Age of Juice Introduction and Cardiometabolic Outcomes in Middle Childhood.

BACKGROUND: The American Academy of Pediatrics recommends juice introduction after 12 months of age. Juice consumption has been linked to childhood obesity and cardiometabolic risk. OBJECTIVES: To examine the prospective relationship between the age of juice introduction and primary and secondary cardiometabolic outcomes in middle childhood. METHODS: Parents reported the age of juice introduction on Upstate KIDS questionnaires completed between 4 and 18 months. The quantity and type of juice introduced were not measured. Anthropometry, blood pressure (BP), and arterial stiffness by pulse wave velocity (PWV) were measured for 524 children (age, 8-10 y) at study visits (2017-2019). Age- and gender-adjusted z-scores were calculated using the Centers for Disease Control and Prevention reference for anthropometrics. Plasma lipids, hemoglobin A1c (HbA1c), and C-reactive protein (CRP) in a subset of children were also measured (n = 248). Associations between age at juice introduction (categorized as <6, 6 to <12, ≥12 months), and outcomes were estimated using mean differences and odds ratios, applying generalized estimating equations to account for correlations between twins. RESULTS: Approximately 18% of children were introduced to juice at <6 months, 52% between 6 and <12 months, and 30% ≥ 12 months of age. Children who were introduced to juice before 6 months had higher systolic BP (3.13 mmHg; 95% confidence interval [CI]: 0.52, 5.74), heart rate (4.46 bpm; 95% CI: 1.05, 7.87), and mean arterial pressure (2.08 mmHg; 95% CI: 0.15, 4.00) compared with those introduced ≥12 months after covariate adjustment including sociodemographic factors and maternal prepregnancy body mass index. No adjusted differences in anthropometry, lipids, HbA1c, and CRP levels were found. CONCLUSIONS: Early juice introduction during infancy was associated with higher systolic BP, heart rate, and mean arterial pressure in middle childhood. This trial was registered at clinicaltrials.gov as NCT03106493 (https://clinicaltrials.gov/study/NCT03106493?term=upstate%20KIDS&rank=1).

MAGA Republicans' views of American democracy and society and support for political violence in the United States: Findings from a nationwide population-representative survey.

BACKGROUND: Identifying groups at increased risk for political violence can support prevention efforts. We determine whether "Make America Great Again" (MAGA) Republicans, as defined, are potentially such a group. METHODS: Nationwide survey conducted May 13-June 2, 2022 of adult members of the Ipsos KnowledgePanel. MAGA Republicans are defined as Republicans who voted for Donald Trump in the 2020 presidential election and deny the results of that election. Principal outcomes are weighted proportions of respondents who endorse political violence, are willing to engage in it, and consider it likely to occur. FINDINGS: The analytic sample (n = 7,255) included 1,128 (15.0%) MAGA Republicans, 640 (8.3%) strong Republicans, 1,571 (21.3%) other Republicans, and 3,916 (55.3%) non-Republicans. MAGA Republicans were substantially more likely than others to agree strongly/very strongly that "in the next few years, there will be civil war in the United States" (MAGA Republicans, 30.3%, 95% CI 27.2%, 33.4%; strong Republicans, 7.5%, 95% CI 5.1%, 9.9%; other Republicans, 10.8%, 95% CI 9.0%, 12.6%; non-Republicans, 11.2%, 95% CI 10.0%, 12.3%; p < 0.001) and to consider violence usually/always justified to advance at least 1 of 17 specific political objectives (MAGA Republicans, 58.2%, 95% CI 55.0%, 61.4%; strong Republicans, 38.3%, 95% CI 34.2%, 42.4%; other Republicans, 31.5%, 95% CI 28.9%, 34.0%; non-Republicans, 25.1%, 95% CI 23.6%, 26.7%; p < 0.001). They were not more willing to engage personally in political violence. INTERPRETATION: MAGA Republicans, as defined, are more likely than others to endorse political violence. They are not more willing to engage in such violence themselves; their endorsement may increase the risk that it will occur.

Purchaser, firearm, and retailer characteristics associated with crime gun recovery: a longitudinal analysis of firearms sold in California from 1996 to 2021.

BACKGROUND: Firearm violence is a major cause of death and injury in the United States. Tracking the movement of firearms from legal purchase to use in crimes can help inform prevention of firearm injuries and deaths. The last state-wide studies analyzing crime gun recoveries used data from over 20 years ago; thus, an update is needed. METHODS: We used data for 5,247,348 handgun and 2,868,713 long gun transactions and law enforcement recoveries from California crime gun recovery (2010-2021) and California's Dealer Records of Sales records. Covariates included characteristics of dealership sales, firearms and their transactions, and purchaser's demographic characteristics, purchasing history, criminal history (from firearm purchaser criminal history records), and neighborhood socioeconomic status. Analyses for handguns and long guns was conducted separately. In multivariable analysis, we included correlates into a Cox proportional hazard model accounting for left truncation and clustering between the same firearm, purchaser, dealerships, and geographic location. Covariates that remained significant (P < 0.05) were retained. For handguns, we evaluated associations of violent and weapons crimes separately. In supplementary analyses, we examined interactions by purchasers' race and ethnicity. RESULTS: In total, 38,441 handguns (0.80%) and 6,806 long guns (0.24%) were recovered in crimes. A firearm dealer's sales volume, percent of transactions that were denials, pawns, pawn redemptions, and firearms that became crime guns were each positively associated with firearm recovery in crime. Handguns that were inexpensive, larger caliber, and that had been reported lost or stolen were positively associated with recovery in crimes. Purchaser characteristics associated with crime gun recovery included: being younger, female, Black, Hispanic, Native American or Pacific Islander, or other race/ethnicity (vs white), having previous arrests, living in close proximity to the firearm dealership, and living in a more socially vulnerable census tract. Associations with race and ethnicity were modified by previous infraction-only arrests. CONCLUSIONS: This study confirms that many previously studied correlates of firearm recovery are still relevant today. We were able to expand on previous research by examining novel associations including purchasers' criminal history and previous firearm transaction history. These results provide evidence that can be used to disrupt firearm use in crimes.

