Injuries

The U.S. Preventive Services Task Force posted a draft research plan on opioid use disorder prevention for public comment on Dec. 13, according to a USPSTF bulletin.

An estimated 2.1 million persons aged 12 years and older had an opioid use disorder in 2017, and opioids were involved in nearly two-thirds of more than 70,000 fatal drug overdoses, according to the task force. Prevention of unnecessary opioid use, opioid misuse, and opioid use disorder in primary care settings is necessary to effectively respond to the ongoing crisis.

In an extensive literature review, an independent research team will look for evidence on strategies for people not currently receiving opioids that can be implemented on the primary care level. The public is invited to submit comments on the research plan that will help focus and guide the literature review.

The USPSTF also will be updating the current 2008 recommendation statement on screening for illicit drugs and nonmedical prescription drugs in adolescents and young adults, including pregnant and postpartum women.

Comments can be submitted until Jan. 16, 2019, on the USPSTF website.

[email protected]

The U.S. Preventive Services Task Force posted a draft research plan on opioid use disorder prevention for public comment on Dec. 13, according to a USPSTF bulletin.

An estimated 2.1 million persons aged 12 years and older had an opioid use disorder in 2017, and opioids were involved in nearly two-thirds of more than 70,000 fatal drug overdoses, according to the task force. Prevention of unnecessary opioid use, opioid misuse, and opioid use disorder in primary care settings is necessary to effectively respond to the ongoing crisis.

In an extensive literature review, an independent research team will look for evidence on strategies for people not currently receiving opioids that can be implemented on the primary care level. The public is invited to submit comments on the research plan that will help focus and guide the literature review.

The USPSTF also will be updating the current 2008 recommendation statement on screening for illicit drugs and nonmedical prescription drugs in adolescents and young adults, including pregnant and postpartum women.

Comments can be submitted until Jan. 16, 2019, on the USPSTF website.

[email protected]

The U.S. Preventive Services Task Force posted a draft research plan on opioid use disorder prevention for public comment on Dec. 13, according to a USPSTF bulletin.

An estimated 2.1 million persons aged 12 years and older had an opioid use disorder in 2017, and opioids were involved in nearly two-thirds of more than 70,000 fatal drug overdoses, according to the task force. Prevention of unnecessary opioid use, opioid misuse, and opioid use disorder in primary care settings is necessary to effectively respond to the ongoing crisis.

In an extensive literature review, an independent research team will look for evidence on strategies for people not currently receiving opioids that can be implemented on the primary care level. The public is invited to submit comments on the research plan that will help focus and guide the literature review.

The USPSTF also will be updating the current 2008 recommendation statement on screening for illicit drugs and nonmedical prescription drugs in adolescents and young adults, including pregnant and postpartum women.

Comments can be submitted until Jan. 16, 2019, on the USPSTF website.

[email protected]

It probably is buried in a box in your parents’ basement, but try to remember your soccer or football or track team picture from when you were in eighth grade. Tragically but predictably, most of your peers who were chubby in third grade are nowhere to be seen in the photo. But still it was a pretty motley crew. Some of you weren’t even up to the armpits of your taller teammates. Some guys were shaving. Others had little boys’ voices. Half the girls had reached menarche. Another third were still waiting impatiently for a breast bud.

james boulette/Thinkstock

The precocious and the late bloomers, you were all on the team. But it was pretty clear that those who had matured first generally were the more talented and successful athletes. By the time you were juniors in high school, many of those who matured late had quit the sport or been cut from the team, unable to catch up. Others may have been forced to give up the sport by their parents, who were concerned about the risk of injury when bodies of disparate size collide. A few of the early bloomers may have become depressed, older adolescents who had failed to match the hype and expectations that came when they were a head taller than their grade school teammates.

These natural consequences of biological variation are not small potatoes for the fragile egos of adolescents and preadolescents. The lead article in the November 2018 Pediatrics offers a partial solution for the issue of sports participation in a population with widely discrepant states of maturity (“Biobanding: A New Paradigm for Youth Sports and Training,” Pediatrics. 2018 Nov;142[5]:e20180423). The authors describe a system they call biobanding, in which “the percentage of predicted adult stature attained at the time of observation as the indicator of maturity status” is used to create groups or bands of participants with similar levels of maturity. They argue that this method is easy to use and report and that has been used with some success in Great Britain.

At first blush, biobanding sounds appealing, particularly for large communities. However, as someone who grew up in and practiced in a small town, I’m not sure how successfully it could be scaled down. There have been years when I could easily have disqualified a third of the high school football team were I to take into consideration the size and maturity of the competition they would be facing. But I didn’t. The fading interest in football in Maine has prompted some schools to consider moving to less-than-11-player competition or even to flag football. To some extent, the problem is taking care of itself.

How much tinkering should we be doing with something that is arguably a distorted natural selection process? With thoughtfully crafted rules, diligent supervision, and officiating, most of the issues of safety that one might attribute to discrepancies in maturity can be minimized. There always will be children who become discouraged and quit when they see the handwriting on the wall that reads “those who mature early win.” I’m certainly not wild about parents holding their children out of school to give them a jump on their peers. It can spiral out of control.

A more appealing solution is to do a better job of advertising the many successful late bloomers in professional sports ... and making sure that late-blooming children are given an abundance of active and competitive (if they wish) alternatives to sports dominated by their early maturing peers.

Dr. Wilkoff practiced primary care pediatrics in Brunswick, Maine for nearly 40 years. He has authored several books on behavioral pediatrics, including “How to Say No to Your Toddler.” Email him at [email protected].

It probably is buried in a box in your parents’ basement, but try to remember your soccer or football or track team picture from when you were in eighth grade. Tragically but predictably, most of your peers who were chubby in third grade are nowhere to be seen in the photo. But still it was a pretty motley crew. Some of you weren’t even up to the armpits of your taller teammates. Some guys were shaving. Others had little boys’ voices. Half the girls had reached menarche. Another third were still waiting impatiently for a breast bud.

james boulette/Thinkstock

The precocious and the late bloomers, you were all on the team. But it was pretty clear that those who had matured first generally were the more talented and successful athletes. By the time you were juniors in high school, many of those who matured late had quit the sport or been cut from the team, unable to catch up. Others may have been forced to give up the sport by their parents, who were concerned about the risk of injury when bodies of disparate size collide. A few of the early bloomers may have become depressed, older adolescents who had failed to match the hype and expectations that came when they were a head taller than their grade school teammates.

These natural consequences of biological variation are not small potatoes for the fragile egos of adolescents and preadolescents. The lead article in the November 2018 Pediatrics offers a partial solution for the issue of sports participation in a population with widely discrepant states of maturity (“Biobanding: A New Paradigm for Youth Sports and Training,” Pediatrics. 2018 Nov;142[5]:e20180423). The authors describe a system they call biobanding, in which “the percentage of predicted adult stature attained at the time of observation as the indicator of maturity status” is used to create groups or bands of participants with similar levels of maturity. They argue that this method is easy to use and report and that has been used with some success in Great Britain.

At first blush, biobanding sounds appealing, particularly for large communities. However, as someone who grew up in and practiced in a small town, I’m not sure how successfully it could be scaled down. There have been years when I could easily have disqualified a third of the high school football team were I to take into consideration the size and maturity of the competition they would be facing. But I didn’t. The fading interest in football in Maine has prompted some schools to consider moving to less-than-11-player competition or even to flag football. To some extent, the problem is taking care of itself.

How much tinkering should we be doing with something that is arguably a distorted natural selection process? With thoughtfully crafted rules, diligent supervision, and officiating, most of the issues of safety that one might attribute to discrepancies in maturity can be minimized. There always will be children who become discouraged and quit when they see the handwriting on the wall that reads “those who mature early win.” I’m certainly not wild about parents holding their children out of school to give them a jump on their peers. It can spiral out of control.

A more appealing solution is to do a better job of advertising the many successful late bloomers in professional sports ... and making sure that late-blooming children are given an abundance of active and competitive (if they wish) alternatives to sports dominated by their early maturing peers.

Dr. Wilkoff practiced primary care pediatrics in Brunswick, Maine for nearly 40 years. He has authored several books on behavioral pediatrics, including “How to Say No to Your Toddler.” Email him at [email protected].

It probably is buried in a box in your parents’ basement, but try to remember your soccer or football or track team picture from when you were in eighth grade. Tragically but predictably, most of your peers who were chubby in third grade are nowhere to be seen in the photo. But still it was a pretty motley crew. Some of you weren’t even up to the armpits of your taller teammates. Some guys were shaving. Others had little boys’ voices. Half the girls had reached menarche. Another third were still waiting impatiently for a breast bud.

james boulette/Thinkstock

The precocious and the late bloomers, you were all on the team. But it was pretty clear that those who had matured first generally were the more talented and successful athletes. By the time you were juniors in high school, many of those who matured late had quit the sport or been cut from the team, unable to catch up. Others may have been forced to give up the sport by their parents, who were concerned about the risk of injury when bodies of disparate size collide. A few of the early bloomers may have become depressed, older adolescents who had failed to match the hype and expectations that came when they were a head taller than their grade school teammates.

These natural consequences of biological variation are not small potatoes for the fragile egos of adolescents and preadolescents. The lead article in the November 2018 Pediatrics offers a partial solution for the issue of sports participation in a population with widely discrepant states of maturity (“Biobanding: A New Paradigm for Youth Sports and Training,” Pediatrics. 2018 Nov;142[5]:e20180423). The authors describe a system they call biobanding, in which “the percentage of predicted adult stature attained at the time of observation as the indicator of maturity status” is used to create groups or bands of participants with similar levels of maturity. They argue that this method is easy to use and report and that has been used with some success in Great Britain.

