The aim of our study was to investigate the impact of curfews imposed due to the COVID-19 pandemic on emergency department visits, orthopedic trauma frequencies, and types of trauma. In this single-center, retrospective cohort study, a total of 16,242 patients, including 3,020 trauma patients, were admitted to level 1 trauma center emergency department between April-June 2020 and 2021 (curfew group) and between April-June 2018 and 2019 (control group). Patients were separated according to emergency department triage categories and trauma mechanisms, and the changes in the days of curfew were analyzed. With the curfews, there was a 54% decrease in emergency room admissions. This decrease was seen especially in yellow and green area patients, whereas there was no significant decrease in red area patients with the highest urgency. When the effect of curfews on orthopedic traumas was analyzed, a 20% decrease was observed in trauma cases. In particular, there was a significant decrease in traffic accidents in and out of the vehicle, assault, and sports injuries, whereas there was no significant decrease in falls from the same level, motor accidents, and occupational accidents. The impact of curfews on the density of emergency departments and trauma patients will guide the health management policies to be followed in future curfews to be implemented for different reasons. In the light of this information, more effective resource management and better quality health service planning will be ensured.
I examine the effect of city-level juvenile curfews on teenage birth rates using the National Center for Health Statistics birth data from 1982 to 2002. I compare differences in birth rates between younger and older age groups in cities with and without curfew ordinances. Before curfew adoption, the age differential in birth rates trended similarly for cities that did and did not adopt a curfew. There were significant decreases in the age differential birth rates in cities that adopted a curfew relative to cities that did not. Curfews reduced birth rates by approximately 3 births per 1000 women ages 15-17. I find a decrease in birth rates among white women. The main results are corroborated using a variety of robustness checks and specifications.
The objective of the current study was to assess the effect of the coronavirus disease 2019 (COVID-19) curfew restrictions on the body mass index (BMI) and dietary and physical activity behaviors of Saudi adults. This cross-sectional study was conducted using an online questionnaire in Saudi Arabia in May and June 2020, during the curfew restriction period. The questionnaire included three sections with questions regarding sociodemographic data, dietary behaviors, and moderate and vigorous activities. A total of 504 Saudi adults participated in this study. Even though there were no significant differences in the BMI status before and during COVID-19 curfew restrictions, the percentage of overweight participants slightly increased during the period of COVID-19 curfew restrictions. The frequency of intake of fruits and beverages were significantly increased (p<0.05), whereas the consumption of meat and fish, bread and cereals, and sandwiches and burgers showed a significant reduction (p=0.001). Although the overall percentage of participants engaged in moderate physical activities increased during curfew restrictions, there was a reduction in vigorous physical activities. This study demonstrated changes in BMI and dietary and physical activity behaviors due to the COVID-19 curfew restrictions.
For young people attending school, social jetlag (SJL) refers to discrepancy in sleep/wake timing between school days and weekends. This study investigated SJL in school-aged children and adolescents in England and whether this is associated with age, gender, and sleep habits including bedtimes and electronic media use. Students (school y 5-13; typical age 9-18 y) completed the 2021 OxWell Student Survey. In total 19,760 participants (55% female) reported on sleep/wake timing, rules concerning bedtime setting on school night/weekend, electronic media curfew, and frequency of social media use and video gaming before sleep intention. The mean SJL was 1 h 53 min (SD = 1 h 7 min) and peaked at 2 h 7 min at age 15. Multiple regression analysis revealed SJL was positively associated with age and being male was associated with slightly lower SJL than being female. After controlling for age and gender, weekend bedtime setting (β = 0.21), frequency of social media use before sleep (β = 0.16) and video gaming before sleep (β = 0.12) were the strongest predictors of SJL. Findings suggest that household rules regarding weekend bedtimes and less electronic media use before sleep may be connected with lower SJL as well as more regular sleep timing across the whole week.
