A community responds to collective trauma: an ecological analysis of the James Byrd murder in Jasper, Texas.

The brutal murder of James Byrd Jr. in June 1998 unleashed a storm of media, interest groups, high profile individuals and criticism on the Southeast Texas community of Jasper. The crime and subsequent response-from within the community as well as across the world-engulfed the entire town in a collective trauma. Using natural disaster literature/theory and employing an ecological approach, Jasper, Texas was investigated via an interrupted time series analysis to identify how the community changed as compared to a control community (Center, Texas) on crime, economic, health, educational, and social capital measures collected at multiple pre- and post-crime time points between 1995 and 2003. Differences-in-differences (DD) analysis revealed significant post-event changes in Jasper, as well as a surprising degree of resilience and lack of negative consequences. Interviews with residents conducted between March 2005 and 2007 identified how the community responded to the crisis and augmented quantitative findings with qualitative, field-informed interpretation. Interviews suggest the intervention of external organizations exacerbated the severity of the events. However, using strengths of specific local social institutions-including faith based, law enforcement, media, business sector and civic government organizations-the community effectively responded to the initial threat and to the potential negative ramifications of external entities.

Once-daily oral levofloxacin monotherapy versus piperacillin/tazobactam three times a day: a randomized controlled multicenter trial in patients with febrile neutropenia.

A prospective, randomized, controlled multicenter trial was performed to evaluate the efficacy and safety of once-daily oral monotherapy with 500 mg levofloxacin in comparison with 4.5 g piperacillin/tazobactam 3 times a day in patients with low-risk febrile neutropenia. Low risk was defined by oral temperature > or = 38.5 degrees C on one occasion or > or = 38.0 degrees C twice within 24 hours and granulocytopenia < or = 500/microL for less than 10 days. The primary end point was defined as defervescence after 72 hours followed by at least 7 afebrile days. Secondary end points were overall response, time to defervescence, survival on day 30, and toxicity. Thirty-four episodes were included. Fever of unknown origin accounted for 26 (76.5%) of the episodes, microbiologically defined infection for 5 (14.7%) of the episodes, and clinically defined infection for 3 (8.8%) of the episodes. On an intent-to-treat basis, all episodes were evaluable for the primary end point. Levofloxacin and piperacillin/tazobactam were successful after 72 hours of treatment in 76.5% and 88.3% of the episodes. Overall response was achieved in 94.1% and 100% of the episodes, respectively. One inpatient in the oral treatment group died of septic shock without identification of a causative pathogen. A larger phase III trial is warranted to further evaluate the lack of inferiority of the oral monotherapy regimen versus standard intravenous therapy.