Rates Of Interpersonal Violence Research Articles

Effect of COVID-19 lockdowns on maxillofacial fractures in New Zealand: a retrospective study

Introduction: The New Zealand Accidents Compensation Corporation received 28,901 new claims for maxillofacial fractures between January 2018 and December 2021, at an annual cost of NZ$70–80 million. We have previously reported interpersonal violence as the most common cause of maxillofacial fractures disproportionately affecting young Māori males. This study provides an update on the incidence and cause of maxillofacial fractures with a specific review of the impact of COVID-19 lockdowns. Methods: Patients referred to the Wellington Regional Plastic, Maxillofacial and Burns Unit from 1 January 2018 to 31 December 2021 were identified from our maxillofacial fracture database. Age, ethnicity, gender, cause of injury, risk factors, and fracture pattern and management were analysed. Results: Out of 1281 patients identified, 75.2 per cent were male, most commonly (38.7%) aged 16–30 years. Interpersonal violence, falls and sports accounted for 37.6 per cent, 24.9 per cent, and 24.0 per cent of all maxillofacial fractures, respectively. Māori (22.0%) and New Zealand Europeans (55.7%) were the two largest groups, most commonly affected by interpersonal violence and falls, respectively. There was a relative increase in referral rates for females and for those older than 60 years (1.78 per 10 person-days versus 0.014 per 10 person-days and 4.2 per 10 person-days versus 1.8 per 10 person-days, respectively) and a decrease in the rates of interpersonal violence and sports related referrals (1.2 per 10 person-days versus 3.4 per 10 person-days and 0.41 per 10 person-days versus 2.19 per 10 person-days, respectively) during COVID-19 lockdowns, compared with outside lockdown. Conclusions: Interpersonal violence remains the main cause of maxillofacial fractures. There is a need for a national prevention strategy to reduce this. During COVID-19 lockdowns, there was a relative increase in the referral rates of females aged 60 years and over. Both sports and interpersonal violence showed significantly reduced referral rates during lockdowns, while falls, road traffic accidents and other were referred at a similar rate as out of lockdown.

Examining the Risks of Multiple Types of Interpersonal Victimization for Transgender and Gender Non-Conforming College Students.

Recent research has shown that transgender and gender non-conforming (TGNC) individuals are at risk of experiencing interpersonal violence, yet there may be differences within this group and across victimization types. The current study examined rates of seven types of interpersonal victimization based on six gender identities (cisgender women, cisgender men, trans women, trans men, nonbinary, and another identity) among a national study of college students. Data from the Spring 2021 American College Health Association's National College Health Assessment III (ACHA-NCHA III), a national-level study of U.S. college students, were used. We examined the association between gender identity and seven types of interpersonal violence victimization (violent victimization, sexual victimization, intimate partner violence victimization, stalking, bullying, microaggression, and discrimination) that occurred within the past 12 months. Logistic regression analyses were performed to examine if, when controlling for competing factors, gender identity was associated with an increase in the expected odds of victimization for each victimization type. Analyses revealed that TGNC college students reported experiencing a greater amount of all seven types of victimization compared to cisgender college students. These findings corroborate previous research indicating that rates of interpersonal violence are higher among TGNC college students compared to those who identify as cisgender, even after controlling for sexual orientation, related demographic factors, and substance use. Findings from the current study suggest that there are differences within individuals who identify as TGNC in terms of their risk for interpersonal victimization and that rates differ across victimization types. More work is needed to provide tailored prevention programming for TGNC college students.

The Concurrent and Longitudinal Relationship between Perinatal Sleep Difficulties and Depression in a Large Sample of High-Risk Women in South Africa.