At first blush, biobanding sounds appealing, particularly for large communities. However, as someone who grew up in and practiced in a small town, I’m not sure how successfully it could be scaled down. There have been years when I could easily have disqualified a third of the high school football team were I to take into consideration the size and maturity of the competition they would be facing. But I didn’t. The fading interest in football in Maine has prompted some schools to consider moving to less-than-11-player competition or even to flag football. To some extent, the problem is taking care of itself.

How much tinkering should we be doing with something that is arguably a distorted natural selection process? With thoughtfully crafted rules, diligent supervision, and officiating, most of the issues of safety that one might attribute to discrepancies in maturity can be minimized. There always will be children who become discouraged and quit when they see the handwriting on the wall that reads “those who mature early win.” I’m certainly not wild about parents holding their children out of school to give them a jump on their peers. It can spiral out of control.

A more appealing solution is to do a better job of advertising the many successful late bloomers in professional sports ... and making sure that late-blooming children are given an abundance of active and competitive (if they wish) alternatives to sports dominated by their early maturing peers.

Dr. Wilkoff practiced primary care pediatrics in Brunswick, Maine for nearly 40 years. He has authored several books on behavioral pediatrics, including “How to Say No to Your Toddler.” Email him at [email protected].

ORLANDO – More stringent gun laws are linked to reduced firearm-related pediatric injury and mortality, and laws restricting children’s access to firearms are linked to reduced pediatric firearm suicide rates, according to research.

Bytmonas/ThinkStock

“State-level legislation could play an important role in reducing pediatric firearm-related deaths,” concluded Jordan S. Taylor, MD, of Stanford (Calif.) University and his colleagues.

Dr. Taylor earned top honors among the American Academy of Pediatrics (AAP) Council on Injury, Violence and Poison Prevention research abstracts when he presented his findings at the annual meeting of the American Academy of Pediatrics.

Firearm injuries account for the second leading cause of death among U.S. children: 3,155 youth ages 19 years and younger died from gunshot injuries in 2016, and more than 17,000 were injured. Yet state laws governing the purchase, ownership, carriage, and storage of guns vary widely across the country. Dr. Taylor and his colleagues conducted two studies to assess the effects of firearm legislation on firearm-related injuries and deaths in U.S. children.

In their first study, they analyzed pediatric inpatient admissions for firearm injuries in 2012 relative to the stringency of state firearm legislation. They relied on five data sources for the analysis: the Kids’ Inpatient Database (KID), the Healthcare Cost and Utilization Project, the Agency for Healthcare Research and Quality, the U.S. Census Bureau, and the 2013 Brady scorecard.

The Brady scorecard provides scores for each state based on the presence and strictness of firearm-related laws, including legislation on background checks, ability of dangerous individuals to purchase guns, trafficking laws, and laws governing the sales, carrying, and purchasing of firearms.

The 10 states with the strictest laws (highest Brady scores) are California, Connecticut, Delaware, Hawaii, Illinois, Maryland, Massachusetts, New Jersey, New York, and Rhode Island. The 10 states with the lowest scores (least-strict legislation) are Alaska, Arizona, Arkansas, Florida, Kentucky, Louisiana, Montana, Nevada, Virginia, and Wyoming.

Among the 6,941 youth (aged 0-20 years) hospitalized in 2012 for firearm injuries, 7% died. More than a third of these (36%) occurred in the South, 25% in the Midwest, 22% in the West, and 17% in the Northeast.

Children most likely to be injured were boys, older children, black and Latino children, and children living in low-income zip codes.

The Midwest and South, which have lower average Brady scores (more lax legislation on guns), had 8.30 injuries per 100,000 children, compared with 7.54 injuries per 100,000 children in the Northeast and West, which have higher average Brady scores (more stringent gun laws). This was a difference of 0.76 injuries per 100,000 children (95% confidence interval, 0.38-1.13; P less than 0.001).

Then the researchers conducted a second analysis that looked specifically at firearm mortality within the context of both child access prevention (CAP) laws and states’ Brady scores. CAP laws include safe storage laws and gun lock laws, for example.

This analysis used the Web-Based Injury Statistics Query and Reporting System to capture pediatric firearm deaths from 2014-2015 and compared these to the 2014 Brady scores and CAP laws.

An estimated 2,715 child gun deaths occurred during the study period, of which 62% were homicides and 31% were suicides. The researchers identified “a significant negative correlation between states’ firearm legislation stringency and pediatric firearm mortality (Spearman correlation coefficient = –0.66) and between presence of CAP laws and firearm suicide rates (Spearman correlation coefficient = –0.56).”

Dr. Taylor said in an interview, “states that have both types of child access prevention laws [had] suicide rates four times lower than states that did not have either of those.”

Positive correlations also showed up between unemployment rate and firearm homicide rate (Spearman correlation coefficient = 0.55) and teen tobacco use and firearm suicide rate (Spearman correlation coefficient = 0.50).

The association between Brady scores and pediatric mortality from firearms remained significant after adjustment for poverty, unemployment, and substance abuse (P less than .01). Similarly, the association between the pediatric firearm suicide rate and CAP laws remained significant after controlling for socioeconomic factors and other firearm legislation (P less than .01).

In a video interview, Dr. Taylor discussed his research findings and their importance in clinical practice.

“It’s absolutely important for pediatricians to talk to families about firearms in their home and also in the homes of their friends that they visit,” Dr. Taylor said. “We try to approach it as a public health issue similar to seat belts and car seats.”

No external funding was used, and Dr. Taylor reported no conflicts of interest.

ORLANDO – More stringent gun laws are linked to reduced firearm-related pediatric injury and mortality, and laws restricting children’s access to firearms are linked to reduced pediatric firearm suicide rates, according to research.

Bytmonas/ThinkStock

“State-level legislation could play an important role in reducing pediatric firearm-related deaths,” concluded Jordan S. Taylor, MD, of Stanford (Calif.) University and his colleagues.

Dr. Taylor earned top honors among the American Academy of Pediatrics (AAP) Council on Injury, Violence and Poison Prevention research abstracts when he presented his findings at the annual meeting of the American Academy of Pediatrics.

Firearm injuries account for the second leading cause of death among U.S. children: 3,155 youth ages 19 years and younger died from gunshot injuries in 2016, and more than 17,000 were injured. Yet state laws governing the purchase, ownership, carriage, and storage of guns vary widely across the country. Dr. Taylor and his colleagues conducted two studies to assess the effects of firearm legislation on firearm-related injuries and deaths in U.S. children.

In their first study, they analyzed pediatric inpatient admissions for firearm injuries in 2012 relative to the stringency of state firearm legislation. They relied on five data sources for the analysis: the Kids’ Inpatient Database (KID), the Healthcare Cost and Utilization Project, the Agency for Healthcare Research and Quality, the U.S. Census Bureau, and the 2013 Brady scorecard.

The Brady scorecard provides scores for each state based on the presence and strictness of firearm-related laws, including legislation on background checks, ability of dangerous individuals to purchase guns, trafficking laws, and laws governing the sales, carrying, and purchasing of firearms.

The 10 states with the strictest laws (highest Brady scores) are California, Connecticut, Delaware, Hawaii, Illinois, Maryland, Massachusetts, New Jersey, New York, and Rhode Island. The 10 states with the lowest scores (least-strict legislation) are Alaska, Arizona, Arkansas, Florida, Kentucky, Louisiana, Montana, Nevada, Virginia, and Wyoming.

Among the 6,941 youth (aged 0-20 years) hospitalized in 2012 for firearm injuries, 7% died. More than a third of these (36%) occurred in the South, 25% in the Midwest, 22% in the West, and 17% in the Northeast.

Children most likely to be injured were boys, older children, black and Latino children, and children living in low-income zip codes.

The Midwest and South, which have lower average Brady scores (more lax legislation on guns), had 8.30 injuries per 100,000 children, compared with 7.54 injuries per 100,000 children in the Northeast and West, which have higher average Brady scores (more stringent gun laws). This was a difference of 0.76 injuries per 100,000 children (95% confidence interval, 0.38-1.13; P less than 0.001).

Then the researchers conducted a second analysis that looked specifically at firearm mortality within the context of both child access prevention (CAP) laws and states’ Brady scores. CAP laws include safe storage laws and gun lock laws, for example.

This analysis used the Web-Based Injury Statistics Query and Reporting System to capture pediatric firearm deaths from 2014-2015 and compared these to the 2014 Brady scores and CAP laws.

An estimated 2,715 child gun deaths occurred during the study period, of which 62% were homicides and 31% were suicides. The researchers identified “a significant negative correlation between states’ firearm legislation stringency and pediatric firearm mortality (Spearman correlation coefficient = –0.66) and between presence of CAP laws and firearm suicide rates (Spearman correlation coefficient = –0.56).”

Dr. Taylor said in an interview, “states that have both types of child access prevention laws [had] suicide rates four times lower than states that did not have either of those.”

Positive correlations also showed up between unemployment rate and firearm homicide rate (Spearman correlation coefficient = 0.55) and teen tobacco use and firearm suicide rate (Spearman correlation coefficient = 0.50).

The association between Brady scores and pediatric mortality from firearms remained significant after adjustment for poverty, unemployment, and substance abuse (P less than .01). Similarly, the association between the pediatric firearm suicide rate and CAP laws remained significant after controlling for socioeconomic factors and other firearm legislation (P less than .01).

In a video interview, Dr. Taylor discussed his research findings and their importance in clinical practice.

