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Silver D, Pomeranz JL, Holm J, Doki M. Beyond Laws: Governors' Roles in Shaping State Firearm Environments, 2020-2022. Am J Prev Med 2024; 66:744-749. [PMID: 38086512 DOI: 10.1016/j.amepre.2023.12.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 12/06/2023] [Accepted: 12/07/2023] [Indexed: 01/06/2024]
Affiliation(s)
- Diana Silver
- Department of Public Health Policy and Management, School of Global Public Health, New York University, New York, New York.
| | - Jennifer L Pomeranz
- Department of Public Health Policy and Management, School of Global Public Health, New York University, New York, New York
| | - Julie Holm
- Department of Public Health Policy and Management, School of Global Public Health, New York University, New York, New York
| | - Miyuki Doki
- Department of Public Health Policy and Management, School of Global Public Health, New York University, New York, New York
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2
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O'Guinn ML, Siddiqui S, Ourshalimian S, Chaudhari PP, Spurrier R. Firearm Injuries in Lower Opportunity Neighborhoods During the COVID Pandemic. Pediatrics 2023; 152:e2023062530. [PMID: 37599643 DOI: 10.1542/peds.2023-062530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/22/2023] [Indexed: 08/22/2023] Open
Abstract
OBJECTIVES We aimed to describe changes in pediatric firearm injury rates, severity, and outcomes after the coronavirus disease 2019 stay-at-home order in Los Angeles (LA) County. METHODS A multicenter, retrospective, cross-sectional study was conducted on firearm injuries involving children aged <18-years in LA County before and after the pandemic. Trauma activation data of 15 trauma centers in LA County from the Trauma and Emergency Medicine Information System Registry were abstracted from January 1, 2018, to December 31, 2021. The beginning of the pandemic was set as March 19, 2020, the date the county stay-at-home order was issued, separating the prepandemic and during-pandemic periods. Rates of firearm injuries, severity, discharge capacity, and Child Opportunity Index (COI) were compared between the groups. Analysis was performed with χ2 tests and segmented regression. RESULTS Of the 7693 trauma activations, 530 (6.9%) were from firearm injuries, including 260 (49.1%) in the prepandemic group and 270 (50.9%) in the during-pandemic group. No increase was observed in overall rate of firearm injuries after the stay-at-home order was issued (P = .13). However, firearm injury rates increased in very low COI neighborhoods (P = .01). Mechanism of injury, mortality rates, discharge capacity, and injury severity score did not differ between prepandemic and during-pandemic periods (all P values ≥.05). CONCLUSIONS Although there was no overall increase in pediatric firearm injuries during the pandemic, there was a disproportionate increase in areas of very low neighborhood COI. Further examination of community disparity should be a focus for education, intervention, and development.
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Affiliation(s)
- MaKayla L O'Guinn
- Department of Pediatric Surgery, Children's Hospital Los Angeles, Los Angeles, California
| | - Sami Siddiqui
- Department of Pediatric Surgery, Children's Hospital Los Angeles, Los Angeles, California
| | - Shadassa Ourshalimian
- Department of Pediatric Surgery, Children's Hospital Los Angeles, Los Angeles, California
| | - Pradip P Chaudhari
- Department of Pedicatrics, Keck School of Medicine of University of Southern California, Los Angeles, California
- Division of Emergency Medicine & Transport Medicine, Children's Hospital Los Angeles, 4650 W Sunset Blvd, Los Angeles, California
| | - Ryan Spurrier
- Department of Pediatric Surgery, Children's Hospital Los Angeles, Los Angeles, California
- Department of Surgery, Keck School of Medicine of University of Southern California, Los Angeles, California
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Donnelly M, Grigorian A, Inaba K, Nguyen N, de Virgilio C, Schubl S, Paladugu A, Swentek L, Nahmias J. Trends in mass shootings in the United States (2013-2021): A worsening American epidemic of death. Am J Surg 2023; 226:197-201. [PMID: 37032237 DOI: 10.1016/j.amjsurg.2023.03.028] [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: 02/11/2023] [Revised: 03/23/2023] [Accepted: 03/29/2023] [Indexed: 04/09/2023]
Abstract
BACKGROUND Mass shootings represent a significant problem in the United States (US). This study aimed to examine trends in mass shootings in the US over time. METHODS Retrospective mass shooting data (1/2013-12/2021) were collected from the Gun Violence Archive. A scatterplot was constructed showing predicted (extrapolated from 2013 to 2019) versus actual total mass shootings in 2020 and 2021. Multivariate linear regressions were performed to evaluate trends in mass shootings over time, associated with gun law strength. RESULTS Mass shooting incidents, injuries, and deaths in 2020 and 2021 exceeded extrapolations from previous years. When comparing 2019 to 2020, stronger gun laws were associated with decreased monthly mass shooting deaths. For these same strong gun law states, monthly mass shooting deaths decreased when comparing 2019 to 2021 and comparing 2020 to 2021. CONCLUSIONS US mass shootings have increased over the past decade. Stronger gun laws appear associated with fewer monthly mass shooting-related deaths. Firearm-related legislation may at least partially, curtail the worsening of this substantial "American problem" of mass shootings.
