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Background: Firearms are of special interest in trauma research due to high lethality and criminal value. Strong correlation between guns per capita and fire-arm related deaths has been shown. Most of existing literature regarding gun-shot fatalities are from the U.S. and data for Central Europe is lacking. Thus, the aim of this study was to assess the legal frameworks regarding gun-ownership in Germany (DE), Austria (A) and Switzerland (CH), and to retrospectively analyze data from the TraumaRegister DGU® regarding the epidemiology, injury severity, intention and outcome of gunshot-related deaths in these countries., Methods: All patients from TR-DGU who sustained a gunshot injury in the time period from 1st January 2009 to 31st December 2019 were considered for analysis. Only cases admitted to level 1 or 2 trauma center in Germany, Switzerland, or Austria were included. Predicted mortality was calculated using the RISC-II. Further, the legal framework for firearm posession were explored., Results: The legal frameworks do not differ significantly between the countries. However, only ex-military men from Switzerland are allowed to keep their automatic (military) weapon at home. We assessed 1312 gunshot fatalities (DE 1,099, A 111, CH 102) of which most were due to suspected suicide (A 72.1 %, CH 64.7 %, and DE 56.6 %, p = 0.003). Act of suspected violent crime or accidental gunshots were rare in all three countries. Amongst all gunshot fatalities, Austria showed the highest mean age (57.6 years), followed by DE (53.4 years) and CH (49.4 years; p < 0.01). Gunshot fatalities amongst all assessed countries due to suspected suicide showed a peak at the age of 60 years and above, whereas suspected violent crime delicts with gunshots were mainly seen in younger age groups. The highest mortality was found in suspected suicide cases, showing a mortality of 82.1 % (predicted 65.2 %) in Switzerland, 75.3 % (predicted 65.8 %) in Austria and 63.7 % (predicted 56.2 %) in Germany., Conclusion: Gunshot wounds are still rare in central Europe, but gunshot-related suicide rates are high. Gun ownership laws may have an impact on gunshot wounds due to suspected suicide. Injury patterns differ compared to countries where a high incidence of gun ownership is seen., Competing Interests: Declaration of competing interest 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., (Copyright © 2024. Published by Elsevier Ltd.)

The reform of rural collective property rights is pivotal in advancing agricultural modernization and comprehensive rural revitalization. This study aims to explore the impact of this reform on income growth and poverty reduction in rural areas, as well as its underlying mechanisms. Utilizing data from the China Rural Revitalization Survey (CRRS), the propensity score matching (PSM) method was employed to empirically analyze the effects of rural collective property rights reform on income growth and poverty reduction. The findings reveal that the reform has a significant positive impact on rural income levels, indirectly enhancing income through two channels: increasing village collective assets and promoting land transfer. Additionally, the reform has a significant negative impact on rural poverty levels, effectively alleviating poverty in rural areas. Heterogeneity analysis further reveals the differential effects of property rights reform, indicating that non-poor villages, villages with higher educational levels among village leaders, and rural areas in the western regions benefit more from the reform. This study provides precise evidence for policymakers, offering a scientific basis for deepening rural collective property rights reform, promoting income growth, and fostering sustainable rural development., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Xiang et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Introduction: Firearm-related suicides among children present a significant public health concern and a tragic loss of young lives. This study explores the relationship between firearm-related suicides, gun ownership, and state-specific gun laws., Methods: This retrospective cohort study collected data from the Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research on children under 18 who died by firearm-related suicides between 2009 and 2016 in all 50 states and D.C. It also utilized data from the RAND State-Level Estimates of Household Firearm Ownership. The study focused on the rate of child firearm suicide deaths per 100,000 individuals. The key variable of interest was the percentage of guns owned per household in each state. Univariable analysis was conducted to examine the association between individual gun laws and child firearm suicide mortalities, while multivariable regression, adjusting for household gun ownership and significant firearm legislation, was employed to assess connection to child firearm suicide mortality., Results: From 2009 to 2016, 3903 children died from firearm-related suicides in the United States. In our analysis, 15 out of 44 firearm laws were found to be associated with reducing the rates of firearm suicides among children (P < 0.05). However, multivariable regression showed that higher state gun ownership rates were the primary predictor of increased child fatalities from firearms, with children in such states being 325% more likely to die when analyzing handgun laws and 337% more likely when analyzing long gun laws, as indicated by coefficients of 4.25 and 4.37, respectively. No state laws alone notably improved death rates., Conclusions: Gun ownership has a stronger association with child suicide rates than state-specific gun laws. Given the weight of gun ownership, future research should prioritize comprehensive public health initiatives to prevent child firearm-related suicides., (Copyright © 2024. Published by Elsevier Inc.)

