Prehospital Assaults Against Asian Americans, Native Hawaiians, and Pacific Islanders During COVID-19.

INTRODUCTION: Anti-Asian sentiment increased when the SARS-CoV-2 virus reached the United States in 2020. Trends in national assaults occurring during the COVID-19 pandemic in the Asian American, Native Hawaiian, and Pacific Islander (AANHPI) community were evaluated. METHODS: Patients treated for assaults by emergency medical services between January 2019 and December 2021 were extracted from ImageTrend Collaborate, a national database. Multivariable logistic regression models, adjusting for age, sex, and urbanicity, were used to compare assault rates overall and in the AANHPI population. RESULTS: There were 84,825 assaults (8.5% of injury incidents) in 2019; 96,314 (9.2%) in 2020; and 97,841 (8.4%) in 2021. Assaults against AANHPI increased from 870 (7.1 assaults per 100 injuries) to 987 (8.3) and 1150 (7.9) between 2019 and 2021, respectively. Compared to 2019, risk of assaults in 2020 in all races increased (OR 1.08; 1.07, 1.10) but decreased in 2021 (OR 0.97; 0.96, 0.98). However, among AANHPI, risk of assaults increased in both 2020 (OR 1.22; 1.10, 1.35) and 2021 (OR 1.13; 1.03, 1.25). Most AANHPI assault victims were between 25 and 34 y old (11.8% in 2019) with an increase in 2020 (15.6%) and 2021 (14.4%). Assaults against AANHPI with blunt and sharp objects increased annually from 2019 to 2021. CONCLUSIONS: Despite national decreases of assaults in 2021 to pre-COVID baseline, the rate of assaults treated by emergency medical services for the AANHPI population remained elevated. Further studies analyzing in-hospital assault trends will allow for better understanding and will quantify the impact the pandemic and surrounding social influences had on minorities across the United States.

Early predictors for maltreatment-related injuries in infancy and long-term mortality: a population-based study.

INTRODUCTION: Incidence, health consequences, and social burden associated with child maltreatment appeared to be borne disproportionately by very young children. We conducted a population-based data linkage study to explore child- and family-level factors that affect receiving different diagnoses of maltreatment injuries and investigate excessive mortality throughout toddlerhood. METHODS: We conducted a retrospective cohort study comprising 2.2 million infants born in 2004-2014 in Taiwan. Incident cases of child maltreatment were defined by hospitalization or emergency department visits for three heterogeneous diagnostic groups of maltreatment-related injuries (i.e., maltreatment syndrome, assaults, and undetermined causes) within 12 months after birth. The generalized linear model and landmark survival analyses were used to evaluate risk factors. RESULTS: An estimated 2.9‰ of infants experienced at least one maltreatment-related injury, with a three-year mortality rate of 1.3%. Low birthweight was associated with increased risk of receiving the diagnosis of three maltreatment injuries, particularly maltreatment syndrome (adjusted Incidence Rate Ratio [aIRR] = 4.08, 95% confidence interval [CI]: 2.93-5.68). Socially advantaged family condition was inversely linked with receiving the diagnosis of maltreatment syndrome and assaults (e.g., high income: aIRR = 0.55 and 0.47), yet positively linked with undetermined cause (aIRR = 2.05, 95% CI: 1.89-2.23). For infants exposed to maltreatment, low birth weight and non-attendance of postnatal care were highly predictive of fatality; low birthweight served as a vital predictor for premature death during toddlerhood (aIRR = 6.17, 95% CI: 2.36-15.4). CONCLUSIONS: Raising awareness of maltreatment-related injuries in infancy and predictors should be a priority for appropriate follow-up assessment and timely intervention.

Systematic Violence Monitoring to Reduce Underreporting and to Better Inform Workplace Violence Prevention Among Health Care Workers: Before-and-After Prospective Study.