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Affiliation(s)
- Megan Donnelly
- University of California, Irvine, Department of Surgery, Division of Trauma, Burns and Surgical Critical Care, Orange, CA, USA.
| | - Areg Grigorian
- University of Southern California, Department of Surgery, Los Angeles, CA, USA.
| | - Kenji Inaba
- University of Southern California, Department of Surgery, Los Angeles, CA, USA.
| | - Ninh Nguyen
- University of California, Irvine, Department of Surgery, Division of Trauma, Burns and Surgical Critical Care, Orange, CA, USA.
| | | | - Sebastian Schubl
- University of California, Irvine, Department of Surgery, Division of Trauma, Burns and Surgical Critical Care, Orange, CA, USA.
| | - Anushka Paladugu
- University of California, Irvine, Department of Surgery, Division of Trauma, Burns and Surgical Critical Care, Orange, CA, USA.
| | - Lourdes Swentek
- University of California, Irvine, Department of Surgery, Division of Trauma, Burns and Surgical Critical Care, Orange, CA, USA.
| | - Jeffry Nahmias
- University of California, Irvine, Department of Surgery, Division of Trauma, Burns and Surgical Critical Care, Orange, CA, USA. https://twitter.com/jnahmias1
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O'Neill KM, Dodington J, Gawel M, Borrup K, Shapiro DS, Gates J, Gregg S, Becher RD. The effect of the COVID-19 pandemic on community violence in Connecticut. Am J Surg 2023; 225:775-780. [PMID: 36253316 PMCID: PMC9540704 DOI: 10.1016/j.amjsurg.2022.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 10/02/2022] [Accepted: 10/05/2022] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Natural disasters may lead to increases in community violence due to broad social disruption, economic hardship, and large-scale morbidity and mortality. The effect of the COVID-19 pandemic on community violence is unknown. METHODS Using trauma registry data on all violence-related patient presentations in Connecticut from 2018 to 2021, we compared the pattern of violence-related trauma from pre-COVID and COVID pandemic using an interrupted time series linear regression model. RESULTS There was a 55% increase in violence-related trauma in the COVID period compared with the pre-COVID period (IRR: 1.55; 95%CI: 1.34-1.80; p-value<0.001) driven largely by penetrating injuries. This increase disproportionately impacted Black/Latinx communities (IRR: 1.61; 95%CI: 1.36-1.90; p-value<0.001). CONCLUSION Violence-related trauma increased during the COVID-19 pandemic. Increased community violence is a significant and underappreciated negative health and social consequence of the COVID-19 pandemic, and one that excessively burdens communities already at increased risk from systemic health and social inequities.
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Affiliation(s)
- Kathleen M O'Neill
- Division of General Surgery, Trauma, and Surgical Critical Care, Yale School of Medicine, Department of Surgery, New Haven, CT, 06520, USA; Investigative Medicine Program, Yale School of Medicine, Yale Graduate School of Arts and Sciences, New Haven, CT, 06510, USA.
| | - James Dodington
- Department of Pediatrics, Yale School of Medicine, New Haven, CT, 06510, USA; Violence Intervention Program, Yale New Haven Hospital, USA.
| | - Marcie Gawel
- Violence Intervention Program, Yale New Haven Hospital, USA.
| | - Kevin Borrup
- Injury Prevention Center, Connecticut Children's Medical Center, Hartford, CT, 06106, USA; Department of Pediatrics, University of Connecticut School of Medicine, Farmington, CT, 06032, USA.
| | - David S Shapiro
- Department of Surgery, Saint Francis Hospital & Medical Center, USA; Associate Professor of Surgery University of Connecticut School of Medicine & Frank L. Netter Schools of Medicine, USA.
| | - Jonathan Gates
- Department of Surgery, Hartford Healthcare Hartford Hospital, USA.
| | - Shea Gregg
- Trauma, Burns and Surgical Critical Care, Bridgeport Hospital, USA.
| | - Robert D Becher
- Division of General Surgery, Trauma, and Surgical Critical Care, Yale School of Medicine, Department of Surgery, New Haven, CT, 06520, USA.
