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Xiuli Dong,1 Ambrose E Bond,1 Nengyu Pan,2 Montrez Coleman,2 Yongan Tang,3 Ya-Ping Sun,2 Liju Yang1 1Biomanufacturing Research Institute and Technology Enterprise, Department of Pharmaceutical Sciences, North Carolina Central University, Durham, NC, USA; 2Department of Chemistry, Laboratory for Emerging Materials and Technology, Clemson University, Clemson, SC, USA; 3Department of Mathematics and Physics, North Carolina Central University, Durham, NC, USA Background: Carbon quantum dots (CDots) have recently been reported as a new class of visible light activated antimicrobial nanomaterials. This study reports the synergistic photoactivated antimicrobial interactions of CDots with photosensitizers on bacterial cells. Methods: The antimicrobial effects of the CDots with surface passivation molecules 2,2'-(ethylenedioxy)bis(ethylamine) in combination with photosensitizer methylene blue (MB) or toluidine blue (TB) at various concentrations were evaluated against Escherichia coli cells with and without 1-hour visible light illumination. The broth microdilution checkerboard method and isobologram analysis were used for determining if synergistic effect existed between CDots and MB or TB.Results: The results showed that CDots alone at a concentration of 5 µg/mL did not display antimicrobial effects, 1 µg/mL MB alone only decreased 1.86 log of viable cell numbers, but the combination treatment with 5 µg/mL CDots combined with 1 µg/mL MB completely inhibited bacteria growth, resulted in 6.2 log viable cell number reduction, suggesting synergistic interaction between the two. The antimicrobial effects of CDots/TB combination exhibited similarly synergistic effects on E. coli cells. These synergistic effects between CDots and MB or TB were further confirmed using the checkerboard microdilution methods, where the fractional inhibitory concentration index value (0.5) and the isobologram analyses. The synergistic interactions were also correlated to the increased generation of intracellular reactive oxygen species in E. coli cells upon the combination treatments of CDots/MB or CDots/TB. Conclusion: The study demonstrated the synergistic photoactivated antimicrobial effects of CDots in combination with other photosensitizers. Such synergistic effect may open new strategies for developing highly effective antimicrobial methods. Keywords: carbon quantum dots, photosensitizer, methylene blue, toluidine blue, reactive oxygen species, synergistic antimicrobial effect

The coupled Thermo-Hydro-Mechanical (THM) behavior of the Callovo-Oxfordian claystone (COx) is of great importance for the design and safety calculations of the high-level radioactive waste disposal project in this potential host rock in France. The heat emitted by the waste causes a pore pressure increase within the surrounding rock essentially due to the differential thermal expansion of the pore water and the solid skeleton. The low permeability of the COx and its relative rigidity inhibits the discharge of the induced pressure build-up. Moreover, thermal loading may provoke thermo-mechanical stresses within the formation due to mechanical confinement by the rigidity of the surrounding host rock. An important research program has been conducted by the French National Radioactive Waste Management Agency (Andra) since 2003 in order to investigate the THM response of the COx under thermal loading, through laboratory tests, in-situ experiments, model development and numerical modeling. Within Task E of the DECOVALEX-2019 project, five research teams investigated upscaling THM modeling from a small-scale in-situ experiment (TED) to a full-scale in-situ experiment (ALC). The upscaling modeling started with a verification test to validate the numerical codes. Then, an interpretative modeling of the TED experiment was performed to calibrate the THM parameters of the COx. Finally, the calibrated THM parameters were used for a blind prediction of the ALC experiment. The modeling teams each adopted a thermo-poro-elastic approach which yielded satisfactory results. The blind prediction of the temperature field showed an overestimation of less than 2 °C which was considered acceptable. On the other hand, pore pressure was well predicted only in the direction parallel to the bedding whereas the slow dissipation of the pore pressure in the direction perpendicular to the bedding was not captured by any of the modeling teams – which remains an open question of the present study.

This paper is devoted to the study of the Thermo-Hydro-Mechanical (THM) responses of a porous rock with low permeability under thermal loading in the context of deep geological disposal of radioactive waste. To this aim, numerical simulations of a benchmark exercise of a hypothetical high-level radioactive waste (HLW) repository were performed. This benchmark exercise considered as a host formation the Callovo-Oxfordian claystone (COx), which has been selected for a deep geological disposal in France. Within the framework of the DECOVALEX-2019 project, five modelling teams (Andra, LBNL, NWMO, Quintessa, UFZ/BGR) adopted a thermo-poro-elastic approach and proposed different 3D representations of the HLW repository. The differences between the teams consisted mostly in the simplification of the geometrical model and the interpretation of the boundary conditions. Numerical results for temperature, pore pressure, and effective stress evolution in the far field (i.e., at the mid-distance of two HLW cells) were compared between the teams, to quantify the impact of modelling simplifications/assumptions for the assessment of the HLW repository. The THM behaviour of the COx formation in the near field (i.e., excavation damaged zone around the HLW cells) is not the objective of this study. Moreover, plane strain conditions were considered and evaluated in comparison to 3D modelling. Key parameters influencing the THM responses of the HLW repository were assessed by both mono- and multi-parametric analyses. Spatial variability analyses of THM parameters were also carried out to study the influence of the spatial correlation length on the Terzaghi effective stress and to estimate its probability distribution. The conclusions of this study provide reliable numerical techniques for modelling large-scale deep geological disposals and deduce the main behavior of the HLW repository.

