Nonfatal firearm misuse: licence status of perpetrators and legality of the firearms

Abstract: The primary aim of this study was to identify the licence status of those involved in incidents of nonfatal firearm-related misuse and to determine the involvement of legal firearms in such incidents. Firearm-related attempted suicides were excluded. The study also sought to identify the types of firearms most likely to be misused. Over a three-month period in early 1994, all nonfatal firearm-related incidents reported in any New Zealand newspaper were identified by a commercial clipping bureau. Data pertaining to the licence status and the legality of the firearm involved in these incidents were obtained from the police who completed a standardised questionnaire under the Official Information Act (1982). Over the study period, 78 incidents yielded information on 97 perpetrators and 100 firearms. Of the 97 perpetrators, 66 per cent were unlicensed, 20 per cent were licensed, the licence status of 8 per cent of the perpetrators was unknown and the remaining 7 per cent were using air guns, and therefore a licence was not required. Half of the perpetrators involved in domestic disputes were licensed. Of the 100 firearms, 44 per cent were classified as 'legal firearms' and 56 per cent were classified as 'illegal firearms'. These findings suggest that strategies aimed at reducing or preventing injury due to firearm misuse must focus on both licensed and unlicensed individuals and both legal and illegal firearms.     

Interpersonal violence: patterns in a Danish community.

We studied all cases of assault with violence (1,639) in a Danish population of 275,000 over a one-year period. Most victims were young men. The incidence rose during evenings, nights and weekends, and assaults were often seen in or around bars and restaurants. Women accounted for 64 per cent of all victims of assault in the home. Influence of alcohol was identified in 43 per cent of all cases. The fist was the most frequent agent of assault; use of firearms was a very rare act of violence but was associated with death in three out of five cases. There were 10 deaths in all.     

Firearm ownership and storage practices, U.S. households, 1992-2002. A systematic review

BACKGROUND: Because the presence and improper storage of household firearms are risk factors for injury, it is important to understand the prevalence of ownership and storage practices within households to help guide intervention development. This systematic review of published articles (1992 to 2002) provides prevalence estimates of firearm ownership and storage practices in U.S. households. METHODS: A search of bibliographic databases (MedLine, CINAHL, PsycInfo, Sociological Abstracts) was completed in January 2003. RESULTS: Although all were cross-sectional, the 42 articles included in this review varied in type; there were seven national and five state prevalence studies, as well as studies using clinic-based convenience samples (n =14) and samples of professionals (n =10). Published studies indicate that firearms are present in about one third of U.S. households. Handguns in particular are present in more than half of U.S. households with firearms, or about 19% of all U.S. households. The prevalence of firearms and handguns in households with young people was similar to the prevalence overall. Firearm ownership was highest in the South. CONCLUSIONS: Although the methodologic rigor of published articles varies substantially, the literature clearly establishes that firearms are common in U.S. households, even in the homes of medical professionals and those with children.     

Suicides in Alaska: firearms and alcohol.

A manual review of death certificates and autopsy records identified 195 suicides in Alaska during 1983-84. Native males, 20-24 years old, had the highest rate of suicide (257 per 100,000 person-years). Gunshot wounds caused 76 per cent of all suicide deaths; 79 per cent of Native and 48 per cent of White suicides had detectable levels of blood alcohol. Suicide by firearms was weakly associated with blood alcohol levels above 100 mg/dl (odds ratio 1.3, 95 per cent confidence interval 1.11-1.47).     

Factors Affecting a Recently Purchased Handgun’s Risk for Use in Crime under Circumstances That Suggest Gun Trafficking

While many handguns are used in crime each year in the USA, most are not. We conducted this study to identify factors present at the time of a handgun’s most recent retail sale that were associated with its subsequent use in crime under circumstances suggesting that the handgun had been trafficked—purchased with the intent of diverting it to criminal use. Handguns acquired in multiple-gun purchases were of particular interest. Using data for 180,321 handguns purchased from federally licensed retailers in California in 1996, we studied attributes of the handguns, the retailers selling them, the purchasers, and the sales transactions. Our outcome measure was a handgun’s recovery by a police agency, followed by a gun ownership trace, conducted by the Bureau of Alcohol, Tobacco, Firearms and Explosives, that determined (a) that the recovery had occurred within 3 years of the handgun’s most recent purchase from a licensed retailer and (b) that the person who possessed the gun when it was recovered by police was not its most recent purchaser. Altogether, 722 handguns were recovered and had trace results that met the additional criteria. Handguns acquired in multiple-gun, same-day transactions were more likely to be traced than were single-purchase handguns (odds ratio [OR] 1.33, 95% confidence intervals [CI] 1.08 to 1.63). This was not the case for multiple-purchase handguns defined more broadly as multiple handguns purchased by one individual over any 30-day period as used in “one-gun-a-month” laws. Bivariate regressions indicated increased risk of a handgun being traced when it sold new for $150 or less (OR 4.28, 95% CI 3.59 to 5.11) or had been purchased by a woman (OR 2.02, 95% CI 1.62 to 2.52). Handguns sold by retailers who also had a relatively high proportion (≥2%) of purchases denied because the prospective purchasers were prohibited from owning firearms were more likely to be traced than were those sold by other retailers (OR 4.09, 95% CI 3.39 to 4.94). These findings persisted in multivariate analyses. Our findings suggest specific strategies for intervention to prevent gun violence.     