BACKGROUND: Monitoring workplace violence (WPV) against health care workers (HCWs) through incident reporting is crucial to drive prevention, but the actual implementation is spotty and experiences underreporting. OBJECTIVE: This study aims to introduce a systematic WPV surveillance in 2 public referral hospitals in Italy and assess underreporting, WPV annual rates, and attributes "before" (2016-2020) and "after" its implementation (November 2021 to 2022). METHODS: During 2016-2020, incident reporting was based on procedures and data collection forms that were neither standardized between hospitals nor specific for aggressions. We planned and implemented a standardized WPV surveillance based on (1) an incident report form for immediate and systematic event notification, adopting international standards for violence definitions; (2) second-level root cause analysis with a dedicated psychologist, assessing violence determinants and impacts and offering psychological counseling; (3) a web-based platform for centralized data collection; and (4) periodic training for workforce coordinators and newly hired workers. We used data from incident reports to estimate underreporting, defined as an observed-to-expected (from literature and the "before" period) WPV ratio less than 1, and the 12-month WPV rates (per 100 HCWs) in the "before" and "after" periods. During the latter period, we separately estimated WPV rates for first and recurrent events. RESULTS: In the "before" period, the yearly observed-to-expected ratios were consistently below 1 and as low as 0.27, suggesting substantial violence underreporting of up to 73%. WPV annual rates declined in 1 hospital (from 1.92 in 2016 to 0.57 in 2020) and rose in the other (from 0.52 to 1.0), with the divergence being attributable to trends in underreporting. Available data were poorly informative to identify at-risk HCW subgroups. In the "after" period, the observed-to-expected ratio rose to 1.14 compared to literature and 1.91 compared to the "before" period, consistently in both hospitals. The 12-month WPV rate was 2.08 (95% CI 1.79-2.42; 1.52 and 2.35 in the 2 hospitals); one-fifth (0.41/2.08, 19.7%) was due to recurrences. Among HCWs, the youngest group (3.79; P<.001), nurses (3.19; P<.001), and male HCWs (2.62; P=.008) reported the highest rates. Emergency departments and psychiatric wards were the 2 areas at increased risk. Physical assaults were more likely in male than female HWCs (45/67, 67.2% vs 62/130, 47.7%; P=.01), but the latter experienced more mental health consequences (46/130, 35.4% vs 13/67, 19.4%; P=.02). Overall, 40.8% (53/130) of female HWCs recognized sociocultural (eg, linguistic or cultural) barriers as contributing factors for the aggression, and 30.8% (40/130) of WPV against female HCWs involved visitors as perpetrators. CONCLUSIONS: A systematic WPV surveillance reduced underreporting. The identification of high-risk workers and characterization of violence patterns and attributes can better inform priorities and contents of preventive policies. Our evaluation provides useful information for the large-scale implementation of standardized WPV-monitoring programs.

Differences in patterns of sexual assault among female victims preceding and during the COVID-19 pandemic: an analysis of encounters in an emergency department.

The aim of this study was to evaluate how the COVID-19 pandemic may have impacted the number and patterns of sexual assault victims within a German metropolitan city. A retrospective single center analysis of the gynecology examination reports of all women presenting to the emergency department of a university hospital after a sexual offense between 03/2013 and 02/2021 (n = 1167). Comparison of the first year of the pandemic 03/2000-03/2021) to previous years (03/2017-02/2020) and comparison of periods of government-imposed social distancing (03/12/2020-05/23/2020 and 10/23/2020-02/28/2021) with corresponding periods of pre-pandemic years. The overall number of sexual assault cases did not change during the first year of the COVID-19 pandemic. However, during the stay-at-home orders, the number of women presenting to the emergency department decreased by 38% (n=45 vs. 72). Fewer victims filed a police report during the pandemic (49.5% vs. 73.9%, p<0.001) and the lockdown period (50% vs. 76.5%, p<0.001). Less genital injuries after sexual assault were detected during the pandemic (14.3% vs. 25.2%, p<0.02), but there was an increase of illegal substance abuse (19.5% vs. 9.3%, p<0.003). During the stay-at-home orders fewer victims reported alcohol consumption (42.4% vs. 62.5 %, p<0.023). Despite the decrease in sexual offense related police reports, the number of sexual assault cases remained consistent, and the usage of illegal drugs increased during the COVID-19 pandemic. These findings represent the importance of providing support to sexual assault victims, as well as the implementation of preventative measures, especially in times of crisis.