This paper provides an overview of an international research collaboration for advancing the understanding and modeling of coupled thermo-hydro-mechanical-chemical (THMC) processes in geological systems. The creation of the international DECOVALEX Project, now running for over 25 years, was initially motivated by the recognition that prediction of these coupled effects is an essential part of the performance and safety assessment of geologic disposal systems for radioactive waste and spent nuclear fuel. Later it was realized that these processes also play a critical role in other subsurface engineering activities, such as storage of CO2, exploration of enhanced geothermal systems, and unconventional oil and gas production through hydraulic fracturing. Research teams from radioactive waste management organizations, national research institutes, regulatory agencies, universities, as well as industry and consulting groups have participated in the DECOVALEX Project, providing a wide range of perspectives and solutions to these complex problems. Analysis and comparative modeling of state-of-the-art field and laboratory experiments has been at the core of the collaborative work, with an increasing focus on characterizing uncertainty and blind prediction of experimental results. Over these 25 years, many of the major advances in this field of research have been made through DECOVALEX, as evidenced by three books, seven journal special issues, and a good number of seminal papers that have emerged from the DECOVALEX modeling work. Examples of specific research advances will be presented in this paper to illustrate the significant impact of DECOVALEX on the current state-of-the-art of understanding and modeling coupled THMC processes. These examples range from the modeling of large-scale in situ heater tests representing mock-ups of nuclear waste disposal tunnels, to studies of fluid flow and chemical-mechanical coupling in heterogeneous fractures, and to the numerical analysis of controlled-injection meso-scale fault slip experiments.

Abstract: Background: Improving cardiac related knowledge to further healthy lifestyles is the best preventive strategy against coronary heart diseases (CHD). Previous studies revealed a critical shortage in all-around cardiac related knowledge, plus an overall shortage in adopting healthy lifestyle behaviors. Aims: To evaluate the effectiveness of an education, counseling and behavioral skill-building program in Jordanian working adults'' knowledge, attitudes, and beliefs about CHD and adoption of a healthy lifestyle. Methods: A non-equivalent quasi-experimental design was used to evaluate the effectiveness of the intervention program that is based on Pender''s Health Promotion Model. The Response Questionnaire and HPLP-II were used to measure subjects'' knowledge, attitudes, beliefs and adoption of healthy lifestyle. Results: One hundred six subjects completed the posttest questionnaires. Experimental group showed significantly better cardiac related knowledge, better scores for attitudes, and better scores for the health responsibility, nutritional behaviors, interpersonal relationships and total HPLP-II score. Subject''s beliefs, physical activity, spiritual growth and stress management were not improved significantly. Men had better scores in beliefs and women had better scores for health responsibility. Conclusion: Individual commitment to healthier lifestyles should be encouraged, and researchers have to design and apply more specific interventions that are directed toward improving factors that are not significantly improved through traditional programs. [ABSTRACT FROM AUTHOR]

Aim. This paper is a report of a study conducted to translate the Disaster Preparedness Evaluation Tool© into Arabic and to determine its psychometric properties, including reliability, validity and factorial structure. Background. Worldwide numbers of natural and man-made disasters have greatly increased in recent years. Since disaster strikes without warning, all healthcare providers, especially nurses, must be prepared with appropriate skills and resources for disaster procedures and management during the three phases of disaster: pre disaster, during disaster and post disaster. Knowledge levels need to be evaluated to plan effective educational programmes. Methods. The Disaster Preparedness Evaluation Tool© was translated into Classical Arabic using Beaton's guideline for translation and validated by experts and a pilot study with 20 Registered Nurses from the target population. Data were collected in 2008 using self-administered questionnaires from 474 (79% return rate) Jordanian Registered Nurses who worked in randomly selected Ministry of Health hospitals and two university hospitals. Results. Principal component analysis (Promax rotation with Kaiser Normalization procedure, SPSS© version 15) was used to determined construct validity, and three factors explained 64% of the variance: knowledge, skills and post disaster management. Cronbach's alpha was 0·90, which demonstrated internal consistency. Conclusion. These results support the reliability and validity of the Disaster Preparedness Evaluation Tool© as a measure of knowledge, skills and post disaster management. It can be used with confidence with an Arabic-speaking nursing population to measure their preparedness for disasters. Based on the results of such studies, effective disaster preparedness programmes could be developed to enhance nurses' disaster preparedness. [ABSTRACT FROM AUTHOR]

INTRODUCTION: Emergency nurses care for dying patients daily. The process of dying in an emergency department can be complicated. Research on specific obstacles that impede the delivery of end-of-life care in emergency departments and behaviors that support it is limited. METHODS: A 70-item questionnaire was mailed to randomly selected ENA members. Subjects were asked to rate items on the size, frequency, and magnitude of obstacles and supportive behaviors that relate to end-of-life care for ED patients. RESULTS: The perceived obstacles with the greatest magnitude were as follows: (a) ED nurses' work loads being too high to allow adequate time for patient care, (b) poor design of emergency departments, and (c) family members not understanding what 'life-saving measures' really mean. The three highest-scoring supportive behaviors were as follows: (a) allowing family members adequate time to be alone with the patient after he or she has died; (b) having good communication between the physician and RN; and (c) providing a peaceful, dignified bedside scene for family members once the patient has died. DISCUSSION: It is hoped that the results of this study will help increase and facilitate the discussions regarding end-of-life care in emergency departments. Realistic initial implications include finding ways to decrease workloads of emergency nurses and increase direct patient care. Another important implication would be the improvement of ED designs. Further research in the area of end-of-life care in emergency settings is recommended. [ABSTRACT FROM AUTHOR]

AIMS: This paper reports a study to investigate and follow-up relationships between post-traumatic stress disorder, anxiety, depression and quality of life in patients after traffic-related injuries. BACKGROUND: Worldwide, traffic accidents kill 1.2 million people and injure 50 million people per year. Accidental injuries are fourth in the top five causes of death in Taiwan. For survivors, traffic accidents not only cause physical impairments, but also psychological trauma, such as post-traumatic stress disorder, depression and anxiety, all of which affect the quality of life. METHODS: An exploratory, correlational design was used, and participants were recruited consecutively. Data were collected at 1 and 6 weeks post-injury for 64 patients from two major medical centres in Taiwan. Instruments were the New Injury Severity Scale, Post-traumatic Stress Disorder Reaction Index, Beck Depression Inventory, State Anxiety Inventory and Medical Outcomes Study Questionnaire. The data were collected in 2002. RESULTS: Statistically significant improvements occurred in depression, anxiety and the quality of life between week 1 and week 6 (P<0.05); high levels of post-traumatic stress disorder symptoms at week 1 (87.5%) and at week 6 (82.8%) showed no statistically significant improvement. There was a positive correlation between post-traumatic stress disorder and depression (r=0.70, P<0.001) and between post-traumatic stress disorder and anxiety (r=0.57, P<0.001), and a negative correlation between post-traumatic stress disorder and quality of life (r=-0.47, P<0.001). Depression was the most important variable to predict post-traumatic stress disorder at week 6, with depression levels at week 6 being a more powerful predictor than those at week 1. Regression analysis revealed that depression (19%) at week 1, depression at week 6 (45%), anxiety (3.8%) at week 6 and post-traumatic stress disorder (5.8%) explained a statistically significant amount of the variance at week 6. CONCLUSIONS: The findings suggest that traffic accidents have an impact on people's psychosocial wellbeing. Healthcare professionals need to implement interventions to decrease post-traumatic stress disorder, depression and anxiety to increase the quality of life for patients following traffic injuries. [ABSTRACT FROM AUTHOR]