“It’s absolutely important for pediatricians to talk to families about firearms in their home and also in the homes of their friends that they visit,” Dr. Taylor said. “We try to approach it as a public health issue similar to seat belts and car seats.”

No external funding was used, and Dr. Taylor reported no conflicts of interest.

ORLANDO – More stringent gun laws are linked to reduced firearm-related pediatric injury and mortality, and laws restricting children’s access to firearms are linked to reduced pediatric firearm suicide rates, according to research.

Bytmonas/ThinkStock

“State-level legislation could play an important role in reducing pediatric firearm-related deaths,” concluded Jordan S. Taylor, MD, of Stanford (Calif.) University and his colleagues.

Dr. Taylor earned top honors among the American Academy of Pediatrics (AAP) Council on Injury, Violence and Poison Prevention research abstracts when he presented his findings at the annual meeting of the American Academy of Pediatrics.

Firearm injuries account for the second leading cause of death among U.S. children: 3,155 youth ages 19 years and younger died from gunshot injuries in 2016, and more than 17,000 were injured. Yet state laws governing the purchase, ownership, carriage, and storage of guns vary widely across the country. Dr. Taylor and his colleagues conducted two studies to assess the effects of firearm legislation on firearm-related injuries and deaths in U.S. children.

In their first study, they analyzed pediatric inpatient admissions for firearm injuries in 2012 relative to the stringency of state firearm legislation. They relied on five data sources for the analysis: the Kids’ Inpatient Database (KID), the Healthcare Cost and Utilization Project, the Agency for Healthcare Research and Quality, the U.S. Census Bureau, and the 2013 Brady scorecard.

The Brady scorecard provides scores for each state based on the presence and strictness of firearm-related laws, including legislation on background checks, ability of dangerous individuals to purchase guns, trafficking laws, and laws governing the sales, carrying, and purchasing of firearms.

The 10 states with the strictest laws (highest Brady scores) are California, Connecticut, Delaware, Hawaii, Illinois, Maryland, Massachusetts, New Jersey, New York, and Rhode Island. The 10 states with the lowest scores (least-strict legislation) are Alaska, Arizona, Arkansas, Florida, Kentucky, Louisiana, Montana, Nevada, Virginia, and Wyoming.

Among the 6,941 youth (aged 0-20 years) hospitalized in 2012 for firearm injuries, 7% died. More than a third of these (36%) occurred in the South, 25% in the Midwest, 22% in the West, and 17% in the Northeast.

Children most likely to be injured were boys, older children, black and Latino children, and children living in low-income zip codes.

The Midwest and South, which have lower average Brady scores (more lax legislation on guns), had 8.30 injuries per 100,000 children, compared with 7.54 injuries per 100,000 children in the Northeast and West, which have higher average Brady scores (more stringent gun laws). This was a difference of 0.76 injuries per 100,000 children (95% confidence interval, 0.38-1.13; P less than 0.001).

Then the researchers conducted a second analysis that looked specifically at firearm mortality within the context of both child access prevention (CAP) laws and states’ Brady scores. CAP laws include safe storage laws and gun lock laws, for example.

This analysis used the Web-Based Injury Statistics Query and Reporting System to capture pediatric firearm deaths from 2014-2015 and compared these to the 2014 Brady scores and CAP laws.

An estimated 2,715 child gun deaths occurred during the study period, of which 62% were homicides and 31% were suicides. The researchers identified “a significant negative correlation between states’ firearm legislation stringency and pediatric firearm mortality (Spearman correlation coefficient = –0.66) and between presence of CAP laws and firearm suicide rates (Spearman correlation coefficient = –0.56).”

Dr. Taylor said in an interview, “states that have both types of child access prevention laws [had] suicide rates four times lower than states that did not have either of those.”

Positive correlations also showed up between unemployment rate and firearm homicide rate (Spearman correlation coefficient = 0.55) and teen tobacco use and firearm suicide rate (Spearman correlation coefficient = 0.50).

The association between Brady scores and pediatric mortality from firearms remained significant after adjustment for poverty, unemployment, and substance abuse (P less than .01). Similarly, the association between the pediatric firearm suicide rate and CAP laws remained significant after controlling for socioeconomic factors and other firearm legislation (P less than .01).

In a video interview, Dr. Taylor discussed his research findings and their importance in clinical practice.

“It’s absolutely important for pediatricians to talk to families about firearms in their home and also in the homes of their friends that they visit,” Dr. Taylor said. “We try to approach it as a public health issue similar to seat belts and car seats.”

No external funding was used, and Dr. Taylor reported no conflicts of interest.

ORLANDO – Injuries related to beds and sofas in children aged under 5 years occur more than twice as frequently than injuries related to stairs, according to new research.

“Findings from our analysis reveal that it is an important source of injury to young children and a leading cause of trauma to infants,” concluded David S. Liu, of Baylor College of Medicine, Houston, who presented the findings at the annual meeting of the American Academy of Pediatrics.

“The rate of bed- and sofa-related injuries is increasing, which underscores the need for increased prevention efforts, including parental education and improved safety design, to decrease soft furniture injuries among young children,” Mr. Liu and his colleagues wrote.

The researchers used the National Electronic Injury Surveillance System of the U.S. Consumer Product Safety Commission to conduct a retrospective analysis of injuries related to sofas and beds from 2007 to 2016.

They found that an estimated 2.3 million children aged under 5 years were treated for injuries related to soft furniture during those years, an average of 230,026 injuries a year, or 115 injuries per 10,000 children. To the surprise of the researchers, injuries related to beds and sofas were the most common types of accidental injury in that age group, occurring 2.5 times more often than stair-related injuries, which occurred at a rate of 47 per 10,000 population.

Boys were slightly more likely to be injured, making up 56% of all the cases. Soft tissue/internal organ injuries were most common, comprising 28% of all injuries, followed by lacerations in 24% of cases, abrasions in 15%, and fractures in 14%.

More than half the children (61%) sustained injuries to the head or face, and 3% were hospitalized for their injuries. Although infants (under 1 year old) only accounted for 28% of children injured, they were twice as likely to be hospitalized than older children.

The researchers also identified increases in injuries over the time period studied. Bed-related injuries increased 17% from 2007 to 2016, and sofa/couch-related injuries increased 17% during that period.

Although the vast majority of children were treated and released, approximately 4% of children were admitted or treated and transferred to another facility. Overall, an estimated 3,361 children died during the 9-year period, translating to a little over 370 children a year.

In a video interview, Mr. Liu discussed the implications of these findings.

“We know how dangerous car accidents and staircases are, and we often recommend car seats and stair gates for those,” Mr. Liu said. “Obviously we can’t put a gate or a barrier on every single sofa, couch, and bed in America, so as clinicians and parents, the best we can do is keep aware of how dangerous these items are. Just because of their soft nature doesn’t mean they’re inherently safer.”

The researchers reported no disclosures and the research received no external funding.

ORLANDO – Injuries related to beds and sofas in children aged under 5 years occur more than twice as frequently than injuries related to stairs, according to new research.

“Findings from our analysis reveal that it is an important source of injury to young children and a leading cause of trauma to infants,” concluded David S. Liu, of Baylor College of Medicine, Houston, who presented the findings at the annual meeting of the American Academy of Pediatrics.

“The rate of bed- and sofa-related injuries is increasing, which underscores the need for increased prevention efforts, including parental education and improved safety design, to decrease soft furniture injuries among young children,” Mr. Liu and his colleagues wrote.

The researchers used the National Electronic Injury Surveillance System of the U.S. Consumer Product Safety Commission to conduct a retrospective analysis of injuries related to sofas and beds from 2007 to 2016.

They found that an estimated 2.3 million children aged under 5 years were treated for injuries related to soft furniture during those years, an average of 230,026 injuries a year, or 115 injuries per 10,000 children. To the surprise of the researchers, injuries related to beds and sofas were the most common types of accidental injury in that age group, occurring 2.5 times more often than stair-related injuries, which occurred at a rate of 47 per 10,000 population.

Boys were slightly more likely to be injured, making up 56% of all the cases. Soft tissue/internal organ injuries were most common, comprising 28% of all injuries, followed by lacerations in 24% of cases, abrasions in 15%, and fractures in 14%.

More than half the children (61%) sustained injuries to the head or face, and 3% were hospitalized for their injuries. Although infants (under 1 year old) only accounted for 28% of children injured, they were twice as likely to be hospitalized than older children.

The researchers also identified increases in injuries over the time period studied. Bed-related injuries increased 17% from 2007 to 2016, and sofa/couch-related injuries increased 17% during that period.

Although the vast majority of children were treated and released, approximately 4% of children were admitted or treated and transferred to another facility. Overall, an estimated 3,361 children died during the 9-year period, translating to a little over 370 children a year.

In a video interview, Mr. Liu discussed the implications of these findings.

“We know how dangerous car accidents and staircases are, and we often recommend car seats and stair gates for those,” Mr. Liu said. “Obviously we can’t put a gate or a barrier on every single sofa, couch, and bed in America, so as clinicians and parents, the best we can do is keep aware of how dangerous these items are. Just because of their soft nature doesn’t mean they’re inherently safer.”

The researchers reported no disclosures and the research received no external funding.

ORLANDO – Injuries related to beds and sofas in children aged under 5 years occur more than twice as frequently than injuries related to stairs, according to new research.

“Findings from our analysis reveal that it is an important source of injury to young children and a leading cause of trauma to infants,” concluded David S. Liu, of Baylor College of Medicine, Houston, who presented the findings at the annual meeting of the American Academy of Pediatrics.

