This information is intended to raise awareness among radiologists, with the ultimate goal of improving the diagnosis of IPV and thus reducing the devastating effects on victims' lives. ©RSNA, 2020.
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Affiliation(s)
- Francesco Alessandrino
- From the Departments of Radiology (F.A., A.K., G.W.L.B., S.E.S., B.K.) and Orthopaedic Surgery (G.S.M.D.) and the Trauma Imaging Research and Innovation Center (B.K.), Brigham and Women's Hospital; and Department of Orthopaedic Surgery, Massachusetts General Hospital (M.B.H.), Harvard Medical School (J.L.), 75 Francis St, Boston, MA 02115; and Department of Orthopaedic Surgery, Boston Medical Center, Boston University Medical School, Boston, Mass (P.T.)
| | - Abhishek Keraliya
- From the Departments of Radiology (F.A., A.K., G.W.L.B., S.E.S., B.K.) and Orthopaedic Surgery (G.S.M.D.) and the Trauma Imaging Research and Innovation Center (B.K.), Brigham and Women's Hospital; and Department of Orthopaedic Surgery, Massachusetts General Hospital (M.B.H.), Harvard Medical School (J.L.), 75 Francis St, Boston, MA 02115; and Department of Orthopaedic Surgery, Boston Medical Center, Boston University Medical School, Boston, Mass (P.T.)
| | - Jordan Lebovic
- From the Departments of Radiology (F.A., A.K., G.W.L.B., S.E.S., B.K.) and Orthopaedic Surgery (G.S.M.D.) and the Trauma Imaging Research and Innovation Center (B.K.), Brigham and Women's Hospital; and Department of Orthopaedic Surgery, Massachusetts General Hospital (M.B.H.), Harvard Medical School (J.L.), 75 Francis St, Boston, MA 02115; and Department of Orthopaedic Surgery, Boston Medical Center, Boston University Medical School, Boston, Mass (P.T.)
| | - George Sinclair Mitchell Dyer
- From the Departments of Radiology (F.A., A.K., G.W.L.B., S.E.S., B.K.) and Orthopaedic Surgery (G.S.M.D.) and the Trauma Imaging Research and Innovation Center (B.K.), Brigham and Women's Hospital; and Department of Orthopaedic Surgery, Massachusetts General Hospital (M.B.H.), Harvard Medical School (J.L.), 75 Francis St, Boston, MA 02115; and Department of Orthopaedic Surgery, Boston Medical Center, Boston University Medical School, Boston, Mass (P.T.)
| | - Mitchel B Harris
- From the Departments of Radiology (F.A., A.K., G.W.L.B., S.E.S., B.K.) and Orthopaedic Surgery (G.S.M.D.) and the Trauma Imaging Research and Innovation Center (B.K.), Brigham and Women's Hospital; and Department of Orthopaedic Surgery, Massachusetts General Hospital (M.B.H.), Harvard Medical School (J.L.), 75 Francis St, Boston, MA 02115; and Department of Orthopaedic Surgery, Boston Medical Center, Boston University Medical School, Boston, Mass (P.T.)
| | - Paul Tornetta
- From the Departments of Radiology (F.A., A.K., G.W.L.B., S.E.S., B.K.) and Orthopaedic Surgery (G.S.M.D.) and the Trauma Imaging Research and Innovation Center (B.K.), Brigham and Women's Hospital; and Department of Orthopaedic Surgery, Massachusetts General Hospital (M.B.H.), Harvard Medical School (J.L.), 75 Francis St, Boston, MA 02115; and Department of Orthopaedic Surgery, Boston Medical Center, Boston University Medical School, Boston, Mass (P.T.)
| | - Giles W L Boland
- From the Departments of Radiology (F.A., A.K., G.W.L.B., S.E.S., B.K.) and Orthopaedic Surgery (G.S.M.D.) and the Trauma Imaging Research and Innovation Center (B.K.), Brigham and Women's Hospital; and Department of Orthopaedic Surgery, Massachusetts General Hospital (M.B.H.), Harvard Medical School (J.L.), 75 Francis St, Boston, MA 02115; and Department of Orthopaedic Surgery, Boston Medical Center, Boston University Medical School, Boston, Mass (P.T.)
| | - Steven E Seltzer
- From the Departments of Radiology (F.A., A.K., G.W.L.B., S.E.S., B.K.) and Orthopaedic Surgery (G.S.M.D.) and the Trauma Imaging Research and Innovation Center (B.K.), Brigham and Women's Hospital; and Department of Orthopaedic Surgery, Massachusetts General Hospital (M.B.H.), Harvard Medical School (J.L.), 75 Francis St, Boston, MA 02115; and Department of Orthopaedic Surgery, Boston Medical Center, Boston University Medical School, Boston, Mass (P.T.)
| | - Bharti Khurana
- From the Departments of Radiology (F.A., A.K., G.W.L.B., S.E.S., B.K.) and Orthopaedic Surgery (G.S.M.D.) and the Trauma Imaging Research and Innovation Center (B.K.), Brigham and Women's Hospital; and Department of Orthopaedic Surgery, Massachusetts General Hospital (M.B.H.), Harvard Medical School (J.L.), 75 Francis St, Boston, MA 02115; and Department of Orthopaedic Surgery, Boston Medical Center, Boston University Medical School, Boston, Mass (P.T.)