Faculty, students, and alumni wrote stories of their nursing experiences for the Brigham Young University (BYU) College of Nursing 50th Anniversary Celebration. Analysis revealed the stories reflected professional values (altruism, autonomy, human dignity, integrity, social justice) identified in the American Association of Colleges of Nursing's Essentials for Baccalaureate Nursing. Nursing educators can use such innovative and creative assignments to document how students integrate professional values into their practice, reflect on their interactions with patients, and validate teaching effectiveness. [ABSTRACT FROM AUTHOR]

Introduction: Suicide is a major public health concern within the United States, and prevention efforts are essential for decreasing the suicide rate. Researchers and clinicians have knowledge and effective treatments for preventing suicide; however, their impact is limited to those with access to services. Science Communication (SciComm) is an effective tool that can be integrated into the field of suicide prevention and can bridge the gap between scientific findings and the general population. SciComm can help disseminate evidence-based strategies for suicide prevention, dispel misinformation on suicide, and normalize help-seeking., Purpose: In this article, we propose specific, tangible ways that SciComm can be integrated into graduate school programs, mentorship, career advancement requirements and can help enact systemic change within the field of suicide prevention. Additionally, we discuss why it is important that the field of suicide prevention, specifically, adopts a SciComm framework. Embracing SciComm can help the field of suicide prevention to have a broader impact and can help to reduce rates of suicide., (© 2024 The Author(s). Suicide and Life‐Threatening Behavior published by Wiley Periodicals LLC on behalf of American Association of Suicidology.)

Objectives: To examine factors that differentiate firearm owners who endorse specific reasons for secure and unsecure firearm storage., Methods: A subsample of firearm-owning adults (n = 3,119) drawn from a representative sample of adults (n = 7,785) residing in nine US states participated in an online survey., Results: The most common reason for not always using a gun safe was concerns that they render firearms too slow to access during an emergency (60.2%). The most common reasons for current firearm storage were ensuring ready access in case of emergency (59.7%) and preventing access by children and adolescents (44.6%). Firearm owners varied on their reasons based upon current storage habits, reasons for ownership, and the presence of firearms in the home., Conclusions: Firearm owners with children in the home are more likely to select storage methods they feel will prevent access by vulnerable individuals, whereas those who own for defensive purposes and those who store firearms loaded and unlocked are more likely to endorse storing their firearms for quick home defense and convenience and to see gun safes as unnecessary obstacles., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. The New Jersey Gun Violence Research Center (GVRC) is funded annual by the state budget of the State of New Jersey, with funding provided through the New Jersey Office of the Secretary of Higher Education. Funds from the general GVRC budget were used to acquire the data for this project. Dr. Anestis reports personal income in the form of book royalties, speaking fees, consulting fees, and training fees related to secure firearm storage. Dr. Anestis also reports grant funding on separate projects related to the understanding of secure firearm storage., (© 2024 The Authors.)

To examine the differences in treatment seeking behaviors, previous suicidal thoughts, previous suicide attempts, and disclosure of suicidal thoughts among female service members (SM)/Veteran suicide decedents who used a firearm and those who used another method. Data was acquired from the National Violent Death Reporting System which is maintained and monitored by the Center for Disease Control and Prevention. Data included in the present study were from suicide deaths that occurred between 2003-2018. Female SM/Veterans who died by firearm suicide had lower proportions of current mental health or substance use treatment, lifetime mental health or substance use treatment, and previous suicide attempts compared to those who used another method. Female SM/Veterans who die by firearm suicide are less likely to encounter mental health services than those who use another method. Conversations on secure firearm storage need to occur outside of the health care setting.

Objectives: To examine rankings of credible sources for discussing secure storage within a representative sample of firearm-owning service members, and examine how combinations of demographic variables impact the ranking of credible sources., Methods: The probability-based sample was collected with the help of Ipsos. Participants were US service members who owned a firearm at the time of the survey (n = 719)., Results: The total sample ranked service members, Veterans, and members of law enforcement as the most credible sources and faith leaders, casual acquittances, and celebrities as the least credible sources. Black men ranked the NRA as a highly credible source whereas Black females ranked the NRA as one of the least preferred sources. Regardless of political preference, those who lived in non-metropolitan rural environments ranked members of law enforcement as highly credible sources. Those who lived in non-metropolitan rural and urban settings and identified as liberal ranked the National Shooting Sports Foundation as a highly credible source., Conclusions: Law enforcement officers, military members, and Veterans are ranked as highly credible sources by most subgroups of firearm-owning service members. Leveraging these voices in firearm safety conversations is necessary, may increase adherence to secure storage recommendations, and ultimately reduce suicide., (© 2024 The Authors. Suicide and Life‐Threatening Behavior published by Wiley Periodicals LLC on behalf of American Association of Suicidology.)

Purpose: This study utilized demographic and intrapersonal variables to identify individuals who may have falsely denied firearm ownership and determined if individuals can be divided into meaningful subgroups., Methods: Participants were United States residents (N = 3500) recruited from January to June 2020. matched to the 2010 census data for age, race, sex, income, and education level. A Zero-Inflated Negative Binomial (ZINB) regression was utilized to determine potential underreporting of firearm ownership, and a latent class analysis was utilized to determine unique subgroups of those who were identified as underreporting firearm ownership in the ZINB., Results: Participants (N = 1306) were identified as underreporting firearm ownership (excess zeros) based on a model that included demographic and intrapersonal variables. A latent class analysis indicated that among excess zeros, three unique subgroups exist., Conclusions: Determining who may be underreporting firearm ownership will allow for a more comprehensive understanding of firearm ownership in the US and more targeted safe storage messages that may reach those who own firearms and are at risk for firearm-related injury and death., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany.)