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Monteith LL, Miller CN, Polzer E, Holliday R, Hoffmire CA, Iglesias CD, Schneider AL, Brenner LA, Simonetti JA. "Feel the need to prepare for Armageddon even though I do not believe it will happen": Women Veterans' Firearm Beliefs and Behaviors during the COVID-19 Pandemic, Associations with Military Sexual Assault and Posttraumatic Stress Disorder Symptoms. PLoS One 2023; 18:e0280431. [PMID: 36763646 PMCID: PMC9917279 DOI: 10.1371/journal.pone.0280431] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 01/01/2023] [Indexed: 02/12/2023] Open
Abstract
AIMS Firearm purchasing increased within the U.S. during the coronavirus disease 2019 pandemic. While rates of firearm ownership and suicide are elevated among women Veterans compared to women non-Veterans, no studies have examined if and how firearm beliefs and behaviors changed among women Veterans during the pandemic. We examined women Veterans' changes in firearm beliefs and engagement in firearm behaviors during the early pandemic era. METHOD 3,000 post-9/11 era women Veterans were invited to participate in a survey. 501 respondents (May-December 2020) comprised the sample for this concurrent nested mixed-method analysis. Thematic analysis and log-binomial regression were used. RESULTS 13.88% (n = 69) of women Veterans in our sample reported changes in their firearm beliefs; 22.15% (n = 109) reported engaging in firearm behaviors. The most prevalent reported behaviors were making household firearms more accessible (16.13%) and purchasing ammunition (11.97%). Smaller percentages reported carrying a firearm more frequently (6.71%), loading previously unloaded firearms (5.69%), or purchasing a firearm (4.24%). Thematic analysis suggested firearm behaviors were likely driven by a perceived increased need to protect oneself, family, and property due to: (1) uncertainties brought on by the pandemic; (2) pandemic-related threats necessitating self-defense, preparedness, and self-sufficiency; (3) political, social, and racial unrest and protests. PTSD symptom severity and military sexual assault history were associated with higher prevalence of changes in firearm beliefs and engagement in firearm behaviors during the pandemic. DISCUSSION Consideration of women Veterans' prior experiences and pandemic-related factors may be necessary to contextualize firearm discussions and inform future research. Given associations of military sexual assault and PTSD symptoms with firearm beliefs and behaviors, it may be crucial to ensure that such discussion are trauma-informed.
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Affiliation(s)
- Lindsey L. Monteith
- VA Rocky Mountain Mental Illness Research, Education and Clinical Center for Suicide Prevention, Aurora, Colorado, United States of America
- Department of Psychiatry, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States of America
- Department of Physical Medicine and Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States of America
- * E-mail:
| | - Christin N. Miller
- VA Rocky Mountain Mental Illness Research, Education and Clinical Center for Suicide Prevention, Aurora, Colorado, United States of America
| | - Evan Polzer
- VA Rocky Mountain Mental Illness Research, Education and Clinical Center for Suicide Prevention, Aurora, Colorado, United States of America
| | - Ryan Holliday
- VA Rocky Mountain Mental Illness Research, Education and Clinical Center for Suicide Prevention, Aurora, Colorado, United States of America
- Department of Psychiatry, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States of America
| | - Claire A. Hoffmire
- VA Rocky Mountain Mental Illness Research, Education and Clinical Center for Suicide Prevention, Aurora, Colorado, United States of America
- Department of Physical Medicine and Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States of America
| | - Christe’An D. Iglesias
- VA Rocky Mountain Mental Illness Research, Education and Clinical Center for Suicide Prevention, Aurora, Colorado, United States of America
| | - Alexandra L. Schneider
- VA Rocky Mountain Mental Illness Research, Education and Clinical Center for Suicide Prevention, Aurora, Colorado, United States of America
| | - Lisa A. Brenner
- VA Rocky Mountain Mental Illness Research, Education and Clinical Center for Suicide Prevention, Aurora, Colorado, United States of America
- Department of Psychiatry, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States of America
- Department of Physical Medicine and Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States of America
- Department of Neurology, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States of America
| | - Joseph A. Simonetti
- VA Rocky Mountain Mental Illness Research, Education and Clinical Center for Suicide Prevention, Aurora, Colorado, United States of America
- Division of Hospital Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States of America
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Theodorou CM, Brown EG, Jackson JE, Castle SL, Chao SD, Beres AL. Unintended Consequences of COVID-19 on Pediatric Falls from Windows: A Multicenter Study. J Surg Res 2022; 279:187-192. [PMID: 35779448 PMCID: PMC9149047 DOI: 10.1016/j.jss.2022.05.022] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2022] [Revised: 03/19/2022] [Accepted: 05/22/2022] [Indexed: 11/28/2022]