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15
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Agarwal P, Chug A, Bhatt S, Kumar S, Jain K. Maxillofacial injuries in pregnancy following domestic abuse: A challenge in management. Dent Traumatol 2020; 36:685-691. [PMID: 33245628 DOI: 10.1111/edt.12595] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 06/30/2020] [Accepted: 07/01/2020] [Indexed: 11/30/2022]
Abstract
Domestic violence against women remains one of the most difficult obstacles in the growth of civilization. The maxillofacial region is commonly involved, and injuries are complex to characterize and manage due to diverse presentations, underlying physiological changes and sometimes an association with pregnancy complications, creating a challenge for the operating surgeon. This case report discusses the clinical presentation of maxillofacial injuries sustained by a pregnant woman who also had obstetric complications. The management of such trauma by a multidisciplinary squad led by the maxillofacial surgery team is outlined. Increasing awareness among oral healthcare providers for the early identification of interpersonal abuse along with timely intervention and adequate referral is important. Close monitoring and follow-up are also mandatory.
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Affiliation(s)
- Padmanidhi Agarwal
- Department of Dentistry and Craniomaxillofacial Surgery, AIIMS, Rishikesh, India
| | - Ashi Chug
- Department of Dentistry and Craniomaxillofacial Surgery, AIIMS, Rishikesh, India
| | - Sumit Bhatt
- Department of Oral and Maxillofacial Surgery, Institute of Dental Sciences, Bareily, India
| | - Shailesh Kumar
- Department of Dentistry and Craniomaxillofacial Surgery, AIIMS, Rishikesh, India
| | - Kanav Jain
- Department of Dentistry and Craniomaxillofacial Surgery, AIIMS, Rishikesh, India
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16
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Olding J, Zisman S, Olding C, Fan K. Penetrating trauma during a global pandemic: Changing patterns in interpersonal violence, self-harm and domestic violence in the Covid-19 outbreak. Surgeon 2020; 19:e9-e13. [PMID: 32826157 PMCID: PMC7392113 DOI: 10.1016/j.surge.2020.07.004] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 07/01/2020] [Accepted: 07/14/2020] [Indexed: 02/03/2023]
Abstract
INTRODUCTION The restrictions imposed on social activity in response to the Covid-19 pandemic have had a profound impact globally. In the UK, the NHS was placed on a war-footing, with elective surgery, face-to-face outpatient clinics, and community care facilities all scaled back as a temporary measure to redistribute scarce resources. There has been concern during this period over increasing levels of violence in the domestic setting, as well as self-harm. METHODS Data was collected on all patients presenting with traumatic penetrating injuries during the 'lockdown' period of 23rd March to 29th April 2020. Demographics and injury details were compared with the same period in the two preceding years. RESULTS Overall trauma fell by 35% compared with the previous year. Over one in four penetrating injuries seen were a result of self-harm, which was significantly higher than in previous years (11% in 2019, 2% in 2018). There were two cases of injuries due to domestic violence, while a total of 4 cases of injury arose in separate violent domestic incidents. Self-harm commonly involved penetrating injury to the neck. DISCUSSION Our centre has seen an increase in the proportion of penetrating injuries as a result of both self-harm and violence in the domestic setting. The number of penetrating neck injury cases, which can represent suicidal intent or a major presentation of psychiatric illness, is of particular concern. We must further investigate the effect of social restrictions on violent injury, and how home confinement may influence a changing demographic picture of victims.
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Affiliation(s)
- James Olding
- Department of Oral & Maxillofacial Surgery, King's College Hospital, London, SE5 9RS, United Kingdom
| | - Sophia Zisman
- South London and Maudsley NHS Foundation Trust (SLaM), London, SE5, United Kingdom
| | - Carole Olding
- Emergency Department, King's College Hospital, London, SE5 9RS, United Kingdom
| | - Kathleen Fan
- Department of Oral & Maxillofacial Surgery, King's College Hospital, London, SE5 9RS, United Kingdom; Faculty of Dentistry, Oral Craniofacial Sciences, King's College London, United Kingdom.
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17
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Coulthard P, Hutchison I, Bell JA, Coulthard ID, Kennedy H. COVID-19, domestic violence and abuse, and urgent dental and oral and maxillofacial surgery care. Br Dent J 2020; 228:923-926. [PMID: 32591703 PMCID: PMC7319221 DOI: 10.1038/s41415-020-1709-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Household isolation measures to reduce coronavirus transmission during the COVID-19 pandemic have resulted in increased risk of domestic violence and abuse (DVA). DVA physical injury most frequently involves the face. Dentists, dental care professionals, oral surgeons and oral and maxillofacial surgeons all have a critical part to play in identifying patients experiencing DVA, who present with dental and facial injury, and in making referrals to specialist agencies. This paper describes how to ask questions about DVA sensitively and how to make an appropriate referral. Early intervention and referral to a DVA advocate can prevent an abusive situation becoming worse with more intense violence. It can save lives.
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Affiliation(s)
- Paul Coulthard
- Dean & Director, Professor of Oral & Maxillofacial Surgery, Institute of Dentistry, Consultant in Oral Surgery, Bart's Health NHS Trust, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, Turner Street, London, E1 2AD, UK.
| | - Iain Hutchison
- Professor of Oral & Maxillofacial Surgery, Queen Mary University of London, Director, The National Facial Oral and Oculoplastic Research Centre (NFORC), Chief Executive Saving Faces - The Facial Surgery Research Foundation, UK
| | - Joseph A Bell
- Dental Core Trainee, Oral and Maxillofacial Surgery, Bradford Teaching Hospital NHS Foundation Trust, UK
| | - Imogen D Coulthard
- RISE Charity DVA Ambassador Brighton, Biomedical Science Student, University of Brighton, UK
| | - Helena Kennedy
- Doughty Street Chambers, Director of the International Bar Association's Institute of Human Rights, UK
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18
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Facial surgeons call for better frontline staff training as lockdown may lead to increase in incidents. Br Dent J 2020; 228:494. [DOI: 10.1038/s41415-020-1499-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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