暂无摘要（点击查看详情）
The present communication examines the phenomenon of curfew in relation to the COVID-19 pandemic with special attention being laid on the management of the epidemic by Italian health authorities. A literature review and a historical-medical analysis were performed. A historical-medical excursus on the word curfew is offered and a comparison between military and health scenarios is given. Finally, this article stresses how words connected with wartime events should be contextualized when adopted in unmilitary scenarios such as pandemic emergencies and related public health responses.
People worldwide have been affected by coronavirus disease 2019 (COVID-19), which was the fifth pandemic after the 1918 flu pandemic. People have had their sense of normality torn apart, and these changes have taken a toll on their mental health.
During the COVID-19 pandemic, many countries implemented restrictions, social distancing measures, and lockdowns to limit the spread of the disease. These lockdowns have affected children's screen time (ST), pain, and physical activity (PA) levels. The present study aimed to explore the relationships between ST, pain, age, and PA before, during, and after the COVID-19 pandemic. The caregivers of 329 children (median age = 8 years) filled out an online self-reported survey about the children's PA, ST, and pain before, during, and after the COVID-19 curfew. Spearman's rank correlation coefficient was used to explore the associations between these variables. After the curfew, pain that existed before the pandemic had a weak negative relationship with PA intensity (-0.11, p = 0.04) and a weak positive relationship with ST (r = +0.12, p = 0.04). There was a strong positive relationship between ST in all time periods (p > 0.01). PA and ST had a weak negative relationship (p > 0.05) during the curfew and after the curfew but not before the COVID-19 pandemic. Age had a weak positive correlation with ST in all time periods (p > 0.01). In addition, ST was affected by the curfew. The study findings indicated that young children had longer ST during the curfew and after the curfew compared with before the curfew. Increasing PA could lessen children's ST, which could, in turn, increase the probability that their general pain would decrease.
Interventions such as vaccinations, treatment et cetera are usually the gold standard of disease control, as measured by reducing the reproduction number below unity. However, in practice, few diseases are reduced below this eradication threshold and instead persist despite active intervention campaigns. We propose an epidemic model of rabies with a saturated incidence rate that represents "soft" interventions such as public-awareness campaigns, animal curfews, fences etc. We prove local and global stability results based on the reproduction number. However, numerical simulations suggest that eradication is unlikely to occur using current practices. We thus investigate the effect of altering the saturated incidence term using "soft" interventions and show that near-eradication can be achieved even when the reproduction number exceeds unity. Soft interventions such as public-awareness campaigns, reducing contacts, animal curfews and fences can have a greater effect on eradicating rabies than current vaccination programs.
Alcohol use has previously been associated with femicide, the most extreme form of gender-based violence, but research on femicide from low-income and middle-income countries is scarce. We aimed to examine the role of alcohol restrictions during South Africa's COVID-19 lockdowns on femicide rates in the country. In this cross-sectional study, we compared estimates of overall femicide, intimate partner femicide, and non-intimate partner femicide from two retrospective national surveys of female individuals aged 14 years and older killed in 2017 and during nine COVID-19 lockdown periods in 2020-21. Both surveys used multistage, stratified cluster sampling with mortuaries or medico-legal laboratories as the primary sampling unit. Sampling frames that listed all mortuaries operating in the country in each study year were developed and mortuaries were stratified by size on the basis of the number of autopsies they performed per year. Mortuary data were supplemented with investigative data extracted from police dockets during interviews with police members. Cases in which age and sex were unknown and in which the cause of death was undetermined were excluded from data collection. Linearisation was used to obtain robust variance estimators for parameter estimates. Female population estimates were derived from the Thembisa mathematical model to calculate age-standardised rates, and the WHO world standard population distribution was used to normalise weightings for age-standardised rate calculations. We used Poisson regression and incidence rate ratios (IRRs) with 95% CIs to compare femicide estimates for periods of complete and partial alcohol sales and curfews with periods of no restrictions and to compare data from corresponding calendar periods in 2017 and 2020-21. We found no evidence of a significant change in age-standardised rates of overall