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Thank you Paul, and thank you Julie for spreading this.

There’s a huge rally coming on March 24th. I could foresee an editorial in a leading journal and a talking point that can be broadcast at the rally stating that this country can expect another mass school shooting by November 4, 2018 (170 days, allowing for 2 months of summer vacation). 

A simple benchmark date like this can focus the discussion in a way that makes the gun lobby defensive, and can be repeated. aThe action points you mention below, (mass shooter drills, focused MH awareness drives early on) also put the momentum towards action and sustaining the principle that this should not be considered normal or acceptable.

I am not a writer or authority, but I’d love to hear someone from this group who is and can further mold this into action.

One further idea: on March 24th, the day of the rally, I’d love to see ER docs (and nurses and staff) wearing a scrub/shirt supporting the rally. For example: a red top saying “we stand with victims of gun violence” or “no more shootings”

… again, the germ of an idea and I’m grateful for this forum to help work it out.

Julian Orenstein


> On Feb 26, 2018, at 11:22 AM, Paul M <[log in to unmask]> wrote:
> 
> More or less the same results as Matt - 95% CI upper limit every
> ~5months.  More important though is what we can expect to occur, which is
> every 30 days during the school year.
> 
> Source: https://en.wikipedia.org/wiki/List_of_school_
> shootings_in_the_United_States
> Mass shooting definition:  shooting resulting in at least 3 victims,
> excluding the perpetrator (per definition of the Investigative Assistance
> for Violent Crimes Act of 2012, signed into law on Jan 2013)
> 
> SPC T chart of days between mass school shootings (n=121), last 100 years
> (Upper Control Limit = 3SD); not adjusted for population growth or
> seasonality; CL = average of 1 every 113 days
> 
> 
> [image: Inline image 1]
> 
> 
> The most recent period of stability goes back from event #86 in the figure
> above, starting at the beginning of 2013 until the current date. This time
> period makes a new T chart below, which is stable (no significant change)
> by all special cause rules (1 point >3SD from the center line, 9 points in
> a row on same side of center line, 6 points in a row all increasing or
> decreasing, 2 of 3 points >2 SD on same side from CL, 3 of 4 points >1 SD
> on same side of CL). Now, there is 1 every 41 days, with 3SD UCL of 271
> days; not adjusted for seasonality, population growth, or transformed for
> normality). To the original question of 95% CI question, the UCL for 2 SD
> is 170 days. The good news is that this is a stable process, so the effect
> of interventions could be associated with changes in the outcomes.  The bad
> news is that this is a stable process.
> 
> [image: Inline image 7]
> 
> 
> 
> But kids are in school seasonally - with decreases seen in spring break and
> summer. So when school's in session, it's probably more like one mass
> shooting every 30 days.
> 
> 
> [image: Inline image 3]
> 
> If you expand the criteria from school mass shooting to any school shooting
> (at least 1 injury or death), January is the most frequent month for any
> school shooting.
> 
> [image: Inline image 4]
> 
> Implications: Mass shooter drills in September?  Increase mental health
> resources/screenings in schools/staff/communities after winter break? Other
> ideas with likely bipartisan support?
> 
> Long road ahead...
> 
> Paul
> 
> Paul Mullan, MD, MPH
> Director of Research and Quality Improvement, Division of Emergency Medicine
> Children's Hospital of the King's Daughters
> Associate Professor, Eastern Virginia Medical School
> Cell: (713) 855-4827. Office: (757) 668-9220
> [log in to unmask]
> 
> For more information, send mail to [log in to unmask] with the message: info PED-EM-L
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> <image.png><image.png><image.png><image.png>

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