Implementing a hospital based injury surveillance system: a case study in Nigeria.

A pilot study of violent injury surveillance was implemented in two hospitals in Kano, Nigeria, in two phases: a formative evaluation including training and arranging the collection of hospital information, followed by a 6 month prospective data collection. Road traffic injuries constituted about 80 per cent of the cases, gunshot injuries were the commonest in victims of interpersonal violence (IPV). The causes and context of IPV, the relationship of victims and perpetrators, and the place, related activities and anatomical site of injuries from IPV are summarized.

Intimate partner violence and reproductive health of women in Kenya.

BACKGROUND: Reproductive age represents an augmented risk of intimate partner violence (IPV) despite its occurrence in women of all ages. IPV has been associated with various reproductive health outcomes (e.g. terminated pregnancies and infant mortality), although multi-country studies indicate that the findings may not be consistent across all cultures. STUDY AIM AND METHOD: The current work describes the association between IPV and reproductive health of women in Kenya using the Demographic and Health Survey of 2003. RESULTS: A significant association between physical/emotional/sexual abuse of women and negative reproductive health outcomes such as terminated pregnancies and infant mortality was identified. In addition, IPV exposure was associated with use of family planning methods and high fertility. CONCLUSION AND RECOMMENDATIONS: Practitioners in the healthcare sector should inquire about abuse. Provision of counselling services and information regarding IPV effects on reproductive outcomes as well as referring abused women to relevant institutions is recommended in secondary prevention of IPV and to improve the reproductive health status of abused women.

The significance of addressing trauma in outpatient psychiatry.

Establishing post-traumatic stress disorder as a psychiatric diagnosis has only marginally increased awareness of traumatic experiences. Traumas are inconsistently recorded in initial psychiatric histories and, when observed, rarely reflected in the primary diagnosis and treatment. The present study aimed to investigate if there is an association between sufficiently addressing trauma and long-term outcome and what factors affect whether trauma, according to the patient's view, is sufficiently addressed or not. Socio-demographic data, experiences of trauma and treatment, and outcome, were collected retrospectively from Arabic, Iranian, Turkish and Swedish patients, who had visited a psychiatric clinic 3-4 years earlier. Fifty-one patients whose traumatic experiences had been sufficiently addressed were compared with 39 patients who perceived that their traumas had not been addressed. Logistic regression analyses were performed to examine relationships between clinical variables and whether or not traumas had been addressed. Patients with trauma sufficiently addressed reported high confidence in staff (odds ratio, OR=7.2, p<0.001), high self-rated health (OR=8.0, p<0.01) and low scores on the Self-rating Inventory for PTSD (OR=7.7, p<0.05) and Depression Scale (OR=3.0, p<0.15). Reporting less than five different traumas (OR=4.6, p<0.01) and being an ethnic Swede (OR=2.4, p<0.10) were the background variables independently related to having trauma sufficiently addressed. Addressing trauma may improve patients' confidence in staff, self-rated health and trauma-related symptoms. Multiplicity of traumas and belonging to an ethnic minority implied that trauma was less addressed.

Quality of life among parents of children with congenital heart disease, parents of children with other diseases and parents of healthy children.

We compared quality of life among parents of children with congenital heart disease (PCCHD, n = 1092), parents of children with other diseases (PCOD, n = 112) and parents of healthy children (PHC, n = 293). We also identified determinants of quality of life among the parents. The parents completed a questionnaire about such areas as quality of life and financial situation. The design was cross-sectional and data were collected during 20 consecutive days. The univariate analyses showed that PCCHD tended to report lower quality of life than PHC. Mothers reported lower quality of life than fathers, with the lowest levels among mothers of children with CHD. The multivariate analyses revealed however that variables such as distress, hopelessness and financial situation were more important in explaining the reduced quality of life than parental gender and the presence/severity of the children's heart diseases. We corroborated previous findings and may have provided new insights into the quality of life experiences of parents of children with CHD that may be important when considering interventions to improve their situation.