A Systematic Review and Meta-Analysis of Bystander's Barriers to Intervene in Gender-Based Violence and the Role of Failed Prior Attempts.

Gender-based violence (GBV) is a pervasive public health issue that harms victims. Bystanders' interventions are crucial in preventing the risks of GBV; however, numerous barriers impede their willingness and behaviors to intervene. As a part of efforts to thwart these barriers, this study used a systematic review and meta-analysis to identify such barriers and assess their impact on bystanders' engagement to intervene. The researchers explored academic databases and included 38 studies in the analysis; we extracted and coded the identified barriers (e.g., lack of responsibility, rape myth) and allocated them to six domains: failure to notice, failure to perceive risk, failure to take responsibility for engaging, lack of bystander efficacy/competency, failure to take an action, and failure of previous intervention attempts. We calculated the overall and domain-specific effect sizes (ES) and performed moderator analysis. The overall ES of the barriers identified in the review were small but statistically significant. The most potent bystander intervention barrier domain was failed previous intervention attempts; the greatest specific barriers therein were negative emotions and feelings of uncertainty after engaging in bystander behaviors. University/college populations were more vulnerable to barriers to intervention than community members. Moreover, the barriers were more prohibitive in incidents of violence against women and sexual assaults than in intimate partner violence. Bystander-focused programs that address negative emotions and feelings arising from prior intervention experiences are needed to foster continued bystander engagement and assistance in GBV; moreover, tailored program content should also be provided for groups most vulnerable to intervention barriers.

Characteristics of International Assaultive Psychiatric Patients: Review of Published Findings, 2017-2022.

Since the 1960s, empirical research has focused on a better understanding of the characteristics of assaultive psychiatric patients. International research from 1960 to 2017 indicated that male and female patients with schizophrenia and substance use disorder presented the greatest risk for assault with nursing personnel being at higher risk. This present review of studies sought to assess the latest research findings on assaultive patients for the most recent five-year period, 2017-2022. It was hypothesized that patients with schizophrenia and substance use disorders would present the greatest assault risk for nursing personnel. The studies in this review supported this hypothesis. Assaults by patients with schizophrenia and substance abuse has been a consistent finding worldwide for 62 years of published research. Explanations for these findings, the possible role of posttraumatic stress disorder (PTSD) in assaultive patients, and an updated methodological review are presented.

Agresiones a personal adscrito a la Gerencia de Atención Primaria de Tenerife y pandemia por SARS-CoV2 / Attacks on personnel assigned to the Primary Care Management of Tenerife and the SARS-CoV2 pandemic

Objetivo Medir y caracterizar las agresiones sufridas por los profesionales sanitarios en el ámbito de la atención primaria de Tenerife entre el año 2018-2019 (prepandemia) y el 2020-2021 (pandemia). Secundariamente, analizar el grado de conocimiento de los profesionales en relación con el procedimiento de actuación frente a agresiones, las medidas de seguridad existentes y aspectos mejorables para su protección. Materiales y métodos Estudio observacional, descriptivo y transversal mediante un formulario autocumplimentado telemáticamente. Se difundió mediante los diferentes canales de comunicación con los profesionales sanitarios estando disponible entre marzo y abril del año 2022. Las variables cuantitativas se analizaron mediante medidas de tendencia central y de dispersión, y las cualitativas en porcentaje, realizando además un análisis bivariado utilizando el test χ2 y el test de la t de Student. Resultados De los participantes, 72,50% ha sufrido algún tipo de agresión en el ámbito laboral, siendo más frecuente en la zona metropolitana de Tenerife, las cuales se producen fundamentalmente por parte del paciente como de sus familiares. Estas agresiones son mayormente verbales y se producen en mayor cantidad hacia mujeres con la categoría de enfermera. Conclusiones La enfermería es la categoría que más sufre las agresiones en la atención primaria de Tenerife, de manera independiente a la zona de la isla donde desempeñe su trabajo (AU)