Single-year change in views of democracy and society and support for political violence in the USA: findings from a 2023 nationally representative survey.

BACKGROUND: A 2022 survey in the USA found concerningly high prevalences of support for and personal willingness to engage in political violence, of beliefs associated with such violence, and of belief that civil war was likely in the near future. It is important to determine the durability of those findings. METHODS: Wave 2 of a nationally representative cohort survey was conducted May 18-June 8, 2023; the sample comprised all respondents to 2022's Wave 1. Outcomes are expressed as weighted proportions; changes from 2022 to 2023 are for respondents who participated in both surveys, based on aggregated individual change scores. RESULTS: The completion rate was 84.2%; there were 9385 respondents. After weighting, 50.7% (95% confidence interval (CI) 49.4%, 52.1%) were female; weighted mean (SD) age was 48.5 (25.9) years. About 1 in 20 respondents (5.7%, 95% CI 5.1%, 6.4%) agreed strongly/very strongly that "in the next few years, there will be civil war in the United States," a 7.7% decrease. In 2023, fewer respondents considered violence to be usually/always justified to advance at least 1 of 17 specific political objectives [25.3% (95% CI 24.7%, 26.5%), a 6.8% decrease]. However, more respondents thought it very/extremely likely that within the next few years, in a situation where they consider political violence justified, "I will be armed with a gun" [9.0% (95% CI 8.3%, 9.8%), a 2.2% increase] and "I will shoot someone with a gun" [1.8% (95% CI 1.4%, 2.2%), a 0.6% increase]. Among respondents who considered violence usually/always justified to advance at least 1 political objective, about 1 in 20 also thought it very/extremely likely that they would threaten someone with a gun (5.4%, 95% CI 4.0%, 7.0%) or shoot someone (5.7%, 95% CI 4.3%, 7.1%) to advance such an objective. CONCLUSIONS: In this cohort, support for political violence declined from 2022 to 2023, but predictions of firearm use in political violence increased. These findings can help guide prevention efforts, which are urgently needed.

Firearm Ownership and Support for Political Violence in the United States.

Importance: Little is known about support for and willingness to engage in political violence in the United States. Such violence would likely involve firearms. Objective: To evaluate whether firearm owners' and nonowners' support for political violence differs and whether support among owners varies by type of firearms owned, recency of purchase, and frequency of carrying a loaded firearm in public. Design, Setting, and Participants: This cross-sectional nationally representative survey study was conducted from May 13 to June 2, 2022, among US adult members of the Ipsos KnowledgePanel, including an oversample of firearm owners. Exposure: Firearm ownership vs nonownership. Main Outcomes and Measures: Main outcomes concern (1) support for political violence, in general and to advance specific political objectives; (2) personal willingness to engage in political violence, by severity of violence and target population; and (3) perceived likelihood of firearm use in political violence. 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 analytic sample comprised 12 851 respondents: 5820 (45.3%) firearm owners, 6132 (47.7%) nonowners without firearms at home, and 899 (7.0%) nonowners with firearms at home. After weighting, 51.0% (95% CI, 49.9%-52.1%) were female, 8.5% (95% CI, 7.5%-9.5%) Hispanic, 9.1% (95% CI, 8.1%-10.2%) non-Hispanic Black, and 62.6% (95% CI, 61.5%-63.8%) non-Hispanic White; the mean (SD) age was 48.5 (18.0) years. Owners were more likely than nonowners without firearms at home to consider violence usually or always justified to advance at least 1 of 17 specific political objectives (owners: 38.8%; 95% CI, 37.3%-40.4%; nonowners: 29.8%; 95% CI, 28.5%-31.2%; adjusted difference, 6.5 percentage points; 95% CI, 4.5-9.3 percentage points; q < .001) but were not more willing to engage in political violence. Recent purchasers, owners who always or nearly always carry loaded firearms in public, and to a lesser extent, owners of assault-type rifles were more supportive of and willing to engage in political violence than other subgroups of firearm owners. Conclusions and Relevance: In this study of support for political violence in the United States, differences between firearm owners and nonowners without firearms at home were small to moderate when present. Differences were greater among subsets of owners than between owners and nonowners. These findings can guide risk-based prevention efforts.