Perinatal depression and sleep difficulties are common among studies conducted in high income countries (HIC). This study examines the relationship between sleep difficulties and depression during the perinatal period and over an eight-year follow-up period in South Africa, a middle income country. A population cohort of 1238 pregnant women (mean age = 26.33) in 24 township neighborhoods in South Africa were recruited and reassessed six times over the next 8years post birth with follow-up rates of 96-83%. The relationship between maternal depressed mood and sleep difficulties was examined over time, as well as the relationship of sleep with other socioeconomic, environmental, and psychiatric risk factors. Thirty-five percent of the women reported sleep difficulties during the perinatal period; whereas only 8% reported sleep difficulties at 8-year follow-up. Perinatal sleep difficulties were associated with lower income, lower educational attainment, less access to electricity, more food insecurity, higher rates of interpersonal violence and HIV, alcohol consumption, and depressed mood at 8years. However, the severity of depressed mood was the strongest predictor of sleep problems longitudinally and cross-sectionally, after accounting for all other risk factors. We found that the severity of depressed mood is highly associated with sleep difficulties from pregnancy to 8years post-birth and in a linear relationship, so that higher depressed mood is associated with more sleep problems. ClinicalTrials.gov registration: # NCT00996528.

Interpersonal violence and suicide risk: Examining buffering effects of school and community connectedness

BackgroundExposure to interpersonal violence is associated with elevated suicide risk. Preventing suicide among high-risk adolescents is most often discussed from a clinical treatment perspective, resulting in a gap in research examining whether school and community connectedness can buffer the relationships between forms of interpersonal violence and suicide risk in clinical samples of adolescents. MethodsBaseline data from 294 adolescents who received substance use treatment were analyzed to help fill this gap in research. Adolescents in this sample were at greater risk for suicidal thoughts and behaviors given their histories of substance use disorders and high rates of interpersonal violence, with 57% reporting experiencing at least one form of abuse/violence. Independent variables included lifetime exposure to physical abuse, sexual abuse, and weapon violence; moderators included various measures of school and community connectedness. Multinomial logistic regression models were estimated to examine the main and interaction effects predicting a three-category measure of suicide risk: non-suicidal, suicidal ideation only, and prior suicide attempts. ResultsSexual abuse survivors had the highest predicted probability of a prior suicide attempt when reporting lower levels of teacher support, school-based positive peer interactions, or neighborhood social connection, but at higher levels of these protective factors, their predicted probability was similar to those not exposed to sexual abuse. The same protective pattern was observed for physical abuse survivors with high neighborhood social connection. ConclusionThe buffering effects observed in this study identified dimensions of school and community social connectedness as protective factors for youth exposed to abuse. Although promoting social connectedness is often cited as a universal suicide prevention approach, tailored efforts to enhance connectedness within this population may also be a promising secondary prevention strategy. Thus, in addition to clinical treatment, more emphasis should be placed on systems-level approaches to reducing risk among youth most vulnerable to suicide.

Effect ofthe NFL's Super Bowl on emergency department visits for assault-related injuries.

Through its associations with mass gatherings, alcohol consumption, emotional cues, and gambling, the Super Bowl (SB) has been implicated in increased rates of interpersonal violence and assaults. This study endeavors to investigate the relationship between assault-related injuries, especially intimate partner violence (IPV) and SB. A retrospective review of prospectively collected data from the National Electronic Injury Surveillance System (NEISS) spanning 2005 to 2017 was conducted. Assault-related injuries were examined in relation to (1) the 4-day Super Bowl weekend (Friday-Monday), (2) Super Bowl Sunday, and (3) the Super Bowl week (Friday-Thursday) for all years, following the loss of the projected winning team (underdog victories), and losses despite a significant point spread favoring one team (upset losses). National estimates of injuries and associated variables were derived using the SUDAAN software. While there were no significant differences in the overall number of assaults or assault types during the SB weekend (5.6% vs 5.5%; p = 0.31), relative decreases were observed for altercations (21.1% vs 24.8%; p < 0.01), sexual assault (3.4% vs 4.0%; p < 0.01), and IPV (8.3% vs 12.5%; p < 0.01) on the Friday preceding SB, and robbery incidents on SB Sunday (2.1% vs 3.5%; p = 0.01). No changes in the incidence of assault-related injuries were found based on the favored or underdog status of the teams, including upset losses. Contrary to expectations, SB was not associated with increased assault-related injuries. This study underscores the need for year-round structural changes in addressing violence rather than relying solely on heightened awareness during specific events.