“The rate of bed- and sofa-related injuries is increasing, which underscores the need for increased prevention efforts, including parental education and improved safety design, to decrease soft furniture injuries among young children,” Mr. Liu and his colleagues wrote.

The researchers used the National Electronic Injury Surveillance System of the U.S. Consumer Product Safety Commission to conduct a retrospective analysis of injuries related to sofas and beds from 2007 to 2016.

They found that an estimated 2.3 million children aged under 5 years were treated for injuries related to soft furniture during those years, an average of 230,026 injuries a year, or 115 injuries per 10,000 children. To the surprise of the researchers, injuries related to beds and sofas were the most common types of accidental injury in that age group, occurring 2.5 times more often than stair-related injuries, which occurred at a rate of 47 per 10,000 population.

Boys were slightly more likely to be injured, making up 56% of all the cases. Soft tissue/internal organ injuries were most common, comprising 28% of all injuries, followed by lacerations in 24% of cases, abrasions in 15%, and fractures in 14%.

More than half the children (61%) sustained injuries to the head or face, and 3% were hospitalized for their injuries. Although infants (under 1 year old) only accounted for 28% of children injured, they were twice as likely to be hospitalized than older children.

The researchers also identified increases in injuries over the time period studied. Bed-related injuries increased 17% from 2007 to 2016, and sofa/couch-related injuries increased 17% during that period.

Although the vast majority of children were treated and released, approximately 4% of children were admitted or treated and transferred to another facility. Overall, an estimated 3,361 children died during the 9-year period, translating to a little over 370 children a year.

In a video interview, Mr. Liu discussed the implications of these findings.

“We know how dangerous car accidents and staircases are, and we often recommend car seats and stair gates for those,” Mr. Liu said. “Obviously we can’t put a gate or a barrier on every single sofa, couch, and bed in America, so as clinicians and parents, the best we can do is keep aware of how dangerous these items are. Just because of their soft nature doesn’t mean they’re inherently safer.”

The researchers reported no disclosures and the research received no external funding.

Children and adolescents who suffer sports-related concussion should engage in light activities for their minds and bodies, while being monitored and evaluated, according to a new clinical report from the American Academy of Pediatrics.

The update to the 2010 guidelines was needed to reflect the latest research “and it was necessary to provide this new information to guide pediatricians in evaluating and treating concussions they may see in their practice,” Mark Halstead, MD, of Washington University, St. Louis, said in an interview.

The biggest changes to the guidelines involve management of concussion, noted Dr. Halstead, who was a coauthor of the AAP clinical report. “The previous recommendation called for cognitive and physical rest, which unfortunately was interpreted as complete removal from all physical activity and limiting many other things including electronic use.

“Because of research that has been conducted since the original report, it has been shown that starting some light physical activity to increase heart rate, provided it does not worsen symptoms, can be beneficial in recovery. Also, the recommendation for complete removal of electronics and computer use has unfortunately created some issues with kids getting socially isolated,” he added.

James Boulette/iStockphoto

“For better or for worse, kids are connected through their electronic devices. Removing them, with no evidence that it worsens the concussion, essentially punishes kids for their injury. We also are trying to discourage prolonged removal of kids from school,” Dr. Halstead emphasized.

The new recommendations emphasize the unique nature of sports-related concussion (SRC) from one individual to another, and the need for individualized management.

Symptoms of SRC fall into five categories, according to the guidelines: somatic, vestibular, oculomotor, cognitive, and emotional/sleep. Pediatric health care providers should rule out more severe head injuries and recognize that concussion symptoms are nonspecific and may reflect preexisting conditions, such as migraine or headache disorders, learning disorders, ADHD, mental health conditions, or sleep disorders.

Use of assessments such as the Sport Concussion Management Tool (SCAT5 for 13 years and older or Child SCAT5 for 5-12 years) can help guide clinicians, but should not be used in isolation to diagnose a concussion, the guideline authors wrote.

Strategies for injury prevention are included in the guidelines as well, such as the use of appropriate headgear. As for management, computerized neurocognitive testing can play a role in decisions regarding return to play, but should not be used in isolation.

“The biggest thing we are lacking is an objective diagnostic test to determine the presence of a concussion or its resolution,” coauthor Kody A. Moffatt, MD, of Creighton University, Omaha, Nebraska, said in an interview.

“Mandatory baseline and postinjury computerized neurocognitive testing is not recommended,” he added.

Clinicians can best manage SRC with prompt recognition and diagnosis using the available tools, followed by relative rest and return to school, then noncontact physical activities, and eventually a return to sport if appropriate.

“Most concussions in children and adolescents will resolve within 4 weeks as long as there is not additional injury to the brain during that time,” Dr. Moffat said.

More research is needed in particular about concussions in elementary and middle school children, Dr. Halstead added.

In the meantime, the take-home message to pediatricians for managing SRC is one of common sense. “Extremes of removing all stimulus from a child is not likely to get them better sooner and research suggests may take them longer to get better,” Dr. Halstead noted. “That doesn’t mean they don’t have to reduce anything, as it is important to reduce physical activity and modify school workload while recovering but we should be avoiding the blanket recommendation to ‘stay home and do nothing until you are better’ approach to concussion management.”

Dr. Halstead and Dr. Moffatt reported no relevant financial conflicts to disclose; the same was true for the other report coauthors. There was no external funding for the report.

SOURCE: Halstead M et al. Pediatrics. 2018 Nov 12. doi: 10.1542/peds.2018-3074.

Children and adolescents who suffer sports-related concussion should engage in light activities for their minds and bodies, while being monitored and evaluated, according to a new clinical report from the American Academy of Pediatrics.

The update to the 2010 guidelines was needed to reflect the latest research “and it was necessary to provide this new information to guide pediatricians in evaluating and treating concussions they may see in their practice,” Mark Halstead, MD, of Washington University, St. Louis, said in an interview.

The biggest changes to the guidelines involve management of concussion, noted Dr. Halstead, who was a coauthor of the AAP clinical report. “The previous recommendation called for cognitive and physical rest, which unfortunately was interpreted as complete removal from all physical activity and limiting many other things including electronic use.

“Because of research that has been conducted since the original report, it has been shown that starting some light physical activity to increase heart rate, provided it does not worsen symptoms, can be beneficial in recovery. Also, the recommendation for complete removal of electronics and computer use has unfortunately created some issues with kids getting socially isolated,” he added.

James Boulette/iStockphoto

“For better or for worse, kids are connected through their electronic devices. Removing them, with no evidence that it worsens the concussion, essentially punishes kids for their injury. We also are trying to discourage prolonged removal of kids from school,” Dr. Halstead emphasized.

The new recommendations emphasize the unique nature of sports-related concussion (SRC) from one individual to another, and the need for individualized management.

Symptoms of SRC fall into five categories, according to the guidelines: somatic, vestibular, oculomotor, cognitive, and emotional/sleep. Pediatric health care providers should rule out more severe head injuries and recognize that concussion symptoms are nonspecific and may reflect preexisting conditions, such as migraine or headache disorders, learning disorders, ADHD, mental health conditions, or sleep disorders.

Use of assessments such as the Sport Concussion Management Tool (SCAT5 for 13 years and older or Child SCAT5 for 5-12 years) can help guide clinicians, but should not be used in isolation to diagnose a concussion, the guideline authors wrote.

Strategies for injury prevention are included in the guidelines as well, such as the use of appropriate headgear. As for management, computerized neurocognitive testing can play a role in decisions regarding return to play, but should not be used in isolation.

“The biggest thing we are lacking is an objective diagnostic test to determine the presence of a concussion or its resolution,” coauthor Kody A. Moffatt, MD, of Creighton University, Omaha, Nebraska, said in an interview.

“Mandatory baseline and postinjury computerized neurocognitive testing is not recommended,” he added.

Clinicians can best manage SRC with prompt recognition and diagnosis using the available tools, followed by relative rest and return to school, then noncontact physical activities, and eventually a return to sport if appropriate.

“Most concussions in children and adolescents will resolve within 4 weeks as long as there is not additional injury to the brain during that time,” Dr. Moffat said.

More research is needed in particular about concussions in elementary and middle school children, Dr. Halstead added.

In the meantime, the take-home message to pediatricians for managing SRC is one of common sense. “Extremes of removing all stimulus from a child is not likely to get them better sooner and research suggests may take them longer to get better,” Dr. Halstead noted. “That doesn’t mean they don’t have to reduce anything, as it is important to reduce physical activity and modify school workload while recovering but we should be avoiding the blanket recommendation to ‘stay home and do nothing until you are better’ approach to concussion management.”

Dr. Halstead and Dr. Moffatt reported no relevant financial conflicts to disclose; the same was true for the other report coauthors. There was no external funding for the report.

SOURCE: Halstead M et al. Pediatrics. 2018 Nov 12. doi: 10.1542/peds.2018-3074.

Children and adolescents who suffer sports-related concussion should engage in light activities for their minds and bodies, while being monitored and evaluated, according to a new clinical report from the American Academy of Pediatrics.

The update to the 2010 guidelines was needed to reflect the latest research “and it was necessary to provide this new information to guide pediatricians in evaluating and treating concussions they may see in their practice,” Mark Halstead, MD, of Washington University, St. Louis, said in an interview.

The biggest changes to the guidelines involve management of concussion, noted Dr. Halstead, who was a coauthor of the AAP clinical report. “The previous recommendation called for cognitive and physical rest, which unfortunately was interpreted as complete removal from all physical activity and limiting many other things including electronic use.

“Because of research that has been conducted since the original report, it has been shown that starting some light physical activity to increase heart rate, provided it does not worsen symptoms, can be beneficial in recovery. Also, the recommendation for complete removal of electronics and computer use has unfortunately created some issues with kids getting socially isolated,” he added.