Laws regulating exotic animal ownership vary throughout the world. While some differences regarding the legal status and use of exotic companion animals are associated with cultural differences and public perception, some differences may result in different outcome, which could be of interest for other parts of the world. This article provides a general overview of relevant laws pertaining to exotic companion animals in certain developed countries., Competing Interests: Disclosure The authors have nothing to disclose., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Introduction: Firearms now represent the leading cause of death in U.S. children. Therefore, this study aimed to determine if state-level rates of gun ownership, guns in circulation, and strictness of firearm-related laws are related to firearm-related mortality among both juveniles and overall populations., Materials and Methods: State firearm mortality rates among the juvenile and overall populations were obtained from 2010 to 2020. The number of weapons registered with the Bureau of Alcohol, Tobacco, Firearms, and Explosives (ATF) and federal firearms licensees for each state were also recorded. Giffords Law Center Scorecard Rankings, a relative measure of the restrictiveness of each state's gun laws, were also collected. Unadjusted linear regressions modeled the relationships between firearm-associated mortality and ATF-registered weapons, federal firearm licensees, Giffords Center rankings, and gun ownership rates. Multivariable (adjusted) analyses were performed to control for poverty, unemployment, and poor mental health., Results: Unadjusted analyses demonstrated that higher gun ownership rates and more lenient gun laws were associated with increased firearm-associated mortality among juveniles. Similarly, these measures as well as increased ATF-registered weapons and ATF federal firearm licensees were associated with increased firearm mortality in the overall population. In the adjusted analyses, more ATF-registered weapons, more ATF federal firearm licensees, higher gun ownership rates, and more lenient firearm laws were associated with increased firearm-related mortality in the overall population, while increased gun ownership and higher Giffords Center rankings were associated with increased firearm-associated mortality in the pediatric population., Conclusions: To reduce the toll of gun violence in the United States, policymakers should focus on implementing more restrictive firearm laws and reducing the prevalence of guns in their communities., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Importance: Extreme risk protection orders (ERPOs)-also known as red flag, risk warrant, and gun violence restraining orders-authorize law enforcement, family members, and sometimes others to petition a court to remove firearms from and prevent the acquisition of new firearms by a person judged to pose an immediate danger to themselves or others. Previous estimates suggest that 1 suicide is prevented for every 10 ERPOs issued, a number needed to treat that depends critically on the counterfactual estimate of the proportion of suicidal acts by ERPO respondents that would have involved firearms in the absence of ERPOs., Objective: To empirically inform updated estimates of the number of ERPOs needed to prevent 1 suicide., Design, Setting, and Participants: This cohort study used data from California for method-specific suicides by handgun ownership (October 18, 2004, to December 31, 2015). Handgun-owning suicide decedents in California were identified using individual-level registry data about lawful handgun ownership linked to cause-specific mortality for a cohort of more than 25 million adults. The study also used data from Connecticut for method-specific suicides among ERPO respondents who died by suicide, extracted from published data (October 1999 to June 2013). Data analysis was performed in December 2023., Exposure: Handgun ownership., Main Outcomes and Measures: The primary outcomes were the number and distribution of suicidal acts by handgun owners in California, estimated using method-specific suicide mortality data and published case fatality ratios, and the counterfactual number and distribution of suicidal acts and deaths among ERPO respondents in Connecticut had no ERPOs been issued., Results: A total of 1216 handgun owners (mean [SD] age, 50 [18] years; 1019 male [83.8%]) died by suicide during the study period. Among male handgun owners in California, 28% of suicidal acts involved firearms, 54% involved drug poisoning, 9% involved cutting or piercing, 3% involved hanging or suffocation, 2% involved poisoning with solids and/or liquids, and the remaining 4% involved other methods. Assuming this distribution approximates the counterfactual distribution among ERPO respondents in Connecticut in the absence of ERPOs, 1 suicide death was prevented for every 22 ERPOs issued., Conclusions and Relevance: The estimates produced by this cohort study of California handgun owners suggest that ERPOs can play an important role in averting deaths among high-risk individuals.

