Lower social vulnerability is associated with a higher prevalence of social media-involved violent crimes in Prince George's County, Maryland, 2018-2023.

BACKGROUND: Social vulnerability may play a role in social media-involved crime, but few studies have investigated this issue. We investigated associations between social vulnerability and social media-involved violent crimes. METHODS: We analyzed 22,801 violent crimes occurring between 2018 and 2023 in Prince George's County, Maryland. Social media involvement was obtained from crime reports at the Prince George's County Police Department. Social media application types included social networking, advertising/selling, ridesharing, dating, image/video hosting, mobile payment, instant messaging/Voice over Internet Protocol, and other. We used the Centers for Disease Control and Prevention's Social Vulnerability Index to assess socioeconomic status (SES), household characteristics, racial and ethnic minority status, housing type and transportation, and overall vulnerability. Modified Poisson models estimated adjusted prevalence ratios (aPRs) among the overall sample and stratified by crime type (assault and homicide, robbery, and sexual offense). Covariates included year and crime type. RESULTS: Relative to high tertile areas, we observed a higher prevalence of social media-involved violent crimes in areas with low SES vulnerability (aPR: 1.82, 95% CI: 1.37-2.43), low housing type and transportation vulnerability (aPR: 1.53, 95% CI: 1.17-2.02), and low overall vulnerability (aPR: 1.63, 95% CI: 1.23-2.17). Low SES vulnerability areas were significantly associated with higher prevalences of social media-involved assaults and homicides (aPR: 1.64, 95% CI: 1.02-2.62), robberies (aPR: 2.00, 95% CI: 1.28-3.12), and sexual offenses (aPR: 2.07, 95% CI: 1.02-4.19) compared to high SES vulnerability areas. Low housing type and transportation vulnerability (vs. high) was significantly associated with a higher prevalence of social media-involved robberies (aPR: 1.54, 95% CI:1.01-2.37). Modified Poisson models also indicated that low overall vulnerability areas had higher prevalences of social media-involved robberies (aPR: 1.71, 95% CI: 1.10-2.67) and sexual offenses (aPR: 2.14, 95% CI: 1.05-4.39) than high overall vulnerability areas. CONCLUSIONS: We quantified the prevalence of social media-involved violent crimes across social vulnerability levels. These insights underscore the need for collecting incident-based social media involvement in crime reports among law enforcement agencies across the United States and internationally. Comprehensive data collection at the national and international levels provides the capacity to elucidate the relationships between neighborhoods, social media, and population health.

Firearm Homicide Mortality is Linked to Food Insecurity in Major US Metropolitan Cities.

BACKGROUND: Gun violence disproportionately affects metropolitan areas of the United States (US). There is limited information regarding the influence of social determinants of health, such as food insecurity (FI) on firearm homicide mortality (FHM) in major metropolitan cities in the US. We sought to examine the relationship between FI and FHM. MATERIALS AND METHODS: This was a cross-sectional analysis examining the largest 51 US major metropolitan statistical areas (MSAs) using data from 2018. Demographic data, markers of social inequities, and firearm homicide data were obtained from the US Census Bureau, US Department of Education, and the Frey and Brookings Institute. Food insecurity prevalence was obtained from Feeding America. Spearman ρ and linear regression were performed. RESULTS: Using Spearman rho analysis, higher FI (r = 0.55, P < 0.001) was associated with FHM. Other variables associated with FHM included percent Black/African American (AA) (r = 0.77, P < 0.001), poverty rate (r = 0.53, P < 0.001), and percent of children living in single parent households (r = 0.58, P < 0.001). In linear regression analyses, FI was associated with increased FHM, with 1.3 additional FHM events for each unit increase in FI (ß = 1.33, 95% CI 0.27-2.39, P = 0.02). The percent of a population that is Black/AA was also associated with FHM, with more than 4 additional cases for each 1% increase in the population (ß = 4.32, 95% CI 3.26-5.38, P < 0.001). CONCLUSION: Food insecurity may influence FHM in major US metropolitan cities. Community- and hospital-based programs that target FI may help combat the gun violence epidemic and decrease gun violence.