Fatal occupational injuries of women, Texas 1975-84

A review of Texas death certificates for 1975-84 identified 348 cases of fatal occupational injuries of civilian females. Homicides accounted for 53 per cent and motor vehicle-related injuries accounted for 26 per cent of the deaths. Injuries from firearms caused 70 per cent of the homicides. One hundred thirty-three deaths occurred to women employed in the retail trade industry; of these, 77 per cent resulted from homicide. Women workers in gasoline service stations, food-bakery-and-dairy stores, and eating-and-drinking places had especially high risks of homicide. Texas female heavy-truck drivers had the highest fatal-injury rate, with motor-vehicle-related injuries causing 89 per cent of their deaths. These results indicate that effective strategies to prevent fatal occupational injuries of Texas women will need to address the problems of workplace violence and the hazards posed by motor vehicles.     

Violent death in a metropolitan county: II. Changing patterns in suicides (1959-1974).

Suicide rates in Cuyahoga County (metropolitan Cleveland) rose from 10.2 in 1958 to 12.5 per 100,000 populations in 1974 (23 per cent increase) with the greatest rise among nonwhite males (from 5.9 to 13.1, or 122 per cent). Increased rates were observed in both the city (19 per cent increase) and suburbs (35 per cent increase). Rates increased among young non-white and white adults of both sexes aged 15--34 years, but decreased slightly among adults aged 65 years and older. These findings are consistent with national trends. Alcohol was present in the blood of one-fourth of the individuals who were "dead on arrival," and at intoxicating levels in 20 per cent. There were increasing percentages of victims with positive blood alcohol and with intoxicating levels during the study period. White male victims in the city had significantly higher frequencies of such findings than their counterparts in the suburbs. The rates of suicide committed by firearms rose among all race-sex groups, with the greatest increase among city nonwhite males (2.1 to 7.7, or 267 per cent). Suicide by chemical agents (roughly one-half being barbiturates) increased in all groups except city nonwhite males, with the greatest increase among white males and suburban white females. Firearms among males and poisoning among females displaced asphyxia as the leading modes of suicide.     

Workplace homicides of Texas males.

A review of Texas death certificates for 1975-84 identified 779 civilian males whose deaths were homicides that occurred in the workplace. Injuries from firearms caused 81 per cent of the deaths. The overall rate of workplace homicide was 2.1/100,000 male workers/year. Males employed in taxicab service had the highest rate of workplace homicide. 78.2/100,000 male workers/year. Males employed in certain retail trade industries, law enforcement, and the private-security industry also had high rates of workplace homicide. Male workers greater than or equal to 65 years old were at especially high risk, with a workplace-homicide rate 3.5 times that of younger workers. A review of medical examiners' records in five urban counties indicated that 32 per cent of victims who had worked in eating-and-drinking places and 5 per cent of other workers had blood or cerebrospinal-fluid alcohol levels greater than or equal to 0.10 g/dl. These results provide a base for designing effective strategies to prevent workplace homicides.     

Epidemiologic features of Reye syndrome seen in southwestern Pennsylvania 1970-80.

In 11 years of surveillance in southwestern Pennsylvania there were 97 cases of Reye syndrome. Peak incidence was in February and March, corresponding to periods of influenza A and B activity. Mean age of cases was 7.9 years; 57 per cent were female. Case fatality declined from 55 per cent in 1970-75 to 16 per cent in 1976-80 (p less than .001). Influenza was associated with 45 per cent of cases, varicella 19 per cent; the remaining 36 per cent of cases did not occur during periods of influenza activity. Reye syndrome occurred significantly more frequently in suburban and rural areas than in central city (p less than .01), more frequently among White persons than Blacks (p less than .01), and more frequently in counties where the total population under 17 years was less than 25,000 (p less than .01).     

