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The health care system has only recently adopted protocols and training to enable practitioners to identify and respond to victims of domestic violence. Currently, most hospitals have domestic violence protocols in place, although training in the use of protocols is less routine. However, because the provision of health care focuses on the treatment of the individual, the well-being of the children of adult domestic violence victims has received little attention in adult health care settings. Pediatricians do not routinely receive training in domestic violence identification and do not see responding to battered mothers as within the purview of their practice. Innovative programs in children's hospitals in Boston, Massachusetts, and San Diego, California, recognize that the safety of children is integrally tied to the safety of their mothers. These programs identify abused children whose mothers are the victims of domestic violence and provide advocacy and support that allow mothers and children to remain together in most instances. Little is known about the health impacts of teen dating violence, and opportunities for screening exist in the settings where teens receive health care. Likewise, prenatal visits provide regularized opportunities for domestic violence screening. Integrating the health care needs of mothers and children from violent households will require continued and expanded training, collaboration with community institutions, and improvements in insurance reimbursements to cover the costs of needed services.

Existing data sources do not provide comprehensive and timely information to adequately monitor drug-related mortality in Los Angeles County. To fill this gap, a surveillance system using coroner data was developed to examine patterns in drugrelated deaths. The coroner provided data on all injury deaths in Los Angeles County. A list of keywords that indicate a death was caused by drug use was developed. The cause of death variables in the coroner data were searched for mentions of one of the keywords; if a keyword was detected, that death was classified as drug related. The effectiveness of the keyword list in classifying drug-related deaths was evaluated by matching records in the coroner death data to records in the state death files. Then, the drug-related deaths identified using the keywords were compared to drug-related deaths in the state mortality files identified using International Classification of Death codes. Toxicological test results were used to categorize drug-related deaths based on the type and legality of the drug(s) ingested. Mortality rates were calculated for each category of drug and legal status and for different demographic groups. Compared to the gold standard state mortality files, the coroner data had a sensitivity of 95.6% for identifying drug-related deaths. Over three quarters of all drug-related deaths tested positive for opiates and/or stimulants. Males, Whites, and 35-54-year-olds each accounted for more than half of all drug-related deaths. The surveillance of drug-related deaths using coroner data has several advantages: data are available in a timely fashion, the data include information about the specific substances each victim ingested, and the data can be broken down to compare mortality among specific subpopulations.

Injury prevention experts have suggested that gun manufacturers could reduce youth violence by changing the design of guns. Product safety features could make guns more difficult for children to fire unintentionally and more difficult to use if stolen or obtained illegally. This article gives a brief history of efforts to make safer, smarter guns and assesses the potential of the product safety approach for reducing youth gun violence. Among the article's key findings: Research from the injury prevention field suggests that changing product design may be more effective in preventing injuries than trying to change personal behaviors; Existing product safety technologies for guns could reduce unintentional gun injuries, especially to young children. In addition, emerging technologies will enable gun manufacturers to "personalize" guns, which could prevent unauthorized users of any age from firing the weapons. Personalization could decrease access to guns by adolescents; Gun manufacturers have been slow to incorporate safety features into their products; but legislative, regulatory, and litigation efforts are under way to mandate safer guns. The authors envision a future when the law requires product safety features--including personalization--on all new firearms. These product safety features have the potential to reduce both intentional and unintentional firearm injury and death.