James Boulette/iStockphoto

“For better or for worse, kids are connected through their electronic devices. Removing them, with no evidence that it worsens the concussion, essentially punishes kids for their injury. We also are trying to discourage prolonged removal of kids from school,” Dr. Halstead emphasized.

The new recommendations emphasize the unique nature of sports-related concussion (SRC) from one individual to another, and the need for individualized management.

Symptoms of SRC fall into five categories, according to the guidelines: somatic, vestibular, oculomotor, cognitive, and emotional/sleep. Pediatric health care providers should rule out more severe head injuries and recognize that concussion symptoms are nonspecific and may reflect preexisting conditions, such as migraine or headache disorders, learning disorders, ADHD, mental health conditions, or sleep disorders.

Use of assessments such as the Sport Concussion Management Tool (SCAT5 for 13 years and older or Child SCAT5 for 5-12 years) can help guide clinicians, but should not be used in isolation to diagnose a concussion, the guideline authors wrote.

Strategies for injury prevention are included in the guidelines as well, such as the use of appropriate headgear. As for management, computerized neurocognitive testing can play a role in decisions regarding return to play, but should not be used in isolation.

“The biggest thing we are lacking is an objective diagnostic test to determine the presence of a concussion or its resolution,” coauthor Kody A. Moffatt, MD, of Creighton University, Omaha, Nebraska, said in an interview.

“Mandatory baseline and postinjury computerized neurocognitive testing is not recommended,” he added.

Clinicians can best manage SRC with prompt recognition and diagnosis using the available tools, followed by relative rest and return to school, then noncontact physical activities, and eventually a return to sport if appropriate.

“Most concussions in children and adolescents will resolve within 4 weeks as long as there is not additional injury to the brain during that time,” Dr. Moffat said.

More research is needed in particular about concussions in elementary and middle school children, Dr. Halstead added.

In the meantime, the take-home message to pediatricians for managing SRC is one of common sense. “Extremes of removing all stimulus from a child is not likely to get them better sooner and research suggests may take them longer to get better,” Dr. Halstead noted. “That doesn’t mean they don’t have to reduce anything, as it is important to reduce physical activity and modify school workload while recovering but we should be avoiding the blanket recommendation to ‘stay home and do nothing until you are better’ approach to concussion management.”

Dr. Halstead and Dr. Moffatt reported no relevant financial conflicts to disclose; the same was true for the other report coauthors. There was no external funding for the report.

SOURCE: Halstead M et al. Pediatrics. 2018 Nov 12. doi: 10.1542/peds.2018-3074.

SEATTLE – A new analysis of all school shootings, including those with four or fewer victims, reinforces the need for prevention in the home by preventing guns from falling into unauthorized use.

Jim Kling/MDedge News

The researchers examined 223 shootings in the United States that occurred during 2005-2012 and found that in more than a third of the 60 cases for which information was available, the perpetrator obtained the gun from the home and was aged 17 years or younger. Furthermore, evidence of mental illness in the shooter was rare.

The finding complements studies of “mass shootings,” which tend to garner headlines and more research attention, according to Ayame Takahashi, MD, who presented the findings at a poster session at the annual meeting of the American Academy of Child and Adolescent Psychiatry. “What we see in the news are the big rampage shootings, with multiple victims, where the target may be anyone they can get. You hear in little bits and pieces about the single-shooter incidents, which are way more common.

“We wanted to look at as many of these cases as we could find to look at the overall variables that might be behind these smaller school shootings, which are way more common,” said Dr. Takahashi, who is an assistant professor of psychiatry at Southern Illinois University Medicine, Springfield.

The researchers identified shootings using the data from the Brady Campaign to Prevent Gun Violence during 1997-2012, and supplemented it with listings found in “The Bully Society: School shootings and the crisis of bullying in America’s schools” (New York: NYU Press, 2013). Other sources included a study on rampage shootings in U.S. high school and college settings during 2002-2008; the Virginia Tech Review Panel report, a 2014 FBI report, the Everytown for Gun Safety website, and the list of school shootings on Wikipedia.


The analysis included incidents that had occurred on a school property, including school buses, at a time when students or staff would have been at risk. The offender could have been a current or former student or employee, or anyone who came onto the school property with the intent to harm students or staff.

The sample included 223 shootings. In 60 cases, the researchers found information about how guns were obtained, and in 37% of those cases, the source was the offender’s home and the offender was 17 years old or younger. In 30% of the cases, the shooter owned the gun, but in almost all these cases, the shooter was aged 19 years or older.

Sixty-one cases had information available about the presence or absence of mental illness in the offender. In 20% of these cases, the shooter was determined to have a mental illness or, rarely, a developmental disability.

The results suggest that mental illness might be rare among school shooters, and therefore, call into question efforts to limit gun ownership among people with mental illness. “It may be barking up the wrong tree,” Dr. Takahashi said.

Instead, she advocates more messaging of gun safety in the home, to prevent unauthorized use. Psychiatrists can help by discussing these issues with patients, but she also called for more community involvement and education about the issue.

“The people who come to you, they’re kind of in your court already. I think what we need to do as a profession is go out and educate the public more, talk in schools, community meetings, things like that, so that the message gets out there beyond the folks that we see in our offices,” she said.

Dr. Takahashi has no relevant disclosures.

SEATTLE – A new analysis of all school shootings, including those with four or fewer victims, reinforces the need for prevention in the home by preventing guns from falling into unauthorized use.

Jim Kling/MDedge News

The researchers examined 223 shootings in the United States that occurred during 2005-2012 and found that in more than a third of the 60 cases for which information was available, the perpetrator obtained the gun from the home and was aged 17 years or younger. Furthermore, evidence of mental illness in the shooter was rare.

The finding complements studies of “mass shootings,” which tend to garner headlines and more research attention, according to Ayame Takahashi, MD, who presented the findings at a poster session at the annual meeting of the American Academy of Child and Adolescent Psychiatry. “What we see in the news are the big rampage shootings, with multiple victims, where the target may be anyone they can get. You hear in little bits and pieces about the single-shooter incidents, which are way more common.

“We wanted to look at as many of these cases as we could find to look at the overall variables that might be behind these smaller school shootings, which are way more common,” said Dr. Takahashi, who is an assistant professor of psychiatry at Southern Illinois University Medicine, Springfield.

The researchers identified shootings using the data from the Brady Campaign to Prevent Gun Violence during 1997-2012, and supplemented it with listings found in “The Bully Society: School shootings and the crisis of bullying in America’s schools” (New York: NYU Press, 2013). Other sources included a study on rampage shootings in U.S. high school and college settings during 2002-2008; the Virginia Tech Review Panel report, a 2014 FBI report, the Everytown for Gun Safety website, and the list of school shootings on Wikipedia.


The analysis included incidents that had occurred on a school property, including school buses, at a time when students or staff would have been at risk. The offender could have been a current or former student or employee, or anyone who came onto the school property with the intent to harm students or staff.

The sample included 223 shootings. In 60 cases, the researchers found information about how guns were obtained, and in 37% of those cases, the source was the offender’s home and the offender was 17 years old or younger. In 30% of the cases, the shooter owned the gun, but in almost all these cases, the shooter was aged 19 years or older.

Sixty-one cases had information available about the presence or absence of mental illness in the offender. In 20% of these cases, the shooter was determined to have a mental illness or, rarely, a developmental disability.

The results suggest that mental illness might be rare among school shooters, and therefore, call into question efforts to limit gun ownership among people with mental illness. “It may be barking up the wrong tree,” Dr. Takahashi said.

Instead, she advocates more messaging of gun safety in the home, to prevent unauthorized use. Psychiatrists can help by discussing these issues with patients, but she also called for more community involvement and education about the issue.

“The people who come to you, they’re kind of in your court already. I think what we need to do as a profession is go out and educate the public more, talk in schools, community meetings, things like that, so that the message gets out there beyond the folks that we see in our offices,” she said.

Dr. Takahashi has no relevant disclosures.

SEATTLE – A new analysis of all school shootings, including those with four or fewer victims, reinforces the need for prevention in the home by preventing guns from falling into unauthorized use.

Jim Kling/MDedge News

The researchers examined 223 shootings in the United States that occurred during 2005-2012 and found that in more than a third of the 60 cases for which information was available, the perpetrator obtained the gun from the home and was aged 17 years or younger. Furthermore, evidence of mental illness in the shooter was rare.

The finding complements studies of “mass shootings,” which tend to garner headlines and more research attention, according to Ayame Takahashi, MD, who presented the findings at a poster session at the annual meeting of the American Academy of Child and Adolescent Psychiatry. “What we see in the news are the big rampage shootings, with multiple victims, where the target may be anyone they can get. You hear in little bits and pieces about the single-shooter incidents, which are way more common.

“We wanted to look at as many of these cases as we could find to look at the overall variables that might be behind these smaller school shootings, which are way more common,” said Dr. Takahashi, who is an assistant professor of psychiatry at Southern Illinois University Medicine, Springfield.

The researchers identified shootings using the data from the Brady Campaign to Prevent Gun Violence during 1997-2012, and supplemented it with listings found in “The Bully Society: School shootings and the crisis of bullying in America’s schools” (New York: NYU Press, 2013). Other sources included a study on rampage shootings in U.S. high school and college settings during 2002-2008; the Virginia Tech Review Panel report, a 2014 FBI report, the Everytown for Gun Safety website, and the list of school shootings on Wikipedia.


The analysis included incidents that had occurred on a school property, including school buses, at a time when students or staff would have been at risk. The offender could have been a current or former student or employee, or anyone who came onto the school property with the intent to harm students or staff.

