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OBJECTIVES: Contextual factors that contribute to firearm injuries among children aged 0 to 10 are not well understood. METHODS: A retrospective review of the National Fatality Review-Case Reporting System was conducted for firearm deaths of children aged 0 to 10 from 2004 to 2020. Descriptive analyses characterized child and parent demographics, incident details, firearm characteristics, and firearm use. Cluster analysis identified key clustering of contextual variables to inform prevention efforts. RESULTS: Within the study timeframe, 1167 child firearm deaths were reported (Mage 5 4.9; 63.2% male; 39.4% urban). At the time of the incident, 52.4% of firearms were reported unlocked and 38.5% loaded. Firearm deaths occurred primarily at the child's home (69.0%) or a friend or relative's home (15.9%), with most involving a handgun (80.6%). Children were supervised in 74.6% of incidents, and 38.4% of child supervisors were impaired during the incident. Cluster analysis identified incident contextual factors clustering in distinct groups, including unsupervised firearm play, long gun discharge while cleaning, hunting, or target shooting, supervised discharge within the child's home, murder-suicide events, deaths occurring in the context of intimate partner violence, and community violence firearm deaths. CONCLUSIONS: Data highlight the importance of primary prevention through secure firearm storage to prevent child firearm deaths. Efforts focused on identifying and reducing intimate partner violence, addressing community violence (eg, community greening), and implementing policy that limit firearm access (eg, domestic violence restraining orders, background checks), may reduce child firearm deaths. [ABSTRACT FROM AUTHOR]

Firearm suicides among adolescents have increased in the US and rates vary across racial and ethnic groups. In this study, we examined contextual information around adolescent firearm suicides and analyzed how incident characteristics vary across racial and ethnic groups. We analyzed firearm suicides among adolescents (ages 10–18 years) from 2004 to 2020 using data from the National Fatality Review-Case Reporting System (NFR-CRS). There were 4,153 firearm suicides during that period. Suicides often involved males, older adolescents (15–18 years), and handguns. Most firearms belonged to the primary caregiver and incidents frequently occurred at home. However, we found that characteristics varied substantially across racial and ethnic groups. Overall, we provide new information on firearm suicides among adolescents in the US using a larger dataset than previous studies and found significant differences in characteristics and demographics across racial and ethnic groups. This finding suggests the need for tailored prevention strategies. [ABSTRACT FROM AUTHOR]

PURPOSE We undertook a study to determine the prevalence and associations of technology-facilitated abuse (TFA)--insults, harassment, coercion, or threats carried out using digital tools such as smartphones and computers--among a US nationally representative sample of young men. METHODS Analyses were based on 1,079 men aged 18 to 35 years who completed questionnaires during August and September of 2014 and reported ever having been in a romantic relationship. We used validated measures to assess demographics, health service use, mental health and substance use, and TFA delivered to and received from partners in the past year. We calculated survey-weighted descriptive statistics and conducted multinomial logistic regression analysis. RESULTS Overall, 4.1% of men reported delivering TFA only, 8.0% receiving TFA only, and 25.6% both delivering and receiving TFA. Men were more likely to report only delivering TFA if they identified as Hispanic (adjusted odds ratio [AOR] = 2.72; 95% CI, 1.13 to 6.57), used marijuana (AOR = 1.31; 95% CI, 1.02 to 1.68), and used prescription opioids for nonmedical reasons (AOR 2.86; 95% CI, 1.48 to 5.54). Men were more likely to report only receiving TFA if they identified as Hispanic (AOR = 2.55; 95% CI, 1.01 to 6.43) and used prescription opioids for nonmedical reasons (AOR = 2.43; 95% CI, 1.34 to 4.39), whereas a primary care connection appeared protective (AOR = 0.43; 95% CI, 0.22 to 0.86). Men were more likely to report both delivering and receiving TFA if they identified as nonHispanic Black (AOR = 2.83; 95% CI, 1.44 to 5.58), owned a smartphone (AOR = 1.80; 95% CI, 1.05 to 3.09), had ever had mental health care visits (AOR = 1.86; 95% CI, 1.16 to 2.98), misused alcohol (AOR = 1.10; 95% CI, 1.04 to 1.17), and used prescription opioids for nonmedical reasons (AOR = 1.79; 95% CI, 1.04 to 3.08). CONCLUSIONS We found that TFA was prevalent among young men, with 1 in 25 reporting delivery only, 1 in 12 reporting receipt only, and 1 in 4 reporting both. Primary care physicians can consider assessing TFA among male patients and developing interventions to mitigate this behavior. VISUAL ABSTRACT Key words: technology-facilitated abuse; intimate partner violence, prevalence; young men; screening; primary care, INTRODUCTION Adults in the United States often use technology-facilitated communication tools to form and maintain intimate relationships. Among US adults, 81% own a smartphone, 75% own a desktop or laptop [...]

The article discusses research which described characteristics of childhood firearm intimate partner violence (IPV) incident deaths from 2004 to 2020 and differences between firearm and nonfirearm childhood IPV deaths based on data from the National Fatality Review-Case Reporting System. Data shows comparisons of childhood IPV incident deaths by firearm versus other mechanism of death. The study suggested IPV interventions providing education on safe and healthy relationships and environment.

