Bioterrorism alleging use of anthrax and interim guidelines for management--United States, 1998.
From October 30 through December 23, 1998, CDC received reports of a series of bioterroristic threats of anthrax exposure. Letters alleged to contain anthrax were sent to health clinics on October 30, 1998, in Indiana, Kentucky, and Tennessee. During December 17-23 in California, a letter alleged to contain anthrax was sent to a private business, and three telephone threats of anthrax contamination of ventilation systems were made to private and public buildings. All threats were hoaxes and are under investigation by the Federal Bureau of Investigation (FBI) and local law enforcement officials. The public health implications of these threats were investigated to assist in developing national public health guidelines for responding to bioterrorism. This report summarizes the findings of these investigations and provides interim guidance for public health authorities on bioterrorism related to anthrax. (+info)
Marijuana use among minority youths living in public housing developments.
Youths residing in public housing developments appear to be at markedly heightened risk for drug use because of their constant exposure to violence, poverty, and drug-related activity. The purpose of this study was to develop and test a model of marijuana etiology with adolescents (N = 624) residing in public housing. African-American and Hispanic seventh graders completed questionnaires about their marijuana use, social influences to smoke marijuana, and sociodemographic and psychosocial characteristics. Results indicated that social influences, such as friends' marijuana use and perceived ease of availability of marijuana, significantly predicted both occasional and future use of marijuana. Individual characteristics such as antimarijuana attitudes and drug refusal skills also predicted marijuana use. The findings imply that effective prevention approaches that target urban youths residing in public housing developments should provide them with an awareness of social influences to use marijuana, correct misperceptions about the prevalence of marijuana smoking, and train adolescents in relevant psychosocial skills. (+info)
Developing a plan for primary health care facilities in Soweto, South Africa. Part I: Guiding principles and methods.
The new political era in South Africa offers unique opportunities for the development of more equitable health care policies. However, resource constraints are likely to remain in the foreseeable future, and efficiency therefore remains an important concern. This article describes the guiding principles and methods used to develop a coherent and objective plan for comprehensive primary health care facilities in Soweto. The article begins with an overview of the context within which the research was undertaken. Problems associated with planning in transition are highlighted, and a participatory research approach is recommended as a solution to these problems. The article goes on to describe how the research methods were developed and applied in line with the principles of participatory research. The methods were essentially rapid appraisal techniques which included group discussions, detailed checklists, observation, record reviews and the adaptation of international and local guidelines for service planning. It is suggested that these methods could be applied to other urban areas in South Africa and elsewhere, and that they are particularly appropriate in periods of transition when careful facilitation of dialogue between stakeholders is required in tandem with the generation of rapid results for policy-makers. (+info)
Measuring intermediate outcomes of violence prevention programs targeting African-American male youth: an exploratory assessment of the psychometric properties of six psychosocial measures.
This study examined the psychometric properties of six psychosocial measures that may be useful indicators of intermediate outcomes of violence prevention programs targeting African-American male youth. Baseline and 6 month follow-up survey data are used from 223 African-American male 12-16 year olds participating in a violence prevention program evaluation study. The constructs of interest are beliefs supporting aggression, aggressive conflict-resolution style, hostility, ethnic identity, self-esteem and hopelessness. Each construct is measured as a multi-item scale. Exploratory factor analysis results provided limited support for the unidimensionality of these scales, thus suggesting that further scale development is warranted. Reliability coefficients for the scales ranged from 0.55 to 0.80. Bivariate analyses with baseline data indicate that all six measures have construct and criterion-related validity, as they are associated with each other and with four behavioral criteria in the expected directions. Predictive validity was also demonstrated for beliefs supporting aggression, aggressive conflict-resolution style, hostility and hopelessness which were associated with weapon-carrying behaviors measured in the 6 month follow-up survey both before and after controlling for corresponding behaviors measured in the baseline survey. (+info)
Darryl, a cartoon-based measure of cardinal posttraumatic stress symptoms in school-age children.