Evaluation of a Firearm Safe Storage Device Distribution Program at a Break the Cycle of Violence Summit.

This study assesses the feasibility and acceptability of a Firearm Safe Storage Device Distribution Program. The distribution took place at the Break the Cycle of Violence Summit hosted by the Johns Hopkins Medicine, the Break the Cycle Hospital Violence Intervention Program, and the Johns Hopkins Bloomberg School of Public Health Center for Gun Violence Solutions. The findings will guide future efforts to distribute safe storage devices in clinical settings. Attendees of the Break the Cycle of Violence Summit could choose from three types of safe storage devices to provide to their patients within their practice. Those attendees who participated were asked to participate in an electronic survey to assess the feasibility and acceptability of the safe firearm storage device distribution at the Summit. 24 participants received safe storage devices at the Break the Cycle of Violence Summit. Of the 24 participants, 15 participated in our evaluation. 86% of participants distributed most of the devices by the time of the survey and 57% of participants stated that by having safe storage devices to distribute, they were more likely to provide safe gun storage counseling. All participants would like to see continued safe gun storage distribution programs in their community. The provision of free safe storage devices allowed for open conversations about firearms and safe storage with patients and clients. This study can be used as a model to guide future efforts in safe storage device distribution in a hospital or clinic-based setting and showed feasibility, effectiveness, and efficacy.

Female Victims of Firearm Intimate Partner Violence: Characterization and Lethality Predictors.

Objective: To characterize the sociological risk factors for firearm intimate partner violence (IPV) among women in Texas, with a focus on lethal predictors to aid in screening and intervention guidelines. Methods: A retrospective medical and forensic chart review was conducted and supplemented by news sources, public police reports, and court records on firearm cases in Houston, TX, from 2018 to 2020. IPV was defined as a cis-gendered female victim of firearm violence from a current or ex-intimate partner. Non-IPV was defined as cis-gendered female victims of firearm violence from strangers, friends/acquaintances, gang, client, or similar relationships. Numeric variables were compared using the Wilcoxon rank-sum test and reported as median [Q1, Q3]. Categorical variables were compared using Fisher's exact test and reported as count (%). Results: A total of 102 cases of IPV were identified. Nonspousal IPV was more prevalent than spousal (65.7% versus 34.3%). Lethal injuries, older age, home location, and head injuries were more prevalent in the IPV cohort. Older age, spousal perpetrator, home shooting location, and history of prior domestic abuse were associated with lethal IPV. There were 31 cases of murder-suicide. During the COVID-19 pandemic, IPV cases increased by 91.3%, with lethal cases increasing by 57.6%. Conclusion: Risk factors for overall IPV and lethal IPV are not the same; therefore, it is imperative that all women, irrespective of race, age, or relationship status, be screened for IPV and prior domestic violence to allow intervention and prevention of lethal IPV. Patients should also be screened for personal or partner access to firearms as firearm IPV is a highly lethal form of violence.

The digital MySteps intervention for abused women at risk for firearm-related injuries and homicides: Findings from the feasibility, acceptability and preliminary efficacy trial.

Background: Firearms are the leading cause of victimization of abused women by intimate partner homicide and intimate partner homicide-suicides in the US. This calls for evidence-based intervention strategies to prevent firearm-related injuries or mortality and address the firearms-related safety needs of women in abusive relationships. My Safety Steps (MySteps) was designed to comprehensively assess women's firearm-related risks, and current safety needs and to prevent women's harm from their abuser's access or ownership of a firearm through a digitally delivered firearm-focused safety planning intervention. This paper describes the development, feasibility, acceptability, and preliminary evaluation of the digital BSHAPE intervention among women survivors of intimate partner violence (IPV). Methods: Using a pretest post-test control group design, the study was conducted with 103 participants with 55 women randomly assigned to the MySteps arm and 48 women to the standard of care control arm. The feasibility and acceptability outcomes assessed were enrollment, adherence, and perceptions of the intervention. Preliminary evaluation outcomes included the partner's access to a firearm, women's self-efficacy beliefs, and empowerment. Further, qualitative follow-up interviews were conducted with 30 survivors of IPV in the MySteps arm to follow up on the use and helpfulness of safety strategies provided in MySteps. Results and conclusion: The intervention was found to be feasible, and acceptable and demonstrated improved outcomes for survivors of IPV at risk from their partner's firearm. Women provided feedback for further refinement. The findings of this study will be useful in further refining MySteps and testing it in a full-scale randomized controlled trial.

