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This Week in JAMA
August 2, 2000

This Week in JAMA

JAMA. 2000;284(5):529. doi:10.1001/jama.284.5.529

Violence and human rights

Physical signs of torture may be slight and easily overlooked.

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Mental Health of Albanians and Serbians After the War

Between February 1998 and June 1999, Serbian forces in Kosovo conducted an intense campaign of ethnic cleansing against the majority Albanian population. Lopes Cardozo and colleaguesArticle surveyed Albanian adults in Kosovo between August and October 1999 after NATO forces took control of Kosovo and Albanian refugees began returning to the country. Most respondents reported having experienced traumatic events, and 17.1% met diagnostic criteria for posttraumatic stress disorder. Salama and colleaguesArticle, in a survey of Serbian adults in Kosovo conducted at about the same time, found that Serbian adults had poorer outcomes on measures of social dysfunction and severe depression than Kosovar Albanian adults. In an editorial, WestermeyerArticle points out how correlates of psychiatric morbidity in these populations differ from what is observed in stable society.

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Brady Act and Firearm Homicide and Suicide Rates

When the Brady Handgun Prevention Act was implemented in February 1994, it required background checks and waiting periods for the purchase of handguns from federally licensed firearm dealers in 32 states, exempting states that already had similar legislation. Ludwig and CookArticle found that reductions in firearm homicide and suicide rates in the 32 Brady Act states (treatment states) after the Brady Act were similar to reductions in the exempt (control) states; only the rate of firearm suicides among adults aged 55 years or older decreased significantly more in treatment states. In an editorial, RosenfeldArticle considers how the flow of guns between treatment and control states through unlicensed sources in the secondary gun market might influence the results of this study and asserts that these findings do not warrant relaxation of any of the Brady Act restrictions on handgun purchases.

Stress Responses in Women Abused in Childhood

Evidence suggests that central nervous system corticotropin-releasing factor systems may mediate the association between stress early in life and the development of mood and anxiety disorders in adulthood. Heim and colleagues found that adrenocorticotropic hormone and cortisol levels and heart rate responses to a standardized psychosocial stress protocol were significantly higher among women with a history of childhood abuse than among women with no history of childhood abuse or psychiatric disorder.

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Fatality Trends in United Nations Peacekeeping Forces

The safety of UN peacekeeping forces has become an increasing concern. Seet and Burnham report that more deaths occurred among UN peacekeeping forces during the past decade than during the previous 40 years, but because the number and scale of UN peacekeeping missions have increased since 1990, crude death rates and relative risk of death have not significantly changed. Risk of death was significantly associated with the number of deployed peacekeepers and duration of the peacekeeping mission.

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Public Policy and Mental Health of Asylum Seekers

Policies in developed countries to deter the number of asylum seekers, persons who seek protection refugee status after entering another country rather than prior to arrival, have become increasingly restrictive. Silove and coauthors review research on stress during the asylum process and the mental health of asylum seekers.

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Human Rights Articles in Biomedical Journals

The number of articles on human rights published in biomedical journals has steadily increased since the 1970s. Submissions are invited for next year's JAMA theme issue on violence and human rights scheduled for August 2001.

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A Piece of My Mind

"The world is a bigger place than any US hospital can possibly convey, poverty and disease are a way of life in many parts of the world, and as physicians, we and our skills can make a big difference." From "The Cardboard Box."

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Contempo Updates

Clinical assessment of survivors of torture.

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Medical News & Perspectives

Do screening programs prevent domestic violence? How should physicians deal with violent patients? What can be done about violence in families?

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Genocide as a Public Health Issue

The importance of recognizing genocide as a public health issue.

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Predictors of Mortality in Severe Malnutrition

Clinical signs as prognostic indicators of mortality among severely malnourished adults and adolescents during famine.

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JAMA Patient Page

For your patients: Information on helping children cope with traumatic events.

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