Prevalence of interpersonal violence against children in sport in six European countries

BackgroundInvestigating prevalence of child abuse in sport is a relatively new field of research, born from the need for credible data on this phenomenon. ObjectiveTo establish prevalence rates of interpersonal violence against children in sport in six European countries. Participants and settingThe sample (N = 10,302) consists of individuals aged 18–30 who had participated in organized sport prior to age 18 (49.3 % male, 50 % female). MethodsA self-report questionnaire was developed (the Interpersonal Violence Against Children in Sport Questionnaire or IVACS-Q) to measure prevalence of five categories of interpersonal violence (neglect, psychological violence, physical violence, non-contact sexual violence, and contact sexual violence) against children who participate in sport. Validation testing (published separately) showed reasonable levels of convergent and divergent validity. Prevalence rates are calculated by national context, whether inside or outside sport, and by sex (male/female). ResultsPrevalence of IVACS inside sport differed by category: psychological violence (65 %, n = 6679), physical violence (44 %, n = 4514), neglect (37 %, n = 3796), non-contact sexual violence (35 %, n = 3565), and contact sexual violence (20 %, n = 2060). Relatively small geographical differences were found. Across all categories, males (79 %, n = 4018) reported significantly more experiences inside sport than females (71 %, n = 3653) (χ2(1) = 92.507, p < .000). Strong correlations were found between experiencing violence inside and outside sport. ConclusionsInterpersonal violence against children in sport is widespread. The sector's approach to prevention must recognize the risks to female and male children (and all children) and the additional vulnerabilities of abused children. Further comparative and longitudinal research within sport is required.

Geospatial Analysis of Social Vulnerability, Race, and Firearm Violence in Chicago

IntroductionUrban firearm violence (UFV) is associated with inequities rooted in structural racism and socioeconomic disparities. Social vulnerability index (SVI) is a composite measure that encompasses both. We sought to understand the relationship between SVI and the incidence of UFV in Chicago using geospatial analysis for the first time. Materials and methodsFirearm assaults in Chicago 2001-2019 were obtained from the Trace. Locations of incidents were geocoded using ArcGIS and overlaid with census tract vector files. These data were linked to 2018 SVI measures obtained from the Center for Disease Control and Prevention. Shooting rates were calculated by tabulating the total number of shootings per capita in each census tract. We used Poisson regression with robust error variance to estimate the incident rate of UFV in different levels of social vulnerability and Local Moran's I to evaluate spatial autocorrelation. ResultsIn total, 642 census tracts were analyzed. The median shooting rate was 2.6 per 1000 people (interquartile 0.77, 7.0). When compared to those census tracts with very low SVI, census tracts with low SVI had a 1.7-time increased incident rate of shootings (incidence rate ratio [IRR] 1.74, 95% CI 1.08, 2.81), tracts with moderate SVI had a 3.1-time increased incident rate (IRR 3.07, 95% CI 2.31, 4.10), and tracts with high SVI had a 7-time increased incident rate (IRR 7.03, 95% CI 5.45, 9.07). ConclusionsIn Chicago, social vulnerability has a significant association with rates of firearm violence, providing a focus point for policy intervention to address high rates of interpersonal violence in similar cities.

Implementation of trauma-informed care and trauma-responsive services in clinical settings: a latent class regression analysis.