Storage of firearms in vehicles: findings from a sample of firearm owners in nine U.S. states.

BACKGROUND: In recent years, there has been a growing number of thefts of firearms stored in vehicles. Despite this trend, there is limited research on firearm storage patterns in vehicles in the United States. This study investigates these storage patterns and evaluates the relationship between the surge in firearm purchases after March 2020 and the practice of storing firearms in vehicles. METHODS: Firearm storage practices were classified into four categories: (a) no vehicle storage, (b) locked vehicle storage only, (c) unlocked vehicle storage only, and (d) both locked and unlocked vehicle storage. Multinomial logistic regression analyses were conducted to determine the association between vehicle firearm storage practices and the main independent variable (firearm purchases since March 2020), adjusting for covariates. RESULTS: Those who purchased a firearm since March 2020 were significantly more likely to store at least one firearm in a vehicle unlocked only (RRR = 2.41, 95% CI 1.45-3.99) or both locked and unlocked (RRR = 2.57, 95% CI .180-3.67) compared to the reference category of no vehicle storage. CONCLUSION: Individuals who purchased a firearm after March 2020 were more likely to report storing a firearm in a vehicle. Given the limited research on patterns of firearm storage in vehicles, these findings provide novel evidence suggesting that firearm purchases following the March 2020 firearm purchasing surge may have fomented behaviors that increased the likelihood of firearm storage in automobiles. Moving forward, there is a need for additional quantitative and qualitative research that can better understand patterns and motivations of firearm storage in vehicles.

How firearm legislation impacts firearm mortality internationally: A scoping review.

Background: The literature on gun violence is broad and variable, describing multiple legislation types and outcomes in observational studies. Our objective was to document the extent and nature of evidence on the impact of firearm legislation on mortality from firearm violence. Methods: A scoping review was conducted under PRISMA-ScR guidance. A comprehensive peer-reviewed search strategy was executed in several electronic databases from inception to March 2024. Grey literature was searched for unpublished sources. Data were extracted on study design, country, population, type of legislation, and overall study conclusions on legislation impact on mortality from suicide, homicide, femicide, and domestic violence. Critical appraisal for a sample of articles with the same study design (ecological studies) was conducted for quality assessment. Findings: 5057 titles and abstracts and 651 full-text articles were reviewed. Following full-text review and grey literature search, 202 articles satisfied our eligibility criteria. Federal legislation was identified from all included countries, while state-specific laws were only reported in studies from the U.S. Numerous legislative approaches were identified including preventative, prohibitive, and more tailored strategies focused on identifying high risk individuals. Law types had various effects on rates of firearm homicide, suicide, and femicide. Lack of robust design, uneven implementation, and poor evaluation of legislation may contribute to these differences. Interpretation: We found that national, restrictive laws reduce population-level firearm mortality. These findings can inform policy makers, public health researchers, and governments when designing and implementing legislation to reduce injury and death from firearms. Funding: Funding is provided by the Strategy for Patient-Oriented Research (SPOR) Evidence Alliance and in part by St. Michael's Hospital, University of Toronto. Scoping review registration: Open Science Framework (OSF): https://osf.io/sf38n.

Heterogeneity in momentary affective experiences related to suicidal urges in a non-clinical sample of adult handgun owners and non-owners recruited from the community.

Although suicide is complex and heterogeneous, most suicide theories assume that suicidal urges occur primarily in the context of extreme emotional distress. Newer models of suicide based on complex systems theory propose greater heterogeneity in suicidal experiences across individuals and groups, such that some, but not all, suicidal thoughts, urges, and behaviors are associated with extreme negative affect. The present study investigated individual differences in affective states experienced during suicidal urges among 138 adults recruited from the community; 81 (59.1 %) owned handguns and 57 (41.6 %) did not. Participants self-reported their current affect and urge to kill themselves 6 times per day for 28 consecutive days via ecological momentary assessment. Positive and negative affect ratings varied significantly during suicidal urges. The association of positive and negative affect with suicidal urges significantly varied within and between handgun owners and non-owners. Results suggest suicidal urges are characterized by high affective heterogeneity.