The sample included 223 shootings. In 60 cases, the researchers found information about how guns were obtained, and in 37% of those cases, the source was the offender’s home and the offender was 17 years old or younger. In 30% of the cases, the shooter owned the gun, but in almost all these cases, the shooter was aged 19 years or older.

Sixty-one cases had information available about the presence or absence of mental illness in the offender. In 20% of these cases, the shooter was determined to have a mental illness or, rarely, a developmental disability.

The results suggest that mental illness might be rare among school shooters, and therefore, call into question efforts to limit gun ownership among people with mental illness. “It may be barking up the wrong tree,” Dr. Takahashi said.

Instead, she advocates more messaging of gun safety in the home, to prevent unauthorized use. Psychiatrists can help by discussing these issues with patients, but she also called for more community involvement and education about the issue.

“The people who come to you, they’re kind of in your court already. I think what we need to do as a profession is go out and educate the public more, talk in schools, community meetings, things like that, so that the message gets out there beyond the folks that we see in our offices,” she said.

Dr. Takahashi has no relevant disclosures.

ORLANDO – Less than half of children could identify a real gun from a toy gun in photos, regardless of whether their parents owned a gun or had talked to them about firearm safety, according to a new study.

Tara Haelle/MDedge News

“That is very concerning to us because a large percentage of these parents are actually storing their firearms insecurely and then their children cannot tell the difference,” study investigator Kiesha Fraser Doh, MD, reported at the annual conference of the American Academy of Pediatrics.

Dr. Fraser Doh, assistant professor of pediatrics and emergency medicine physician at Emory University School of Medicine and Children’s Healthcare of Atlanta said she was inspired to conduct this study after she noticed she was seeing approximately one firearm injury in children about every 2½ weeks in her institution. She also realized that her own child frequently went on play dates, but she did not always think to ask about firearms in the home of the friends her child visited.

An estimated one in three U.S. children live in homes with a firearm, she explained, and many of these guns are left loaded and/or unlocked.

The researchers enrolled a convenience sample of 297 English-speaking caregivers who presented at one of three pediatrics EDs over 3 months. Two were suburban departments, and one was urban.

Overall, most respondents (79%) were female and 56% were black, while 33% were white. Most of the caregivers responding had some college education (72%), and just over half (51%) had an income greater than $50,000.

The researchers asked caregivers whether they had guns in their own home and whether their child had access to firearms in their own or other homes. They also asked if their child played with toy guns and whether they believed their child could tell the difference between a real gun and a toy one.

Compared with those who did not own guns, gun owners were significantly more likely to be white and have both an income over $50,000 and some college education.

Meanwhile, researchers showed the children, aged 7-17 years, photos of a toy gun and a real gun and asked which was which.

A quarter of the caregivers (25%) owned guns, and half of them (50%) allowed their children to play with guns, compared with 26% of the non-gun owners.

In addition, 86% of the gun owners had discussed gun safety with their children, and the same proportion believed their children could correctly distinguish between a real gun and a toy gun.

By comparison, 58% of the non-gun owners had discussed gun safety with their children, and the same percentage believed their children could tell the difference between real and fake guns.

The children’s confidence in being able to tell the difference was similar regardless of whether their parents owned guns (79%) or didn’t (76%).

Yet less than half of all children correctly identified the real gun in the photos: 39% of the gun owners’ children and 42% of the non-gun owners’ children correctly pointed out the real gun, a nonsignificant difference.

Throughout the entire sample, more than 8 in 10 respondents, both gun owners (86%) and not (84%), believed there should be a law that requires caregivers to store their guns safely. A similar proportion (85% of gun owners and 80% of non-gun owners) believed legal penalties should exist for caregivers “if a child encounters an unsecured firearm.”

Overall, 5% of the respondents (14% of gun owners and 4% of non-gun owners) believed their child could get a gun within 24 hours if desired.

“So what does this mean to us as clinicians? It behooves [pediatricians] to actually continue to educate families at well-child visits on the guidelines about how to store firearms safely, locked up, unloaded, separate from ammunition,” Dr. Fraser Doh said. “On the flip side, parents need to be asking about the presence of firearms in the homes their children visit and also make sure that they’re storing their weapons safety.”

Dr. Fraser Doh said she had no relevant conflicts of interest.

ORLANDO – Less than half of children could identify a real gun from a toy gun in photos, regardless of whether their parents owned a gun or had talked to them about firearm safety, according to a new study.

Tara Haelle/MDedge News

“That is very concerning to us because a large percentage of these parents are actually storing their firearms insecurely and then their children cannot tell the difference,” study investigator Kiesha Fraser Doh, MD, reported at the annual conference of the American Academy of Pediatrics.

Dr. Fraser Doh, assistant professor of pediatrics and emergency medicine physician at Emory University School of Medicine and Children’s Healthcare of Atlanta said she was inspired to conduct this study after she noticed she was seeing approximately one firearm injury in children about every 2½ weeks in her institution. She also realized that her own child frequently went on play dates, but she did not always think to ask about firearms in the home of the friends her child visited.

An estimated one in three U.S. children live in homes with a firearm, she explained, and many of these guns are left loaded and/or unlocked.

The researchers enrolled a convenience sample of 297 English-speaking caregivers who presented at one of three pediatrics EDs over 3 months. Two were suburban departments, and one was urban.

Overall, most respondents (79%) were female and 56% were black, while 33% were white. Most of the caregivers responding had some college education (72%), and just over half (51%) had an income greater than $50,000.

The researchers asked caregivers whether they had guns in their own home and whether their child had access to firearms in their own or other homes. They also asked if their child played with toy guns and whether they believed their child could tell the difference between a real gun and a toy one.

Compared with those who did not own guns, gun owners were significantly more likely to be white and have both an income over $50,000 and some college education.

Meanwhile, researchers showed the children, aged 7-17 years, photos of a toy gun and a real gun and asked which was which.

A quarter of the caregivers (25%) owned guns, and half of them (50%) allowed their children to play with guns, compared with 26% of the non-gun owners.

In addition, 86% of the gun owners had discussed gun safety with their children, and the same proportion believed their children could correctly distinguish between a real gun and a toy gun.

By comparison, 58% of the non-gun owners had discussed gun safety with their children, and the same percentage believed their children could tell the difference between real and fake guns.

The children’s confidence in being able to tell the difference was similar regardless of whether their parents owned guns (79%) or didn’t (76%).

Yet less than half of all children correctly identified the real gun in the photos: 39% of the gun owners’ children and 42% of the non-gun owners’ children correctly pointed out the real gun, a nonsignificant difference.

Throughout the entire sample, more than 8 in 10 respondents, both gun owners (86%) and not (84%), believed there should be a law that requires caregivers to store their guns safely. A similar proportion (85% of gun owners and 80% of non-gun owners) believed legal penalties should exist for caregivers “if a child encounters an unsecured firearm.”

Overall, 5% of the respondents (14% of gun owners and 4% of non-gun owners) believed their child could get a gun within 24 hours if desired.

“So what does this mean to us as clinicians? It behooves [pediatricians] to actually continue to educate families at well-child visits on the guidelines about how to store firearms safely, locked up, unloaded, separate from ammunition,” Dr. Fraser Doh said. “On the flip side, parents need to be asking about the presence of firearms in the homes their children visit and also make sure that they’re storing their weapons safety.”

Dr. Fraser Doh said she had no relevant conflicts of interest.

ORLANDO – Less than half of children could identify a real gun from a toy gun in photos, regardless of whether their parents owned a gun or had talked to them about firearm safety, according to a new study.

Tara Haelle/MDedge News

“That is very concerning to us because a large percentage of these parents are actually storing their firearms insecurely and then their children cannot tell the difference,” study investigator Kiesha Fraser Doh, MD, reported at the annual conference of the American Academy of Pediatrics.

Dr. Fraser Doh, assistant professor of pediatrics and emergency medicine physician at Emory University School of Medicine and Children’s Healthcare of Atlanta said she was inspired to conduct this study after she noticed she was seeing approximately one firearm injury in children about every 2½ weeks in her institution. She also realized that her own child frequently went on play dates, but she did not always think to ask about firearms in the home of the friends her child visited.

An estimated one in three U.S. children live in homes with a firearm, she explained, and many of these guns are left loaded and/or unlocked.

The researchers enrolled a convenience sample of 297 English-speaking caregivers who presented at one of three pediatrics EDs over 3 months. Two were suburban departments, and one was urban.

Overall, most respondents (79%) were female and 56% were black, while 33% were white. Most of the caregivers responding had some college education (72%), and just over half (51%) had an income greater than $50,000.

The researchers asked caregivers whether they had guns in their own home and whether their child had access to firearms in their own or other homes. They also asked if their child played with toy guns and whether they believed their child could tell the difference between a real gun and a toy one.

Compared with those who did not own guns, gun owners were significantly more likely to be white and have both an income over $50,000 and some college education.

Meanwhile, researchers showed the children, aged 7-17 years, photos of a toy gun and a real gun and asked which was which.

A quarter of the caregivers (25%) owned guns, and half of them (50%) allowed their children to play with guns, compared with 26% of the non-gun owners.

In addition, 86% of the gun owners had discussed gun safety with their children, and the same proportion believed their children could correctly distinguish between a real gun and a toy gun.

By comparison, 58% of the non-gun owners had discussed gun safety with their children, and the same percentage believed their children could tell the difference between real and fake guns.

The children’s confidence in being able to tell the difference was similar regardless of whether their parents owned guns (79%) or didn’t (76%).