Objective: The present study seeks to add to the existing literature by determining if having a plan for suicide, is associated with an individual's self-reported likelihood of attempting suicide in the future., Method: Data came from a sample of 97 United States Army personnel with past week ideation or lifetime attempt history. Assessments were collected at baseline, 1-month, 3-month, and 6-months., Results: Self-reported likelihood of attempting suicide in the future was not associated with the presence of a plan for suicide overall or a plan with a specific method (i.e., firearm, cutting/scratching, and medication)., Discussion: Although a plan for suicide is commonly thought to indicate elevated risk our findings suggest that presence or absence of suicide plans is not associated with more self-reported likelihood of a future suicide attempt.

Objective: This study seeks to better understand firearm ownership among law enforcement officers (LEO), with the goal of informing future firearm injury and suicide prevention efforts. We describe the frequency and sociodemographic correlates of firearm ownership and storage practices among, and examine the association between suicidal ideation and current firearm storage practices., Methods: The present study used data from a large online study (n=6410) and included data from individuals who were currently or previously being employed as an LEO (n=369; M (SD) age=39.2 y (15.8 y), 75.2% male, 66.7% white). Self-report measures were used to assess for firearm ownership, storage habits and suicidal ideation. Descriptive statistics were used to describe the frequency of firearm ownership and logistic regressions were used to examine the extent to which demographic characteristics and suicidal ideation were associated with firearm ownership., Results: Overall, 70.5% (n=261) of the sample reported firearm ownership. LEO who were older had significantly lower odds of reporting firearm ownership. Those who were married and those who reported lifetime suicidal ideation had significantly greater odds of reporting firearm ownership. Whereas firearm-owning LEO who reporting storing a firearm locked had significantly lower odds of reporting lifetime suicidal ideation, those who reported storing a firearm unloaded had significantly greater odds of reporting lifetime suicidal ideation., Conclusion: Findings have important public health implications and can be used to increase adherence with secure storage recommendations. Increasing secure storage may help reduce suicide risk among LEO, a sample at heightened risk for suicide., Competing Interests: Competing interests: Author MA receives personal income in the form of book royalties, speaking fees, honoraria and consulting fees related to firearm suicide prevention. He also serves as the PI or Co-I on several grants focused on firearm suicide prevention., (© Author(s) (or their employer(s)) 2024. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: Although secure firearm storage can prevent firearm injury and death, secure storage is relatively rare. This tendency may be driven in part by a perceived lack of utility for secure storage in preventing suicide and other gun violence-related outcomes., Method: We recruited a large (n = 3510) representative sample of residents from five US states and assessed the degree to which those who do and do not store their firearms securely perceive different utility in specific firearm storage practices for suicide prevention. To test for specificity, we examined if those differences hold when considering unintentional shooting and firearm theft prevention., Results: Those who currently store their firearms unsecured reported lower perceived utility in several firearm storage practices, particularly for suicide and theft prevention., Conclusions: Our findings highlight that a lack of perceived utility in secure firearm storage may partially drive unsecure firearm storage. Efforts to promote secure storage must address this misperception., (© 2023 American Association of Suicidology.)

Background: Firearm access and storage practices influence risk for injury and death; however, prior research has considered only national and regional differences on these variables, overlooking state-level differences., Objectives: To analyse and describe statewide differences in firearm ownership, storage and use in a representative sample of five US states., Design: Variables were assessed via an online self-report survey administered between 29 April 2022 and 15 May 2022., Setting: Surveys were completed online., Participants: Participants (n=3510) were members of knowledge panel, a probability-based sample recruited to be representative of US adults. All participants were aged 18+ and resided in one of five states: Colorado, Minnesota, Mississippi, New Jersey or Texas., Measurements: We used χ 2 tests to examine state differences in firearm ownership, childhood firearm experiences and purchasing. A series of analyses of covariance were then used to assess differences in firearm storage, firearms owned and carrying behaviours while adjusting for pertinent demographic characteristics., Results: We found significant differences in firearm ownership across states. There were significantly more first-time firearm purchasers during the firearm purchasing surge in New Jersey. Both Mississippi and Texas have elevated rates of unsecure storage practices and firearm carrying outside of the home., Limitations: Results are cross-sectional and self-report. Findings may not generalise beyond the five states assessed in this survey., Conclusions: Public health messaging around firearm safety should account for differences in key firearm behaviours related to ownership, storage and use to ensure effective communication and reduce the risk of gun injury and death across states., Competing Interests: Competing interests: MA reports receiving personal income in the form of book royalties, speaking fees, training fees and consultation fees for activities related to firearm access and suicide prevention. He also reports grant funding on topics related to gun violence prevention. DCS reports receiving grant funding on topics related to gun violence prevention., (© Author(s) (or their employer(s)) 2024. No commercial re-use. See rights and permissions. Published by BMJ.)

Objective: Veterinarians die by suicide at elevated rates. Higher levels of capability for suicide among veterinarians, including access to lethal medications, may account for this discrepancy. This study aimed to determine the importance of accessibility of lethal medications in veterinary workplaces in the relationship between recent suicidal ideation and perceived likelihood of making a future suicide attempt., Method: Participants identifying with one or more groups at high-risk for suicide (e.g., veterinarians, firearm owners) were recruited via social media to complete online self-report questionnaires examining demographic, work-related, and suicide-related risk factors. The sample of veterinarians ( n  = 310) was primarily female, White, and worked in small animal practices., Results: Method of lethal medication storage in the workplace moderated the relationship between past week ideation and perceived likelihood of a future suicide attempt such that the relationship became stronger among those storing medications unlocked during business hours and weaker among those storing medications locked during business hours., Conclusion: Secure storage of lethal medications in the workplace may protect against suicide risk. Barriers to lethal medications, when not actively in use, may reduce both physical and cognitive accessibility. Future research should determine the impact of workplace lethal medication storage on suicidal behavior among veterinarians.HIGHLIGHTSLethal med storage moderates link between suicidal thoughts and belief suicide is likelyStoring unlocked may increase physical and cognitive accessibility of this methodWorking with vets to develop and implement means safety strategies will be important.