Public Mass Shootings: Counterfactual Trend Analysis of the Federal Assault Weapons Ban.

Background: Assault weapon and large-capacity magazine bans are potential tools for policy makers to prevent public mass shootings. However, the efficacy of these bans is a continual source of debate. In an earlier study, we estimated the impact of the Federal Assault Weapons Ban (FAWB) on the number of public mass shooting events in the United States. This study provides an updated assessment with 3 additional years of firearm surveillance data to characterize the longer-term effects. Objective: This study aims to estimate the impact of the FAWB on trends in public mass shootings from 1966 to 2022. Methods: We used linear regression to estimate the impact of the FAWB on the 4-year simple moving average of annual public mass shootings, defined by events with 4 or more deaths in 24 hours, not including the perpetrator. The study period spans 1966 to 2022. The model includes indicator variables for both the FAWB period (1995-2004) and the period after its removal (2005-2022). These indicators were interacted with a linear time trend. Estimates were controlled for the national homicide rate. After estimation, the model provided counterfactual estimates of public mass shootings if the FAWB was never imposed and if the FAWB remained in place. Results: The overall upward trajectory in the number of public mass shootings substantially fell while the FAWB was in place. These trends are specific to events in which the perpetrator used an assault weapon or large-capacity magazine. Point estimates suggest the FAWB prevented up to 5 public mass shootings while the ban was active. A continuation of the FAWB and large-capacity magazine ban would have prevented up to 38 public mass shootings, but the CIs become wider as time moves further away from the period of the FAWB. Conclusions: The FAWB, which included a ban on large-capacity magazines, was associated with fewer public mass shooting events, fatalities, and nonfatal gun injuries. Gun control legislation is an important public health tool in the prevention of public mass shootings.

Differences in reasons for secure and unsecure firearm storage: Results from a representative cross-sectional study of nine states.

Objectives: To examine factors that differentiate firearm owners who endorse specific reasons for secure and unsecure firearm storage. Methods: A subsample of firearm-owning adults (n = 3,119) drawn from a representative sample of adults (n = 7,785) residing in nine US states participated in an online survey. Results: The most common reason for not always using a gun safe was concerns that they render firearms too slow to access during an emergency (60.2%). The most common reasons for current firearm storage were ensuring ready access in case of emergency (59.7%) and preventing access by children and adolescents (44.6%). Firearm owners varied on their reasons based upon current storage habits, reasons for ownership, and the presence of firearms in the home. Conclusions: Firearm owners with children in the home are more likely to select storage methods they feel will prevent access by vulnerable individuals, whereas those who own for defensive purposes and those who store firearms loaded and unlocked are more likely to endorse storing their firearms for quick home defense and convenience and to see gun safes as unnecessary obstacles.

The use of micro-CT in the investigation of a case involving 3D printed firearms.

This paper highlights how micro-CT was used to assist in the investigation of hybrid firearms constructed using a mixture of plastic and metal components, as a complementary technique to the physical examination performed by firearms experts. In recent years, there has been an increase in the complexity and sophistication of 3D printed and hybrid firearm designs. This was also the case in the investigation presented herein, with the firearms seized demonstrating a step change in the threat level they pose through their complexity. Thus, we describe how data produced from micro-CT scans was used to help firearms experts study the viability and mechanics of two hybrid weapons prior to dismantling and test-firing. This process aided experts in determining whether components were 3D printed or manufactured through other means, whilst ensuring that a digital record (digital twin) was retained in case evidence was damaged during testing. Finally, we show how the data was presented visually through animations and as evidence in court. This proved to be imperative when communicating to the judge, jury, and wider investigating teams, the complex multiple components and mechanisms within the firearms.

Association of pediatric firearm injury with neighborhood social deprivation in Philadelphia.