Objective To measure and characterize the aggressions suffered by health professionals in the field of primary care in Tenerife between 2018–2019 (pre-pandemic) and 2020–2021 (pandemic). Secondly, to analyze the degree of knowledge of the professionals in relation to the procedure for action against aggressions as well as the existing security measures and aspects that could be improved for their protection. Materials and methods Observational, descriptive and cross-sectional study using a self-completed form electronically. It was disseminated through the different communication channels with health professionals, being available between March and April 2022. The quantitative variables were analyzed using measures of central tendency and dispersion, and the qualitative variables in percentage, also performing a bivariate analysis using the Chi square and Student's T. Results 72.50% of the participants have suffered some type of aggression in the workplace and they are more frequent causes in the metropolitan area of Tenerife, which are produced fundamentally by the patient and their relatives. These aggressions are mostly verbal and occur in greater quantity towards women with the category of nurse. Conclusions Nursing is the category that suffers the most aggressions in primary care in Tenerife, regardless of the area of the island where they carry out their work (AU)

"I don't want to be a victim again": the impact of repeat assault on police officers.

Introduction: The frequency of assaults on police officers in the United Kingdom is rising and evidence suggests that exposure to work-place violence can negatively impact wellbeing, for example, increased perceived stress, feeling worn out and tired, and emotional exhaustion. Despite the prevalence of assaults on police officers, little research has examined the impact of repeat assaults on officers' wellbeing. Method: For the current study, 12 semi-structured interviews were conducted to investigate the impact of repeat assaults on wellbeing and occupational outcomes in police officers and staff, including impacts on their mental and physical heath, impacts on their work, the impact of prior assaults on future assaults, and what support they were provided with. Results: Findings indicate that repeat assaults had a negative impact on participants mental and physical wellbeing. Furthermore, a lack of support both from management and peers within the police force was found to further exacerbate the impact of repeat assaults. However, the provision of support was also identified as a mitigating factor when it was available and provided to participants which helped to protect participants from some of the negative impact of repeat assaults. Discussion: Findings provide a unique in-depth perspective into police officers' experiences following repeat assaults, which can in turn inform national policies and help tailor effective support services within the police force.

"Your Skin Crawled Every Time He Touched You": A Secondary Qualitative Analysis Exploring Bagwell-Gray's Taxonomy of Intimate Partner Sexual Violence.

Bagwell-Gray et al. developed a taxonomy of intimate partner sexual violence (IPSV) focusing on type of force (physical or nonphysical) and type of sexual activity (penetration or no penetration). The current secondary descriptive qualitative analysis of interviews with 89 Canadian women IPV victims assessed IPSV that fit Bagwell-Gray's taxonomy. About half (46 or 51.7%) described sexual violence, most commonly sexual abuse (26 or 29.2%), sexual assaults (17 or 19%), and sexual coercion (16 or 17.9%), with overlap across categories. Forced sexual activity was seldom mentioned (3 or 3.4%). Implications for service providers and researchers are provided.

Prevalence and correlates of destructive behaviors in the US Naval Surface Forces from 2010-2020.

PURPOSE: To estimate the prevalence of domestic violence, sexual assault, and suicide for United States Navy (USN) personnel between 2010 and 2020 and identify potential associated factors. METHODS: Official report data were used to calculate prevalence rates and odds ratios, accounting for sample and general USN population demographic data to assess differences in over- or underrepresentation of destructive behaviors. RESULTS: Domestic violence and sexual assault offenders tended to be younger lower-ranked males. For sexual assaults, offenders were three times more likely to be senior to the victim, which was not the case for domestic violence. Females were overrepresented in terms of suicidal ideation and attempts relative to the USN population, while males accounted for more actual suicides. The relative rates of suicidal ideation and attempts for females exceeded those for males (i.e., comparing the sample rate against the USN male and female populations), but the sample proportion for completed suicides (compared to the USN population) were greater for males than for females. Those in the junior enlisted (E1-E3) paygrades exhibited greater odds of suicide attempts versus suicidal ideations relative to those in the Petty Officers (E4-E6) paygrades, although E4-E6s completed more suicides. CONCLUSION: The descriptive profile of destructive behaviors in a representative sample of USN personnel provides an overview of the possible factors associated with destructive behaviors and includes an exploration of the relational dynamics and nature of the incidents. The results suggest that sexual assault and domestic violence are characterized by unique relational dynamics and that these destructive behaviors should not necessarily be classified together as male-oriented aggressions (i.e., mainly perpetrated by males against female victims). Those in the E1-E3 and E4-E6 paygrades displayed different patterns in suicidal ideation, attempts, and actual suicides. The results highlight individual characteristics to help inform the development of targeted policies, practices, and interventions for military and other hierarchical organizations (e.g., police).