The present study sought to determine the extent to which the message or messenger is more important for news media portrayal of gun violence prevention. Exploratory analyses also examined factors related to Fox News and MSNBC credibility. Participants (N = 3,500) were US adults matched to the 2010 US Census on several demographic variables. Two mock headlines were presented: "Gun violence is result of mental health problems" and "Storing firearms in a safe can help prevent suicides." Headlines were reported to be from either Fox News or MSNBC. Participants then rated accuracy of the headline and credibility of the news source. Headline content did not predict perceived accuracy of the headline. Perceived credibility of the messenger was associated with perceived accuracy for both mock headlines. Exploratory analyses indicated several demographic factors related to Fox News and MSNBC credibility. Regardless of the content of a headline, the degree to which participants perceived it as accurate was associated with how credible they believed the source to be. These findings highlight the importance of credible media portrayal of accurate information on gun violence prevention.

Objective: The present study sought to better understand the characteristics of those who own firearms in the Black community; and to understand how Black firearm owners differ from nonfirearm owning Black individuals on a variety of variables related to safety, threat concerns, and suicide risk., Methods: Two samples were utilized in this study. The first was a subsample of those who identified as Black from a nationally representative sample (N = 502) seeking to understand firearm ownership within the United States. The second used a subsample of those who identified as Black (N = 1086) from a representative sample from New Jersey, Minnesota, and Mississippi. Variables related to safety and threat concerns were included in the second sample., Results: In both samples, multiple demographic variables, such as being a woman and having higher education, predicted firearm ownership. In the second sample, experiences of everyday discrimination and crime experiences were associated with firearm ownership. Additionally, Black firearm owners reported significantly more suicidal ideation than Black nonfirearm owners., Conclusion: The findings demonstrate the unique characteristics and experiences of Black firearm owners and show that firearm ownership is associated with increased suicide risk factors for Black adults. Findings should be used to advocate for the creation of more culturally relevant suicide prevention and firearm means safety strategies., (© 2023 Wiley Periodicals LLC.)

The firearm purchasing surge that began in 2020 has seen an unprecedented number of firearms purchased within the United States. The present study examined if those who purchased during the surge differed in their levels of threat sensitivity and intolerance of uncertainty from firearm owners who did not purchase during the surge and from non-firearm owners. A sample of 6,404 participants from New Jersey, Minnesota, and Mississippi were recruited through Qualtrics Panels. Results indicated that surge purchasers have higher levels of intolerance of uncertainty and threat sensitivity relative to firearm owners who did not purchase during the surge and non-firearm owners. Additionally, first time purchasers reported greater threat sensitivity and intolerance of uncertainty relative to established firearm owners who purchased additional firearms during the purchasing surge. Findings from the present study increase our understanding of how sensitivity to threats and the ability to tolerate uncertainty differs among firearm owners purchasing at this time. The results help us determine what programs will increase safety among firearm owners (e.g., buy back options, safe storage maps, firearm safety trainings)., Competing Interests: Declaration of competing interest Dr. Anestis receives personal income related to firearm suicide prevention in the form of book royalties, speaking fees, and consulting fees. He also serves as the primary investigator or co-investigator on several funded grants related to this issue. Dr. Bryan receives personal income related to firearm suicide prevention in the form of book royalties, speaking fees, and consulting fees. He also serves as the primary investigator or co-investigator on several funded grants related to this issue., (Copyright © 2023. Published by Elsevier Ltd.)

Objective: The present study seeks to determine differences in lifetime suicidal ideation, dispositional capability, acquired capability, and practical capability among those who have and have not served as first responders, and among subgroups of first responders., Methods: Data were collected as part of a large online ( n  = 3,500) study seeking to understand firearm ownership in the United States. Participants were recruited via Qualtrics Panels and were demographically matched to the 2010 US census. Binary logistic regressions and an exploratory multinomial logistic regression examined differences between first responders and non-first responders and among subgroups of first responders., Results: First responders reported more lifetime suicidal ideation and higher acquired, practical, and dispositional capability than did non-first responders. Findings indicated that first responders with and without military affiliation did not differ in terms of suicidal ideation or capability for suicide. Lastly, law enforcement officers (LEOs) reported more lifetime suicidal ideation than emergency medical technicians (EMTs). LEOs, EMTs, and firefighters did not differ in terms of capability for suicide., Discussion: The findings highlight that suicidal ideation and capability for suicide differ between first responders and non-first responders and among subgroups of first responders. The mechanisms driving the increased rates of suicidal ideation and capability among first responders are unknown; however, it is likely due to a combination of personal and occupational factors. Although not without its limitations, the present study provides an understanding of suicide risk among first responders.

Introduction: Two-thirds of military suicides are by firearm, and unsafe storage increases the risk of suicide. Understanding who is at risk for suicide, their interactions with behavioral healthcare, and their firearm storage habits have implications for suicide prevention., Method: Probability-based sampling was used. Inclusion criteria were current military service and firearm ownership. Analyses focused on those who endorsed past year (n = 180) or past month suicidal ideation (n = 85)., Results: Servicemembers with undisclosed past year ideation stored firearms at home more often and with a locking device less often. Servicemembers with past year ideation who did not attend recent behavioral health sessions stored firearms with a locking device and loaded less often. Servicemembers with undisclosed suicidal ideation in the past month stored firearms with a locking device less often. Servicemembers with past month ideation who have not attended recent behavioral health sessions stored firearms with a locking device and loaded less often., Conclusions: Servicemembers experiencing undisclosed suicidal ideation and who are not receiving treatment generally have more ready access to firearms. Safe firearm storage messaging needs to be disseminated in a manner that shifts social norms around firearm storage, whether or not suicide risk is known., (© 2023 American Association of Suicidology.)