Abstract
Introduction In attempts to quell the spread of COVID-19, shelter-in-place orders were employed in most states. Increased time at home, in combination with parents potentially balancing childcare and work-from-home duties, may have had unintended consequences on pediatric falls from windows. We aimed to investigate rates of falls from windows among children during the first 6 mo of the COVID-19 pandemic. Methods Patients <18 y old admitted to three pediatric trauma centers (two - level 1, one - level 2) between 3/19/20 and 9/19/20 (COVID-era) were compared to a pre-COVID cohort (3/19/19 to 9/19/19). The primary outcome was the rate of falls from windows. Secondary outcomes included injury severity score (ISS), injuries sustained, and mortality. Results Of 1011 total COVID-era pediatric trauma patients, 36 (3.6%) sustained falls from windows compared to 23 of 1108 (2.1%) pre-COVID era patients (OR 1.7, P = 0.05). The median ISS was seven pre-COVID versus four COVID-era (P = 0.43). The most common injuries sustained were skull fractures (30.5%), extremity injuries (30.5%), and intracranial hemorrhage (23.7%). One-fifth of patients underwent surgery (21.7% pre-COVID versus 19.4% COVID-era, P = 1.0). There was one mortality in the COVID-era cohort and none in the pre-COVID cohort (P = 1.0). Conclusions Despite overall fewer trauma admissions during the first 6 mo of the COVID-19 pandemic, the rate of falls from windows nearly doubled compared to the prior year, with substantial associated morbidity. These findings suggest a potential unintended consequence of shelter-in-place orders and support increased education on home safety and increased support for parents potentially juggling multiple responsibilities in the home.
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Affiliation(s)
- Christina M Theodorou
- University of California Davis Medical Center, Division of Pediatric General, Thoracic, and Fetal Surgery, Sacramento, California.
| | - Erin G Brown
- University of California Davis Medical Center, Division of Pediatric General, Thoracic, and Fetal Surgery, Sacramento, California
| | - Jordan E Jackson
- University of California Davis Medical Center, Division of Pediatric General, Thoracic, and Fetal Surgery, Sacramento, California
| | - Shannon L Castle
- Valley Children's Hospital, Division of Pediatric Surgery Madera, California
| | - Stephanie D Chao
- Stanford School of Medicine, Department of Surgery, Division of Pediatric Surgery, Palo Alto, California
| | - Alana L Beres
- University of California Davis Medical Center, Division of Pediatric General, Thoracic, and Fetal Surgery, Sacramento, California
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Afif IN, Gobaud AN, Morrison CN, Jacoby SF, Maher Z, Dauer ED, Kaufman EJ, Santora TA, Anderson JH, Pathak A, Sjoholm LO, Goldberg AJ, Beard JH. The changing epidemiology of interpersonal firearm violence during the COVID-19 pandemic in Philadelphia, PA. Prev Med 2022; 158:107020. [PMID: 35301043 PMCID: PMC8920109 DOI: 10.1016/j.ypmed.2022.107020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 01/26/2022] [Accepted: 03/08/2022] [Indexed: 11/29/2022]
Abstract
Recent increases in firearm violence in U.S. cities are well-documented, however dynamic changes in the people, places and intensity of this public health threat during the COVID-19 pandemic are relatively unexplored. This descriptive epidemiologic study spanning from January 1, 2015 - March 31, 2021 utilizes the Philadelphia Police Department's registry of shooting victims, a database which includes all individuals shot and/or killed due to interpersonal firearm violence in the city of Philadelphia. We compared victim and event characteristics prior to the pandemic with those following implementation of pandemic containment measures. In this study, containment began on March 16, 2020, when non-essential businesses were ordered to close in Philadelphia. There were 331 (SE = 13.9) individuals shot/quarter pre-containment vs. 545 (SE = 66.4) individuals shot/quarter post-containment (p = 0.031). Post-containment, the proportion of women shot increased by 39% (95% CI: 1.21, 1.59), and the proportion of children shot increased by 17% (95% CI: 1.00, 1.35). Black women and children were more likely to be shot post-containment (RR 1.11, 95% CI: 1.02, 1.20 and RR 1.08, 95% CI: 1.03, 1.14, respectively). The proportion of mass shootings (≥4 individuals shot within 100 m within 1 h) increased by 53% post-containment (95% CI: 1.25, 1.88). Geographic analysis revealed relative increases in all shootings and mass shootings in specific city locations post-containment. The observed changes in firearm injury epidemiology following COVID-19 containment in Philadelphia demonstrate an intensification in firearm violence, which is increasingly impacting people who are likely made more vulnerable by existing social and structural disadvantage. These findings support existing knowledge about structural causes of interpersonal firearm violence and suggest structural solutions are required to address this public health threat.
