Swapnaa Jayaraman

Human development takes place in a social context. Two pervasive sources of social information are faces and hands. Here, we provide the first report of the visual frequency of faces and hands in the everyday scenes available to infants. These scenes were collected by having infants wear head cameras during unconstrained everyday activities. Our corpus of 143 hours of infant-perspective scenes, collected from 34 infants aged 1 month to 2 years, was sampled for analysis at 1/5 Hz. The major finding from this corpus is that the faces and hands of social partners are not equally available throughout the first two years of life. Instead, there is an earlier period of dense face input and a later period of dense hand input. At all ages, hands in these scenes were primarily in contact with objects and the spatio-temporal co-occurrence of hands and faces was greater than expected by chance. The orderliness of the shift from faces to hands suggests a principled transition in the contents of visual experiences and is discussed in terms of the role of developmental gates on the timing and statistics of visual experiences.

Background Despite the growing burden of injuries in LMICs, there are still limited primary epidemiologic data to guide health policy and health system development. Understanding the epidemiology of injury in developing countries can help identify risk factors for injury and target interventions for prevention and treatment to decrease disability and mortality. Aim To estimate the epidemiology of the injury seen in patients presenting to the government hospital inKampala, the capital city of Uganda. Methods A secondary analysis of a prospectively collected database collected by the Injury Control Centre-Uganda at the Mulago National Referral Hospital, Kampala, Uganda, 2004-2005. Results From 1 August 2004 to 12 August 2005, a total of 3,750 injury-related visits were recorded; a final sample of 3,481 records were analyzed. The majority of patients were treated in the casualty department and then discharged; 38% were admitted. Road traffic injuries were the most common causes of injury for all age groups in this sample, except for those under 5 years old, and accounted for 49% of total injuries. RTIs were also the most common cause of mortality in trauma patients. Within traffic injuries, more passengers and pedestrians were injured than drivers. Other causes of trauma included blunt/penetrating injuries and falls. Less than 5% of all patients arriving to the emergency department for injuries arrived by ambulance. Conclusions Road traffic injuries are by far the largest cause of both morbidity and mortality in Kampala. They are the most common cause of injury for all ages, except those younger than 5, and school-aged children comprise a large proportion of victims from these incidents. The integration of injury control programs with ongoing health initiatives is an urgent priority for health and development. © Springer-Verlag London Ltd 2010.

Background: The burden of global injury-related deaths predominantly affects developing countries, which have little infrastructure to evaluate these disparities. We describe injury-related mortality patterns in Kampala, Uganda and compare them with data from the United States and San Francisco, California. Methods: We created a database in Kampala of deaths recorded by the City Mortuary, the Mulago Hospital Mortuary, and the Uganda Ministry of Health from July to December 2007. We analyzed the rate and odds ratios and compared them to data from the U.S. Centers for Disease Control and Prevention and the California Department of Public Health. Results: In Kampala, 25% of all deaths were due to injuries versus 6% in SF and 7% in the United States. The odds of dying of injury in Kampala were 5.0 times higher than in SF and 4.2 times higher than in the United States. Age-standardized death rates indicate a 93% greater risk of dying from injury in Kampala than in SF. The mean age was lower in Kampala than in SF. The adult injury death rate was higher in Kampala than in SF or the United States. Head/neck injury was reported in 65% of injury deaths in Kampala compared to 34% in SF [odds ratio 3.7] and 28% in the US. Conclusions: Urban injury-related mortality is significantly higher in Uganda than in the United States. Injury preferentially affects adults in the prime of their economically productive years. These findings serve as a call for stronger injury prevention and control policies in Uganda. © 2010 Société Internationale de Chirurgie.

Globally, 90% of road crash deaths occur in the developing world. Children in Africa bear the major part of this burden, with the highest unintentional injury rates in the world. Our study aims to better understand injury patterns among children living in Kampala, Uganda and provide evidence that injuries are significant in child health. Trauma registry records of injured children seen at Mulago Hospital in Kampala were analysed. Data were collected when patients were seen initially and included patient condition, demographics, clinical variables, cause, severity, as measured by the Kampala trauma score, and location of injury. Outcomes were captured on discharge from the casualty department and at two weeks for admitted patients. From August 2004 to August 2005, 872 injury visits for children <18 years old were recorded. The mean age was 11 years ; 68% were males; 64% were treated in casualty and discharged; 35% were admitted. The most common causes were traffic crashes, falls and violence. Most children were mildly injured; 1% severely injured. By two weeks, 6% of the patients admitted for injuries had died and, of these morbidities, 16% had severe injuries, 63% had moderate injuries and 21% had mild injuries. We concluded that, in Kampala, children bear a large burden of injury from preventable causes. Deaths in low severity patients highlight the need for improvements in facility based care. Further studies are necessary to capture overall child injury mortality and to measure chronic morbidity owing to sequelae of injuries.