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Thanks for this cathartic thread, Dr. Pusic and others. Hope fellows are allowed to chime in. Like many on here my gut reaction is to focus on politics, ie an assault weapons ban, the 2nd amendment etc. If Americans were being killed by the same type of airplane that kept crashing, congress would act. Why the same isn’t done with the AR-15 given that it keeps being used to murder kids (in Sandy Hook, Aurora, Orlando, Las Vegas and now Parkland) is maddening. But I wonder if we could do more by taking the lead on another key gun violence issue on which physicians are experts. The problem was encapsulated by the first few hours after the parkland shooting when media outlets were literally arguing over how many school shootings there have been in 2018. We don't even know! We don't know because there are very little data on firearm injury/death in this country on account of Congress blocking gun violence research funding since 1996. And this funding block (the "Dickey amendment," named for the NRA point person in Congress at the time) has created a political chill on research that has trickled down even to academic medical centers. When I tried to examine NY EMS data to look at pre-hospital intervention in pediatric firearm injury, the city blocked it on account of the study being "too political." Where is the research? When SIDs reached epidemic numbers in the 70’s, Congress allocated funds for aggressive research leading to Back to Sleep campaign and SIDS rates plummeted. Similar research campaigns produced life-saving interventions for lead poisoning and car crashes. Yet no research crusade has been directed at the epidemic of pediatric firearm death because Congress essentially prohibits it. The hard part is trying to figure out what to do about it. In my state of New York, A.2977/S.4363, sponsored by New York State Assemblymember Jo Anne Simon and Senator Roxanne Persaud, would create a Firearm Violence Research Institute in New York and I along with some colleagues are trying to support this in a few different ways; if others on here want to discuss or have other ideas pls be in touch. This is not meant to discourage us from yelling from rooftops and writing senators about background checks, assault weapons ban etc. That is so important. But we have a unique vantage point with regard to public health research and we're allowed to do it for every other public health problem except this one.  Thanks so much for allowing me to add my 2 cents

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> On Feb 17, 2018, at 3:43 PM, Joe Nemeth, Dr <[log in to unmask]> wrote:
> 
> Martin,
> 
> As I sit in my living room on this Saturday morning, I’ve also gotten my self in a state about how we tend to focus in on the small picture and neglect an exponentially bigger one.
> 
> Spoiler Alert: this will NOT be a politically laced nor personally biased post...as opposed to some of the previous posts on this issue - I'm actually quite disappointed that politics had to rear its ugly head. 
> 
> Disclaimer: I live in Canada and  love our very strict gun control laws.
>                   Don't claim to be a gun control policy expert
> 
> Now, allow me to expound:
> 
> 1. A troubled young man AND inappropriate access to crazy weapons is what caused this catastrophe.
> 
> Colleagues, I think we all agree that it would be too simplistic and frankly naive to think that stricter gun control would solve all of these gun related deaths...many examples of this false and misleading association of tighter gun control means safer society here are just a few below...many more:
> -explore New Hampshire and Illinois...NH has very liberal gun control, Chicago instead has very strict ones...look up who has more gun related violent crime per capita...
> -the Swiss gov't actually encourages gun ownership.. has one of the highest rates of gun ownership in the world, but little gun-related street crime 
> -Britain has more violent crime then the US (ban on guns since 1997)
> 
> From my viewpoint, attention is being focused in the wrong direction. I think we as powerful respected advocates of "public health" should focus at the root causes of the problem, starting with the breakdown of the family (young males who are deprived of an active father figure are far more likely to commit violent crimes), the relentless stream of violent promoting behaviour from Hollywood, the exponential increase in mental illness in youth to start with.
> 
> How come we don't lambast the horrendous violence coming out of Hollywood which our youth are imbibing with negative consequences?
> 
> 2. As per the CDC, in 2016, ~900 000 legal induced abortions were reported from 49 reporting areas...likely a significant underestimate since CA among other states does not report its numbers  (BTW ~ 1.5% for rape/incest, 3% for fetal health issues).
> 
> Without going into the classic arguments re pro/con, how can we not, how do we not stand up for these children? I agree with the AAP's stance on gun control but what I have trouble understanding is how the AAP does not weigh in on the abortion issue (~10% of abortions are reported in females <19)?
> 
> 17 children violently, meaninglessly murdered. An incredible tragedy. How is this different then close to 1 million kids per year mentioned above. 
> 
> I agree with the AAP's stance on gun control but what I have trouble understanding is how the AAP does not weigh in on the abortion issue?
