title: Maltreatment or violence-related injury in children and adolescents admitted to the NHS: comparison of trends in England and Scotland between 2005 and 2011.
abstract: OBJECTIVE
  Legislation to safeguard children from maltreatment by carers or violence by others was advanced in England and Scotland around 2004-2005 and resulted in different policies and services. We examined whether subsequent trends in injury admissions to hospital related to maltreatment or violence varied between the two countries.
  
  
  METHODS
  We analysed rates of all unplanned injury admission to National Health Service (NHS) hospitals in England and Scotland between 2005 and 2011 for children and adolescents aged less than 19 years.
  
  
  RESULTS
  We compared incidence trends for maltreatment or violence-related (MVR) injury and adjusted rate differences between 2005 and 2011 using Poisson or negative binomial regression models to adjust for seasonal effects and secular trends in non-MVR injury. Infants, children 1-10 years and adolescents 11-18 years were analysed separately.
  
  
  RESULTS
  In 2005, MVR rates were similar in England and Scotland for infants and 1-10-year-olds, but almost twice as high in Scotland for 11-18-year-olds. MVR rates for infants increased by similar amounts in both countries, in line with rising non-MVR rates in England but contrary to declines in Scotland. Among 1-10-year-olds, MVR rates increased in England and declined in Scotland, in line with increasing non-MVR rates in England and declining rates in Scotland. Among 11-18-year-olds, MVR rates declined more steeply in Scotland than in England along with declines in non-MVR trends.
  
  
  CONCLUSIONS
  Diverging trends in England and Scotland may reflect true changes in the occurrence of MVR injury or differences in the way services recognise and respond to these children, record such injuries or a combination of these factors. Further linkage of data from surveys and services for child maltreatment and violence could help distinguish the impact of policies.
authors.affiliation: Centre of Paediatric Epidemiology and Biostatistics, UCL Institute of Child Health, London, UK.
authors.forename: Arturo
authors.initials: A
authors.lastname: Gonzalez-Izquierdo
authors.forename: Mario
authors.initials: M
authors.lastname: Cortina-Borja
authors.forename: Jenny
authors.initials: J
authors.lastname: Woodman
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Mok
authors.forename: Janice
authors.initials: J
authors.lastname: McGhee
authors.forename: Julie
authors.initials: J
authors.lastname: Taylor
authors.forename: Chloe
authors.initials: C
authors.lastname: Parkin
authors.forename: Ruth
authors.initials: R
authors.lastname: Gilbert
mesh_terms: D000293:Adolescent; D002648:Child; D002649:Child Abuse / Q000706:statistics & numerical data*; D002675:Child, Preschool; D004739:England / Q000453:epidemiology; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D010343:Patient Admission / Q000706:statistics & numerical data*; D012606:Scotland / Q000453:epidemiology; D013222:State Medicine; D014947:Wounds and Injuries / Q000453:epidemiology*
references.citation: Child Care Health Dev. 2015 Mar;41(2):186-93
references.pmid: 24635011
references.citation: Arch Dis Child. 2010 Nov;95(11):918-25
references.pmid: 20647257
references.citation: Am J Prev Med. 2004 Dec;27(5):379-84
references.pmid: 15556737
references.citation: JAMA. 1985 Sep 13;254(10):1330-6
references.pmid: 3927014
references.citation: Tijdschr Psychiatr. 2013;55(4):259-68
references.pmid: 23595840
references.citation: Child Abuse Negl. 2011 Jan;35(1):3-17
references.pmid: 21316104
references.citation: Arch Dis Child. 2013 May;98(5):328-34
references.pmid: 23401058
references.citation: J Clin Pharm Ther. 2002 Aug;27(4):299-309
references.pmid: 12174032
references.citation: Child Adolesc Psychiatr Clin N Am. 2000 Oct;9(4):733-48
references.pmid: 11005003
references.citation: MMWR Recomm Rep. 2008 Mar 28;57(RR-1):1-15
references.pmid: 18368008
references.citation: Br J Gen Pract. 2012 Jul;62(600):e478-86
references.pmid: 22781996
references.citation: J Interpers Violence. 2009 May;24(5):711-31
references.pmid: 18467689
references.citation: Prev Sci. 2000 Mar;1(1):31-49
references.pmid: 11507793
references.citation: PLoS Med. 2012;9(11):e1001349
references.pmid: 23209385
references.citation: BMC Health Serv Res. 2013 Jul 06;13:260
references.pmid: 23829876
references.citation: BMJ Open. 2013 Dec 03;3(12):e003894
references.pmid: 24302506
references.citation: Pediatrics. 2008 Sep;122(3):611-9
references.pmid: 18676507
references.citation: Can J Psychiatry. 2010 Oct;55(10):633-42
references.pmid: 20964942
references.citation: J Bone Joint Surg Br. 2007 Nov;89(11):1427-30
references.pmid: 17998176
references.citation: Lancet. 2012 Feb 25;379(9817):758-72
references.pmid: 22169108
references.citation: BMJ. 2013 Jun 07;346:f3677
references.pmid: 23747970
references.citation: Lancet. 2009 Jan 10;373(9658):167-80
references.pmid: 19056119
references.citation: Dev Psychopathol. 2007 Winter;19(1):149-66
references.pmid: 17241488
references.citation: Pediatrics. 2009 Nov;124(5):1411-23
references.pmid: 19805459
references.citation: J Public Health Med. 2001 Sep;23(3):205-11
references.pmid: 11585193
references.citation: BMC Public Health. 2011 Jan 05;11:8
references.pmid: 21208411
references.citation: Child Maltreat. 2009 Nov;14(4):316-29
references.pmid: 19837972
references.citation: PLoS One. 2012;7(11):e49808
references.pmid: 23209604
references.citation: Health Technol Assess. 2008 Nov;12(33):iii, xi-xiii 1-95
references.pmid: 18992184
references.citation: Inj Prev. 2012 Feb;18(1):50-7
references.pmid: 21646244
references.citation: Arch Dis Child. 2010 May;95(5):336-40
references.pmid: 19846995
references.citation: Child Care Health Dev. 2004 Nov;30(6):589-98
references.pmid: 15527470