Introduction: The United States (US) holds the highest personal firearm ownership among industrialized nations, with implications for firearm-related deaths tied to increased per capita gun ownership and varying gun laws. This study examines the influence of gun law strength on legal firearm transactions, positing a correlation between stronger laws and reduced transactions. The analysis, focused on the stress-laden COVID-19 pandemic, evaluates handgun, long gun, and multiple gun transactions in 2020 and 2021 compared to 2018-2019., Methods: The Giffords Gun Law scorecard categorized states into the top 25 "strong" and bottom 25 "weak" gun law groups. Multivariate linear regressions assessed the association between strong gun law states and monthly National Instant Criminal Background Check System (NICS) data from 2018 to 2021. The study queried NICS for handgun, long gun, and multiple gun transactions, comparing median monthly transactions in 2018 and 2019 to 2020 and 2018-2020 to 2021., Results: When evaluating gun law strength through multivariate linear regression models, stronger gun law states had fewer monthly NICS transactions for handguns, long guns, and multiple guns in 2020 and 2021 versus all comparison years (all P < .05). However, from 2018-2019 to 2020 and 2018-2020 to 2021, median monthly NICS transactions per 100,000 people for all gun types increased (all P < .05)., Conclusion: Stricter gun laws correlated with decreased firearm transactions in stronger law states, yet handgun, long gun, and multiple gun transactions increased during the pandemic years of 2020 and 2021. Therefore, strengthening firearm legislation may be protective against the proliferation of firearms, which warrants further research., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

The push towards research commercialisation at universities has highlighted the importance of intellectual property (IP) policies in fostering innovation and guiding and managing research commercialisation activities. This paper undertakes a content analysis of intellectual property policies of all (37) Australian public universities, focusing on policy objectives, definition of IP, ownership of IP created by different creators, and distribution of net commercialisation revenues. It is found that all universities assert ownership over staff-created IP, particularly when related to employment or utilisation of university resources. For students, policies tend to balance their rights with university interests, with nuanced approaches for different types of student participation, but the focus of most policies was on postgraduate students engaging in research activities. While some policies had clear arrangements for IP created by visitors and affiliates and Indigenous cultural and intellectual property (ICIP), about a quarter of policies did not specify arrangements for these groups. Revenue sharing arrangements vary but generally award something between a third to a half of net revenue to creators, to both acknowledge their contribution and incentivise further innovation. Policies included a broad spectrum of objectives, from protecting and commercialising IP to fostering innovation and societal benefit, reflecting varying strategies across the higher education sector. Policies could benefit from further clarity in certain areas such as the rights of students or other creator groups. Research is needed to assess the effectiveness of these policies and their influence on innovation and commercialisation activities., Competing Interests: The author has declared that no competing interests exist., (Copyright: © 2024 Hamid R. Jamali. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Dental Service Organizations (DSOs) are an increasingly visible and available practice option for new dental graduates. While guidance has been published to help dental students make informed decisions when considering a DSO affiliation, they have not focused on the complexities of assessing compliance with controlling state laws. Accordingly, this Perspectives article provides a concise summary of the common components of state regulatory provisions across the United States to support an understanding of the corporate practice of dentistry and compliance considerations. The guiding principles to consider include ownership or proprietorship of and control over a dental practice; control over dental offices, equipment, and materials; employment of dental personnel; and control over clinical judgment. This article should be helpful to students who are considering a DSO affiliation and educators who prepare them to enter dental practice., (© 2024 American Dental Education Association.)

