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Which Are the Factors Associated to Child Mistreatment? Use of a Routinely Collected Specific Dataset for Surveillance in a Belgian Pediatric Unit

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Health 2014年第12期6卷 1396-1407页

作者： christelle senterre Brigitte Vanthournout Research Centre of Epidemiology Biostatistics and Clinical Research School of Public Health Université Libre de Bruxelles Brussels Belgium SOS enfants ULB CHU Saint Pierre Hospital Brussels Belgium

Introduction: Child abuse is a serious health problem with compelling evidence that the phenomenon is common throughout the world. The Center “SOS enfants ULB” is a specialized team, established in a pediatric ward, which had mission to prevent and to treat the situations of children victims of physical, sexual, psychological abuse or of neglect. Our objectives were to describe the characteristics of 439 children hospitalized for (suspicion of) maltreatment and to investigate different factors potentially associated with the children at risk of neglect or maltreatment, the children victims of neglect and the physically maltreated children. Methods: Chi square test and multinomial logistic regression models with clustered robust standard error were applied to assess the relationship between the three types of mistreatment and the potential associated factors. Results: Maltreatment was observed for almost one in two children (48.7%) and approximately four on ten (41.5%) were considered at risk. Physical abuse was the most prevalent (57.9%) among the maltreated children and neglect was the second most prevalent (37.4%) form of maltreatment. Regarding the criteria leading to hospitalisation, at least one protective criterion was observed for a little more than eight children on ten. The parental criteria have shown that social problems and conjugal conflicts were the most prevalent for this category of hospitalisation criteria. Conclusion: These data, concerning the hospitalized children for which there is (suspicion of) mistreatment, collected by this team make important contribution to describing child maltreatment and its associated factors. Despite the fact that these hospitalized cases may be probably more serious than those who were not reported, every event, however small it may be, should be known for better organizing each level of prevention.

关键词： Child Maltreatment Physical Abuse Neglect Epidemiology Surveillance

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Epidemiology of School-Related Injuries in Belgium. A Better Knowledge for a Better Prevention

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Open Journal of Preventive Medicine 2014年第6期4卷 408-420页

作者： christelle senterre Michèle Dramaix Alain Levêque Research Centre of Epidemiology Biostatistics and Clinical Research School of Public Health Université Libre de Bruxelles Brussels Belgium

The landmark Convention on the Rights of the Child states that children around the World have right to safe environment. In Belgium, as in many countries, children spend, on average, 4.5 weekdays at school, during nearly 8 hours per day. Studies have shown that, the risk of school-related injury exceeds the risk during leisure time. Literature reports that school accidents account for 10 to 30% of all accidents among pupils. Despite that, few papers treat of the school-related injuries. Consequently, based on 1540 accidents forms from an insurance company, injury places, mechanisms involved, body parts injured and nature of injuries were described. Head injuries, upper and lower limbs injuries were investigated in more details. Pearson’s chi-square test was used to assess the relationships between the variables and multivariate logistic regression models were used to study the three specific types of injuries cited above. Gender ratio (M/F) was equal to 1.6 with 25.9% of children under 6 years, 29.4% of 6 - 9 years, 26.9% of 10 - 12 years and 17.8% from 13 years or more. The major places of injuries were the playground (56.9%) and the physical education (19.7%). Falls were observed in 52.1% of cases and contacts were reported in 24.3%. The head injuries account for 40.6%, the upper limbs for 32.0% and the lower limbs injuries for 20.2%. The bruises and the scratches were observed in 23.8% and the wounds in 21.5%. Fractures were reported in 16.1%. In conclusion, having a routine access to the data from the insurance companies could be an important source of information for an injury surveillance system in which the school injuries will be included. Taking into account this data will require an awareness of all the concerned persons about the relevance of such a system and a harmonization of the accidental forms.

关键词： School-Related Injuries Injury Determinants Cross-Sectional Survey Epidemiology

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Open Journal of Epidemiology 2014年第2期4卷 89-114页

作者： christelle senterre Alain Levêque Danielle Piette Michèle Dramaix Research Centre of Epidemiology Biostatistics and Clinical Research School of Public Health Université Libre de Bruxelles Brussels Belgium Research Centre of Social Approaches to Health School of Public Health Université Libre de Bruxelles Brussels Belgium

Aims: Establish profiles of young “at risk” of injuries, first, on an overall point of view and, secondly, for some types of injuries (sport, home, road traffic, school and work injuries). Methods: We have taken nearly 50 variables into consideration: 17 variables for construction of the socioeconomic status, 9 variables for the investigation of symptoms, 11 concerning drugs, 5 for healthy habits, 3 for investigating the violence behavior, 4 concerning the school, 3 for subjective health and finally 3 for social network. We have used the principal component analysis, the multiple correspondence analysis and the weighted-frequency score for reducing the number of them. After these reductions, 15 variables were available for analyses. The relationship between injuries and investigated factors was assessed using the Pearson’s chi-square test. We also calculated odds ratio (OR) with their 95% confidence intervals (95%CI) to estimate the strengths of the associations. To further assess these relationships but also for taking into account the potentials confounding effects of some variables, logistic regression model and multinomial logistic regression model were applied. Results: The whole injury prevalence was equal to 45.6% and among the injured, the proportion of the several types was equal to 33.8% for sport injuries, 32.2% for home injuries, 16.6% for traffic injuries, 11.6% for school injuries and 5.7% for work injuries. We can say that, in light of the variables studied, the “at risk” profile for having reported an injury is being a boy, being younger, having drug experiences, with the violent profile, and declaring several symptoms. There are no consistent and marked deviations in this study from the findings obtained in previous studies. Conclusion: Analyzing injuries in general is interesting but for preventing them it is important to know in which activities children and students are engaged when they are injured.

关键词： Injuries Health Behavior Youth Epidemiology Cameroon

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