femicide between 2017 and 2020-21 (IRR 0·95, 95% CI 0·88-1·03). Our Poisson regression results for 2020-21 showed no evidence of a significant difference in the average number of overall femicide cases between the first two lockdown periods, both periods with no alcohol sales but differing curfew levels (1·16, 0·88-1·54), but we found a significant increase in the average number of cases between periods 2 and 3, when alcohol sale restrictions were relaxed (2·14, 1·70-2·69). When combining periods with similar alcohol and curfew restrictions, we found a significant decrease in overall femicide cases between periods of no restriction and periods of restricted alcohol sales and night and late-night curfews (0·57, 0·49-0·66). Similarly, the average number of femicide cases during the period with a complete ban on both movement and alcohol sales was 63% lower than during periods of no restriction (0·37, 0·30-0·47). A similar significant difference was observed for both cases of intimate partner femicide (0·39, 0·28-0·53) and non-intimate partner femicide (0·39, 0·27-0·55). This pattern was not seen during the corresponding calendar periods in 2017. The COVID-19 lockdown presented an opportunity to study the association between alcohol use and femicide in South Africa. We found a decrease in overall femicide, intimate partner femicide, and non-intimate partner femicide during periods of complete alcohol prohibition compared with periods of partial or no alcohol sale bans. This analysis supports alcohol use as a risk factor for severe gender-based violence and emphasises the importance of implementing evidence-based alcohol harm reduction interventions and policies as part of gender-based violence prevention strategies. Ford Foundation, Centers for Disease Control and Prevention Foundation, and South African Medical Research Council.
Alcohol and cannabis are psychotropic substances most used by adolescents. Psychological, behavioral, social, and cognitive factors linked to substance use in adolescents with chronic pain (ACP) are unclear. We examined these factors among four groups: those reporting Only Alcohol Use (AU), Only Cannabis Use (CU), Co-use of Alcohol and Cannabis (CAM), and No Substance Use (No-SU). From September 2021 to May 2024, we surveyed 243 patients from a pediatric pain clinic in the Northeastern U.S. Kruskal Wallis, Mann-Whitney U, and Monte Carlo Chi-Square tests assessed group differences. Among 243 (Mage = 16.9, SD = 1.42 years, 68% female), 12.3% reported AU, 5.3% CU, 19.8% CAM, and 62.6% No-SU in their lifetime. Groups differed by age, functional disability, depressive symptoms, and behavior avoidance in drive and fun-seeking domains (ps < 0.05). CAM group was older (p < 0.001), more depressed (p = 0.003), stressed (p = 0.03), and had more school-related anxious anticipation (p = 0.03) than No-SU, reporting more drinking and drunkenness (ps < 0.05) than AU. CU group reported greater pain interference (p = 0.04) and functional disability (p = 0.01) than AU, with 100% using for symptom relief and 85.6% for pain. Increased drunkenness past-year was positively associated with stricter curfew times and increased parental supervision in the CAM group (p < 0.006). CAM group reported more stress, depression, and alcohol consumption, complicating pain management. CU is frequently used for pain relief and is associated with greater functional disability. Interventions targeting substance use and mental, physical, and social wellbeing in ACP are limited, underscoring the need for multidisciplinary strategies addressing pain and substance use in parallel.
Night-time light (NTL) composites offer a unique spatiotemporal view of urban growth by capturing electricity consumption, infrastructure density, and economic activity patterns that traditional land-cover surveys cannot fully reveal, yet inland China's megaregions remain understudied from this perspective. Using a 23-year (2000-2022) cross-calibrated NTL product integrated with land-cover, population, and topographic data, we analysed illumination dynamics in the Chengdu-Chongqing economic circle. Mean radiance rose by 78% while the lit area expanded from 0.53% to almost 12%. About three-quarters of this growth is confined to a 4-6 km peri-urban "neon ring" created chiefly by cropland conversion to high-rise housing and logistics estates, now ~ 40% brighter than historic cores. Targeted LED retrofits and façade-lighting curfews produced persistent downtown "dark hollows", proving that local policy can dampen sky-glow. Cropland-to-urban parcels emitted roughly 6 nW cm⁻² sr⁻¹ more light than other transitions, and protected wetlands brightened threefold, flagging covert development. Spatial autocorrelation analysis revealed extremely high global Moran's I values (> 0.92 after 2013), indicating strong spatial clustering patterns of illumination changes, with local LISA analysis identifying hotspots predominantly concentrated in the core areas of both cities. Projections indicate ~ 1,000 km² of additional luminous sprawl by 2042 as radiance continues to climb despite a 1.6% population decline, underscoring a widening decoupling between light and headcount.
