Drive-by Shootings Research Articles

Trauma centers: Radiologists’ role

w hile in Denver on vacation this past summer , I took note of the newspaper coverage given to drive-by shootings and other acts o f apparently random violence; the local editorials discussed how to stop them. Even the Governor held a special session with experts to develop strategies to deal with the violence and its aftermath. One editorial especially caught nay eye: "Denver is lucky to have three trauma care inst i tut ions"-for it properly focused on the excellent care that level I trauma centers provide. It even gave some specific examples o f lives recently saved in these trauma centers. But how many did they say again? Three? Perhaps Denver has a corner on the market for level I trauma centers, and perhaps if you live in any of the 70 or so metropolitan centers in the United States, you, too, believe that your city has multiple level I tramna centers. (For awhile, I was under the mistaken impression that there were five such trauma centers in Columbus, Ohio, as well; in fact, there are t h r e e O h i o State University, Childrens, and Grant Hospitals have designation f r o m t h e American College o f Surgeons (ACS) as level I trauma centers.) The National Academy of Sciences/ National Research Council originally proposed that emergency facilities be categorized based on the institutional ability to deal with the broad spectrum of trauma; the article was entitled "Accidental Death and Disability: The Neglected Disease o f Modern Society" (1966). Since 1976, the A m e r i c a n College o f Surgeons has published, and repeatedly updated, a document from its Commit tee on Trauma proposing a national ne twork of trauma centers. This network would consist o f level I (regional resource centers), level II (comnmnity trauma centers), and level III (rural health centers). Yet, even in 1994, realization o f the network has not occurred. The number o f verified centers are: level I, <100; level II, 75-100; and level III, <20. Why? Well, for starters, the level I designation is difficult to obtain, because site visits, p roof o f specialists, many o f t hem not only on call but in-house at all times, and peripheral centers for burn treatment, head and spinal cord injury, and rehabilitation centers (to mention some of the many requirements) are expensive to maintain and require vast resources. Designation is supposed to be a cooperative venture among hospitals in the city, and the injured are to be transported to the appropriate center even though that means bypassing the closest hospital. Such cooperation is frequently difficult to obta in w h e n hospitals see themselves as competitors. The ACS believed that only a few level I centers would be needed; the majority o f centers were envisioned by the ACS as level II. But wi th even fewer level II centers, we must search for other reasons; some clearly are political. In addition, who, after all, likes to be labeled #2? In some regions, hospitals may follow state or county guidelines, where they exist, for trauma level des ignat ion. W h e r e these guidelines are not followed, the hospital may simply designate itself a level I trauma center! I suggest you investigate in your area which hospitals call themselves level I trauma centers, and which of those have met the rigorous criteria as applied by the ACS and your state o r county. The criteria for radiologists' availability in the ACS trauma centers are vague; yet, we can and ottght to play a major role. Our prompt diagnoses in the emergency setting--as radiologists all k n o w c a n n o t be m a t c h e d by untrained observers who only know radiology as a sideline. To be a major player, we must be on site w h e n most trauma cases arrive. Radiologists who abdicate their positions will surely lose them to those who hustle in the Emergency Department.

Drive-By Shootings

Gang violence has reached epidemic proportions in Los Angeles and is occurring with increasing frequency in many other US cities. Gang members and innocent bystanders often suffer severe and sometimes fatal injuries in drive-by shootings. We present the case of one such innocent victim and discuss the personal and societal ramifications of drive-by shootings. [Eckstein M, Hutson HR, Anglin D: Drive-by shootings. Ann Emerg Med January 1995;25:107-110.]

