Violence prevention: reaching adolescents with the message.

OBJECTIVE: To identify an effective medium for communicating with adolescents in a large-scale, cost-effective violence prevention program. METHODS: A set of youth violence prevention programs was established at The Stamford Hospital, a level II trauma center. The traveling version of the program was presented to middle school students in four parts: 1) a rap music video created by our violence prevention staff, 2) a facilitated discussion about dealing with anger, 3) a video of a trauma resuscitation in our emergency department, and 4) a commercial video of a teenage boy paralyzed after a gunshot wound. A written questionnaire with a five-point rating scale (1 to 5) was used to survey the audience 1 month after the program. The survey assessed the respondents' recall of each part of the program and the perceptions of the value of each part in identifying the problem of violence and reducing violent behavior. RESULTS: Of 99 respondents, the highest ratings for retention, problem identification, and impact were given to the commercial video (combined average category ranking of 11.394) and the rap music video (11.182). The trauma resuscitation video and the discussion of anger were ranked as being less effective (10.253 and 9.383, respectively). The audience seemed to comprehend the main point of the program and ranked the program, as a whole, higher than any of the parts when measured by success at problem identification and impact. CONCLUSION: Effective communication with adolescents is possible through many avenues. Children of the video age respond well to visual material. A violence prevention program should incorporate effective multimedia presentations. A variety of methods in combination proves to be most effective.

Munchausen syndrome presenting as trauma.

Rarely, a patient with Munchausen syndrome will present with apparent trauma. A computerized literature search from 1966 until the present discovered only three such case reports, none of which appeared in a surgical journal. We report a fourth case. The characteristics of Munchausen syndrome are illustrated. The possibility that such a patient may have a true injury is also discussed.