Beliefs and behaviour of general practitioners regarding promotion of physical activity

To assess current practice, perceived desirable practice and barriers related to the promotion of physical activity in general practice, a questionnaire was developed and distributed to all 1228 general practitioners in Perth. From these, 789 valid returns were received (71 per cent response). The mean age of the respondents was 45 years, 69 per cent were male, 52 per cent had postgraduate qualifications and 73 per cent were in full-time practice. General practitioners most frequently asked patients about their current level of physical activity and discussed physical activity programs when seeing patients with symptoms of conditions that could benefit from exercise, rather than asking all patients, new patients or patients previously seen. Walking specifically for fitness was the activity most likely to be recommended. General practitioners felt more able to offer general advice than specific advice on physical activity. Lack of time was reported most frequently as a barrier to the promotion of physical activity (47 per cent), followed by insufficient educational materials (29 per cent), and preference of patients for drug treatment (27 per cent). There were significant differences between self-reports of current practice and perceived desirable practice in the promotion of physical activity by general practitioners. Future strategies should aim to increase the frequency of advice to patients with specific health conditions.     

Contamination of protective clothing and nurses' uniforms in an isolation ward

Staphylococcus aureus was frequently isolated, usually in small numbers, from cotton gowns (12.6 per cent), plastic aprons (9.2 per cent) and nurses' uniforms (15 per cent). Gram-negative bacilli were infrequently isolated. Contamination of the protective clothing did not increase when used over periods of up to 11 days. Fewer organisms were recovered from the front of nurses' uniforms when plastic aprons instead of gowns were worn, but gowns provided better shoulder protection. However, no differences were observed in isolations of Staph, aureus or Gram-negative bacilli from these sites.     

Household firearm storage practices: Do responses differ by whether or not individuals ever use firearms?

INTRODUCTION: The prevalence with which firearms are stored loaded or unlocked has been measured in previous surveys. Our purpose was to compare household firearm storage practices reported by firearm users and nonusers. METHODS: We analyzed telephone survey data from the 1992 and 1993 Oregon Behavioral Risk Factor Surveillance System on 2454 randomly selected adults in households with firearms. We compared reported firearm storage practices among persons who ever used firearms with persons who had never used firearms by demographics and type of firearm. RESULTS: Nonusers of firearms were much less likely than firearm users to report that household firearms were always or sometimes stored loaded [odds ratio (OR) = 0.45, 95% confidence interval (CI):0.36-0.54] or stored loaded and unlocked (OR = 0.46, 95% CI: 0.36-0.57). Except for persons aged 18 to 34 years and persons in handgun-only households, differences in reported firearm storage practices between nonusers and users varied little by demographic characteristics or by type of firearm. Nonusers of household firearms may be unaware that firearms are stored loaded or stored loaded and unlocked in their homes. CONCLUSIONS: Surveys that do not consider firearm use status may underestimate household exposure to loaded firearms or to loaded and unlocked firearms.     

Ranking states' immunization coverage: an example from the National Immunization Survey

The National Immunization Survey (NIS) provides state-level estimates of preschool immunization coverage. These coverages are frequently presented in ranked lists, and ranks are frequently over-interpreted. In this paper, we highlight the difficulty in interpreting ranked point estimates. To demonstrate the uncertainty of ranks, parametric bootstrap methods were used to derive 90 per cent confidence intervals for ranks of state vaccination coverage levels among preschool children. We graphically compared states to a reference state. If NIS data are used to rank states, one should consider presenting confidence intervals for rank and the results of comparisons of one state with another graphically.     

Primary care teams work harder in deprived areas

BACKGROUND: The NHS Plan promises an equitable distribution of resources within primary care. To inform the debate on the extent to which resources should be redistributed we examined the association between primary care activity and deprivation. We used the natural experiment of the organization of primary care in Mansfield, Nottinghamshire, where town centre general practices have patients from electoral wards with a range of socio-economic characteristics who are subject to the same degree of supplier-induced demand and variations in data quality. METHODS: We used one year's prospective data for two practices with 20,106 patients from 15 electoral wards. We performed linear regression analysis of directly age-standardized rates for different types of primary care activity and primary care morbidity-specific contacts against Townsend and Index of Multiple Deprivation 2000 scores. RESULTS: There were 44 per cent more out-of-hours contacts in more deprived areas (95 per cent confidence interval (CI) 17-70 per cent), 18 per cent more surgery consultations (95 per cent CI 8-27 per cent), and 28 per cent more same-day consultations (95 per cent CI 12-44 per cent). Routine visits by doctors and contacts by district and practice nurses did not have substantial associations with deprivation. Morbidity-specific contacts for psychological problems and respiratory problems were associated with deprivation but there was no significant association for contacts for low back pain, asthma or menopausal problems. CONCLUSIONS: Different types of primary care activity and contacts for different morbidities had different associations with deprivation. This makes it difficult to recommend a simple list size adjustment; however, increased activity in deprived wards needs to be recognized in resource allocation, service configuration and performance management in primary care.     