[Attacks on personnel assigned to the Primary Care Management of Tenerife and the SARS-CoV2 pandemic]. / Agresiones a personal adscrito a la Gerencia de Atención Primaria de Tenerife y pandemia por SARS-CoV2.

OBJECTIVE: To measure and characterize the aggressions suffered by health professionals in the field of primary care in Tenerife between 2018-2019 (pre-pandemic) and 2020-2021 (pandemic). Secondly, to analyze the degree of knowledge of the professionals in relation to the procedure for action against aggressions as well as the existing security measures and aspects that could be improved for their protection. MATERIALS AND METHODS: Observational, descriptive and cross-sectional study using a self-completed form electronically. It was disseminated through the different communication channels with health professionals, being available between March and April 2022. The quantitative variables were analyzed using measures of central tendency and dispersion, and the qualitative variables in percentage, also performing a bivariate analysis using the Chi square and Student's T. RESULTS: 72.50% of the participants have suffered some type of aggression in the workplace and they are more frequent causes in the metropolitan area of Tenerife, which are produced fundamentally by the patient and their relatives. These aggressions are mostly verbal and occur in greater quantity towards women with the category of nurse. CONCLUSIONS: Nursing is the category that suffers the most aggressions in primary care in Tenerife, regardless of the area of the island where they carry out their work.

Implementation of a Behavioral Emergency Response Team in the Emergency Department.

INTRODUCTION: Emergency nurses, physicians, and patients experience occurrences of workplace violence. Having a team to respond to escalating behavioral events provides a consistent approach to reducing occurrences of workplace violence and increasing safety. The purpose of this quality improvement project was to design, implement, and evaluate the effectiveness of a behavioral emergency response team in an emergency department to reduce occurrences of workplace violence and increase the perception of safety. METHODS: A quality improvement design was used. The behavioral emergency response team protocol was created using evidenced-based protocols that have been shown to be effective in reducing the number of occurrences of workplace violence. Emergency nurses, patient support technicians, security personnel, and a behavioral assessment and referral team were trained in the behavioral emergency response team protocol. Data on occurrences of workplace violence were collected from March 2022 to November 2022. Postbehavioral emergency response team debriefings were conducted, and real-time education was provided after implementation. Survey data were collected to evaluate the emergency team members' perceptions of safety and of the effectiveness of the behavioral emergency response team protocol. Descriptive statistics were calculated. RESULTS: The number of reported occurrences of workplace violence decreased by to 0 postimplementation of the behavioral emergency response team protocol. The perception of safety increased 36.5% postimplementation (mean 2.2 preimplementation, mean 3.0 postimplementation). In addition, an increase in awareness about reporting occurrences of workplace violence resulted from education and implementation of the behavioral emergency response team protocol. CONCLUSION: Postimplementation, participants reported an increase in the perception of safety. Implementation of a behavioral emergency response team was effective in reducing assaults toward emergency department team members and increasing the perception of safety.

Characteristics of International Staff Victims of Psychiatric Patient Assaults: Review of Published Findings, 2017-2022.

Psychiatric patient assaults on staff are a worldwide occupational hazard for health care staff that results in medical injury, human suffering, and dollar cost expense. International research through 2000-2017 documented the continued frequency of these assaults and a continuing high risk for nursing personnel. This present paper reviewed the international published literature on staff victims of patient assaults during the next five-year period of 2017-2022. There were 39,034 assaults on 34,679 employee victims. The findings indicate that assaults on staff remain a serious worldwide issue as it has been since the 1990s and that nursing personnel continued to be at greater risk. Aggression management approaches, post-incident interventions, and an updated methodological inquiry are presented.

DNA recovery and human identification from semen stains washed at different temperatures.