Engagement and retention in health care is vital to sustained health among people living with HIV (PLWH), yet clinical environments can deter health-seeking behavior, particularly for survivors of interpersonal violence. PLWH face disproportionate rates of interpersonal violence; clinical interactions can provoke a re-experiencing of the sequalae of trauma from violence, called re-traumatization. Trauma-informed care (TIC) is a strengths-based approach to case that minimizes potential triggers of re-traumatization and promotes patient empowerment, increasing acceptability of care. Yet, Ryan White HIV/AIDS clinics, at which over 50% of PLWH received care, have struggled to IMPLEMENT TIC. In this analysis, we sought to (1) identify unique sub-groups of HIV clinics based on clinical attributes (i.e., resources, leadership, culture, climate, access to knowledge about trauma-informed care) and (2) assess relationships between sub-group membership and degree of implementation of TIC and trauma-responsive services offered. A total of 317 participants from 47 Ryan White Federally-funded HIV/AIDS clinics completed a quantitative survey between December 2019 and April 2020. Questions included assessment of inner setting constructs from the Consolidated Framework for Implementation Research (CFIR), perceived level of TIC implementation, and trauma-responsive services offered by each respondent's clinic. We employed latent class analysis to identify four sub-groups of clinics with unique inner setting profiles: Weak Inner Setting (n = 124, 39.1%), Siloed and Resource Scarce (n = 80, 25.2%), Low Communication (n = 49, 15.5%), and Robust Inner Robust (n = 64, 20.2%). We used multilevel regressions to predict degree of TIC implementation and provision of trauma-responsive services. Results demonstrate that clinics can be distinctly classified by inner setting characteristics. Further, inner setting robustness is associated with a higher degree of TIC implementation, wherein classes with resources (Robust Inner Setting, Low Communication) are associated with significantly higher odds reporting early stages of implementation or active implementation compared to Weak class membership. Resourced class membership is also associated with availability of twice as many trauma-responsive services compared to Weak class membership. Assessment of CFIR inner setting constructs may reveal modifiable implementation setting attributes key to implementing TIC and trauma-responsive services in clinical settings. Introduction.

State expansion of supplemental nutrition assistance program eligibility and rates of interpersonal violence

IntroductionFood insecurity is associated with an increased likelihood of interpersonal violence. The Supplemental Nutrition Assistance Program (SNAP) is the largest program addressing food insecurity in the U.S. States can eliminate the asset test and/or increase the income limit for SNAP eligibility, expanding the number of households receiving assistance. We examined the association of state elimination of the asset test and increases in the income limit with rates of interpersonal violence, including intimate partner violence (IPV), other relationship violence (violence by a parent, friend, etc.), and stranger violence. MethodsWe used data from the SNAP Policy Database and state-level estimates of rates of interpersonal violence per 1000 population ages ≥12 years from the 2012–2014 to 2016–2018 National Crime Victimization Survey. ResultsStates that adopted both SNAP eligibility policies (eliminated the asset test and increased the income limit) had a lower rate of IPV (β = −0.4, 95% CI -0.9, 0.0) and other relationship violence (β = −2.4, 95% CI -3.8, −1.1) compared to states that did not adopt either policy. The rate of stranger violence (β = −0.5, 95% CI -2.3, 1.4) did not differ for states that adopted both policies compared to states that did not adopt either policy. Rates of IPV (β = −0.4, 95% CI -0.9, 0.2), other relationship violence (β = −1.2, 95% CI -3.2, 0.7), and stranger violence (β = −0.2, 95% CI -2.0, 1.6) did not differ for states that eliminated the asset test only compared to states that did not adopt either policy. ConclusionExpanding SNAP eligibility may help prevent interpersonal violence at the population-level.

