Non-fatal head injury among Scottish young people: the importance of assault

Prevalence and correlates of physical fighting among school-going adolescents in Santiago, Chile

OBJECTIVE

There is a growing interest in injury as a public health issue across the world. There is paucity of data on the prevalence and social correlates of non-fatal interpersonal violence in low- and middle-income income nations. The objective of this study was to estimate the prevalence of, and associated factors for physical fighting among school-going adolescents in Santiago, Chile.

METHOD

We conducted a secondary analysis of the Chilean Global School-Based Health Survey conducted in 2004 in Santiago. We aimed to assess the prevalence and social correlates of having been involved in a physical fight in the prior 12 months.

RESULTS

Of the 2111 respondents, 40.7% (54.3% males and 26.6% females) reported having been in a physical fight in the prior 12 months. Males were more likely to have been in a physical fight than females [OR = 3.89, 95% CI (3.11, 4.85)]. Substance use (cigarette smoking, drinking alcohol, and using drugs) and bullying victimization were positively associated with fighting [OR = 3.05, 95% CI (2.40, 3.87) for substance use, and OR = 1.65, 95% CI (1.32, 2.05) for bullying]. Parental supervision was negatively associated with physical fighting [OR = 0.62, 95% CI (0.50, 0.78)].

CONCLUSION

We have estimated the prevalence of having engaged in a physical fight among in-school adolescents in Santiago, Chile. We have found that the prevalence is similar to what has been reported in diverse settings in Africa, Europe and North America.

A population survey found an association between self-reports of traumatic brain injury and increased psychiatric symptoms

OBJECTIVE

This study determined whether self-reported Traumatic Brain Injury (TBI), identified in a community sample and occurring up to 60 years previously, is associated with current psychiatric symptoms, suicidality, and psychologic well-being.

STUDY DESIGN AND SETTING

Three age cohorts (20-24, 40-44, 60-64) were randomly sampled from the cities of Canberra and Queanbeyan, Australia, yielding a total of 7,485 participants. The samples were administered scales measuring anxiety, depression, suicidality, positive and negative affect, personality traits, and physical health status.

RESULTS

Of the total sample, 5.7% reported history of TBI involving loss of consciousness for at least 15 min, occurring an average of 22 years previously. History of TBI was associated with increased symptoms of depression, anxiety, negative affect, and suicidal ideation.

CONCLUSION

History of TBI is a risk factor for psychiatric morbidity. The effect is greatest in young adults, and occurs up to several decades subsequent to the occurrence of TBI.

Reporting of the incidence of hospitalised injuries: numerator issues

OBJECTIVES

To examine and discuss the implications on the incidence of hospitalised injuries of selecting cases from principal diagnosis field only compared with considering all diagnosis fields, the inclusion compared with the exclusion of medical injuries, and the impact of identifying multiple admissions.

METHODS

Analysis of data from the 1999-2000 New South Wales Inpatient Statistics Collection, Australia, including an internal linkage of the same dataset.

RESULTS

Approximately 27.5% of records with a non-injury primary diagnosis include a nature of injury diagnosis in a subsequent diagnostic field. This figure increased to more than half (53%) of discharges for medical injuries. The internal linkage showed that 6.5% of discharges were repeat admissions for the same International Classification of Diseases, 10th revision (ICD-10) injury code and that 13.8% were repeat admissions for any ICD-10 injury code. The proportions of repeat admissions varied according to the type and the mechanism of injury.

CONCLUSIONS

Selecting hospitalised injury cases from the principal diagnosis alone would underestimate medical injury cases as well as other injuries occurring in hospital. Repeat admissions should always be considered particularly in the case of thermal injuries, self harm, and medical injuries. Due to the limitations of data linkage, alternative methods need to be developed to identify repeat admissions. Other areas in which further research would be beneficial to a more uniform reporting of injury hospitalisations include better identification of injuries occurring in hospital, a review of ICD-10 injury codes, and the development an ICD-10 based severity measure which can be readily used with hospital discharge data.