> 
> 
> Joe
> 
> 
> 
> 
> 
> Joe Nemeth MD FCFP EM
> Associate Professor
> McGill University
> 
> 
> ________________________________________
> From: Pediatric Emergency Medicine Discussion List <[log in to unmask]> on behalf of Barry Nathan <[log in to unmask]>
> Sent: February 17, 2018 7:23:57 AM
> To: [log in to unmask]
> Subject: Re: The shooting in Florida
> 
> In case you don't get emails from the AAP:
> 
> [image: AAP_400_61.jpg]
> 
> 
> 
> *Statement on School Shooting in Parkland, Florida*
> 
> from *Colleen A. Kraft, MD, FAAP, President, American Academy of Pediatrics*
> 
> "Yesterday just before the dismissal bell rang, 17 children and adults were
> shot and killed and 15 were injured inside Marjory Stoneman Douglas High
> School in Parkland, Fla. We find ourselves once again filled with grief and
> horror, and we mourn alongside all those impacted by the shooting. As our
> hearts are in Parkland, our eyes are on Congress.
> 
> "This is the eighteenth school shooting in 2018, the equivalent of one
> every two and a half days so far this year. Shootings have an indelible
> impact on entire communities, on the families who lost children and loved
> ones, and on the children who survived. Columbine. Virginia Tech. Newtown.
> Orlando. Las Vegas. And now, Parkland. Children are dying from gun violence
> and Congress is failing to act. Every one of our 100 U.S. senators, and all
> 435 U.S. representatives bear a responsibility to take meaningful action to
> protect our children, our families, and our communities. Our elected
> leaders cannot continue to fail at this most essential task.
> 
> "We can start by working to advance meaningful legislation that keeps
> children safe. The American Academy of Pediatrics advocates for stronger
> state and federal gun laws that protect children, including a ban on
> assault weapons like the one used in yesterday's school shooting. We also
> call for stronger background checks, solutions addressing firearm
> trafficking, and encouraging safe firearm storage. We will also continue to
> work to ensure that children and their families have access to appropriate
> mental health services, particularly to address the effects of exposure to
> violence.
> 
> "Although these mass shootings command our attention, our children remain
> at risk daily for suicide, homicide, and unintentional injury because of
> the current policy regarding access to guns in the United States. Gun
> violence is a public health threat to children, and one the American
> Academy of Pediatrics will continue to take on, in state capitals across
> the country and in the halls of Congress. Parents across the United States
> send their children to school every day, and hope and trust they will be
> safe. As long as children continue to be injured and killed by guns in this
> country, pediatricians will not rest in our pursuit to keep them safe."
> 
> *The American Academy of Pediatrics is an organization of 66,000 primary
> care pediatricians, pediatric medical subspecialists and pediatric surgical
> specialists dedicated to the health, safety and well-being of infants,
> children, adolescents and young adults. For more information, visit *
> www.aap.org
> <https://linkprotect.cudasvc.com/url?a=http://www.mmsend70.com/link.cfm%3fr%3dP1AWQRX2DH6KpZKp05dazA~~%26pe%3dBH4KXYJXftdV7_OrPTTyUbVAzQsfgoRvleBm2XUVQ6AiEVwuBNacQ0AWbz2OcXguY6Y2i1bNdCMkiPdWG-fHRg~~%26t%3dP2O93UltqkjSP1tT62_PaA~~&c=E,1,EDnzTesKajviC9Rbq687pz7yfFyRgC2WBFw6mF1beQyzL2WYF_fPWMjWxOixG1eagtp40GaUhhxZ8IL4zNcR4weeC1DLvkbbpHQsmMSnszDC&typo=1>*
> and
> follow us on Twitter @AmerAcadPeds.*
> 
> On Fri, Feb 16, 2018 at 9:22 PM, Chamberlain, James <
> [log in to unmask]> wrote:
> 
>> I think we need to move to repeal the second amendment. It's the only way
>> the NRA can be stopped. They resist all reasonable attempts to limit the
>> carnage and then hide behind a misinterpretation of the second amendment.
>> 
>> Very well, let's repeal it. I know many people agree that we don't need
>> militias any longer.
>> 
>> Jim Chamberlain
>> 
>> 
>> 
>> -----Original Message-----
>> From: Pediatric Emergency Medicine Discussion List [mailto:
>> [log in to unmask]] On Behalf Of Martin Pusic
>> Sent: Friday, February 16, 2018 6:29 PM
>> To: [log in to unmask]
>> Subject: The shooting in Florida
>> 
>> Hi colleagues,
>> 
>> As I sit in my office late on a Friday, I've gotten myself into a state
>> about the 17 children gunned down in a school.  For the umpteenth time.
>> 
>> I think the thing that has me so upset, is that this state of gun
>> complaisance is an affront to everything a pediatric emergency physician
>> stands for.  We sweat whether it's too risky when the WBC is 15.1 and not
>> 14.9.  We study 40,000 children in order sort out who deserves the x-ray
>> risk of a maybe brain tumor 30 years from now.  We work in difficult,
>> burnout inducing conditions so that we can personally save, say, one life a
>> year.
>> 
>> Today it feels to me like someone with an AK-whatever just wiped out 17
>> years of my work.  In minutes.  I want to cry.  We SHOULD cry.  Try and
>> watch that Parkland mother on CNN.  I dare you.
>> 
>> Today is not a day like all the others.  It's just not.
>> 
>> --Martin Pusic
>> 
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