Healthcare providers are well positioned to screen for firearm access to reduce risk of suicides, yet there is a limited understanding of how often and for whom firearm access screening occurs. The present study examined the extent to which providers screen for firearm access and sought to identify who has been screened in the past. The representative sample included 3510 residents from five US states who reported whether they have been asked about their access to firearms by a healthcare provider. The findings demonstrate that most participants have never been asked by a provider about firearm access. People who have been asked were more likely to be White, male, and firearm owners. Those with children under 17 years old in the home, that have been in mental health treatment, and report a history of suicidal ideation were more likely to be screened for firearm access. Although there are interventions for mitigating firearm related risks in healthcare settings, many providers may be missing the opportunity to implement these because they do not ask about firearm access., Competing Interests: Declaration of Competing Interest None., (Copyright © 2023 Elsevier Inc. All rights reserved.)

Background: Firearms account for over 40,000 deaths in the USA each year in addition to thousands of nonfatal injuries. One notable prevention strategy for firearm-related fatalities and nonfatal injuries is safe storage. Safe storage of firearms emphasizes using storage mechanisms that limit ready access of firearms to unauthorized users. Cable locks are one safe storage option that is easy to access and typically free, as they are included in many firearms sales. The present study examined the extent to which firearms retailers notifying purchasers at the point of sale about the included cable locks was associated with subsequent locking device use in two large samples and three subsamples. Exploratory analyses then examined demographic factors associated with frequency of seller notification of locks., Methods: Sample 1 included 1203 firearm owners and sample 2 included 1556 firearm owners. Subsamples were drawn from sample 2 to examine if there were differences by state. The three subsamples included firearm owners from Minnesota (n = 515), Mississippi (535), and New Jersey (506). Logistic regressions were used to examine the association between frequency of sellers notifying buyers of locks and subsequent locking device use. Linear regressions were used to examine what demographic factors were associated with greater frequency of seller notification of locking devices., Results: Results indicated a general trend such that more frequent notification of cable locks at the point of purchase was associated with greater likelihood of using locking devices to secure firearms. At the subsample level, these findings were most consistent for Mississippi relative to Minnesota and New Jersey. Exploratory analyses generally indicated those who were younger and those living in more densely populated areas were more likely to be notified about cable locks at the point of purchase., Conclusions: These findings suggest that interactions about cable locks at the point of firearm purchase has an impact on firearm storage behaviors. Such results indicate that encouraging firearm retailers to have these discussions with those purchasing firearms might be an important strategy for preventing firearm-related fatalities and nonfatal injuries., (© 2023. The Author(s).)

Introduction: The aim of this study was to determine the safety and feasibility of convection-enhanced delivery of autologous cerebrospinal fluid (CSF) for enhancing intraoperative magnetic resonance imaging (MRI) of the basal ganglia during stereotactic neurosurgery., Methods: This pilot study was conducted in 4 patients with Parkinson's disease (PD) who underwent MRI-guided deep brain stimulation of the globus pallidus internus (GPi). CSF was obtained via lumbar puncture after general anesthesia and prior to incision. A frameless stereotaxy system was installed, and an infusion catheter was inserted to the GPi using intraoperative MRI. Infusion of autologous CSF was performed at a convective rate of 5 µL/min with a maximum volume of infusion (Vi) of 500 mL. T2-weighted MRI scans were obtained every 15 min up to a maximum of 105 min in order to calculate the volume of distribution (Vd). Safety was assessed with adverse event monitoring, and clinical outcomes were measured with changes in unmedicated UPDRS part III and PDQ-39 scores from baseline to 6 months postoperatively., Results: All four infusions were safe and without adverse events. The mean unmedicated UPDRS part III and PDQ-39 scores improved by 24% and 26%, respectively. The Vd:Vi ratio ranged from 2.2 to 2.8 and peaked 45 min from the onset of infusion, which is when the borders of the GPi could generally be visualized based on T2-weighted MRI. Two patients underwent refinement of the stereotactic targeting based on infusion-enhanced images., Conclusions: The convective administration of autologous CSF to deep brain structures appears safe and feasible for enhancing intraoperative MRI during stereotactic procedures. Infusion-enhanced imaging with target-specific infusates could be developed to visualize neurochemical circuits or cellular regions that currently are not seen with anatomic/structural MRI., (© 2023 S. Karger AG, Basel.)

This study describes the type of firearm used and location of bodily injury among demographic subgroups of suicide decedents. Data on those who died by suicide via firearm from the National Violent Death Reporting System ( N  = 117,126) between the years 2003-2018 was utilized. A series of five logistic regression analyses examining the age of decedent, type of firearm, location of wound site, loaded vs. unloaded firearms, and locked vs. unlocked storage, using predictors including gender, race, who owns the firearm and age were performed. Findings have important public health implications. Increasing safe storage or removing the specific types of firearms one is likely to use in their death from the home during a time of crisis may decrease risk of suicide.

Introduction: Despite representing fewer than 5% of suicide attempts, firearms account for over half of deaths. Yet there is little clinical information regarding firearm attempts, particularly survivors. We assessed clinical factors differentiating firearm suicide survivors from decedents, firearm attempters from other methods, and firearm attempters from similarly injured trauma patients., Methods: We used clinical data from the National Trauma Data Bank (2017) to assess firearm suicide attempts using cross-sectional and case-control designs. We used logistic and multinomial regression to compare groups and assess firearm type and discharge destination., Results: Older age, being uninsured, and injury location were associated with increased mortality among firearm attempters. Older age, White race, male sex, and being uninsured were associated with firearm attempts. Major psychiatric disorders were associated with firearm attempts and using a rifle or shotgun. Major psychiatric disorders, female sex, and smoking were associated with psychiatric discharge. Black and other race were associated with law enforcement discharge, and Black race was associated with lower odds of psychiatric discharge. Uninsured patients had lower odds of discharge to long-term care, psychiatric, or rehabilitation facilities., Conclusions: This study identifies factors associated with firearm suicide and includes indicators of disparities in health services for patients at high risk of suicide death., (© 2022 American Association of Suicidology.)