One of the most important pieces of evidence to find the suspect of a sexual assault are semen stains. It has been observed that suspects do not use condoms in many cases and transfer seminal fluids over the body of the victim, to their clothes, to bed linen, or to other objects in the environment. However, in many cases, it has been seen that the suspects or the victims tend to clean their bodies and clothes because of psychological conditions such as fear, panic, and anxiety. This study aims to determine whether human identification can be accomplished from washed semen stains by evaluating the quantity of extracted DNA obtained from washed clothes. In this study, both cotton- and nylon-blended fabrics were stained with semen samples taken from 10 volunteers and washed with detergent at 40 °C, 60 °C, and 90 °C. After stains were made re-visible using an ultraviolet (UV) light source, DNA was extracted using two different extraction methods (phenol-chloroform and spin-column). As a result, DNA extraction methods, washing conditions, and obtained DNA quantity from different washed fabrics were compared. It was shown that DNA could be obtained from all samples and that these DNA amounts could be used to perform identification. This study gives hope to the victims who have not been able to go to the judicial units immediately after the incident for fear or any other reasons and who think that they cannot get results because they have washed the laundry.

Understanding Best Practices in Implementation of Behavioral Emergency Response Teams Through a Scoping Review.

BACKGROUND: Health care providers are at risk of suffering physical or emotional abuse from patients, family members, and visitors. This results in decreased job satisfaction, high turnover, increased rates of patient physical and pharmacologic restraint, and poor patient outcomes. Behavioral emergency response teams (BERTs) have proven effective in reducing workplace assaults directed at staff, reducing the rate at which behaviorally disruptive patients are physically or pharmacologically restrained and are associated with increased staff satisfaction. AIMS: This scoping review seeks to highlight the best practices and limitations of BERT use with adult populations in hospital settings to guide future implementation across academic medical centers. METHOD: A literature review was conducted using PubMed, Tisch Library, and Tufts University School of Medicine's search tool "Jumbo Search" to screen articles for a duration from 2000 to 2021. The review was conducted following PRISMA-ScR guidelines using three screens for the inclusion of papers most relevant to the review's aims. RESULTS: BERTs are commonly implemented with trained medical staff. The most common interventions used by the BERTs are de-escalation techniques and education for staff about the incidents. Most BERT implementation involves a proactive screening protocol for identifying high-risk patients and a team-based approach. CONCLUSIONS: BERTS are effective at reducing assaults directed at staff and are associated with increased staff satisfaction. Using a proactive process to identify high-risk patients for disruptive behavior in conjunction with a team-based response to behavioral emergencies, academic medical centers can decrease the use of physical restraints and increase staff satisfaction leading to a higher quality of care.

The Effect of COVID-19 on Domestic Violence and Assaults.

The purpose of this research was to examine the effect of COVID-19 on four outcomes including calls for service for domestic violence, calls for service for assaults, arrests for domestic violence, and arrests for assaults in Burlington, Vermont. The data for each outcome collected over the time periods January 2012 through May 2021 were obtained from the Burlington Police Department website and then a monthly time-series data set were created. The analyses including an independent samples t-test, a Poisson regression test, and a monthly interrupted time-series analyses (ITSA) were employed to test the effects of COVID-19 on the previously mentioned outcomes. The results of the ITSA showed that in the first month following the onset of the COVID-19 pandemic, domestic violence calls statistically significantly increased, but no statistically significant change was observed in domestic violence arrests, while assault calls and assault arrests statistically significantly decreased. In addition, during COVID-19, there was a statistically significant decreasing trend in domestic violence calls and domestic violence arrests, while there was no statistically significant change in the trends of assault calls and assault arrests. The results suggest that COVID-19 had an immediate as well as a persistent effect on the numbers of domestic violence and assaults. The results and limitations of this study were also discussed.

Forensic intelligence-led prevention of drug-facilitated sexual assaults.