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Affiliation(s)
- Iman N Afif
- Division of Trauma Surgery and Surgical Critical Care, Temple University Lewis Katz School of Medicine, Philadelphia, PA, USA
| | - Ariana N Gobaud
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Christopher N Morrison
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA; Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Sara F Jacoby
- Department of Family and Community Health, University of Pennsylvania School of Nursing, Philadelphia, PA, USA
| | - Zoë Maher
- Division of Trauma Surgery and Surgical Critical Care, Temple University Lewis Katz School of Medicine, Philadelphia, PA, USA
| | - Elizabeth D Dauer
- Division of Trauma Surgery and Surgical Critical Care, Temple University Lewis Katz School of Medicine, Philadelphia, PA, USA
| | - Elinore J Kaufman
- Division of Traumatology, Surgical Critical Care, and Emergency Surgery, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Thomas A Santora
- Division of Trauma Surgery and Surgical Critical Care, Temple University Lewis Katz School of Medicine, Philadelphia, PA, USA
| | - Jeffrey H Anderson
- Division of Trauma Surgery and Surgical Critical Care, Temple University Lewis Katz School of Medicine, Philadelphia, PA, USA
| | - Abhijit Pathak
- Division of Trauma Surgery and Surgical Critical Care, Temple University Lewis Katz School of Medicine, Philadelphia, PA, USA
| | - Lars Ola Sjoholm
- Division of Trauma Surgery and Surgical Critical Care, Temple University Lewis Katz School of Medicine, Philadelphia, PA, USA
| | - Amy J Goldberg
- Division of Trauma Surgery and Surgical Critical Care, Temple University Lewis Katz School of Medicine, Philadelphia, PA, USA
| | - Jessica H Beard
- Division of Trauma Surgery and Surgical Critical Care, Temple University Lewis Katz School of Medicine, Philadelphia, PA, USA.
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Lester A, Leach P, Zaben M. The Impact of the COVID-19 Pandemic on Traumatic Brain Injury Management: Lessons Learned Over the First Year. World Neurosurg 2021; 156:28-32. [PMID: 34530146 PMCID: PMC8435471 DOI: 10.1016/j.wneu.2021.09.030] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Revised: 09/06/2021] [Accepted: 09/07/2021] [Indexed: 02/07/2023]
Abstract
The COVID-19 pandemic has had widespread consequences on health care systems around the world. It resulted in extensive changes to the referral patterns, management, and rehabilitation of surgical conditions. We aimed to evaluate the effect the COVID-19 pandemic has had on traumatic brain injury (TBI) specifically. We reviewed the literature published on COVID-19 and TBI referrals, management, and rehabilitation. Significant changes were seen in the referral patterns of TBIs worldwide, explained by changes in societal behaviors and changes in the mechanism of injury. Implementation of strict infection control measures and COVID-19 screening was commonplace, with some reporting changes to operating room protocols. TBI was more likely to be conservatively managed. Rehabilitation services were restricted, with a greater shift towards telemedicine to provide rehabilitative therapy remotely.
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Affiliation(s)
- Aled Lester
- School of Medicine, Cardiff University, Cardiff, United Kingdom.
| | - Paul Leach
- Department of Neurosurgery, University Hospital of Wales, Cardiff, United Kingdom
| | - Malik Zaben
- Department of Neurosurgery, University Hospital of Wales, Cardiff, United Kingdom; Neuroscience and Mental Health Research Institute, School of Medicine, Cardiff University, United Kingdom
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Wang L, Alexander CA. Cyber security during the COVID-19 pandemic. AIMS ELECTRONICS AND ELECTRICAL ENGINEERING 2021. [DOI: 10.3934/electreng.2021008] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
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