Are Goods for Guns Good for the Community? An Update of a Community Gun Buyback Program

BACKGROUND: Gun violence remains a leading cause of death in the United States. Community gun buyback programs provide an opportunity to dispose of extraneous firearms. The purpose of this study was to understand the demographics, motivation, child access to firearms and household mental illness of buyback participants in hopes of improving the program\u27s effectiveness. METHODS: A 2015 Injury Free Coalition for Kids gun buyback program which collaborated with local police departments was studied. We administered a 23-item questionnaire survey to gun buyback participants assessing demographic characteristics, motivation for relinquishing firearms, child firearm accessibility, and mental illness/domestic violence history. RESULTS: A total of 186 individuals from Central/Western Massachusetts turned in 339 weapons. Participants received between $25 and$75 in gift cards dependent on what type of gun was turned in, with an average cost of $41/gun. A total of 109 participants (59%) completed the survey. Respondents were mostly white (99%), male (90%) and first-time participants in the program (85.2%). Among survey respondents, 54% turned in firearms for safety reasons . Respondents reported no longer needing/wanting their weapons (47%) and approximately one in eight participants were concerned the firearm(s) were accessible to children. Most respondents (87%) felt the program encouraged neighborhood awareness of firearm safety. Three out of every five participants reported that guns still remained in their homes, additionally; 21% where children could potentially access them and 14% with a history of mental illness/suicide/domestic violence in the home. CONCLUSIONS: Gun buybacks can provide a low-cost means of removing unwanted firearms from the community. Most participants felt their homes were safer after turning in the firearm(s). In homes still possessing guns, emphasis on secure gun storage should continue increasing the safety of children and families. The results of this survey also provided new insights into the association between mental illness/suicide and gun ownership. LEVEL OF EVIDENCE: Level III, Prognostic and Epidemiological

The incidence of pedestrian distraction at urban intersections after implementation of a Streets Smarts campaign

Background: Pedestrians distracted by digital devices or other activities are at a higher risk of injury as they cross streets. We sought to describe the incidence of pedestrians distracted by digital devices or other activities at two highly traveled urban intersections after the implementation of a pedestrian safety intervention at one of the intersections. Methods: This was an observational field study of two urban intersections. Two investigators were stationed at each of the four corners of the intersection. Each pair of observers included one “person counter” and one “behavior counter”. The “person counter” tallied every individual who approached that corner from any of the three opposing corners. The “behavior counter” tallied every individual approaching from the three opposing corners who were exhibiting any of the following behaviors: 1) eating, 2) drinking, 3) wearing ear buds/headphones, 4) texting, 5) looking at mobile phone or reading something on mobile phone, or 6) talking on mobile phone. Every 15 min, each pair of observers rotated to the next corner of the same intersection, allowing each pair of observers to complete one 15-min observation at each of the four corners of the intersection. Intersection A had stencils at the curb cuts of each corner alerting pedestrians to put down a digital device while crossing the intersection while intersection B did not. Results: 1362 pedestrians were observed; of those, 19 % were distracted by another activity at both intersections. Of the total, 9 % were using ear buds/headphones; 8 % were using a digital device (talking, texting, or looking down at it); and 2 % were eating or drinking. Inter-observer validity among observers (kappa) was 98 %. Of those that were distracted, 5 % were either using an assistive device (cane, walker, motorized scooter) or walking with a child (either on foot or in stroller). There were no differences in the proportion of pedestrians who were distracted at either intersection, except that more pedestrians were talking on a cell phone while crossing intersection B. Conclusions: It is unclear to what degree a pedestrian safety messaging campaign is effective in decreasing distraction by digital devices. Further evaluation of the effect of posted warnings about pedestrian distraction on the safety of crossing behaviors is needed

Behaviors increasing the risk of crash injury in Latino adolescent males: The influence of acculturation and parent connectedness

Motor vehicle crashes (MVC) are the leading cause of death for U.S. teens and cause the largest proportion of mortality among Latino adolescent males. MVC-related injury disparities persist and are growing among U.S. Latino adolescent males, where current mortality rates exceed those of their non-Latino white peers. For adolescent drivers, substance use is a known risk factor for a serious or fatal MVC. Acculturation in U.S. Latino adolescents has been previously shown to play an important role in substance use propensity (Castro, Stein, & Bentler, 2009), while substance use of any kind is linked to an increase in MVC risk among adolescents (Dunlop & Romer, 2010). Despite the negative effects of poverty, low education, and poor access to healthcare, U.S. Latinos as a group have been noted for having health outcomes similar, and in some cases, better than non-Latino white peers in what is commonly described as the “Latino Epidemiological Paradox” (Morales, Lara, Kington, Valdez, & Escarce, 2002). We sought to assess the effects of acculturation and parent connectedness on behaviors increasing the risk of crash injury in Latino adolescent males

Prevention of fall-related injuries in the elderly: An Eastern Association for the Surgery of Trauma practice management guideline.