Breed-Specific Legislation is a type of law that bans or restricts ownership of specific dog breeds. Some local governments - including over seventy municipalities in the state of Missouri - have enacted Breed-Specific Legislation to prevent injuries from dog bites. Several studies from the peer-reviewed literature have found that aggressive behavior is not associated with any particular dog breeds and, since 2018, at least a dozen municipalities in Missouri have repealed these laws. To evaluate the impact of Breed-Specific Legislation on public safety, the 2010-2015 rates of emergency department visits for dog bite-related injuries in Missouri municipalities with and without Breed-Specific Legislation were compared. Propensity-score matched negative binomial regression models were used to assess the effect of breed restrictions on injury rates while balancing the samples on population characteristics and estimates of dog ownership. After matching the sample on population, housing and dog ownership estimates, no association was found between emergency department visits for dog bite injuries and whether the municipality enacted Breed-Specific Legislation. However, the incidence rate ratio of emergency room visits for dog bite-related injuries increased by 13.8% for every 1% increase in the percentage of males aged 5 to 9 in the population ( p < 0.01). This study has found breed discriminatory laws have not reduced the risk of emergency department visits for injury from dog bites in Missouri. There appears to be no greater risk to public safety as local governments move to repeal existing breed bans., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Wyker and Gupta.)

This article proposes ethical - and legal - accountability for lawyers representing clients such as private equity (PE) firms who create ownership structures for nursing home systems. Using PE ownership as a case study, I will show that nursing home residents are often harmed and Medicaid costs inflated. I propose private law provides tools to compel such accountability, through (1) aiding and abetting doctrines and (2) fiduciary doctrines that require that the fiduciary be responsible for its vulnerable beneficiaries, not just ethically but for damages and equitable relief. I further propose that the teaching of Professional Responsibility needs to be changed to force law students to consider the effect of legal practice on third parties in situations like health care financing.

Montana, Alaska, and Wyoming lead the United States in a category coveted by no one: the suicide rate. Firearm ownership drives the rate to the disproportionate level it reaches year after year and the states are left with little recourse. This article argues the usefulness and constitutionality of narrowly tailored red-flag laws aimed exclusively at reducing the rate of suicide in these mountain states. The article follows Supreme Court jurisprudence leading up to New York Rifle and Pistol Association v. Bruen and offers an analysis that complies with the hyper textualist history and tradition test laid out by Scalia in District of Columbia v. Heller and McDonald v. City of Chicago. The analysis demonstrates that narrowly tailored red flag laws are a constitutional means of reducing the suicide rate in these at-risk states and references statutory and cultural avenues for the implementation of the legislation., (Copyright by Cleveland State University.)

Commentators discussed the coherence and validity of a minimalist approach to ownership intuitions, in ways that make it possible to clarify the model, re-evaluate its cognitive underpinnings, and sketch some of its implications. This response summarizes the model; addresses issues concerning the need for a special technical lexicon when describing cognitive semantics; the psychology involved in contexts of competitive acquisition and their consequences for possession and use of rival resources; the role of cooperative expectations in creating mutually beneficial allocation of resources; the consequences of ownership psychology for social interaction and the production of social norms of property; and the relations between psychological processes and legal institutions in the domain, before proposing some final thoughts.

Importance: Given the dangers that firearms in the home pose to children, it is critical to engage parents in effective firearm safety counseling. This requires a broader understanding of how the presence of children in the home is associated with motivations surrounding gun ownership., Objective: To examine the association of having children in the home and gun owners' attitudes and beliefs., Design, Setting, and Participants: This cross-sectional survey study analyzed data from the National Lawful Use of Guns Survey conducted in 2019. A representative sample of 3698 adult gun owners nationwide were randomly invited to participate, with a 56.5% survey response rate. Survey responses were weighted to account for survey nonresponse and selection bias, and comparison groups were matched by age. Statistical analysis was performed in 2020., Main Outcomes and Measures: Reasons for gun ownership, symbolic meaning of guns, and attitudes toward gun policies., Results: Of the 2086 respondents, 383 (18.4%) had children in the home, 68.7% (95% CI, 66.4%-71.0%) were male, 8.2% (95% CI, 6.8%-9.7%) were Black, 76.3% (95% CI, 73.8%-78.6%) were White, 79.4% (95% CI, 77.5%-81.2%) were living in metropolitan areas, 51.3% (95% CI, 48.9%-53.8%) identified as Republican; 34.7% (95% CI, 32.6%-36.9%) were aged 60 years or older. Despite the majority of respondents feeling safe in their local communities (respondents with children: 93.4% [95% CI,: 89.3%-96.0%]; without children: 88.9% [95% CI, 87.0%- 90.6%]), 92.3% (95% CI, 87.0%-95.6%) of respondents with children stated the primary reason for gun ownership was to protect their family, compared with 68.6% (95% CI, 65.2%-71.8%) of respondents without children. On logistic regression analysis, having children in the home remained an independent factor associated with reasons for gun ownership. Gun owners with children were more likely than those without children to feel that guns make them feel more valuable to their family (23.5% [95% CI, 18.9%-28.8%] vs 17.0% [95% CI, 15.0%-19.2%]). Among those with children, 35.2% (95% CI, 30.0%-40.8%) believed gun laws should be more strict compared with 40.7% (95% CI, 38.1%- 43.3%) of those without children., Conclusions and Relevance: These findings suggest that acknowledging parental motivations for gun ownership is a pivotal component of educational efforts toward firearm injury prevention. These findings can guide clinicians to engage in effective individual counseling and community level efforts to reduce pediatric gun injuries.