An editorial is presented discussing the findings of Wolf et al., highlighting the significant increase in pediatric fatalities in the U.S., particularly due to preventable injuries, with notable racial and ethnic disparities, emphasizing the urgent need for addressing firearm injury through established public health principles. It also emphasizes the importance of examining upstream social and structural determinants of health associated with disparities in firearm injury outcomes.

The article discusses a study which aims to assess the influence of elevation on obstructive sleep apnea (OSA) on children with Down syndrome (DS) and the rate of hospitalization between children with and without DS. Topics discussed include the disparity in cardiopulmonary diagnoses by DS and elevation for OSA, pneumonia, and congenital heart disease. Also discussed are the use of the multi-variable relative risk (RR) model in analyzing the association between hospitalization and elevation.

Background: Adolescents and young adults with risk factors for opioid misuse and opioid use disorder are at elevated risk for overdose. We examined prior non-fatal overdose experiences among at-risk adolescents/young adults to inform prevention efforts., Methods: Adolescents/young adults (ages 16-30) in two US emergency departments self-reporting past year opioid misuse or opioid use plus a misuse risk factor completed a baseline survey as part of an ongoing randomised controlled trial. We describe baseline factors associated with (a) overall non-fatal overdose experiences and (b) groups based on substance(s) used during the worst overdose experience., Results: Among 771 participants (27.9% male), 40.7% reported a non-fatal overdose experience. Compared with those without a prior overdose experience, those with prior overdose experience(s) were less likely to be heterosexual, and more likely to report a prior suicide attempt and greater peer substance misuse. Regarding the worst overdose experience, substance(s) included: 36.6% alcohol only, 28.0% alcohol and cannabis, 22.6% alcohol with other substance(s) and 12.7% other substance(s) only (eg, opioids). Compared with the alcohol only group, the alcohol and cannabis group were younger and less likely to be heterosexual; the alcohol with other substance(s) group were older and had greater peer substance misuse; and the other substance(s) only group were more likely to be male, receive public assistance, screen positive for anxiety and less likely to be heterosexual., Conclusions: Among at-risk adolescents/young adults, findings support the need for tailored overdose prevention efforts based on substance(s) used, with consideration of sexuality, mental health and peer substance use., Trial Registration Number: NCT04550715., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. No commercial re-use. See rights and permissions. Published by BMJ.)

Survey results regarding primary care physicians' likelihood of recommending a new vaccine were compared before and after the vaccine was licensed by the Food and Drug Administration for three new vaccines: herpes zoster (HZ), human papillomavirus (HPV) and rotavirus (RV), using physician networks representative of United States physicians. The main purpose of this study was to determine (a) how accurately physicians predict their eventual vaccine recommendations and the barriers they will experience in delivering the new vaccine and (b) whether physicians shift towards more or less strongly recommending a new vaccine from pre- to post-licensure. Responses from 284, 152 and 184 physicians were analyzed for the three vaccines, respectively. For all vaccines, there was a significant association between physicians' pre- and post-licensure recommendations (p<0.05). When responses changed from pre- to post-licensure, physicians tended to recommend a given vaccine more strongly than they had anticipated pre-licensure. Before vaccine availability, physicians tended to predict greater barriers to vaccine delivery than they eventually experienced. Surveys are useful for predicting physician practices, but may provide a slightly pessimistic view of physician adoption of new vaccines. Such data can be helpful in devising strategies to encourage vaccine delivery by physicians., (Copyright © 2013 Longwoods Publishing.)

Objective: To assess practices regarding the expanded Advisory Committee on Immunization Practices (ACIP) recommendations for influenza vaccination in children among US pediatricians and family medicine physicians (FMs) and strategies to promote vaccination., Study Design: We administered a survey between July and October 2009 to 416 pediatricians and 424 FMs from nationally representative networks., Results: The response rate was 75% (79% pediatricians, 70% FMs). FMs were less likely than pediatricians to report adherence to ACIP recommendations (35% vs 65%; adjusted risk ratio [RR], 0.60; 95% CI, 0.50-0.72). Most physicians (89% pediatricians and 89% FMs) reported using posters or pamphlets to encourage influenza vaccination, and 57% pediatricians and 41% FMs reported offering after hours dedicated influenza vaccination clinics. Only 23% pediatricians and 14% FMs reported providing written, telephone, or e-mail reminders to all children. Having dedicated influenza vaccination clinics after hours or weekends was associated with routine vaccination of all children (adjusted RR, 1.33; 95% CI, 1.15-1.57)., Conclusion: In the first year of the expanded ACIP recommendations to immunize all eligible children against influenza, two-thirds of pediatricians and one-half of FMs reported adherence, although less than one-quarter were actively engaging in reminder/recall efforts. Practices that adhered to the ACIP recommendations were more likely to put a substantial effort into promoting vaccination opportunities., (Copyright © 2012 Mosby, Inc. All rights reserved.)