National survey of hospital infection control organization in Italian public hospitals

A questionnaire was mailed to 1073 Italian public hospitals in an attempt to find out if infection control programmes existed, the type of programme used and available resources. After two attempts a total of 54.9 per cent of the hospitals responded to the request and of these 16.1 per cent claimed to have an infection control programme. Sixty-six per cent of the hospitals who have a control programme also have a system of continuous surveillance whilst the remainder investigated epidemics only. Infection control programmes were encountered most frequently in paediatrics, obstetrics and surgical departments. The organisms most often surveyed were the salmonellas, other types of enterobacteria, staphylococci and streptococci.     

Drinking patterns and alcohol related admissions of acute medical patients in Stracathro Hospital

A study has been made of the drinking patterns of male and female patients admitted to the acute medical wards of a rural district general hospital. Thirty-four per cent of males and 18.5 per cent of females were regular drinkers, while 54 per cent of males and 70.5 per cent of females never, or rarely drank. The young drank more frequently than the elderly. Alcohol ingestion was the determining factor in 7.9 per cent of the male admissions and 7.5 per cent of the female admissions. Drug overdosage was the single most common associated problem.     

Gun utopias? Firearm access and ownership in Israel and Switzerland

The 2011 attempted assassination of a US representative renewed the national gun control debate. Gun advocates claim mass-casualty events are mitigated and deterred with three policies: (a) permissive gun laws, (b) widespread gun ownership, (c) and encouragement of armed civilians who can intercept shooters. They cite Switzerland and Israel as exemplars. We evaluate these claims with analysis of International Crime Victimization Survey (ICVS) data and translation of laws and original source material. Swiss and Israeli laws limit firearm ownership and require permit renewal one to four times annually. ICVS analysis finds the United States has more firearms per capita and per household than either country. Switzerland and Israel curtail off-duty soldiers' firearm access to prevent firearm deaths. Suicide among soldiers decreased by 40 per cent after the Israeli army's 2006 reforms. Compared with the United States, Switzerland and Israel have lower gun ownership and stricter gun laws, and their policies discourage personal gun ownership.     

Invasive pneumococcal disease in Australia, 2002.

There were 2,271 cases of invasive pneumococcal disease (IPD) notified to the National Notifiable Diseases Surveillance System in Australia in 2002; a rate of 11.5 cases per 100,000 population. The notification rate varied between states and territories and by geographical region with the highest rates in the north of the country. Invasive pneumococcal disease was reported most frequently in children aged less than five years (57.3 per 100,000 population). Enhanced surveillance for IPD in 2002 was carried out in all states and territories, providing additional data on 1,929 (85%) of all notified cases. Rates of IPD in Indigenous Australians were 2.7 times the rate in non-Indigenous Australians. The clinical presentation of IPD was most commonly pneumonia (44%) and bacteraemia (35%). There were 175 deaths attributed to IPD resulting in an overall case fatality rate of 9.2 per cent. Forty-two per cent of all cases had a recognised risk factor for IPD. Seventy-five per cent of all pneumococcal isolates serotyped were serotypes in the seven-valent conjugate vaccine and 93 per cent were serotypes in the 23-valent polysaccharide pneumococcal vaccine. The clinical presentation and rates of risk factors varied between Indigenous and non-Indigenous cases and non-vaccine serotypes occurred more frequently among Indigenous children and adults.     

An analysis of the economic implications of elective induction of labour at term

Summary The economic implications of induction of labour were assessed by scrutinizing the case records of 228 women who participated in a randomized controlled trial. The trial group of 111 women who had elective induction of labour performed at between 39 and 40 weeks was compared with 117 controls who were managed expectantly until 41 weeks. The trial and control groups had induction rates in excess of 90 per cent and 45 per cent respectively. As approximately 50 per cent of the total hospital population was excluded from the study, however, the figures when expressed as a percentage of the hospital population would reflect induction rates of approximately 45 per cent and 23 per cent respectively for the alternative management approaches. The only economic resources used more frequently by the trial group were those associated with the induction procedure itself. The patients managed expectantly required significantly more subsequent visits to the antenatal clinic but the additional costs were insignificant when related to total expenditure. Induction of labour did not increase the use of paediatric facilities or prolong postpartum stay in hospital. The patients in the trial group had significantly fewer procedures performed on them during the hours between 1 a.m. and 9 a.m. but the changes were insufficient to lead to cost saving. It was concluded that decisions to induce labour or to manage patients conservatively had negligible economic consequences.