Our research goal was to investigate the primate pet trade in the United States. While dogs and cats are the most common type of pet, there are an estimated 15,000 pet primates in the United States and the demand for exotic pets in general has been rising. Most research on pet primates occurs in habitat countries and little is known about these pets in the United States. We collected data from six exotic pet-trade websites twice a month for 12 months. We recorded the type of primate for sale, sex, age, location, and price. We used Chi-Square Goodness-of-Fit tests to compare whether the number of male and female pet primates for sale and the number of different age categories of pet primates for sale differed from equality and Spearman Correlation to examine associations between price and size and price and supply. We recorded 551 pet primates for sale between June 2019-June 2020, with 69.1% platyrrhines, 21.6% strepsirrhines, and 8.9% catarrhines. Marmosets were sold most often (36.7%, N = 202) followed by lemurs (21.6%, N = 119), capuchins (11.3%, N = 62), and squirrel monkeys (10.5%, N = 58). Almost two-thirds of the pet primates for sale were male (Chi-Square = 16.056, df = 1, P = 0. 00006) and 78.7% were under one year old (Chi-Square = 440.264, df = 2, P<0.00001). The median price was $3,800 though price was highly variable, even for the same taxa. There are several potential drivers for the primate pet trade, including media influence, fashion/status, and profitable breeding though these are not mutually exclusive. Primates do not make good pets and even when captive-bred, pet primates impact the conservation of their wild counterparts. Advertisement campaigns focusing on disease transmission and legal consequences and a federal ban on pet primate ownership are two avenues to pursue to end the ownership of pet primates in the United States., Competing Interests: The authors have declared that no competing interests exist.

Intimate partner violence (IPV) affects 30% of ever-partnered women worldwide. This study demonstrates how stronger female marital property rights can lead to lower levels of IPV. If women are financially protected outside of marriage, they in turn experience lower levels of violence inside marriage. Using a natural experiment from the colonization of Sub-Saharan Africa, this study aims to isolate the direct effect of large-scale changes to women's property rights from other IPV risk factors. The findings show that more equitable marital property rights could both reduce the incidence of IPV and also increase women's own condemnation of the violence. The empirical estimates suggest that legal property reform could render at least 12 million women less vulnerable to IPV across Sub-Saharan Africa., (© 2021. The Author(s), under exclusive licence to Springer Nature Limited.)

Background: The Dangerous Dogs Act (DDA) is considered among the most controversial pieces of legislation ever passed in the UK. Its effectiveness and how it works in practice, up until a dog and its owner are charged, has been subjected to considerable analysis. However, there has been little examination of how the DDA works after charging, nor of how courts are interpreting it., Method: We accessed legal cases from 1992 to 2019, the period in which the DDA has been in force. Each case was examined from a legal and ethical perspective, using doctrinal legal methodology and the principlism approach to ethics described by Beauchamp and Childress., Results: Analysis showed that while improvements to the function of the act have been made, substantial legal and ethical failings remain, particularly with Section 1 and the therein breed specific legislation (BSL)., Conclusion: Legal failings could be partially resolved by removing the reversed burden of proof placed on dog owners and allowing a change of ownership for banned breeds. However, ethical failings could only be resolved through the abolition of BSL. Further study into whether judicial bias exists against certain breeds found to be dangerously out of control is warranted., (© 2021 The Authors. Veterinary Record published by John Wiley & Sons Ltd on behalf of British Veterinary Association.)