Non-pharmaceutical interventions (NPIs) such as city-level curfews and local lockdowns were implemented to control SARS-CoV-2 transmission, yet their effectiveness at fine spatial scales remains uncertain. We evaluated a rotational lockdown policy in Bogotá, Colombia, applied at the locality level-an administrative aggregation of neighborhoods. Mobility patterns derived from mobile phone data were analyzed to quantify commuting changes, defined as relative variations in movement compared to a pre-intervention baseline (one month before restrictions). We distinguished between external mobility (between localities) and internal mobility (within localities). Using epidemiological surveillance data, we estimated the effective reproductive number ([Formula: see text]) and assessed its association with mobility reductions. A compartmental transmission model simulated counterfactual epidemic trajectories without NPIs, comparing predicted and observed infections, mortality, and [Formula: see text]. The intervention reduced inter-locality mobility by up to 40% but only minimally affected within-locality movement (median change < 5%), a descriptive result based on mobility data. Early lockdown cycles produced the largest declines in transmission (up to 27% reduction in cases), while subsequent rounds showed diminishing effects. Socioeconomic heterogeneity explained substantial spatial variability in transmission dynamics, revealing stronger associations between mobility and [Formula: see text] in localities with lower socioeconomic status. Our findings demonstrate that fine-scale NPIs can transiently reduce community transmission, but their impact depends on the spatial distribution of mobility and socioeconomic inequalities across the urban landscape.
To evaluate the relative effectiveness of voluntary social distancing appeals versus mandated lockdowns in reducing population mobility during the COVID-19 pandemic, using India as a developing country case study. This study analyzed daily mobility data from Google's Community Mobility Reports across six location categories between February 16 and May 31, 2020. A geographic-level regression model was employed to isolate voluntary mobility changes during India's 14-hour voluntary Janta Curfew prior to the mandatory nationwide lockdown. The model controlled for pandemic severity, health infrastructure, and socioeconomic factors. Conservative estimates indicate that voluntary measures accounted for a substantial proportion of overall mobility declines, ranging from 27% to 71% depending on the location. The most pronounced voluntary reductions occurred in retail and recreational centers, parks, and transit stations. Timely and targeted non-mandated appeals can achieve meaningful behavioral change, complementing formal restrictions. These findings offer critical guidance for health promotion policy, demonstrating that voluntary public compliance can be a viable, flexible strategy for pandemic management, particularly in resource-limited settings where strict mandates may cause severe socioeconomic strain.