Significantly reduced rates of interpersonal violence in an urban Danish population 2003–2021

This study aimed to describe changes in annual incidence rates and the severity of deliberate interpersonal violence based on hospital and forensic data in a Danish urban population 2003–2021. Included in the study were local victims of violence admitted to Odense University Hospital and/or subjected to medico-legal autopsy at the Institute of Forensic Medicine, University of Southern Denmark from 2003 to 2021. Based on population counts, we estimated overall and gender specific annual incidence rates in different age groups. For the 14,788 victims included in the study, the gender-specific incidence rates were 5.7 for males and 2.4 for females per 1000 population/year. The incidence rates decreased almost fourfold for both genders in all age groups. In both gender, the incidence rate of violence involving mild injuries decreased significantly, whereas incidence rate of violence involving severe injuries remained unchanged over the study period. The proportion of superficial lesions decreased and the proportion of wounds, bone fractures, and deep lesions increased. The proportion of victims with injuries from knifes increased from 3.0 to 5.4% in the study period. Overall, 0.3% died from their injuries. The present study showed a significant decreased in the incidence rate of violence based on hospital and forensic data. The decrease involved solely victims with less severe injuries. We recommend studies combining hospital, forensic, and police data.

Childhood and Adult Sexual Violence Exposures as Predictors of PTSD, Dissociation, and Substance Use in Women in Jail

ABSTRACT Women involved in the criminal legal system report high rates of interpersonal violence, particularly sexual violence, and mental health problems. Although existing research has linked experiences of interpersonal violence to multiple negative mental health outcomes, few researchers have examined concurrent psychopathology as an outcome of child and adult sexual violence in system-involved women. The purpose of this study was to examine child sexual abuse (CSA) and adult sexual violence, while controlling for other forms of interpersonal violence, as predictors of current symptoms of posttraumatic stress disorder (PSTD), substance use disorder (SUD), and dissociation in women in jail in the Mountain West. Randomly selected participants (N = 146) completed clinician-administered measures of trauma histories and mental health symptoms. The majority of the women (73%) reported experiences of CSA and about half reported experiences of adult sexual violence. Over half of the women reported symptoms consistent with current probable PTSD, about 20% reported dissociation symptoms in a clinical range, and over 70% met criteria for a SUD in the past year. The proposed model was tested with path analysis. CSA significantly predicted current symptoms of PTSD while adult sexual violence exposure predicted symptoms of SUD and dissociation. These results illustrate the high rates of sexual violence exposure as well as the complexity of mental health needs associated with these exposures in system-involved women. Findings highlight the need to comprehensively assess incarcerated women’s trauma exposure and psychological distress to better meet the needs of this population.

Climate change intensified violence in the south-central Andean highlands from 1.5 to 0.5 ka

AbstractThe archaeology of the pre-contact Andes provides an ideal study of human responses to climate change given the region's extreme climatic variability, excellent archaeological preservation, and robust paleoclimate records. We evaluate the effects of climate change on the frequency of interpersonal violence in the south-central Andes from ca. 1.5–0.5 ka (AD 470–1540) by comparing incidents of skeletal trauma observed among 2753 crania from 58 sites to rates of ice accumulation at the Quelccaya Glacier. We find that, in the highlands, the odds of identifying inter-personal violence increase on average by a multiplicative factor of 2.4 (1.8–3.2; 95% C.I.) for every 10-centimeter decrease in annual ice accumulation. Our statistical analysis does not detect a relationship between ice accumulation and interpersonal violence rates among coastal or mid-elevation populations. This disparity likely resulted from variable economic and sociopolitical strategies at different elevations. The failure of rain-fed agriculture during periods of drought and concomitant dissolution of organizing polities likely predisposed highland populations to socioeconomic stress and violent competition for limited resources. Conversely, diversity among lowland and midland economies may have buffered against the effect of drought.

Do Changes to the Alcohol Retail Environment Reduce Interpersonal Violence?