Background: Firearm-related injury is the leading cause of death among children and adolescents. There is a need to clarify the association of neighborhood environment with gun violence affecting children. We evaluated the relative contribution of specific social determinants to observed rates of firearm-related injury in children of different ages. Methods: This was a population-based study of firearm injury in children (age <18 years) that occurred in Philadelphia census tracts (2015-2021). The exposure was neighborhood Social Deprivation Index (SDI) quintile. The outcome was the rate of pediatric firearm injury due to interpersonal violence stratified by age, sex, race, and year. Hierarchical negative binomial regression measured the risk-adjusted association between SDI quintile and pediatric firearm injury rate. The relative contribution of specific components of the SDI to neighborhood risk of pediatric firearm injury was estimated. Effect modification and the role of specific social determinants were evaluated in younger (<15 years old) versus older children. Results: 927 children were injured due to gun violence during the study period. Firearm-injured children were predominantly male (87%), of black race (89%), with a median age of 16 (IQR 15-17). Nearly one-half of all pediatric shootings (47%) occurred in the quintile of highest SDI (Q5). Younger children represented a larger proportion of children shot in neighborhoods within the highest (Q5), compared with the lowest (Q1), SDI quintile (25% vs 5%; p<0.007). After risk adjustment, pediatric firearm-related injury was strongly associated with increasing SDI (Q5 vs Q1; aRR 14; 95% CI 6 to 32). Specific measures of social deprivation (poverty, incomplete schooling, single-parent homes, and rented housing) were associated with significantly greater increases in firearm injury risk for younger, compared with older, children. Component measures of the SDI explained 58% of observed differences between neighborhoods. Conclusions: Neighborhood measures of social deprivation are strongly associated with firearm-related injury in children. Younger children appear to be disproportionately affected by specific adverse social determinants compared with older children. Root cause evaluation is required to clarify the interaction with other factors such as the availability of firearms and interpersonal conflict that place children at risk in neighborhoods where gun violence is common. Level of evidence: Level III - Observational Study.

Threat perceptions, defensive behaviors, and the perceived suicide prevention value of specific firearm storage practices.

INTRODUCTION: Secure firearm storage has been proposed as a suicide prevention method within the military; however, secure storage practices are uncommon. Service members may perceive limited value in secure storage as a suicide prevention tool and threat-related factors may influence such perceptions. METHOD: A nationally representative sample of firearm-owning military service members (n = 719) was recruited between December 3, 2021 and January 4, 2022 to complete a self-report survey by Ipsos using their KnowledgePanel calibration approach to optimize representativeness. RESULTS: Threat sensitivity was associated with less perceived suicide prevention value across all within-home storage practices as well as out-of-home storage. Defensive firearm ownership was associated with less perceived out-of-home storage value. Contrary to expectations, PTSD symptoms were associated with greater perceived suicide prevention value across all storage practices and intolerance of uncertainty was associated with greater perceived out-of-home storage value. DISCUSSION: Perceptions of, sensitivity to, and reactions to threat represent a complicated confluence of factors that may influence firearm views and behaviors in disparate ways. Viewing the world as dangerous and other people as a threat may limit perceived suicide prevention value for secure storage and increase the drive for firearm access.

Terminal ballistics performance of 9 × 19 mm cartridges in 10% ballistic gelatin: FBI Protocol based analysis of Brazilian-made law enforcement ammunition.

PURPOSE: Understanding that a projectile entering the human body can cause damage or destruction to live tissues through a variety of wounding mechanisms - permanent cavity, temporary cavity, and fragmentation - is crucial for researching terminal ballistics and understand the patterns of gunshot wound configuration. METHODS: The present work tested four different types of ammunition in caliber 9 × 19 mm (Full Metal Jacketed, Gold Hex, Copper Bullet Tactical and Bonded), using ballistic gelatin at 10% as soft tissue surrogate. The tests were based on the Federal Bureau of Investigation Protocol and included shots through bare gelatin, heavy clothing, plywood, steel sheets and auto glass. As a comparison parameter, the American-made Federal™ HST, used by several law enforcement agencies in the USA, was also tested in the same conditions. RESULTS: The Full Metal Jacketed cartridge had a uniform performance throughout the experiment, showing high penetration levels and no expansion, as expected. Gold Hex demonstrated a strong tendency to fragment with low levels of penetration and weight retention. Copper Bullet Tactical did not achieve the 12" minimum penetration in the soft barrier phases but expanded aggressively. Finally, Bonded only failed to achieve the 12" mark of penetration in phase 5 (auto glass), the hardest barrier in the whole Protocol. Tested for comparison purposes, Federal HST showed aggressive expansion in the initial phases (over 100%), after surpassing the 12" threshold. CONCLUSION: The study concluded that heavier projectiles (CBC Bonded and Federal HST) performed better than lighter and faster bullets in terms of terminal ballistics.