Background In Uganda, village health workers (VHWs) use the integrated community case management (iCCM) strategy to treat malaria, pneumonia, and diarrhea in the community. It is very important for children to get treatment within 24 hours of getting sick to lower their risk of death and illness. In March 2020, Uganda imposed nationwide COVID-19 lockdown measures, encompassing transport restrictions and curfews, potentially impacting healthcare accessibility. This study evaluated the impact of the lockdown on the timeliness of treatment-seeking from VHWs for children under five years in southwestern Uganda. Methods We conducted a retrospective review of VHW patient registers from 22 villages in Bugoye sub-county, Kasese district, for the time between December 1, 2019, and May 31, 2020. The time before the lockdown was from December 1, 2019, to March 22, 2020, and the time during the lockdown was from March 23 to May 31, 2020. There were 4,024 child records in total, and 3,822 of them were used in regression models because they had all the information needed. Timeliness was defined as seeking care within 24 hours of the onset of illness. We used logistic regression to find crude and adjusted odds ratios (ORs) with 95% confidence intervals (CIs). Results Overall, a total of 2,428 out of 3,822 (63.5%) children sought care within 24 hours. In the pre-lockdown period, 823 out of 1,330 people (61.9%) sought care on time. During the lockdown, 1,605 out of 2,492 people (64.4%) (p = 0.131) sought care on time. In multivariable logistic regression, the lockdown period was not significantly associated with timely care-seeking (adjusted OR (aOR) = 1.13, 95% CI: 0.99-1.30; p = 0.079). Fever was independently correlated with increased likelihood of timely care-seeking (aOR = 1.18, 95% CI: 1.02-1.37; p = 0.023), and increasing age in months was similarly associated with slightly higher odds (aOR = 1.01 per month increase, 95% CI: 1.00-1.01; p = 0.024). There was no significant association between sex, rapid breathing, diarrhea, and danger signs and timeliness. Conclusion The nationwide COVID-19 lockdown period was associated with a modest but non-significant increase in timely care-seeking. These results indicate that community-based health services delivered by VHWs remained accessible and robust despite mobility restrictions. Improving VHW programs could help make sure that important child health services are still available during future public health emergencies.
Juvenile cybercrime is a salient governance challenge in digitalizing societies, yet scholarship concentrates on ex post sanction and under-theorizes the interaction among platform design, the digital risk environment, and minors' developmental vulnerability. Drawing on K.G.M. v. Meta Platforms, this study develops a "front-end governance" framework anchored in the best-interests-of-the-child principle and articulated through three doctrinal pillars, the platform duty of risk mitigation, the regulation of harmful design and risky digital environments, and the foreseeability of risk. An empirical component, based on a cross-sectional survey in China, examines institutional support for prevention. Endorsement is broad, 92% for strengthened market regulation, 91% for cyber-law education, 84% for technical firewalls, and 83% for internet classification and digital curfews. On responsibility allocation, 76% prioritize tri-partite collaborative governance involving families, schools, and society. Multinomial logistic regression indicates occupational positioning is the only significant predictor of priority orientation; regional, income, and educational variation are non-significant once controls are applied, a null pattern we read as suggestive rather than confirmatory. The findings support a shift from ex post sanction to ex ante risk governance, organized around platform accountability, age-appropriate design, rule-of-law education, and graded content ecosystems.
Japanese elementary school children experience short weekday sleep because of academic demands and increasing digital media use. This study examined lifestyle factors associated with children's weekday sleep duration and social sleep restriction (SSR: weekend minus weekday sleep duration) within a sociocultural context. Caregivers of 4273 children aged 6-12 years from 125 Japanese schools (response rate: 8.8%) completed online questionnaires between November 2023 and March 2024. Multivariable regression analysis was used to identify correlates, and structural equation modeling (SEM) examined pathways among them. Weekday sleep duration was the primary outcome and SSR was the secondary outcome. Mean weekday sleep duration was 9 h 16 min (SD = 112 min); SSR was 30 min (SD = 52 min). Female, older age, homework/extracurriculars, pre-bedtime media use, and absent bedtime rules were associated with shorter weekday sleep duration, whereas bedtime reading and outdoor play were associated with longer sleep. Room-sharing, a characteristic of the sleep environment for Japanese children, was also associated with shorter weekday sleep duration. SEM showed the strongest total effect of age (β = -0.389), followed by pre-bedtime media use (β = -0.194), and household rules (β = 0.154) on weekday sleep duration. Family-based sleep rules, especially media curfews and fixed bedtimes, may help protect weekday sleep duration and reduce SSR among Japanese children despite academic and digital pressures. Findings propose culturally adapted, family-centered interventions for Japanese children's sleep.
