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BMJ 2012; 345 doi: (Published 18 July 2012) Cite this as: BMJ 2012;345:e4799

High rates of violence against children with disabilities

A new meta-analysis reports high rates of sexual and physical violence, emotional abuse, and neglect in children with disabilities. Estimates are imprecise because of serious shortcomings in the available data, but the authors are confident that children with disabilities have a significantly higher lifetime risk of violence against them than their able peers. Pooled analyses gave odds ratios of 2.88 (95% CI 2.24 to 3.69) for sexual violence, and 3.56 (2.80 to 4.52) for physical violence, although the results of individual studies varied widely.

They found 17 eligible studies of more than 18 000 disabled children after a systematic search. Most studies were from the US, and a linked comment (http://dx.doi:10.1016/S0140-6736(12)61071-X) urges researchers to study children from middle income and low income countries too. Children living in countries with limited resources and poor support networks for carers are likely to be even more vulnerable.

A detailed study of children with different disabilities wasn’t possible, although the authors found hints that violence is more prevalent against children with intellectual rather than physical disabilities.

Researchers in this area have a lot to do, says the comment. Definitions of both disability and violence are inadequate, sampling is haphazard, and study populations poorly characterised and too small. We urgently need reliable and reproducible information on children with well defined problems, including purely physical limitations. And we need to look more closely for peer to peer violence or bullying. Finally, future studies must try to differentiate more clearly between violence caused by disability and disability caused by violence.

Fast food lunch is now slightly healthier in New York

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Partially hydrogenated vegetable oil, a leading source of industrial trans fats, was finally banned from New York’s chain restaurants in mid-2008. Has it made any difference to the population’s intake of such fats? …

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