The impact of protected areas on local communities is the subject of intense discussions as part of the implementation of the global ecosystem protection agenda. Conflicts between the interests of environmental protection and the needs of socio-economic development become particularly acute when large areas of land are taken out of economic circulation as a result of organizing protected areas. In this case, there is an urgent need for detailed and reliable information about the social impacts of such land withdrawal on the well-being of the local population. An analysis of the methodological approaches widely presented in the literature, used to assess the social impact of protected areas, testifies to the insufficiency of completed and practically applicable methodological guidelines for the areas with significant restrictions for people who form part of the protected landscape. In this study, we understand the cost estimate of the social impact of national parks on the local population as a quantitative calculation of the losses due to restrictions on their ownership rights to land and property assets. The methodological approach consists in considering the category of losses as a sum total of the actual damage and lost profits. The assessment algorithm includes three stages: systematization of social impacts on citizens, development of indicators and data collection, and calculation of actual damage to the population and lost profits. The assessment is performed using the example of the Tunkinsky National Park located in the Tunkinsky municipal district of the Republic of Buryatia, a region of the Russian Federation, where there are 14 rural settlements with a population of more than 20,000 people. The results of the calculations show that the losses of the rural population due to legal restrictions on the registration of land dealings amount to 170.4 million USD. Taking into account the potential amount of administrative fines and the value of property subject to demolition, the losses amount to 239.2 million USD. It is more than an order of magnitude greater than the amount of own revenues of the Tunkinsky municipal district in 2011-2019. The results obtained demonstrate the real picture of the impact of restrictions on the rights of local people to land within the boundaries of national parks and are useful for developing measures to account for their interests and include protected areas in the socio-economic development of regions. The methodological approach developed by the authors can be used in other national parks, where it is necessary to optimize the policy of improving land use for local residents., Competing Interests: The authors have declared that no competing interests exist.

This first-of-its-kind national survey of 485 psychiatrists in nine states and the District of Columbia (DC) finds substantial evidence of clinicians being uninformed, misinformed, and misinforming patients of their gun rights regarding involuntary commitments and voluntary inpatient admissions. A significant percentage of psychiatrists (36.9%) did not understand that an involuntary civil commitment triggered the loss of gun rights, and the majority of psychiatrists in states with prohibitors on voluntary admissions (57%) and emergency holds (56%) were unaware that patients would lose gun rights upon voluntary admission or temporary commitment. Moreover, the survey found evidence that psychiatrists may use gun rights to negotiate "voluntary" commitments with patients: 15.9% of respondents reported telling patients they could preserve their gun rights by permitting themselves to be voluntarily admitted for treatment, in lieu of being involuntarily committed. The results raise questions of whether psychiatrists obtained full informed consent for voluntary patient admissions, and suggest that some medical providers in states with voluntary admission prohibitor laws may unwittingly deprive their patients of a constitutional right. The study calls into question the fairness of state prohibitor laws as policy, and - at minimum - indicates an urgent need for psychiatrist training on their state gun laws.

Intimate partner violence (IPV) is a major threat to women's safety and well-being worldwide. Firearms heighten this threat by increasing the morbidity and mortality of IPV. This paper focuses on the United States, a nation with high rates of IPV alongside high rates of gun ownership. The United States has implemented several policy approaches to reduce the harmful role that firearms play in IPV by limiting access to firearms for IPV offenders. One such law prohibits persons under Domestic Violence Restraining Orders (DVROs) from purchasing or possessing firearms or ammunition. Although DVRO firearm prohibitions can reduce the risk of firearm-related injury and homicide associated with IPV, implementation and enforcement of these laws at regional and local levels is challenging and variable. We discuss implications for DVRO research, policy, and practice as part of a comprehensive approach to prevent and reduce firearm-related IPV.

