Search

Aim: The COVID‐19 pandemic drastically altered human behaviour and socialisation and may have created an environment that could lead to increased incidence of domestic abuse and non‐accidental trauma, or child physical abuse (CPA). Initial reports about the effect of the COVID‐19 pandemic on the rates of CPA have been mixed. The purpose of this study is to describe the effects of COVID‐19 on rates of CPA in a large metropolitan paediatric hospital and level I paediatric trauma centre. Methods: We identified and compared all CPA admissions under 18 years from May 2019 to February 2020 and considered that to be the pre‐COVID time frame. The ensuing 12‐month period of March 2020 to February 2021 was considered to be the intra‐COVID time frame. Results: There were 49 (0.32%) unique CPA patients pre‐COVID and 83 (0.85%) unique CPA patients intra‐COVID (P < 0.001) with lower total admissions for any reason during the intra‐COVID time frame. Monthly CPA cases were increased (P < 0.03) during the intra‐COVID time period (mean 6.9, 95% confidence interval: 5.8–12.7) compared to the pre‐COVID time period (mean 4.9, 95% confidence interval: 3.3–8.2). Conclusion: During the COVID‐19 pandemic, there were decreased overall hospital admissions in the period of mandated shutdowns and isolation. However, we saw an increased rate of CPA admissions compared to the time period prior to the pandemic. Knowledge of such data, trends and circumstances will help keep health‐care providers alert and vigilant in identifying children at risk for maltreatment, and may impact child abuse protocols and guidelines. [ABSTRACT FROM AUTHOR]

This study's purpose is to evaluate whether bone speed of sound (SOS) data, a parameter of quantitative ultrasound, collected from an infant autopsy sample are comparable to data collected from healthy, living infants. We hypothesize that SOS values obtained from deceased term‐born infants will fall within the normal range for healthy, living infants. The study sample consists of 351 deceased infants between the ages of 30 weeks gestation at birth to 1 year postnatal at the time of death receiving autopsies at the Harris County Institute of Forensic Sciences or Texas Children's Hospital in Houston, TX. Various multivariate and univariate statistics were used to examine the relationship between SOS and age, prematurity, and chronic illness. The results of an ANOVA comparing the study sample data to published data from healthy, living infants indicate the SOS data are comparable. Additionally, a MANOVA indicated significant differences in SOS related to prematurity (p = 0.001) and age (p < 0.001). Mean SOS was significantly greater among term‐born infants (M = 3065.66, SD =165.05) than premature infants (M = 2969.71, SD =192.72). Age had a significant polynomial (cubic) relationship with SOS for both the premature and term groups (p < 0.001). Results suggest that bone from an infant autopsy sample is an appropriate surrogate to examine the relationship between SOS and determinants of bone strength. Therefore, future research will use this study sample to investigate the relationship between SOS and determinants of bone strength in infants. [ABSTRACT FROM AUTHOR]

In 2012, the Harris County Institute of Forensic Sciences began prospectively collecting injury data from pediatric autopsies. These data and associated case information from 635 pediatric cases are archived in the Infant Injury Database (IID). This paper introduces the IID to the forensic community and demonstrates its potential utility for child abuse and infant fatality investigations. The database is intended to be a source of evidence‐based research for coroners/medical examiners and clinicians in the recognition and diagnosis of child abuse. RR estimates were employed to quantify the relationship between individual autopsy findings to trauma‐related and nontrauma‐related causes of death. For example, unsurprisingly, the RR of trauma cases with multiple injury types is significantly greater than other causes of death, but the RR results provide a quantitative representation of the relationship. ROC curve modeling of the presence/absence of various injury types performed well at discriminating trauma from other causes of death (AUC = 0.96). [ABSTRACT FROM AUTHOR]