OBJECTIVES: This report examines the reliability and validity of Darryl, a cartoon-based measure of the cardinal symptoms of posttraumatic stress disorder (PTSD). METHODS: We measured exposure to community violence through the reports of children and their parents and then administered Darryl to a sample of 110 children aged 7 to 9 residing in urban neighborhoods with high crime rates. RESULTS: Darryl's reliability is excellent overall and is acceptable for the reexperiencing, avoidance, and arousal subscales, considered separately. Child reports of exposure to community violence were significantly associated with child reports of PTSD symptoms. CONCLUSIONS: Darryl possesses acceptable psychometric properties in a sample of children with frequent exposure to community violence. (+info)
What pediatricians can do to further youth violence prevention--a qualitative study.
OBJECTIVE: Youth violence is a public health problem world wide. However, the United States has the worst rate of youth violence among industralized countries. This study was conducted to learn what pediatricians, community leaders, and parents think the doctor's role is in youth violence prevention during the well-child examination for children. METHODS: Interviews were conducted with pediatricians, community leaders, and parents living or working in Los Angeles, California. RESULTS: All three groups interviewed believed that the physician should incorporate violence prevention counseling as part of the well-child examination. The mechanism of action differed for the three groups. Almost half of pediatricians' statements focused on their role as prevention counselor, with respect to such issues as appropriate discipline and gun safety. One third of community leaders' statements, however, related to physician referral to existing community resources. More than half of parents' statements referred to the pediatrician as someone who can directly educate their child about making positive choices. CONCLUSIONS: Although pediatricians cannot solve the problem of youth violence alone, findings from this study suggest that they should address this issue with their patients and should work in tandem with existing community resources to further a solution to this growing epidemic. (+info)
A new paradigm of injury intentionality.
OBJECTIVE: To improve understanding of processes leading to injury and assess more specifically the degree of intentionality. METHODS: A new paradigm was developed that characterizes the act of inflicting injury (self, other, not inflicted) and the motive. Motives are determined for the act of injury and for the outcome. To test this, 986 cases of adolescent injuries in seven hospitals were reviewed. Three investigators independently classified all cases using the new paradigm and three used standard definitions of intent. Inter-rater reliability was measured. RESULTS: Of injuries inflicted by others, 61% were intentional using the standard classification. In the new paradigm 67% were intended acts and 59% involved intentional motive for outcome. Altogether 87% of sports injuries were coded as unintentional acts compared with 96% using standard methods. Using standard classification there was 93% agreement between paired raters, with an average kappa of 0.86. In the new paradigm questions on intentionality of act, outcome, and infliction of act, the agreement was 89%, 91%, 88%, with a kappa of 0.79, 0.80, 0.76, respectively. CONCLUSIONS: This paradigm defines a spectrum of injury intent, enhances understanding of the causal sequence of injury, and has important implications for research and prevention. (+info)
Evaluating the impact of a street barrier on urban crime.
OBJECTIVES: Violence is a major urban public health problem in the United States. The impact of a physical barrier placed across a street in a public housing project to prevent street violence and drug activity was evaluated. METHODS: Hartford Police Department data on violent and drug related crime incidence within the housing project containing the barrier were analyzed by use of a computerized geographic information system. RESULTS: Violent crime decreased 33% on the intervention street during the 15 month period after erection of the barrier, compared with the 15 month period before erection of the barrier, but there was no change in drug related crime. On adjoining streets and surrounding blocks, violent crime decreased 30%-50% but drug related crimes roughly doubled. A non-adjacent area of the housing project and the entire city experienced 26% and 15% decreases in violent crimes, and 414% and 25% increases in drug crimes, respectively. CONCLUSIONS: The barrier decreased violent crime but displaced drug crimes to surrounding areas of the housing project. These results have important implications for other cities that have erected or are considering erecting similar barriers. (+info)