The evolving healthcare landscape creates unique challenges for private practitioners. They experience the same issues that face physicians in general - including increased regulatory/documentation burdens and downward financial pressures - but without the safety nets that exist in larger healthcare systems. Costs are born more directly, as there are fewer providers over which to spread expenditures. Financial reserves are less robust, making margins thinner to maintain profitability. Guaranteed referral streams are absent, requiring additional effort and creative solutions to maintain patient volume. As hospital systems expand, private practitioners must remain nimble, while maintaining excellent service and outcomes, in order to stay ahead., Competing Interests: Disclosure The authors have nothing to disclose., (Copyright © 2020 Elsevier Inc. All rights reserved.)

Objective: To assess whether there are differences in support for handgun purchaser licensing., Methods: We used data from four waves of online, national polling on gun policy. To estimate differences in support for licensing across groups, we categorised respondents by whether they personally owned a gun, lived in a state with handgun purchaser licensing or lived in a state regulating private sales without a licensing system., Results: Eighty-four per cent of adults living in states with licensing supported the policy compared with 74% in states without the law (p<0.001). Seventy-seven per cent of gun owners living in states with licensing supported the policy vs 59% of gun owners in states without licensing (p<0.001)., Conclusions: Support for licensing among gun owners living in states with these laws, many of whom have presumably gone through the process, was much higher than gun owners in states without such laws., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: The progress of electronic health technologies and biobanks holds enormous promise for efficient research. Evidence shows that studies based on sharing and secondary use of data/samples have the potential to significantly advance medical knowledge. However, sharing of such resources for international collaboration is hampered by the lack of clarity about ethical and legal requirements for transfer of data and samples across international borders., Main Text: Here, the International Clinical Trial Center Network (ICN) reports the legal and ethical requirements governing data and sample exchange (DSE) across four continents. The most recurring requirement is ethical approval, whereas only in specific conditions approval of national health authorities is required. Informed consent is not required in all sharing situations. However, waiver of informed consent is only allowed in certain countries/regions and under certain circumstances. The current legal and ethical landscape appears to be very complex and under constant evolution. Regulations differ between countries/regions and are often incomplete, leading to uncertainty., Conclusion: With this work, ICN illuminates the unmet need for a single international collaborative framework to facilitate DSE. Harmonising requirements for global DSE will reduce inefficiency and waste in research. There are many challenges to realising this ambitious vision, including inconsistent terminology and definitions, and heterogeneous and dynamic legal constraints. Here, we identify areas of agreement and significant difference as a necessary first step towards facilitating international collaboration. We propose the establishment of a working group to continue the comparison across jurisdictions, create a standardised glossary and define a set of basic principles and fundamental requirements for DSE.

Mandatory background checks on firearm purchasers receive widespread support from the general public and firearm owners. Background checks appear to reduce the risk of violence substantially among prohibited persons whose purchases are denied. However, population-level studies, including studies of comprehensive background check policies, have often shown no clear evidence of benefit. There is one notable exception: Permit-to-purchase policies have consistently been associated with beneficial population-level effects. The findings of no benefit may in part be an artifact of history, as the completeness of the data on which background checks are run has improved substantially since the periods examined by those studies. Nonetheless, significant problems with implementation and design still limit the population-level effectiveness of background check policies. In this article I review nine of these problem areas and suggest actions that could substantially improve the effectiveness of background check policies in preventing firearm-related violence.

Gun policy is a prominent topic of debate in the 2020 US election cycle. Tracking evolving public attitudes about gun policy is critical in this context. Using data from the National Survey of Gun Policy fielded in 2013, 2015, 2017, and 2019 by the Johns Hopkins Center for Gun Policy and Research, we examined trends in support for more than two dozen gun policies over time by gun ownership status and political party affiliation, and across states. Most policies that we considered had majority support across the study period. We identified increases in public support over time for licensing and universal background checks of handgun purchasers, stronger regulation of gun dealers, and extreme risk protection orders. Gun owners and non-gun owners were highly supportive of requiring tests to demonstrate safe handling before carrying a concealed weapon, but there were large differences in support for other concealed carry policies by gun ownership status. A new item included in the 2019 survey showed that 84 percent of Americans supported requiring first-time gun purchasers to take a safety course. While gun policy continues to be characterized as highly polemical, large majorities of both gun owners and non-gun owners strongly support a range of measures to strengthen US gun laws.