The present study is an examination of laypersons' preferences regarding therapists with lived mental health experiences. Specifically, we investigated participants' preferences for a treatment with a therapist who has sought personal therapy, experienced suicidal ideation, or made a suicide attempt. Additionally, we explored how participants' personal experiences may impact these preferences. Three hundred ninety-eight community members were recruited to complete an online survey through Amazon's Mechanical Turk. Participants completed delayed discounting paradigms which involve choices between a therapist with the experience (e.g., suicidal ideation) and a therapist without the experience providing treatment with varied levels of therapeutic efficacy (i.e., average percentage of client recovery). Overall, participants were willing to lose therapeutic efficacy in order to work with a therapist who has not been in prior mental health treatment (9.36% efficacy loss), experienced suicidal ideation (19.43% efficacy loss), and engaged in suicide attempts (20.18% efficacy loss). Across these therapist options, the strongest preference was for therapists with prior treatment compared to the other two conditions. Preferences differed somewhat depending on the participant's social stigma, history of suicide attempts, and prior suicidal ideation; however, these effects were small in size. Overall, participants preferred less effective therapists without a history of personal therapy, suicidal ideation, and suicide attempts, compared to more effective therapists with a history of these experiences. Findings from this study highlight the pervasiveness of negative attitudes toward suicidal thoughts and behaviors and lived experience. If replicable, these results emphasize a need for destigmatization of these experiences in mental health care. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Objective: The present study sought to determine if among a sample of firearm owning suicide decedents, the type and number of firearms owned was associated with dying by suicide using a firearm compared to another method., Method: Data were collected as part of a larger online study that gathered information on suicide decedents and the context surrounding their death from family members and friends. The present study used data from those who owned at least one firearm ( n  = 121). Participants in the present study were mostly male and white., Results: Among firearm owners, handgun ownership was significantly associated with dying by suicide using a firearm compared to using another method. The number of firearms owned was inversely associated with using a firearm compared to another method in a suicide death. The average number of firearms owned was higher among those who owned shotguns compared to handguns., Conclusions: Handgun ownership, not shotgun ownership, was associated with having died from a self-inflicted gunshot wound. The finding regarding number of firearms should be interpreted with caution. Overall, findings provide insight into what differentiates firearm owners who die by suicide using a firearm compared to another method.

Objective: To identify and verify classes of firearm owners that exist within the United States and determine the sources that classes deemed credible to discuss firearm safety for suicide prevention., Methods: The study is composed of two parts. Part 1 (N = 1018) utilizes a nationally representative sample of firearm owners. Part 2 (N = 1064) consists of firearm owners from Mississippi, Minnesota, and New Jersey., Results: Four unique classes were identified in Sample 1: multiple firearms class, single handgun class, few firearms class, and long-gun class. A three-class solution was found for sample 2. Two of the classes from sample 1 replicated: multiple firearms class and single handgun class. Although many of the classes differed in the ranking of credible sources, a combination of The American Foundation for Suicide Prevention, law enforcement officers, and family members was ranked as credible sources among all classes., Conclusions: Findings provide evidence of the heterogenous nature of firearm owners and can be utilized to better understand the subgroups of firearm owners. Additionally, the findings from the credible sources analyses can be leveraged to create more effective safe firearm storage messaging which may increase adherence with safe storage suggestions and ultimately reduce suicide rates., (© 2022 American Association of Suicidology.)

Importance: Understanding mental health and substance use treatment seeking and suicidality among suicide decedents is important to determine prevention efforts., Objective: To evaluate differences in treatment seeking and suicidality between suicide decedents who died by firearms and those who died by other methods., Design, Setting, and Participants: Cross-sectional data were collected on 234 652 suicide decedents from 2003 to 2018. Participant information was reported by their state of residence to the National Violent Death Reporting System. Statistical analysis was performed from July 1, 2021, to January 21, 2022., Main Outcomes and Measures: Main outcomes were treatment for mental health and substance use at time of death, previous treatment for mental health and substance use, history of suicidal ideation or plans, history of suicide attempts, and disclosure of suicidal ideation or plans., Results: A total of 234 652 participants (182 520 male [77.8%]; 205 966 White [87.8%]; mean [SD] age, 46.3 [18.2] years [range, 3-112 years]) were included in this study. Compared with suicide decedents who died by another method (n = 117 526 [50.1%]), those who died by firearm (n = 117 126 [49.9%]) were more likely to have disclosed thoughts or plans of suicide within the month prior to death (odds ratio [OR], 1.16 [95% CI, 1.13-1.18]) and were less likely to have previously attempted suicide (OR, 0.44 [95% CI, 0.43-0.46]). Compared with those who died by poisoning, those who used a firearm were more likely to have had a history of suicidal thoughts or plans (OR, 1.19 [95% CI, 1.15-1.23]) and to have disclosed their thoughts or plans of suicide within the month prior to death (OR, 1.06 [95% CI, 1.03-1.10]). Compared with those who died by hanging, those who used a firearm were more likely to have disclosed their thoughts or plans of suicide to another person within the month prior to their death (OR, 1.14 [95% CI, 1.11-1.17])., Conclusions and Relevance: These findings provide information that suggests who is at risk to die by firearm suicide. Community-based interventions in suicide prevention could help reduce access to firearms during a time of crisis. The finding that firearm suicide decedents were more likely to disclose their suicidal thoughts or plans provides an important avenue for prevention.

Objective: This study examined if essential workers (EW) reported higher past month suicidal ideation (SI) and coronavirus-19 (COVID-19) stress than non-EW, explored if the association between EW status and SI is indirect through COVID stress, and tested whether EW who identified as black, indigenous, and people of color (BIPOC) experienced more past month SI and COVID stress than white EW., Methods: Participants (N = 3500) were predominately white and female. COVID-19 was assessed with the COVID-19 subscale., Results: EWs reported higher past month ideation and COVID-19 stress than non-EWs. EWs who identified as BIPOC reported higher past month ideation and higher fears about economic consequences and compulsive checking and reassurance seeking subscales compared to White EWs., Conclusion: EWs experience higher rates of SI and stress than non-EW; and BIPOC EWs experience higher SI and stress than White EWs. Accessibility of support should be a priority for this group at high risk for both the physical and emotional burden of COVID-19., (© 2021 Wiley Periodicals LLC.)