Expectations of and perceived need for civil war in the USA: findings from a 2023 nationally representative survey.

BACKGROUND: Surveys have found concerningly high levels of agreement that the United States will experience civil war soon. This study assesses variation in expectation of and perceived need for civil war with respondent sociopolitical characteristics, beliefs, firearm ownership, and willingness to engage in political violence. METHODS: Findings are from Wave 2 of a nationally representative annual longitudinal survey of members of the Ipsos KnowledgePanel, conducted May 18-June 8, 2023. All respondents to 2022's Wave 1 who remained in KnowledgePanel were invited to participate. Outcomes are expressed as weighted proportions and adjusted prevalence differences, with p-values adjusted for the false discovery rate and reported as q-values. RESULTS: The completion rate was 84.2%; there were 9385 respondents. After weighting, half the sample was female (50.7%, 95% CI 49.4%, 52.1%); the weighted mean (± standard deviation) age was 48.5 (25.9) years. Approximately 1 respondent in 20 (5.7%, 95% CI 5.1%, 6.4%) agreed strongly or very strongly that "in the next few years, there will be civil war in the United States." About 1 in 25 (3.8%, 95% CI 3.2%, 4.4%), and nearly 40% (38.4%, 95% CI 32.3%, 44.5%) of those who strongly or very strongly agreed that civil war was coming, also agreed strongly or very strongly that "the United States needs a civil war to set things right." Expectation of and perceived need for civil war were higher among subsets of respondents who in Wave 1 were more willing than others to commit political violence, including MAGA Republicans, persons in strong agreement with racist beliefs or statements of the potential need for violence to effect social change, persons who strongly approved of specified extreme right-wing political organizations and movements, firearm owners who purchased firearms in 2020 or later, and firearm owners who carried firearms in public all or nearly all the time. CONCLUSIONS: In 2023, the expectation that civil war was likely and the belief that it was needed were uncommon but were higher among subsets of the population that had previously been associated with greater willingness to commit political violence. These findings can help guide prevention efforts.

Nonresponse to an item assessing firearm ownership: Associations with suicide risk and emotional distress.

INTRODUCTION: Firearms account for more than half of suicide deaths in the United States (US) and both ownership and access are associated with increased risk of intentional and unintentional injury. Despite evidence linking ownership and access to suicide risk, individuals may be reticent to answer questionnaire items assessing ownership. The current study examined characteristics of individuals who do not provide a response (nonresponders) to a firearm ownership item in a community sample. METHODS: Data were collected from a cross-sectional online survey of 10,625 US adults. Univariate and multivariate analyses were conducted to examine demographic, emotional distress, and suicide risk differences across three groups (firearm owners, nonowners, and nonresponders). RESULTS: Nonresponders were significantly younger, more likely to be female and non-White than firearm owners and nonowners. Nonresponders were less likely to endorse recent suicidal ideation and probable PTSD than firearm owners, but more likely to endorse probable PTSD than nonowners. Firearm owners were significantly more likely to report several correlates of suicide risk than nonowners. CONCLUSIONS: Nonresponders may be a unique subgroup with distinct demographic, emotional distress, and suicide risk profiles compared to both firearm owners and nonowners. Implications of these findings for future directions are discussed.

Diagnostic and therapeutic considerations in cases of civilian intravascular ballistic embolism: a review of case reports.

