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Ugandan policy regarding infant feeding for HIV-positive mothers is replacement feeding (RF), if feasible; otherwise, exclusive breastfeeding (EBF) for 3 months is advised (or EBF for 6 months, if RF is still not feasible). HIV-negative mothers should practise EBF for 6 months. The study objective was to explore the association between maternal HIV status and breastfeeding practices in Kabarole, Uganda. Data were collected from questionnaires administered at home to 182 women (44 HIV-positive and 138 HIV-negative) 3 months post-partum and from medical charts. The HIV-negative women were matched on delivery date to HIV-positive women at a ratio of 3:1. Interviewers were blinded to HIV status. There was no statistically significant association between adherence to Ugandan national feeding guidelines and maternal HIV status in bivariate analysis [odds ratio (OR) = 1.52; confidence interval (CI): 0.76-3.04]. Multivariate analyses showed a significant association between adherence to feeding guidelines and child illness (OR = 0.40; CI: 0.21-0.79) and between adherence to feeding guidelines and rural residence in Burahya county (OR = 2.43; CI: 1.15-5.13). Many mothers do not follow the feeding guidelines for HIV infection. This region-specific information on breastfeeding practice determinants will be used to inform local Prevention of Mother-to-Child Transmission (PMTCT) programmes. The nature of the association between child illness and EBF should be further explored. [ABSTRACT FROM AUTHOR]

Objectives: To describe the epidemiology of depression following traumatic spinal cord injury (SCI) and identify risk factors associated with depression. Methods: This population-based cohort study followed individuals from date of SCI to 6 years after injury. Administrative data from a Canadian province with a universal publicly funded health care system and centralized databases were used. A Cox proportional hazards model was developed to identify risk factors. Results: Of 201 patients with SCI, 58 (28.9%) were treated for depression. Individuals at highest risk were those with a pre-injury history of depression [hazard rate ratio (HRR) 1.6; 95% CI: 1.1–2.3], a history of substance abuse (HRR 1.6; 95% CI: 1.2–2.3) or permanent neurological deficit (HRR 1.6; 95% CI: 1.2–2.1). Conclusion: Depression occurs commonly and early in persons who sustain an SCI. Both patient and injury factors are associated with the development of depression. These should be used to target patients for mental health assessment and services during initial hospitalization and following discharge into the community. Copyright © 2005 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Abstract: Objective: Ordinal scales often generate scores with skewed data distributions. The optimal method of analyzing such data is not entirely clear. The objective was to compare four statistical multivariable strategies for analyzing skewed health-related quality of life (HRQOL) outcome data. HRQOL data were collected at 1 year following catheterization using the Seattle Angina Questionnaire (SAQ), a disease-specific quality of life and symptom rating scale. Study Design and Setting: In this methodological study, four regression models were constructed. The first model used linear regression. The second and third models used logistic regression with two different cutpoints and the fourth model used ordinal regression. To compare the results of these four models, odds ratios, 95% confidence intervals, and 95% confidence interval widths (i.e., ratios of upper to lower confidence interval endpoints) were assessed. Results: Relative to the two logistic regression analysis, the linear regression model and the ordinal regression model produced more stable parameter estimates with smaller confidence interval widths. Conclusion: A combination of analysis results from both of these models (adjusted SAQ scores and odds ratios) provides the most comprehensive interpretation of the data. [Copyright &y& Elsevier]

Abstract: Bicyclists are vulnerable road users for severe injury all over the world. The nature and extent of such injuries are less well known in Iran. Using data from a comprehensive survey conducted by the Ministry of Health and Medical Education in 13 health divisions of Iran, in 2003, we examined circumstances around bicyclist injury and death. Trained health workers completed the survey instruments by interviewing patients who stayed more than 24h in hospitals and/or relatives, hospital personnel and by reviewing patient charts. Data were cross-matched with medico-legal documents to prevent missing deaths. The information that was collected from 64 cities/towns’ emergency departments (EDs), over the study period, showed that 440 injured cyclists were hospitalized and/or died due to traffic collisions. Most injuries occurred in males (94.8%) and in the young (median age: 14 years with 75% ≤18 years). Head injury occurred in 14% of all hospitalized and in 90% of fatally injured bicyclists. Striking a moving vehicle increased the odds of death (OR: 32.3; 95% CI 3.5–291.0) as well as the odds of severe injury (OR: 1.9; 95% CI 1.2–3.2) compared with other mechanisms of injury. As a conclusion, bicyclists in Iran, particularly males and young children, are vulnerable to severe injury and death when struck by moving vehicles on highways. [Copyright &y& Elsevier]