This work explores the potentially broader contribution of forensic science to preventive public health through the proactive view promoted by forensic intelligence. For that purpose, a new working framework is applied as a strategic tool that channelizes forensic intelligence in a more understandable and didactic way for decision-makers, guiding preventive crime processes. Concretely, the implementation of this operational framework focuses on preventing drug-facilitated sexual assaults in the nightlife context. Through a two-stage research scheme, the working framework is used as a study tool for understanding this violent phenomenon and as a strategic thinking and action platform for overcoming it. Forensic intelligence-guided actions significantly enhanced institutional and direct support facing this specific form of sexual violence. Awareness messages targeting potential assailants, witnesses, and victims reached more than half a thousand students from the university and pre-university education through a preventive intervention within the educational system. Moreover, the inter-professional dialogue between forensic science and other health, security, and education disciplines shows the broader proactive role of forensic science beyond the traditional retroactive view limited to courtrooms and intelligence-led policing. This study demonstrates as forensic intelligence becomes applicable for civilians, who participate as decision-makers in intelligence-led preventive processes, anticipating the need for intervention by police and judicial authorities.

Violence in the Big Apple throughout the COVID-19 pandemic: A borough-specific analysis.

In early 2020, the world faced a rapid, life-changing, public health crisis in the form of the Coronavirus (COVID-19) pandemic. The pandemic and its associated social-distancing measures collided with a period of social unrest following the murder of George Floyd at the hands of Minneapolis police and persisted for nearly two years following its emergence. The current study adds to existing research by examining the effect of these events on the incidence of violence (shootings and assaults) in New York City (NYC) over a longer period of time, both in the city as a whole and at the borough-level. To accomplish this, the current study draws from publicly available data using series of analytical techniques to account for underlying trends, seasonality, and temperature while also estimating borough-specific effects. Results indicate that the prevalence of COVID-19 cases, associated social-distancing mandates, and the period of social unrest following Floyd's murder were associated with violence in NYC. Further, findings suggest while a number of the factors explored had consistent effects across each of NYC's five boroughs there was some evidence of heterogeneity. The implications for future research on the COVID-19 pandemic are discussed.

Ridesharing and alcohol-related assaults in NYC: A spatial ecological case-crossover study.

OBJECTIVE: Ridesharing has changed urban transportation and the distribution of some health outcomes, including alcohol consumption. Studies relating ridesharing to crime and violence at low space-time resolution (e.g., county-months) find mixed results. The aim of this study was to examine whether ridesharing was associated with increased incidence of alcohol-related assaults within highly resolved space-time units. METHODS: This spatial ecological case-crossover study used rideshare and taxi trip data from the New York City (NYC) Taxi and Limousine Commission for 2017-2018 and assault data from the NYC Police Department, aggregated within taxi zone-hours. Conditional logistic regression models estimated the odds of observing an assault for case taxi zone-hours in which an assault occurred compared to two control units of the same taxi zone-hour one week before (-168 h) and one week after (+168 h) relative to the number of rideshare trips. Separate analyses assessed assaults occurring at bars and restaurants. RESULTS: From 2017-2018, there were 47,124 nighttime assaults in the 262 taxi zones. There were 2482 taxi zone-hours at a bar and 693 taxi zone-hours at a restaurant that contained at least one nighttime assault. Ridesharing was positively associated with nighttime assaults at bars (OR: 1.050; 95% CI: 1.002-1.100) but not at restaurants (OR: 1.049; 95% CI: 0.943-1.168). CONCLUSIONS: Additional ridesharing trips are associated with increased incidence of assaults at on-premise alcohol outlets in NYC at the precise hour and taxi zone of trip origins.

Mass casualty, intentional vehicular trauma and anaesthesia.

The use of motor vehicles to initiate mass casualty incidents is increasing in frequency and such events are called intentional vehicular assaults. Perpetrators are inspired by a range of terrorist ideologies or have extremist views, criminal intent, or mental health issues. Assaults using a motor vehicle as the principal weapon of attack are easy to launch and require little to no forward planning. This makes them difficult for police and security agencies to predict, prevent, or interdict. With the increasing frequency of intentional vehicular assaults, anaesthesiologists in various settings may be involved in caring for victims and should be engaged in preparing for them. This narrative review examines the literature on vehicle assaults committed around the world and provides an overview of the unique injury patterns and considerations for the pre-hospital, perioperative, and critical care management of victims of these mass casualty events. The article discusses planning, education, and training in an attempt to reduce the mortality and morbidity of intentional vehicular assaults.