OBJECTIVE To determine prevalence and correlates of handgun access among adolescents seeking care in an urban Emergency Department (ED) in order to inform future injury prevention strategies. METHODS In this observational cross-sectional study performed in the ED of a large urban hospital, 14- to 18-year-old adolescents completed a computerized survey of risk behaviors. Adolescents seeking ED care (for injury or medical complaint) were approached seven days a week over a 22-month period. Validated measures included measures of demographics, sexual activity, substance use, injury, violent behavior, and handgun access. A logistic regression model predicting handgun access was performed. RESULTS A total of 3050 adolescents completed the survey (44% male, 58.9% African American), with 417 (12%) refusing to participate. One-third of the sample (n=1003) reported access to a handgun, and of those 54% were males (n=542). Logistic regression results indicated that older age (AOR: 1.58; 95% CI: 1.30–1.94), African American race (AOR: 1.34; 95% CI: 1.11–1.61), male gender (AOR: 1.99; 95% CI: 1.66–2.37), and being employed (AOR: 1.35; 95% CI: 1.11–1.65), as well as seeking ED care for a medical complaint as compared to intentional injury (AOR: 1.69; 95% CI 1.62–2.50) predicted handgun access. Binge drinking (AOR: 1.75; 95% CI: 1.37–2.27),marijuana use (AOR: 1.93; 95% CI: 1.58–2.36), sexual activity (AOR: 1.64; 95% CI: 1.32–2.02), prior injury by a gun (AOR: 1.80; 95% CI: 1.32–2.46), serious physical violence (AOR: 1.37; 95% CI: 1.13–1.66) and group fighting (AOR: 2.07; 95% CI: 1.68–2.56) also predicted access. CONCLUSIONS High rates of handgun access were evident among adolescents presenting in an inner city ED, including those seeking care for non injury related reasons. Adolescents with access to handguns were more likely to report risk behaviors and past injury, providing clinicians with an opportunity for injury prevention initiatives.

Falls are a significant cause of morbidity and mortality in older people. There is an increased frequency of falls in older adults with cognitive impairment and dementia which may be due to impaired judgement of self capability to mobilise safely. This case control study assessed 53 Aged Care subjects aged 75? years that were hospitalised post fall, from January 2008-December 2009, and compared these subjects' responses to those of 26 non-fallers to a standard question: 'While you are in the hospital, what would you do if you need to go to the toilet later?' This hypothetical scenario question was designed to assess judgement based on selftoileting behaviour and mobility. The study group and control group were similar in age (83.9 ± 4.7 vs. 82.0 ± 4.6 years respectively, p = 0.081) but the study group had statistically lower MMSE results when compared to controls (median 23 vs. 26.5 respectively, p = 0.031). Impaired judgement, defined as an unsafe/inappropriate response to the scenario question, was significantly more prevalent in the study group (fallers) compared to the control group (nonfallers) (41.5 vs. 15.4 %, p = 0.020). Impaired judgement was also more common with lower MMSE scores with 80.9 % of unsafe/inappropriate responses given by participants with MMSE of B20. The authors suggest there may be an association between impaired judgement, evidenced by responses to a standardised question, and falls history in older subjects, particularly in those with cognitive impairment or dementia. Ultimately, this may lead to identification of people at increased risk of falls and possibly effective falls prevention strategies in this population.