This present study sought to examine how demographics and the availability of means for suicide converge to impact method selection between firearms and hanging, which are the two most lethal and commonly used methods for suicide in the United States. Data were collected as part of a larger online study that gathered information about suicide decedents and the circumstances around their death from family members and friends; the most common sources being parents, friends, and other family members. This study used data from those who died by suicide by firearm or hanging ( n  = 149); and was restricted to those who identified as male and white. The study examined if age, education, marital status, military affiliation, and firearm ownership impacted method selection. Results indicated that age and owning a firearm were associated with using a firearm in a suicide death. Additionally, those who used a firearm were significantly younger and more likely to own a firearm than those who used another method; and those who died by hanging were significantly younger than those who used another method. Findings from this study can be leveraged to improve the effectiveness of means safety efforts and create more personalised public health messages on firearm safe storage.

Objective: Physical, emotional, and sexual abuse are subtypes of childhood abuse that may persist into adulthood. This study applied latent class analysis to describe the pattern of co-occurrence of these three abuse subtypes during childhood and adulthood and examined latent class differences in psychosocial characteristics and three types of suicide attempt history (aborted, interrupted, and actual)., Methods: Data were drawn from a high-risk sample of 115 military service members and adult beneficiaries who were psychiatrically hospitalized following a suicide-related crisis., Results: Three latent classes were identified: Multiple and Persistent Abuse (Class One: 29.6%), Childhood Physical and Persistent Emotional Abuse (Class Two: 27.0%), and Minimal Abuse (Class Three: 43.5%). Females were more likely than males to report a history of Multiple and Persistent Abuse. After controlling for gender, the Multiple and Persistent Abuse Class had higher scores of depressive symptoms and hazardous drinking, poorer sleep quality, and increased social stress than the Minimal Abuse Class. Moreover, the Multiple and Persistent Abuse Class was associated with increased likelihood of lifetime interrupted suicide attempt (Odds Ratio [OR] = 3.81, 95% CI = 1.20, 12.07) and actual suicide attempt (OR = 3.65, 95% CI = 1.23, 10.85), and had the greatest number of total actual suicide attempt (1.82 times on average)., Conclusion: Co-occurrence of multiple subtypes of abuse across development is associated with higher psychosocial risk and history of suicide attempt. The assessment of specific subtypes of abuse and their timing may inform case conceptualization and the management of suicide risk among psychiatric inpatients., (Published by Elsevier Ltd.)

Objective: The present study sought to determine which painful and provocative events differentiated those with suicidal ideation from those who attempted suicide. Additionally, it presents a novel way of utilizing the Painful and Provocative Scale (PPES) by looking at items dichotomously as experienced or not experienced, instead of the frequency at which they are experienced., Method: Participants (N = 666) were recruited as part of a large online study seeking to understand suicide risk across multiple high-risk groups (i.e., veterinarians, military service members, transgender individuals, and gun owners) for suicide. Participants in the present study were predominately white, female, and heterosexual., Results: First, the PPES was examined as a dichotomous measure and results indicate that experiencing physical or sexual abuse, tying a noose, using intravenous drugs, or having injuries that required medical attention were associated with greater odds of attempting suicide; shooting a gun was associated with decreased odds. Next, the PPES was examined as a scale measure and findings indicate that increased exposure to rock climbing, experiencing physical or sexual abuse, or using intravenous drug were associated with increased odds of attempting suicide; while increased exposure to shooting a gun was associated with decreased odds., Conclusions: The present study adds to the literature on the ideation-to-action framework and provides evidence considering the frequency of experiences using the Painful and Provocative Event Scale may not provide substantial information beyond dichotomous scoring., (© 2021 The American Association of Suicidology.)

Importance: Firearm access is associated with risk for suicide, and, since early 2020, the US has experienced an unprecedented surge in firearm sales., Objective: To assess frequency of suicidal ideation among individuals who purchased firearms during the surge period (surge purchasers), other firearm owners, and non-firearm owners., Design, Setting, and Participants: Cross-sectional online survey data were collected from January to June 2021. Participants were recruited via quota sampling through Qualtrics Panels. Within Minnesota, zip codes from Minneapolis and St Paul were oversampled. Participants included 6404 US adults recruited from 3 states: New Jersey (n = 3197), Minnesota (n = 1789), and Mississippi (n = 1418). Participants identified as becoming a first-time firearm owner during the surge period, being an established firearm owner who purchased a firearm during the surge period, being a firearm owner who did not buy firearms during the surge period, and not owning firearms., Main Outcomes and Measures: The primary outcomes were lifetime, past year, and past month suicidal ideation as measured by the Self-injurious Thoughts and Behaviors Interview-Revised., Results: The mean (SD) age within the full sample was 44.81 (18.45) years, with 3132 males (48.8%), 4706 White adults (73.4%), 2674 reporting annual household income less than $50 000 (41.7%), and 1546 (24.1%) reporting current firearm ownership. In the full sample, individuals who purchased firearms during the surge period were more likely than were non-firearm owners to report lifetime suicidal ideation (odds ratio [OR], 2.21; 95% CI, 1.82-2.68), past-year suicidal ideation (OR, 2.10; 95% CI, 1.72-2.55), and past-month suicidal ideation (OR, 1.80; 95% CI, 1.41-2.29). In addition, among individuals who purchased firearms during the surge period, first-time owners were more likely than established firearm owners to report lifetime suicidal ideation (OR, 2.12; 95% CI, 1.43-3.14) and past-year suicidal ideation (OR, 2.37; 95% CI, 1.59-3.53). Results were largely consistent across states., Conclusions and Relevance: In this survey study, results highlighted that individuals who acquired firearms during the purchasing surge were more likely than other firearm owners and non-firearm owners to have experienced suicidal thoughts. This is particularly true for individuals who purchased a firearm for the first time during the surge period. This illustrates the need to implement policies and interventions that increase safety among firearm purchasers (eg, safe firearm storage) as well as those that promote the acquisition of alternative forms of protection (eg, home alarm systems).