A JAMA Theme Issue Edited by Annette Flanagin, RN, MA and Thomas
B. Cole, MD, MPH
The health problems of street youth are well described, but little is
known about mortality rates and risks in this population. Roy and colleaguesArticleused 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,ArticleAbdalian discusses
the vulnerabilities of street life and novel approaches for addressing the
health care needs of street youth.
The postwar mental health of the Afghan people is the subject of 2 articles
in this issue of JAMA. Lopes Cardozo and colleaguesArticlereport results of a national, population-based mental health survey, and Scholte
and colleaguesArticlereport 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,ArticleBolton 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
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.
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.
"Academic strength defines a physician: to gain standing within the
medical community, I must publish." From "Soul (Re)Searching."
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.
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.
The diagnosis and treatment of adult attention-deficit/hyperactivity
For your patients: Information about malnutrition in children.
This Week in JAMA. JAMA. 2004;292(5):531. doi:10.1001/jama.292.5.531