To summarize recent research on the alcohol retail environment (sales, policies, availability) and interpersonal violence (assault, intimate partner violence, sexual assault), including methods utilized, theoretical frameworks employed, and associations by types of alcohol environmental exposure and violence. Studies continue to demonstrate that reducing alcohol availability directly and indirectly lowers rates of interpersonal violence. Many of the 30 studies used state-of-the-art analytic methods and study designs. Few studies examined heterogeneity by minoritized identities or between alcohol environments and violence by other contextual characteristics. There was a dearth of theoretical frameworks and mechanisms explicated. To increase impacts of alcohol control policies, specific, practical advice is needed about where, when, and for whom changes will reap the biggest effects. Methodological next steps include analyzing natural experiments, incorporating legal epidemiology, designing studies to examine heterogeneities, developing spatiotemporal simulations, and investigating how embodiment of historic injustices contributes to violence. The online version contains supplementary material available at 10.1007/s40471-022-00315-7.

Introduction to the Special Issue on Common Goals, Different Needs: Improving Communication and Collaboration Between Researchers and Practitioners to End Interpersonal Violence.

Rates of interpersonal violence have largely remained stagnant over the past three decades, despite the magnitude of prevention and response efforts to address this issue. Although interpersonal violence researchers have stressed the importance of partnerships between researchers and campus and community-based practitioners, there is still a disconnect between the work done by researchers and those engaged in direct practice in the field. This special issue brings together researchers and practitioners to explore a variety of challenges and successes in identifying common goals, building relationships, and improving strategies for addressing interpersonal violence using researcher-practitioner models.

THE INJUSTICE OF UNDER-POLICING IN AMERICA

THE INJUSTICE OF UNDER-POLICING IN AMERICA

Psychological, Physical, and Sexual Violence Against Children in Australian Community Sport: Frequency, Perpetrator, and Victim Characteristics.

Childhood sport participation is associated with physical, social, and mental health benefits, which are more likely to be realized if the sport environment is safe. However, our understanding of children's experience of psychological, physical, and sexual violence in community sport in Australia is limited. The aims of this study were to provide preliminary evidence on the extent of experiences of violence during childhood participation in Australian community sport and to identify common perpetrators of and risk factors for violence. The Violence Towards Athletes Questionnaire (VTAQ) was administered online to a convenience sample of Australian adults (>18 years), retrospectively reporting experiences of violence during childhood community sport. Frequencies of experience of violence were calculated and Chi-square tests were conducted to determine differences between genders. In total, there were 886 respondents included in the analysis. Most survey respondents were women (63%) and about a third were men (35%). About 82% of respondents experienced violence in sport as a child. Psychological violence was most prevalent (76%), followed by physical (66%) and sexual (38%) violence. Peers perpetrated the highest rates of psychological violence (69%), and the rates of physical and psychological violence by coaches (both >50%) were also high. Age, sexual orientation, disability, and hours of weekly sport participation as a child were all associated with childhood experience of violence in sport. The rates of interpersonal violence against children in sport were high. This novel data on perpetrators of the violence and the risk factors for experiencing violence provides further context to inform safeguarding strategies in sport. A national prevalence study is recommended to advance our understanding of the childhood experiences of violence in Australian sport.

Interest in physical danger: does it mediate the relationship between gender and violent offending?

PurposeThe purpose of this study is to test the hypothesis that the relationship between gender and violent offending is mediated, in part, by an interest in participating in physically dangerous activities.Design/methodology/approachThis study makes use of self-report data from a sample of college students and other adults that they recruited to participate in this study to test the hypothesis that having an interest in physically dangerous activities mediates, at least in part, the gender–violence association. Two measures of violent offending are examined: total violent offending and the number of different types of violence committed. Relevant control variables are included in multivariate models, and bootstrapping mediation analysis is also conducted.FindingsNet of the effects of controls, an index for interest in physically dangerous activities, significantly predicts both total violence and the number of types of violence committed. Bootstrapping-based mediation analysis produces support for the hypothesis that males have higher rates of interpersonal violence than females, in part, because of a greater desire to engage in physically dangerous activities.Originality/valueThis study is an important step in understanding why males are more likely to engage in interpersonal violence than females.

Associations between interpersonal violence and cancer risk factors for transgender and cisgender people.