Background: Ballistic embolism (BE) is a rare complication of firearm injuries notoriously associated with a vexing clinical picture in the trauma bay. Unless considered early, the associated confusion can lead to needless delay in the management of the patient with a gunshot wound. Despite this known entity, there is a relative paucity of high-grade evidence regarding complications, management, and follow-up in these patients. Methods: An electronic database literature search was conducted to identify cases of acute intravascular BE in pediatric and adult civilians occurring during index hospitalization, filtered to publications during the past 10 years. Exclusion criteria included non-vascular embolization, injuries occurring in the military setting, and delayed migration defined as occurring after discharge from the index hospitalization. Results: A total of 136 cases were analyzed. Nearly all cases of BE occurred within 48 hours of presentation. Compared with venous emboli, arterial emboli were significantly more likely to be symptomatic (71% vs. 7%, p<0.001), and 43% of patients developed symptoms attributable to BE in the trauma bay. In addition, arterial emboli were significantly less likely to be managed non-invasively (19% vs. 49%, p<0.001). Open retrieval was significantly more likely to be successful compared with endovascular attempts (91% vs. 29%, p<0.001). Patients with arterial emboli were more likely to receive follow-up (52% vs. 39%) and any attempt at retrieval during the hospitalization was significantly associated with outpatient follow-up (p=0.034). All but one patient remained stable or had clinically improved symptoms after discharge. Conclusion: Consideration for BE is reasonable in any patient with new or persistent unexplained signs or symptoms, especially during the first 48 hours after a penetrating firearm injury. Although venous BE can often be safely observed, arterial BE generally necessitates urgent retrieval. Patients who are managed non-invasively may benefit from follow-up in the first year after injury.

Correlates of dangerous firearm storage among a representative sample of firearm owners across nine states.

OBJECTIVE: To identify demographic and behavioral correlates of dangerous firearm storage (i.e., unlocked and loaded) among firearm owners in nine states. METHODS: Online survey data from the probability-based sample were collected using Ipsos Knowledge Panel. Participants were adults residing in nine states across the United States (n = 7785). RESULTS: Nearly one third of the firearm owners within the sample stored at least one of their firearms unlocked and loaded. Greater threat sensitivity was associated with dangerous firearm storage. Established firearm owners who purchased an additional firearm during the firearm purchasing surge (2020-2021) had increased odds of storing at least one firearm unlocked and loaded. Those who had direct exposure to firearm violence and those whose primary reason for having a firearm at home was protection also had increased odds of storing at least one firearm unlocked and loaded. CONCLUSIONS: The results contribute to the literature on firearm storage tendencies, highlighting correlates of dangerous firearm storage within the home related to perceptions of threat and direct experiences with firearm violence. Implications include the need for broad public education on the value of secure storage targeted toward to those who have an elevated perception of danger and have been personally exposed to firearm violence.

Officer gunpoint during police stops: Repercussions for youth mental health and perceived safety.

Youth-police contact is increasingly acknowledged as a stressor and a racialized adverse childhood experience that can undermine youths' mental health. The present study investigates a particularly distressing feature of youths' direct and witnessed in-person police stops-officer gunpoint (i.e., officers drawing of firearms and pointing them at youth, their peers, or other community members). We examine patterns of youths' officer gunpoint exposure and associations with youth mental health and safety perceptions. Data come from the Survey of Police-Adolescent Contact Experiences (SPACE), a cross-sectional survey of a community-based sample of Black youth ages 12-21 in Baltimore City, Maryland (n = 335), administered from August 2022 to July 2023. Findings indicate that ~33% of youth reporting in-person police stops had been exposed to officer gunpoint during stops. Officer gunpoint was significantly and positively associated with being male, unemployed, having an incarcerated parent, living in a neighborhood with greater disorder, and having been directly stopped by police, in addition to youth delinquency and impulsivity. Net of covariates, experiencing officer gunpoint was associated with a significantly higher rate of youth emotional distress during stops. Significant associations between officer gunpoint and youths' current police violence stress, police avoidance, and diminished safety perceptions also emerged and were largely explained by youths' heightened emotional distress at the time of police stops. Trauma-informed approaches are needed to mitigate the mental health harms of youth experiencing officer gunpoint.