Major interpersonal violence cases seen in a Pretoria academic hospital over a one-year period, with emphasis on community assault cases

Introduction: Interpersonal violence cases make up a significant portion of the trauma cases seen in emergency centres in South Africa. Community assaults are extremely violent attacks on suspected perpetrators by members of the community aimed at inflicting serious injury. The aim of this study was to profile the major interpersonal violence cases at Kalafong Hospital with emphasis on the community assaults and how this group compares with non- community assaults regarding demographics, surgical intervention and mortality. Methods: A retrospective analysis was conducted of the major interpersonal violence cases seen over a one-year period (1 January 2016 to 31 December 2016) at Kalafong Hospital, Pretoria, South Africa. Data was manually collected and entered into a Microsoft Excel spreadsheet. The Stata 13 statistical program was used for data analysis. Results: During the study period, a total of 578 cases were analysed. Penetrating trauma accounted for 446 (77.2%) cases and blunt trauma for 132 (22.8%) cases. The number of community assault cases was 75 (12.9%). A total of 28 deaths were recorded during this period. Community assaults accounted for 13 (46.4%) of these deaths. Community assault cases had a significantly higher mortality compared to non-community assault cases with 17.3% versus 3%; Odds ratio 6.82 (95% CI 3.04­15.33, p < 0.001). The community assault group also showed a statistically significant difference in the intensive care admission rate with 15.3% compared to 6.9% in the interpersonal violence cases; Odds ratio 2.41 (CI 1.07­5.43, p = 0.028). Conclusion: Community assault cases may present with similar demographics when compared to non-community assault cases, but the difference in disposition and outcome was highlighted in this study with a higher intensive care unit admission rate and a higher mortality rate. A multi-centre follow-up study is recommended to compare demographics across Pretoria and to monitor trends in this subgroup of interpersonal violence cases

Revue de 10 annees d'autopsies medico-legales en Cote d'Ivoire (2002 A 2011)

Introduction : Le but de cette etude etait de faire une analyse synoptique des resultats de 10 annees d'autopsies judiciaires afin de disposer de donnees statistiques nationales au plan epidemiologique et medico legal. Patients et Methode : Il s'agissait d'une etude retrospective descriptive sur les autopsies judiciaires pratiquees de 2002 a 20011 (10 ans) dans le service d'anatomo-pathologie et de medecine legale du CHU d'Abidjan Treichville. Resultats : 834 autopsies judiciaires sur 24227 deces enregistres ont ete realisees sur la periode d'etude; ce qui representait 3;4 des actes medico legaux. La majorite des sujets autopsies etait des adultes jeunes (moyenne d'age = 37;6 ans); de sexe masculin (87) et les deces survenaient le plus souvent sur la voie publique (36;2) des suites d'une agression physique (26). Ainsi les morts violentes predominaient (71;7) et etaient volontiers d'origine criminelle (55). Ces agressions criminelles etaient dans la majorite des cas perpetrees avec les armes a feu (60;8) qui representaient en outre la premiere origine des morts violentes. Les deces accidentels representaient 30;8 et etaient en rapport avec les accidents du trafic (31) tandis que les morts naturelles (23;6) etaient liees essentiellement a des pathologies cardio vasculaires (41;6). Conclusion : L'autopsie medico legale joue un role important dans la manifestation de la verite au plan judiciaire mais permet egalement de participer a la collecte de donnees en matiere de sante publique; d'ou l'interet d'encourager la pratique de cet acte medico legal qui merite egalement d'etre valoriser au plan des frais de justice criminelle

The Modified Overt Aggression Scale: How Valid in this Environment?

Background:The Modified Overt Aggression Scale (MOAS) has been validated for use in the study of aggression in the developed world; unlike in the undeveloped world. The aim of this study therefore is to ascertain the discriminant validity of the MOAS for use in this part of the world using psychiatric in-patients at the Jos University Teaching Hospital. Methodology: Forty aggressive psychiatric patients and 40 non-aggressive healthy subjects were randomly selected for this study. The psychiatric patients were enlisted after fulfilling the ICD-10 (World Health Organization; 1993) criteria for a specific clinical diagnosis. The 40 non-aggressive subjects were mainly medical students and hospital staff. The MOAS was subsequently used to assess aggression in the entire cohort.Results: The males had higher mean global weighted score than the females in both the aggressive and nonaggressive categories. The mean global weighted scores of the aggressive and non-aggressive categories were 13.70+ 7.25 and 0.65 + 1.01 respectively. The difference in means is statistically significant; hence the MOAS has discriminant validity. Conclusion: Therefore; the modified overt aggression scale is a valid instrument in this environment for the study of aggression

The Modified Overt Aggression Scale: How Valid in this Environment?

Background:The Modified Overt Aggression Scale (MOAS) has been validated for use in the study of aggression in the developed world; unlike in the undeveloped world. The aim of this study therefore is to ascertain the discriminant validity of the MOAS for use in this part of the world using psychiatric in-patients at the Jos University Teaching Hospital. Methodology: Forty aggressive psychiatric patients and 40 non-aggressive healthy subjects were randomly selected for this study. The psychiatric patients were enlisted after fulfilling the ICD-10 (World Health Organization; 1993) criteria for a specific clinical diagnosis. The 40 non-aggressive subjects were mainly medical students and hospital staff. The MOAS was subsequently used to assess aggression in the entire cohort.Results: The males had higher mean global weighted score than the females in both the aggressive and nonaggressive categories. The mean global weighted scores of the aggressive and non-aggressive categories were 13.70+ 7.25 and 0.65 + 1.01 respectively. The difference in means is statistically significant; hence the MOAS has discriminant validity. Conclusion: Therefore; the modified overt aggression scale is a valid instrument in this environment for the study of aggression

Fears, coping and perceived efficacy of coping mechanisms among South African children living in childrens homes

Background: The present study examined common childhood fears, coping strategies and perceived efficacy of coping mechanisms among 8- to 13-year-old South African children (n = 141) living in four children's homes.Method: Fears were assessed by means of the Fear List Method (FLM) and the Fear Survey Schedule for Children Revised (FSSC-R). For both measures, the content and number of fears were determined. The FSSC-R was also used to establish the levels of fearfulness, as well as the pattern of fears. Coping strategies and the perceived efficacy of these strategies were assessed by means of open-ended questions.Results: The rank orders of fears as obtained with the FLM were quite different from those derived from the FSSC-R. Girls expressed more fears as well as higher levels of fears than boys. Secondary coping strategies (i.e. seeking social and/or spiritual support) were most often engaged in and were also perceived as most effective.Conclusions: A greater sensitivity to the emotional needs, especially with regard to fears, coping and perceived efficacy, of special populations is recommended