American journal of preventive medicine
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Assault injuries and deaths are a major public health problem in New York City but they are poorly understood because there is a dearth of information concerning them. ⋯ NYC WRISS is an efficient, cost-effective surveillance system, particularly suited to big cities with many assault injuries. Its low cost and obvious importance as a public health tool have allowed for its institutionalization, reflected by a permanent health department position, and annual reports alongside the more traditional public health surveillance systems. Analyses of data from 1990 to 1996 have lent new understanding to the decrease in homicides and assaults in New York City during that period.
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The magnitude of firearm-related deaths is known, but few studies have evaluated the magnitude and epidemiology of nonfatal firearm-related injuries. The circumstances resulting in fatal versus nonfatal injury are likely very different. No single data source provides complete details on nonfatal shootings. ⋯ Statewide surveillance of firearm-related injuries using multiple data sources is possible and provides a picture of the overall firearm-related injury problem. Strategies to enhance computer linkages of medical and police data should be pursued to maximize the sensitivity of reporting and minimize the costs of surveillance.
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Domestic violence (DV) against women often goes unrecognized by health care providers due to multiple barriers. In an effort to increase screening, identification, and referral for services, the RADAR Training Project was created for the health care staff of 12 federally qualified community health centers (CHCs). ⋯ This intervention was successful in increasing provider perceived knowledge and comfort; however, comfort decreased at follow-up. Additionally, the rates of screening and referrals increased 6 months post-training. Health care provider training and support and integrated quality assurance mechanisms may be necessary to increase the overall rate of these activities, and to sustain this effort over time. Further study is needed to identify effective methods to increase provider comfort regarding DV screening.
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Over half of all breast cancer deaths occur among women 65 years of age or older. However, mammography screening decreases with increasing age, despite better survival rates for tumors detected early. ⋯ Despite dual coverage, Medicare beneficiaries enrolled in Medicaid had few mammograms. African-American Medicare beneficiaries, with and without Medicaid, had low mammography rates. Intervention efforts should be targeted toward these women.