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JAMA. 2004;292:531.

Violence/Human Rights
A JAMA Theme Issue
Edited by Annette Flanagin, RN, MA and Thomas B. Cole, MD, MPH

Mortality Among Street Youth
The health problems of street youth are well described, but little is known about mortality rates and risks in this population. Roy and colleagues (SEE ARTICLE) used data from a cohort of Montreal street youth to estimate the mortality rate and to determine causes of and risk factors for death in this population. The mortality rate was more than 11 times that of the general population of Montreal youth, with suicide and drug overdose as the 2 leading causes of death. Heavy drug and alcohol use and homelessness were key risk factors for death. In an editorial, (SEE ARTICLE) Abdalian discusses the vulnerabilities of street life and novel approaches for addressing the health care needs of street youth.

Mental Health in Postwar Afghanistan
The postwar mental health of the Afghan people is the subject of 2 articles in this issue of JAMA. Lopes Cardozo and colleagues (SEE ARTICLE) report results of a national, population-based mental health survey, and Scholte and colleagues (SEE ARTICLE) report results of their survey in Nangarhar province, where the Taliban originated. Both surveys assessed exposure to traumatic events and symptoms of depression, anxiety, and posttraumatic stress disorder (PTSD). Results from both surveys documented high rates of trauma exposure and symptoms of depression, anxiety, and PTSD. In an editorial, (SEE ARTICLE) Bolton and Betancourt discuss the challenges of assessing mental health during humanitarian emergencies, the need for locally validated assessment tools, and the importance of systematic evaluation of postdisaster interventions.

Youth-Focused Firearm Laws and Adolescent Suicides
Firearms are a frequent means of adolescent suicide in the United States despite federal and state laws limiting youth access to handguns. To assess for an association between suicide rates and youth-focused firearm laws, Webster and colleagues examined adolescent suicide rates in states that adopted youth access laws and compared these with rates in states that did not. They found that overall suicide rates for youth aged 14 to 20 years were not decreased significantly in states with minimum purchase age and possession age. However, state child access prevention laws were associated with a significant decrease in suicide rates among 14- to 17-year-olds.

(SEE ARTICLE)

Trauma and the Response to Reconciliation in Rwanda
In the aftermath of the 1994 genocide in Rwanda, international, national, and local judicial courts were established to try persons accused of human rights violations. In a survey of adults from 4 diverse areas of Rwanda, where genocide and war-related retaliation had occurred, Pham and colleagues sought to assess exposure to trauma, symptoms of posttraumatic stress disorder (PTSD), and attitudes toward justice and reconciliation. High levels of exposure to trauma and symptoms of PTSD and associations between exposure to trauma, PTSD symptoms, personal and environmental factors, and attitudes toward judicial mechanisms for justice and openness to reconciliation were found.

(SEE ARTICLE)

A Piece of My Mind
"Academic strength defines a physician: to gain standing within the medical community, I must publish." From "Soul (Re)Searching."

(SEE ARTICLE)

Medical News & Perspectives
An estimated 300 000 children and adolescents serve in rebel armies and government forces, many of whom were abducted and forced to enlist. Efforts are under way to help reintegrate child soldiers into their families and communities.

(SEE ARTICLE)

Quality of Malnutrition Surveys
Methodological errors in malnutrition surveys used during recent famine in Ethiopia may have caused invalid or imprecise malnutrition estimates. Ways to improve the nutrition assessment process are offered.

(SEE ARTICLE)

CLINICIAN'S CORNER
Contempo Updates
The diagnosis and treatment of adult attention-deficit/hyperactivity disorder.

(SEE ARTICLE)

JAMA Patient Page
For your patients: Information about malnutrition in children.

(SEE ARTICLE)

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