Pediatric Firearm Injuries, Kansas City, 1992: A Population-Based Study

To determine the morbidity, mortality, and epidemiologic features of pediatric powder-firearm injuries in a defined urban population. A population-based, descriptive epidemiologic study was conducted of firearm injuries to children in a mid-size urban community (total population: 435,178) in 1992. The population was 56% white and 39% black. Data from prehospital care providers, all city and adjacent community hospitals, and medical examiner and police records were searched for cases of firearm injury. The 1990 United States census provided denominator data. Subjects were all 0- to 16-year-old residents of Kansas City, Missouri who sought medical treatment at a hospital for a powder-firearm injury or who presented to the medical examiner with a fatal firearm injury in calendar year 1992. Seventy-two children met the case definition, for an incidence of 70 per 100,000 persons per year. There were 12 (16.7%) fatalities, for a mortality rate of 11.7 per 100,000 persons per year. Almost 10% of the patients sustained permanent disability. Mean and median ages of the patients were 14.9 years and 15.8 years, respectively; 79% were male and 82% were black. The majority of the children (63%) lived in census tracts with a high proportion of families in poverty. Black males had the highest rates of firearm injury, with a 1-year incidence of 233 per 100,000 persons per year. At younger than 12 years, the rates were equal among the races; however, for those 12 years and older, black adolescents had 13 times the risk of white adolescents (541 compared to 42 per 100,000 persons per year). The majority (71%) of injuries were due to assaults, with drive-by shootings the most frequent circumstance. The majority of unintentional injuries occurred to adolescents as the result of an unplanned discharge of a handgun as it was being placed in or removed from concealment. Among the patients, 39% were admitted to the hospital and 26% required surgery. 1) Black male adolescents had the highest risk of firearm injury or fatality. 2) The majority of victims lived in census tracts characterized by poverty. 3) injuries were alarmingly severe. 4) Interpersonal violence was the leading contributor to fatal and nonfatal injuries. 5) Unintentional injuries characteristically occurred during the process of weapon concealment. 6) The leading contributor to injury and death was the interaction of adolescents and guns, particularly handguns. The main implication for firearm-injury prevention in this population is the limiting of access to guns by adolescents. In addition, measures aimed at preventing violent behavior, such as education in nonviolent methods of conflict resolution, should be explored.

Secondary School Counseling In Texas: The Impact of Responsive Services on the Job Description

The continuing frequency of gang violence, drive-by shootings, teenage pregnancy, suicide, and substance abuse suggests that secondary school counselors in Texas are providing mental health and crisis intervention services that, otherwise, would not be available to students. Accordingly, school districts are encouraged to consider a division of duties such that Responsive Services would be delivered by a “Clinical Counselor” while Guidance Curriculum, Individual Planning, and System Support services would be provided by a “Guidance Counselor”.

Drive-by Shootings in Los Angeles

Drive-by Shootings in Los Angeles

Trapped in a metaphor

I have no trouble accepting the major conclusions of James Q. Wilson there are aspects of our moral life are universal(1) and these aspects can be called fundamental dispositions[226], which we might label sympathy, fairness, self-control, and duty. I take this proposition to be a self-evident product of the fact humans are bound together mutual interdependence [xii] in collectivities we call societies. Without acts demonstrating thoughtfulness, fairness, and duty shown toward at least some others, without self-control expressed in at least some arenas of desire, a functioning, healthy social collectivity would not be possible. In other words, at a certain level of generality the kinds of moral senses Wilson describes can be found anywhere among the social animals. In presenting his universalist argument, Wilson classifies anthropologists as either relativists or universalists. I am neither. I would classify myself as a culturalist interested in how generic human potentialities are focused in specific performances. In particular, I am interested in the ways in which metaphors trap people in a self-absorbed cycle of violence or free them to work for the common good. In this short essay, I will first discuss the area in which I agree with Wilson. I will then move on to the area of disagreement by presenting a short case study of the moral senses based on fieldwork in a modern Southeast Asian matriarchy. I include this information partly because of Wilson's claim matriarchies have never existed and partly to out-line the logic of an approach to the moral senses which is neither relativist nor universalist. Contemporary American Society Wilson's discussion of contemporary American society offers me much food for thought. I applaud his criticism of the all-too-frequent tendency for social scientists to suspend judgment. However, he is a little too fixated on anthropologists when making this criticism. In my mind, this tendency is widespread in academia. In today's climate of identity politics it takes courage to speak in behalf of the common good. If not judged harshly by one's colleagues, one can expect to disappear altogether from the list of names announced in grant awards. I agree we live in a world shaped by the ambiguous legacy of the Enlightenment[244]. On this point I would like to push further. As Wilson points out, we inherit from the Enlightenment the idea each and every citizen is entitled to equal and opportunity along with the notion that man must be treated as an end and not merely as a means to someone else's[245]. The first idea emphasizes equality for all; the second, for the individual. Recently, we have become a society worships rights, but not equality. The closer America inches toward sympathy (we are all brothers under the skin) or fairness (I am entitled to the same rewards for a given effort as you) the more we hear of rights talk[245]. Wilson provides a telling quote from Ronald Dworkin: [I]f someone has a right to do something, then it is wrong for the government to deny it to him even though it would be in the general interest to do so[245]. In the current climate of politics, Dworkin's words have a far greater capacity to move the nation than the words of those who preach sympathy and fairness. The contemporary rhetoric seems unable to comprehend the necessity of finding a balance between individual and the social good. There are dangers in moving too far in either direction. Too much concern for the common good can lead to fascism, too little concern can lead to social extinction. America has lost its bearings with respect to the common good. Increasingly we seem to be moving toward a Hobbesian war of all against all. Everyday, we learn about another crime of violence, be it hate crime, wife abuse, murder, drive-by shooting, or children killing one another in the schools. …