BACKGROUND: Fall-related injuries among the elderly (age 65 and older) are the cause of nearly 750,000 hospitalizations and 25,000 deaths per year in the United States, yet prevention research is lagging. Using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology, the Eastern Association for the Surgery of Trauma produced this practice management guideline to answer the following injury prevention-related population, intervention, comparator, outcomes (PICO) questions:PICO 1: Should bone mineral-enhancing agents be used to prevent fall-related injuries in the elderly?PICO 2: Should hip protectors be used to prevent fall-related injuries in the elderly?PICO 3: Should exercise programs be used to prevent fall-related injuries in the elderly?PICO 4: Should physical environment modifications be used to prevent fall-related injuries in the elderly?PICO 5: Should risk factor screening be used to prevent fall-related injuries in the elderly?PICO 6: Should multiple interventions tailored to the population or individual be used to prevent fall-related injuries in the elderly? METHODS: A comprehensive search and review of all the available literature was performed. We used the GRADE methodology to assess the breadth and quality of the data specific to our PICO questions. RESULTS: We reviewed 50 articles that met our inclusion and exclusion criteria as they applied to our PICO questions. CONCLUSION: Given the data constraints, we offer the following suggestions and recommendations:PICO 1: We conditionally recommend vitamin D and calcium supplementation for frail elderly individuals.PICO 2: We conditionally recommend hip protectors for frail elderly individuals, in the appropriate environment.PICO 3: We conditionally recommend evidence-based exercise programs for frail elderly individuals.PICO 4: We conditionally recommend physical environment modification for frail elderly people.PICO 5: We conditionally recommend frailty screening for the elderly.PICO 6: We strongly recommend risk stratification with targeted comprehensive risk-reduction strategies tailored to particular high-risk groups. LEVEL OF EVIDENCE: Systematic review, level III

Preparing for Disaster: a Cross-Sectional Study of Social Connection and Gun Violence

Living in communities with persistent gun violence is associated with negative social, behavioral, and health outcomes, analogous to those of a natural disaster. Taking a disaster-preparedness approach may identify targets for community-based action to respond to on-going gun violence. We assessed the relevance of adapting a disaster-preparedness approach to gun violence and, specifically, the relationship between perceived collective efficacy, its subscales of social cohesion and informal social control, and exposure to gun violence. In 2014, we conducted a cross-sectional study using a community-based participatory research approach in two neighborhoods in New Haven, CT, with high violent crime rates. Participants were ≥18 years of age and English speaking. We measured exposure to gun violence by adapting the Project on Human Development in Chicago Neighborhoods Exposure to Violence Scale. We examined the association between perceived collective efficacy, measured by the Sampson Collective Efficacy Scale, and exposure to gun violence using multivariate modeling. We obtained 153 surveys (51% response rate, 14% refusal rate, and 35% non-response rate). Ninety-five percent reported hearing gunfire, 58% had friend or family member killed by gun violence, and 33% were physically present during a shooting. In the fully adjusted model, one standard deviation higher perceived collective efficacy was associated with lower reported exposure to gun violence (β = -0.91, p \u3c 0.001). We demonstrated that it is possible to activate community members and local officials to engage in gun violence research. A novel, community-based approach adapted from disaster-preparedness literature may be an effective framework for mitigating exposure to gun violence in communities with persistent gun violence

Primary prevention of contact sports-related concussions in amateur athletes: a systematic review from the Eastern Association for the Surgery of Trauma.

Background: Awareness of the magnitude of contact sports-related concussions has risen exponentially in recent years. Our objective is to conduct a prospectively registered systematic review of the scientific evidence regarding interventions to prevent contact sports-related concussions. Methods: Using the Grading of Recommendations Assessment, Development, and Evaluation methodology, we performed a systematic review of the literature to answer seven population, intervention, comparator, and outcomes (PICO) questions regarding concussion education, head protective equipment, rules prohibiting high-risk activity and neck strengthening exercise for prevention of contact sports-related concussion in pediatric and adult amateur athletes. A query of MEDLINE, PubMed, Scopus, Cumulative Index of Nursing and Allied Health Literature, and Embase was performed. Letters to the editor, case reports, book chapters, and review articles were excluded, and all articles reviewed were written in English. Results: Thirty-one studies met the inclusion criteria and were applicable to our PICO questions. Conditional recommendations are made supporting preventive interventions concussion education and rules prohibiting high-risk activity for both pediatric and adult amateur athletes and neck strengthening exercise in adult amateur athletes. Strong recommendations are supported for head protective equipment in both pediatric and adult amateur athletes. Strong recommendations regarding newer football helmet technology in adult amateur athletes and rules governing the implementation of body-checking in youth ice hockey are supported. Conclusion: Despite increasing scientific attention to sports-related concussion, studies evaluating preventive interventions remain relatively sparse. This systematic review serves as a call to focus research on primary prevention strategies for sports-related concussion. Level of evidence: IV. PROSPERO registration number: #42016043019