Yet less than half of all children correctly identified the real gun in the photos: 39% of the gun owners’ children and 42% of the non-gun owners’ children correctly pointed out the real gun, a nonsignificant difference.

Throughout the entire sample, more than 8 in 10 respondents, both gun owners (86%) and not (84%), believed there should be a law that requires caregivers to store their guns safely. A similar proportion (85% of gun owners and 80% of non-gun owners) believed legal penalties should exist for caregivers “if a child encounters an unsecured firearm.”

Overall, 5% of the respondents (14% of gun owners and 4% of non-gun owners) believed their child could get a gun within 24 hours if desired.

“So what does this mean to us as clinicians? It behooves [pediatricians] to actually continue to educate families at well-child visits on the guidelines about how to store firearms safely, locked up, unloaded, separate from ammunition,” Dr. Fraser Doh said. “On the flip side, parents need to be asking about the presence of firearms in the homes their children visit and also make sure that they’re storing their weapons safety.”

Dr. Fraser Doh said she had no relevant conflicts of interest.

ORLANDO – The American Academy of Pediatrics created the Gun Safety and Injury Prevention Research Initiative to study and implement gun safety interventions to prevent homicide, suicide and unintentional injuries caused by firearms.

In an interview at the annual meeting of the American Academy of Pediatrics, Colleen A. Kraft, MD, FAAP, current AAP president, explained how AAP has renewed its efforts to protect children from firearm injuries. Black children are more likely to die in a homicide, while white children are more likely to die in a suicide through use of a firearm, Dr. Kraft said. The AAP seeks to find a nonpolitical way to discuss gun safety “with a lens on children and a lens on safety,” she said.

“What we are looking to do is to bring together partners who have the research expertise in gun safety and injury prevention, find out what we know, decide what we don’t know yet, and begin to bring together focus groups of parents and families and legislators and doctors, and people to talk about … gun safety in a way that resonates with everyone,” Dr. Kraft said.

Visit AAP’s website for more information on the Gun Safety and Injury Prevention Research Initiative.

Dr. Kraft reports no relevant conflicts of interest.

ORLANDO – The American Academy of Pediatrics created the Gun Safety and Injury Prevention Research Initiative to study and implement gun safety interventions to prevent homicide, suicide and unintentional injuries caused by firearms.

In an interview at the annual meeting of the American Academy of Pediatrics, Colleen A. Kraft, MD, FAAP, current AAP president, explained how AAP has renewed its efforts to protect children from firearm injuries. Black children are more likely to die in a homicide, while white children are more likely to die in a suicide through use of a firearm, Dr. Kraft said. The AAP seeks to find a nonpolitical way to discuss gun safety “with a lens on children and a lens on safety,” she said.

“What we are looking to do is to bring together partners who have the research expertise in gun safety and injury prevention, find out what we know, decide what we don’t know yet, and begin to bring together focus groups of parents and families and legislators and doctors, and people to talk about … gun safety in a way that resonates with everyone,” Dr. Kraft said.

Visit AAP’s website for more information on the Gun Safety and Injury Prevention Research Initiative.

Dr. Kraft reports no relevant conflicts of interest.

ORLANDO – The American Academy of Pediatrics created the Gun Safety and Injury Prevention Research Initiative to study and implement gun safety interventions to prevent homicide, suicide and unintentional injuries caused by firearms.

In an interview at the annual meeting of the American Academy of Pediatrics, Colleen A. Kraft, MD, FAAP, current AAP president, explained how AAP has renewed its efforts to protect children from firearm injuries. Black children are more likely to die in a homicide, while white children are more likely to die in a suicide through use of a firearm, Dr. Kraft said. The AAP seeks to find a nonpolitical way to discuss gun safety “with a lens on children and a lens on safety,” she said.

“What we are looking to do is to bring together partners who have the research expertise in gun safety and injury prevention, find out what we know, decide what we don’t know yet, and begin to bring together focus groups of parents and families and legislators and doctors, and people to talk about … gun safety in a way that resonates with everyone,” Dr. Kraft said.

Visit AAP’s website for more information on the Gun Safety and Injury Prevention Research Initiative.

Dr. Kraft reports no relevant conflicts of interest.

The American College of Physicians supports appropriate regulations surrounding the purchase of firearms; best practices ownership, storage, and safe use to minimize the risk of accidental or intentional death or injury; and a ban on civilian use of semiautomatic weapons and large capacity magazines, according to an expanded and updated policy statement issued Oct. 29.

Joshuashearn/Wikimedia Commons/CC BY-SA 3.0

The updated policy statement was issued at the end of a week that saw a mass shooting at a Pittsburgh synagogue where 11 people were killed as well as an incident in which two others were shot to death in a Kentucky grocery store.

“Physicians regularly come face to face with the tragedy that gun violence brings, whether maliciously or unintentionally,” ACP President Ana María López, MD, said in a statement after the synagogue shooting. “The rate of injuries and deaths related to firearms and the growing incidence of mass shootings brings to light, once again, the glaring lack of firearm policy in the United States – a country with one of the highest rates of gun violence in the world. This most recent event makes it more important than ever that Congress and states implement common-sense policies that could prevent injuries and deaths from firearms.”

The policy statement reaffirms all policies included in the college’s 2014 policy.

New to the ACP policy is the college’s support for “appropriate regulation of the purchase of legal firearms to reduce firearms-related injuries and deaths.” ACP specifies that any policy “must be consistent with the Supreme Court ruling establishing that individual ownership of firearms is a constitutional right under the Second Amendment of the Bill of Rights.”

The expanded policy calls for universal criminal background checks for firearms purchase and completion of an educational program on firearm safety; strengthening and enforcing laws on prohibiting convicted domestic violence offenders from purchasing firearms; banning firearms that cannot be detected by metal detectors and standard security screening devices; and a reexamining of concealed carry laws. ACP also favors strong penalties and criminal prosecution for those who sell firearms illegally and for those who legally purchase firearms for the sole purpose of acting as the purchaser for someone who is not legally able to possess the firearm.

The policy also “favors enactment of legislation to ban the manufacture, sale, transfer, and subsequent ownership for civilian use of semiautomatic firearms that are designed to increase their rapid killing capacity (often called ‘assault weapons’) and large-capacity magazines, and retaining the current ban on automatic weapons for civilian use.”

As part of this, ACP is calling for a comprehensive definition of semiautomatic firearms that would be subject to the ban as well as a definition of sporting and hunting purposes that should be narrowly defined.

The policy also calls for raising of the minimum age to purchase a semiautomatic weapon to 21 years, prior to the full ban being put in place.

Finally, ACP is calling on firearm owners to “adhere to best practices to reduce the risk of accidental or intentional injuries or deaths from firearms,” including ensuring that firearms “cannot be accessed by children, adolescents, people with dementia, people with substance use disorder, and the subset of people with serious mental illness that are associated with greater risk of harming themselves and others.”

Finally, the expanded policy calls for enactment of extreme risk protection order laws, under which a family member or law enforcement officer can seek a court order to temporarily remove firearms from an individual who is at imminent risk of self-harm or to others, while preserving the individual’s due process protections.

[email protected]

SOURCE: Butkus R et al. Ann Intern Med. 2018 Oct 29. doi: 10.7326/M18-1530.

The American College of Physicians supports appropriate regulations surrounding the purchase of firearms; best practices ownership, storage, and safe use to minimize the risk of accidental or intentional death or injury; and a ban on civilian use of semiautomatic weapons and large capacity magazines, according to an expanded and updated policy statement issued Oct. 29.

Joshuashearn/Wikimedia Commons/CC BY-SA 3.0

The updated policy statement was issued at the end of a week that saw a mass shooting at a Pittsburgh synagogue where 11 people were killed as well as an incident in which two others were shot to death in a Kentucky grocery store.

“Physicians regularly come face to face with the tragedy that gun violence brings, whether maliciously or unintentionally,” ACP President Ana María López, MD, said in a statement after the synagogue shooting. “The rate of injuries and deaths related to firearms and the growing incidence of mass shootings brings to light, once again, the glaring lack of firearm policy in the United States – a country with one of the highest rates of gun violence in the world. This most recent event makes it more important than ever that Congress and states implement common-sense policies that could prevent injuries and deaths from firearms.”

The policy statement reaffirms all policies included in the college’s 2014 policy.

New to the ACP policy is the college’s support for “appropriate regulation of the purchase of legal firearms to reduce firearms-related injuries and deaths.” ACP specifies that any policy “must be consistent with the Supreme Court ruling establishing that individual ownership of firearms is a constitutional right under the Second Amendment of the Bill of Rights.”

The expanded policy calls for universal criminal background checks for firearms purchase and completion of an educational program on firearm safety; strengthening and enforcing laws on prohibiting convicted domestic violence offenders from purchasing firearms; banning firearms that cannot be detected by metal detectors and standard security screening devices; and a reexamining of concealed carry laws. ACP also favors strong penalties and criminal prosecution for those who sell firearms illegally and for those who legally purchase firearms for the sole purpose of acting as the purchaser for someone who is not legally able to possess the firearm.

The policy also “favors enactment of legislation to ban the manufacture, sale, transfer, and subsequent ownership for civilian use of semiautomatic firearms that are designed to increase their rapid killing capacity (often called ‘assault weapons’) and large-capacity magazines, and retaining the current ban on automatic weapons for civilian use.”

As part of this, ACP is calling for a comprehensive definition of semiautomatic firearms that would be subject to the ban as well as a definition of sporting and hunting purposes that should be narrowly defined.

The policy also calls for raising of the minimum age to purchase a semiautomatic weapon to 21 years, prior to the full ban being put in place.