This ecological study aimed to investigate changes in the time-varying reproduction number (Rt) of SARS-CoV-2 across six regions of Massachusetts from 2020 to 2022 and to evaluate the impact of various nonpharmaceutical interventions (NPIs) implemented in 2020 by examining associated changes in the Rt. COVID-19 incident case data from the Johns Hopkins University database were adjusted for reporting delays using deconvolution and for underreporting via a Poisson-distributed multiplier of 4. Negative and zero counts were corrected using imputation. Rt was estimated using R package EpiEstim (Version 2.2-4) with a 7-day sliding window from 2020 to 2022 and with non-overlapping time windows between policy changes in 2020. From 2020 to 2022, Massachusetts experienced five COVID-19 surges, linked to the wild-type strain and emerging variants, with Rt exceeding 1 during each wave and stabilizing at or dropping below 1 during low-incidence phases. School closure and gathering restrictions, the first major intervention, were associated with a 14.7% statewide reduction in Rt (95% credible interval (CrI): -23.6%, -5.6%), with greater reductions in high-density areas such as Boston (-16.9%; 95% CrI: -26.9%, -7.5%). No statistically significant changes in Rt were found to be associated with other NPIs in 2020, including the mask mandate, reopening phases, travel restrictions and quarantine requirements, and curfews. Our findings highlight the different NPIs' varying impacts on COVID-19 transmission dynamics across regions in Massachusetts in 2020 and underscore the importance of early interventions for future pandemic preparedness.
During the COVID-19 pandemic many people experienced psycho-social stress which affected their sleep. This study was conducted during the third and fourth epidemic wave when international borders of Serbia and Bosnia-Herzegovina were entirely open, no curfew or wearing face masks were imposed, but the highest rates of COVID-19-related fatalities were reported. The aim of this study was to examine sleep patterns with COVID-related stress during the pandemic. Anonymous paper questionnaires were distributed from September 2020 to October 2021 across 8 cities in Serbia and Republic of Srpska (Bosnia and Herzegovina). Socio-epidemiologic characteristics, the COVID Stress Scales-CSS and the Perceived Stress Scale were administered. Sleeping patterns before and during the COVID-19 pandemic (bedtime, time spent sleeping and sleep quality) were recorded. Responses of 2,301 participants suggested that bedtime after midnight before and during the pandemic did not differ (13.4% vs. 14.8%, respectively). Most participants reported similar length of sleep before and during the pandemic (around 7 h), although 11% of them reported that during the pandemic they slept more often compared to pre-pandemic sleeping schedule. There was an increase in prevalence of poor sleep quality during the pandemic (4.5% vs. 9.4%, respectively). Sleeping more often compared to pre-pandemic sleeping schedule and poor sleep quality during the pandemic were independently associated with a higher CSS. Proportion of people who reported poor sleep quality doubled in the pandemic. Optimizing sleep quality in crises among people who experience poor sleep quality should be prioritized when managing public health emergencies.
Harm reduction can decrease negative consequences of substance use, but the extent to which harm reduction practices are implemented in emergency shelter settings is unknown. We conducted 55 semi-structured interviews at four shelters across Massachusetts to understand guest (40) and staff (15) experiences with harm reduction practices. We conducted thematic analysis rooted in the Social Ecological Model (SEM). Well-established harm reduction practices include naloxone distribution, bathroom checks, and safe-sex supplies. Less established practices include wound care supplies, bad-date lists for people engaging in survival sex work, "no questions asked" lockers, amnesty beds, and abolishing curfews. Recommended future practices include safer consumption spaces, drug checking, and a full suite of harm reduction supplies. Key findings at each SEM level were: At the individual level: guest and staff attitudes toward harm reduction were mixed and influenced by personal experience, or gender identity. At the interpersonal level: tensions between people who use drugs (PWUD) and others who are abstinent; stigma prevents guests from being candid with staff about substance use, and fuels tension between staff and guests. At the community level: Guests and staff have access to naloxone at shelters, carry it, and use it regularly; communication around the presence and availability of naloxone is essential; women innovate distinct interventions for themselves. Last, at the societal level: prohibitory policies do not stop people from using drugs but make people less safe; shelters can collaborate with community organizations to provide necessary harm reduction services. Shelters are implementing increasingly creative programs of harm reduction practices.