6516 Background: Cancer risk factors for transgender people are largely unexplored. Extreme rates of interpersonal violence experienced by transgender people may increase the risk of cancer. The associations between exposure to interpersonal violence and cancer risk factors have not been investigated. Methods: We searched for experiences of violence in cohorts of 923 transgender and 1846 cisgender people matched by age, follow-up time, and year of the first encounter and measured the association between these experiences and smoking as well as BMI ≥ 40. We then estimated the prevalence ratios for these risk factors using robust Poisson regression models including gender identity, violence, and their interaction, adjusted for age and follow-up time. Results: Transgender people experienced more violence than cisgender people. Among transgender people, there were significantly higher rates of smoking among those who had experienced any type of violence (50% vs 35%, p&lt;.0001) and borderline significantly higher rates of BMI ≥ 40 (23% vs 18%, p=.05). Among cisgender people, significantly higher rates of smoking in those who had experienced violence (52% vs 31%, p&lt;.0001) and significantly higher rates of BMI ≥ 40 (23% vs 11%, p&lt;0.001) were also demonstrated. No statistically significant difference was demonstrated in the association between violence and smoking in transgender compared with cisgender people (prevalence ratio (PR).87, p=.17). A statistically significant difference was demonstrated in the association between violence and BMI ≥ 40 in transgender compared to cisgender people (PR.65, p=.02). Conclusions: Given the association between violence and cancer risk factors, eliminating violence is of profound concern to the oncology community. Violence across the life course is markedly higher in transgender versus cisgender people. Interventions are urgently needed to eliminate violence. Cancer prevention research should investigate the efficacy of methodologies known to impact interpersonal violence, including those modifying structural factors to decrease socioeconomic disparities, stigma, and oppression. [Table: see text]

Influence of Covid-19 Restrictions on Urban Violence.

We investigated whether the COVID-19 pandemic affected rates of interpersonal violence (IV). A retrospective study was performed using city-wide crime data and the trauma registry at one high-volume trauma center pre-pandemic [PP] (March-October 2019) and during the pandemic [PA] (March-October 2020). The proportion of trauma admissions attributable to IV remained unchanged from PP to PA, but IV increased as a proportion of overall crime (34% to 41%, p<0.001). Assaults decreased, but there was a proportionate increase in penetrating trauma which was mostly attributable to firearms. Despite a reduction in admissions due to IV in the first 4 months of the pandemic, the rates of violence subsequently exceeded that of the same months in 2019. The cause of the observed increase of IV is multi-factorial. Future studies aimed at identifying the root causes are essential to mitigate violence during this ongoing health crisis.

The changing face of maxillofacial trauma during the 2020 COVID-19 lockdowns in Melbourne, Australia

PurposeTo compare the incidence, aetiology, and patterns of maxillofacial fracture presentations during the various stages of the 2020 Melbourne COVID-19 lockdown restrictions to periods outside lockdown in 2019 and 2020.MethodsThis is a retrospective study of 344 subjects. The patterns of facial trauma presentations to a tertiary hospital in metropolitan Melbourne during the 2020 COVID-19 restrictions were compared to periods with no restrictions over 22 months from March 2019 to December 2020.ResultsThe incidence of maxillofacial fractures decreased by 28% during lockdown (0.41 vs. 0.57 injuries/day, P = 0.0003). Falls overtook interpersonal violence as the leading cause of fractures (44% of lockdown presentations vs. 25.7% of presentations outside lockdown, P = 0.002), while sporting injuries dropped drastically (4% vs. 17.1%, P = 0.005). Lockdowns saw an increase in the proportion of female patients (40% vs. 26.8%, P = 0.03) and a fivefold increase in proportion of domestic violence-related fractures (6.7% vs. 1.1%, P = 0.006). Alcohol-related injuries decreased significantly (11% vs. 21%, P = 0.03).ConclusionsWhile restrictions reduced rates of interpersonal violence and alcohol-related maxillofacial trauma, there was a higher proportion of injuries to females, increased falls, and domestic violence-related injuries.