Finally, ACP is calling on firearm owners to “adhere to best practices to reduce the risk of accidental or intentional injuries or deaths from firearms,” including ensuring that firearms “cannot be accessed by children, adolescents, people with dementia, people with substance use disorder, and the subset of people with serious mental illness that are associated with greater risk of harming themselves and others.”

Finally, the expanded policy calls for enactment of extreme risk protection order laws, under which a family member or law enforcement officer can seek a court order to temporarily remove firearms from an individual who is at imminent risk of self-harm or to others, while preserving the individual’s due process protections.

[email protected]

SOURCE: Butkus R et al. Ann Intern Med. 2018 Oct 29. doi: 10.7326/M18-1530.

The American College of Physicians supports appropriate regulations surrounding the purchase of firearms; best practices ownership, storage, and safe use to minimize the risk of accidental or intentional death or injury; and a ban on civilian use of semiautomatic weapons and large capacity magazines, according to an expanded and updated policy statement issued Oct. 29.

Joshuashearn/Wikimedia Commons/CC BY-SA 3.0

The updated policy statement was issued at the end of a week that saw a mass shooting at a Pittsburgh synagogue where 11 people were killed as well as an incident in which two others were shot to death in a Kentucky grocery store.

“Physicians regularly come face to face with the tragedy that gun violence brings, whether maliciously or unintentionally,” ACP President Ana María López, MD, said in a statement after the synagogue shooting. “The rate of injuries and deaths related to firearms and the growing incidence of mass shootings brings to light, once again, the glaring lack of firearm policy in the United States – a country with one of the highest rates of gun violence in the world. This most recent event makes it more important than ever that Congress and states implement common-sense policies that could prevent injuries and deaths from firearms.”

The policy statement reaffirms all policies included in the college’s 2014 policy.

New to the ACP policy is the college’s support for “appropriate regulation of the purchase of legal firearms to reduce firearms-related injuries and deaths.” ACP specifies that any policy “must be consistent with the Supreme Court ruling establishing that individual ownership of firearms is a constitutional right under the Second Amendment of the Bill of Rights.”

The expanded policy calls for universal criminal background checks for firearms purchase and completion of an educational program on firearm safety; strengthening and enforcing laws on prohibiting convicted domestic violence offenders from purchasing firearms; banning firearms that cannot be detected by metal detectors and standard security screening devices; and a reexamining of concealed carry laws. ACP also favors strong penalties and criminal prosecution for those who sell firearms illegally and for those who legally purchase firearms for the sole purpose of acting as the purchaser for someone who is not legally able to possess the firearm.

The policy also “favors enactment of legislation to ban the manufacture, sale, transfer, and subsequent ownership for civilian use of semiautomatic firearms that are designed to increase their rapid killing capacity (often called ‘assault weapons’) and large-capacity magazines, and retaining the current ban on automatic weapons for civilian use.”

As part of this, ACP is calling for a comprehensive definition of semiautomatic firearms that would be subject to the ban as well as a definition of sporting and hunting purposes that should be narrowly defined.

The policy also calls for raising of the minimum age to purchase a semiautomatic weapon to 21 years, prior to the full ban being put in place.

Finally, ACP is calling on firearm owners to “adhere to best practices to reduce the risk of accidental or intentional injuries or deaths from firearms,” including ensuring that firearms “cannot be accessed by children, adolescents, people with dementia, people with substance use disorder, and the subset of people with serious mental illness that are associated with greater risk of harming themselves and others.”

Finally, the expanded policy calls for enactment of extreme risk protection order laws, under which a family member or law enforcement officer can seek a court order to temporarily remove firearms from an individual who is at imminent risk of self-harm or to others, while preserving the individual’s due process protections.

[email protected]

SOURCE: Butkus R et al. Ann Intern Med. 2018 Oct 29. doi: 10.7326/M18-1530.

Hospital costs for children with firearm-related injuries rose from 2006 to 2014, while the incidence of emergency department visits declined over the same period, according to the first national study of such visits in children.

Median charges were $2,445 for an ED visit and $44,966 for inpatient management of individuals under 18 years of age for the entire study period, with both increasing over time and all data adjusted to 2018 dollars. The median charge for an ED visit rose from over $2,100 in 2006 to under $2,900 in 2014, while the inpatient median increased from approximately $43,000 to about $59,000. Total charges for firearm-related injuries in children were $2.5 billion during 2006-2014, with a mean of $270 million a year, Faiz Gani, MBBS, and Joseph K. Canner, MHS, said in JAMA Pediatrics.

The overall incidence of ED visits was 11.3/100,000 children under 18 years of age for the study period, with a steady decline seen from 2006, when incidence was about 15 visits/100,000, to 10/100,000 in 2014. The rate had dropped to about 7.5 visits/100,000 in 2013 before increasing in 2014, Dr. Gani and Mr. Canner of Johns Hopkins University, Baltimore, said based on data for 75,086 visits from the Nationwide Emergency Medicine Sample.

A trend observed throughout the course of the study was the higher incidence of ED visits among males, which was consistently more than five times higher than that of females. The highest incidence by age group was 85.9/100,000 for males aged 15-17 years. The most common intent of injury was assault at 49%, with unintentional injury next at 39% and suicide at 2%, the investigators reported.

This “first and largest nationally representative study” demonstrates the “substantial clinical and financial burden associated with firearm-related injuries among pediatric patients. Moving forward, additional resources and funds should be allocated to the study of firearm-related injuries. Only through further understanding of the social, political, and health-related risk factors for these injuries can we develop and implement effective policies to address this public health concern, wrote Dr. Gani and Mr. Canner, who reported no conflicts of interest.

[email protected]

SOURCE: JAMA Pediatr. 2018 Oct 29. doi: 10.1001/jamapediatrics.2018.3091.

Hospital costs for children with firearm-related injuries rose from 2006 to 2014, while the incidence of emergency department visits declined over the same period, according to the first national study of such visits in children.

Median charges were $2,445 for an ED visit and $44,966 for inpatient management of individuals under 18 years of age for the entire study period, with both increasing over time and all data adjusted to 2018 dollars. The median charge for an ED visit rose from over $2,100 in 2006 to under $2,900 in 2014, while the inpatient median increased from approximately $43,000 to about $59,000. Total charges for firearm-related injuries in children were $2.5 billion during 2006-2014, with a mean of $270 million a year, Faiz Gani, MBBS, and Joseph K. Canner, MHS, said in JAMA Pediatrics.

The overall incidence of ED visits was 11.3/100,000 children under 18 years of age for the study period, with a steady decline seen from 2006, when incidence was about 15 visits/100,000, to 10/100,000 in 2014. The rate had dropped to about 7.5 visits/100,000 in 2013 before increasing in 2014, Dr. Gani and Mr. Canner of Johns Hopkins University, Baltimore, said based on data for 75,086 visits from the Nationwide Emergency Medicine Sample.

A trend observed throughout the course of the study was the higher incidence of ED visits among males, which was consistently more than five times higher than that of females. The highest incidence by age group was 85.9/100,000 for males aged 15-17 years. The most common intent of injury was assault at 49%, with unintentional injury next at 39% and suicide at 2%, the investigators reported.

This “first and largest nationally representative study” demonstrates the “substantial clinical and financial burden associated with firearm-related injuries among pediatric patients. Moving forward, additional resources and funds should be allocated to the study of firearm-related injuries. Only through further understanding of the social, political, and health-related risk factors for these injuries can we develop and implement effective policies to address this public health concern, wrote Dr. Gani and Mr. Canner, who reported no conflicts of interest.

[email protected]

SOURCE: JAMA Pediatr. 2018 Oct 29. doi: 10.1001/jamapediatrics.2018.3091.

Hospital costs for children with firearm-related injuries rose from 2006 to 2014, while the incidence of emergency department visits declined over the same period, according to the first national study of such visits in children.

Median charges were $2,445 for an ED visit and $44,966 for inpatient management of individuals under 18 years of age for the entire study period, with both increasing over time and all data adjusted to 2018 dollars. The median charge for an ED visit rose from over $2,100 in 2006 to under $2,900 in 2014, while the inpatient median increased from approximately $43,000 to about $59,000. Total charges for firearm-related injuries in children were $2.5 billion during 2006-2014, with a mean of $270 million a year, Faiz Gani, MBBS, and Joseph K. Canner, MHS, said in JAMA Pediatrics.

The overall incidence of ED visits was 11.3/100,000 children under 18 years of age for the study period, with a steady decline seen from 2006, when incidence was about 15 visits/100,000, to 10/100,000 in 2014. The rate had dropped to about 7.5 visits/100,000 in 2013 before increasing in 2014, Dr. Gani and Mr. Canner of Johns Hopkins University, Baltimore, said based on data for 75,086 visits from the Nationwide Emergency Medicine Sample.

A trend observed throughout the course of the study was the higher incidence of ED visits among males, which was consistently more than five times higher than that of females. The highest incidence by age group was 85.9/100,000 for males aged 15-17 years. The most common intent of injury was assault at 49%, with unintentional injury next at 39% and suicide at 2%, the investigators reported.

This “first and largest nationally representative study” demonstrates the “substantial clinical and financial burden associated with firearm-related injuries among pediatric patients. Moving forward, additional resources and funds should be allocated to the study of firearm-related injuries. Only through further understanding of the social, political, and health-related risk factors for these injuries can we develop and implement effective policies to address this public health concern, wrote Dr. Gani and Mr. Canner, who reported no conflicts of interest.

[email protected]

SOURCE: JAMA Pediatr. 2018 Oct 29. doi: 10.1001/jamapediatrics.2018.3091.