Caught in the crossfire of gang violence: Small children as innocent victims of drive-by shootings

Caught in the crossfire of gang violence: Small children as innocent victims of drive-by shootings

Adolescents and Children Injured or Killed in Drive-By Shootings in Los Angeles

Drive-by shootings by violent street gangs contribute to early morbidity and mortality among adolescents and children in Los Angeles. This study attempted to determine the frequency of this problem and the population at greatest risk. We also studied the most frequently injured areas of the body, the seasons in which the most shootings occurred, the most common sites for drive-by shootings, and the types of firearms used. We retrospectively reviewed the files of the Gang Information Section of the Los Angeles Police Department to identify all drive-by shootings in Los Angeles in 1991 in which a child or adolescent under the age of 18 was shot at, injured, or killed. A total of 677 adolescents and children were shot at, among whom 429 (63 percent) had gunshot wounds and 36 (5.3 percent) died from their injuries. Three hundred three of those with gunshot wounds (71 percent) were gang members. Arms and legs were the areas of the body most commonly injured. Handguns were the most frequently used type of firearm. All the homicide victims were African American or Hispanic, and 97 percent were boys. African American and Hispanic children and adolescents, especially male gang members, had a significantly higher risk than their Asian and white counterparts of injury and death from drive-by shootings in Los Angeles (P < 0.001). Drive-by shootings involving adolescents and children are frequent in Los Angeles. Although Los Angeles may be an atypical case, understanding why violent street gangs form, preventing causes of violence, and limiting access to firearms are essential steps in preventing this serious problem.

Ivy Day in the Empty Room

ABOUT SIX YEARS AGO, at a time when the issues clustered around race still simmered on the back burners of national consciousness, I had a fierce argument with one of my oldest black friends. He had called me from his home in Lansing, Michigan, to report about a conflict between members of his group, people devoted to the memory of Malcolm X, and a group of black ministers who were partisans of the memory of Martin Luther King, Jr. At issue between the two groups was the naming of a street in Lansing, one of the early homes of Malcolm Little, now known as Malcolm X. My friend's group wanted a certain street in Lansing named for Malcolm X. The black ministers wanted the same street named for Martin Luther King. I responded to the conflict by pointing out what I considered a bizarre contradiction. At a time when drugs, drive-by shootings, teenage pregnan cies, unemployment, self-hatred and racism were decimating whole seg ments of the group, it seemed of little practical consequence whether a street in Lansing, Michigan, bore the name of either man. I said that it seemed of greater importance for the two opposing groups to unite their energies to advance the causes for which both men stood and for which they gave their lives. I went further, and enraged my friend, by saying that the worship of the images of these two martyrs, during such a bleak and deadly time, was in reality a substitute for meaningful actions, if not the institutionalization of a death wish. My friend and I broke off our communication after this exchange, and I fell to brooding over whether my response to him had grown out of my own insensitivity to the basic needs, of unsophisticated people, for positive images or role models. Still, the ease with which images were used to obscure substance continued to bother me. Now, a few years later, the generation of men whose work in early life made the Civil Rights Movement is re-surfacing, though they are radically transformed in terms of public image. Vernon Jordan seems to be a Washington insider. Andrew Young seems to be an elder statesman. James Farmer was on television recently, speaking professorily as a repository of

Gang-Related Homicides in Los Angeles County

The incidence of gang homicides in Los Angeles County has increased faster than that of non-gang homicides in the past decade. This study compares characteristics of gang homicide victims with those of non-gang homicide victims for the year 1987. In 1186 cases, gang members were more likely to be young Black men who died of gunshot wounds. Gang homicide victims were more likely to die of firearm injuries in the early evening, and were more likely to die in a relatively small area of Los Angeles County. Drive-by shooting was highly associated with gang homicide.

Personal Safety in Dangerous Places.

Personal safety during fieldwork is seldom addressed directly in the literature. Drawing from many prior years of ethnographic research and from field experience while studying crack distributors in New York City, the authors provide a variety of strategies by which ethnographic research can be safely conducted in dangerous settings. By projecting an appropriate demeanor, ethnographers can seek others for protector and locator roles, routinely create a safety zone in the field, and establish compatible field roles with potential subjects. The article also provides strategies for avoiding or handling sexual approaches, common law crimes, fights, drive-by shootings, and contacts with the police. When integrated with other standard qualitative methods, ethnographic strategies help to ensure that no physical harm comes to the field-worker and other staff members. Moreover, the presence of researchers may actually reduce (and not increase) potential and actual violence among crack distributors/abusers or others present in the field setting.