Recent years have witnessed a proliferation of interest in the phenomenon of the gang both in the UK and across Europe. Such concern has been driven forward by growing reports of gang activity reported in the media, circulated by populist politicians as well as by academic researchers convinced the European gang has been ignored for too long. This anxiety has coalesced in a perception that the gang is a serious and growing problem, that the rise in lethal violence, as seen recently in inner cities such as London, Birmingham, Manchester and Liverpool, is connected to the proliferation of the gang, and that the solution to the problem of urban gang violence lies in its suppression. This article takes a critical standpoint against these statements and challenges attempts to interpret urban violence in the UK as a problem of gangs or a burgeoning gang culture. It argues that the problem of street-based violence is not always reducible to the gang and suggests that the solution to preventing urban violence will not be found by sanctioning crackdowns or gang suppression programmes. It concludes by offering an alternate perception of the gang and urban violence and signposts areas that research on urban violence might need to address.

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BackgroundGrowing levels of both obesity and chronic disease in the general population pose a major public health problem. In the UK, an innovative 'health and weight' cohort trials facility, the 'South Yorkshire Cohort', is being built in order to provide robust evidence to inform policy, commissioning and clinical decisions in this field. This protocol reports the design of the facility and outlines the recruitment phase methods.Method/DesignThe South Yorkshire Cohort health and weight study uses the cohort multiple randomised controlled trial design. This design recruits a large observational cohort of patients with the condition(s) of interest which then provides a facility for multiple randomised controlled trials (with large representative samples of participants, long term outcomes as standard, increased comparability between each trial conducted within the cohort and increased efficiency particularly for trials of expensive interventions) as well as ongoing information as to the natural history of the condition and treatment as usual.This study aims to recruit 20,000 participants to the population based South Yorkshire Cohort health and weight research trials facility. Participants are recruited by invitation letters from their General Practitioners. Data is collected using postal and/or online patient self completed Health Questionnaires. NHS numbers will be used to facilitate record linkage and access to routine data. Participants are eligible if they are: aged 16 - 85 years, registered with one of 40 practices in South Yorkshire, provide consent for further contact from the researchers and to have their information used to look at the benefit of health treatments. The first wave of data is being collected during 2010/12 and further waves are planned at 2 - 5 year intervals for the planned 20 year duration of the facility.DiscussionThe South Yorkshire Cohort combines the strengths of the standard observational, longitudinal cohort study design with a population based cohort facility for multiple randomised controlled trials in a range of long term health and weight related conditions (including obesity). This infrastructure will allow the rapid and cheap identification and recruitment of patients, and facilitate the provision of robust evidence to inform the management and self-management of health and weight.

Telemedicine decreases ED door-to-provider time, most commonly because the telemedicine provider was the first provider seeing a patient. Among transferred patients, ED LOS at the first hospital was shorter in patients who had telemedicine consulted. Future work will focus on the clinical impact of more timely rural ED care.

In recent years there have been a number of high profile stories reporting increasing levels of female involvement in group related crime. According to these reports teenage girls are no longer spectators hovering on the periphery of street gangs but are hard core members actively engaging in the kind of extreme violence that is usually the preserve of men. As girl ‘gangsters’, young women are seen to be engaging in a wide range of crimes such as robbery, rape and murder. Using findings from an empirical study on young people’s use of weapons and involvement in street based groups, this article examines female involvement in ‘gangs’ and their violent behaviour. It challenges the dominant stereotype of girl ‘gangsters’ as malicious violent aggressors. The notion of the gang and implications for policy and practice will also be considered.

The response of trauma systems in rural areas is uncertain since distances between injury scenes and trauma care are considerable. Timely arrival at definitive care is critical for persons with traumatic brain injury (TBI) since secondary damage can occur during the hours following injury. We evaluated how the implementation of a trauma system in a predominately rural state affected the triage of TBI patients and their risk for mortality. The Iowa System Trauma Registry Dataset was analyzed, and included patients evaluated before trauma system implementation, 1997-1998, and after implementation, 2002-2003. Patients were identified using ICD9-CM codes or AIS codes, and included 710 pre-system patients and 886 post-system patients. Multivariate logistic regression assessed the effect of the trauma system on survival while controlling for confounders. Following implementation of the trauma system, patients treated in Level I or II facilities were older (p = 0.019), more often had multiple injuries (p = 0.0002), and had more severe TBI (p = 0.008). After controlling for confounders, transferred patients and those directly admitted were less likely to die in 72 h in the post-system than the pre-system (odds ratio [OR] = 0.56, 95% confidence interval (CI) = 0.36, 0.88; OR = 0.50, 95% CI = 0.32, 0.79). Implementation of the Iowa trauma system seems to have led to more appropriate triage and transport for TBI patients, and this likely contributed to reduced in-hospital mortality.

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