Firearm injuries to children in Cape Town, South Africa: impact of the 2004 Firearms Control Act.

BACKGROUND: Before the introduction of the Firearms Control Act in 2004, the epidemiology of childhood firearm injuries from 1991 to 2001 in Cape Town, South Africa, was reported. This study analyses current data as a comparator to assess the impact of the Act. METHODS: Firearm injuries seen at Red Cross War Memorial Children's Hospital, Cape Town, from 2001 to 2010 were respectively reviewed. Data recorded included the patients' folder numbers, gender, date of birth, age, date of presentation, date discharged and inpatient stay, firearm type, number of shots, circumstances, injury sites, injury type, treatment, resulting morbidities and survival. These data were compared with the 1991 - 2001 data. RESULTS: One hundred and sixty-three children presented with firearm injuries during this period. The results showed a decrease in incidence from 2001 to 2010. Older children and males had a higher incidence than younger children and females. Most injuries were to an extremity and were unintentional. Mortality had reduced significantly from the previous study (6% to 2.6%), as did the total number of inpatient days (1 063 to 617). CONCLUSIONS: Compared with the earlier study, this study showed a significant reduction in the number of children presenting with a firearm-related injury. Mortality and inpatient stay were also significantly reduced. The study shows the impact that the Firearms Control Act has had in terms of paediatric firearm-related injury and provides evidence that the medical profession can play an important role in reducing violence.

The role of cognitive factors in cue reactivity: extinction on demand.

Cue reactivity measures have become common in addictions research for their apparent objectivity. We used an analog paradigm to examine whether such measures are subject to impression management. Students with conditioned reactions of salivation to the sight and smell of a lemon were assigned to a control group, an experimental group asked to reduce salivation, or an experimental group asked to reduce salivation and promised a reward if successful. Both experimental groups reduced salivation more than the control group; the group rewarded for reduction reduced salivation more than the group that was only asked to do so. This suggests that cue reactivity measures can be manipulated by research participants or clients in treatment. Suggestions for research and implications for treatment are addressed.

The aging physician and retirement.

The attitude of physicians toward retirement was studied using a questionnaire sent to physicians aged 65 and older. The information obtained was supplemented by organizing a study group of interested doctors. Of the 58 respondents whose average age was 71, 54 were still in practice and 65% had no plans for retirement. There was a strong urge to maintain the status quo. The group discussion centered around the loss of control over one's declining practice and the fear of diminishing competence with advancing age. The dedicated lifetime pursuit of a medical practice makes retirement extremely difficult for today's older physician. This study supports surveys on the working life span, longevity and mortality of North American physicians.