This paper outlines a novel application of the social ecological model (SEM) for firearm suicide prevention. It focuses on four levels of intervention (societal, relationship, community and individual) to reduce access to firearms, a practical contributor to the capacity to attempt suicide, from individuals when they are at an elevated risk for suicide. There is substantive research linking easy access to firearms with an increased risk of firearm suicide, and suicide prevention interventions that address access to lethal means are critical components of a comprehensive suicide prevention strategy. Potential interventions using the SEM framework include: at the policy level-extreme risk laws, voluntary self-prohibition policies and policies that reduce the availability of firearms; at the community level-gun shop projects; at the relationship level-lethal means safety counselling; and at the individual level-safer storage. Taken together with upstream interventions, such as increased access to mental health services and substance use treatment, a multilevel approach for suicide prevention that addresses access to firearms can save lives., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2019. No commercial re-use. See rights and permissions. Published by BMJ.)

Background and Objective: This project links population data to the Wisconsin Violent Death Reporting System (WVDRS) to determine the extent to which firearm possession criteria are being followed as well as the potential impact of the adoption of proposed possession criteria., Design and Study Population: Criminal justice data for WVDRS homicide suspects and victims and suicide decedents 2008-2011 and a sample of matched control group of driver's license holders (to characterise the state population) will be abstracted., Methods: Individual legal possession statuses (prohibited/not prohibited) under each current and expanded criterion will be determined. Proportions of interest will be calculated from two-way contingency tables, and tests between groups with categorical variables (eg, criterion is met or not) will be performed with Fisher's exact or binomial proportion tests. Tests between groups with continuous variables (eg, number of misdemeanours) will be performed by zero inflated negative binomial regression. Area under the receiver operating characteristic curve will be used to quantify the prediction accuracy of specific univariate or multivariate logistic model for prediction. Inverse probability weighting will be used for analyses that extend from matched controls to the general state population of license holders., Discussion: Linked data sets and partnerships are challenging, but necessary for comprehensive public health research. Results of this study will contribute knowledge on the proportion of prohibited suspects and suicide decedents that used firearms in violent deaths and, if applying expanded criteria would have increased prohibited persons. This study will also investigate risk and protective factors for being a victim of homicide., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2019. No commercial re-use. See rights and permissions. Published by BMJ.)

The effectiveness of laws depends on circumstances affecting their enforcement. To assess such circumstances for comprehensive background check (CBC) and straw purchase laws for firearm sales, we examined prosecutions for CBC and straw purchase violations in Pennsylvania and CBC violations in Maryland. We generated pre-post variables and conducted t-tests to assess differences in the mean number of prosecutions filed following changes to the legal environments. The annual number of prosecutions for straw purchase violations increased significantly in Pennsylvania following the passage of a law that strengthened penalties for these violations (difference in means = +1310.86, P=0.003). The annual number of prosecutions for CBC violations decreased significantly in Maryland following a court decision that narrowed the definition of a firearm transfer making enforcement more difficult (difference in means = -20.52, P=0.026). Our findings suggest enforcement is likely influenced by the penalties associated with violating these laws and the interpretation of the language of the laws., Competing Interests: Competing interests: None declared., (© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2019. All rights reserved. No commercial use is permitted unless otherwise expressly granted.)

The USA is unique among industrialized nations in its dramatic rate of firearm violence. Unfortunately, firearm-related issues in America are politically divisive and fraught with controversy, thus impeding the study and implementation of safety strategies. Despite the lack of consensus, there is agreement that firearms should be kept away from individuals with criminal intent and those who are dangerous due to medical impairment. While predicting criminal intent remains challenging, assessment of medical impairment remains a viable target. One approach in which physicians could contribute their expertise includes training a subset of doctors to perform specialized medical evaluations as a prerequisite for gun ownership. Such a process is not unprecedented, as physicians currently have a role in protecting the public's safety through assessments for commercial drivers, pilots, and train operators. Certified physician examiners could conduct these evaluations with a focus on evaluating objective, skill-based metrics to limit potential evaluator bias. The results of the medical evaluation would then be considered by an existing regulatory body to determine if disqualifying criteria are present. This proposal provides a mechanism for trained physicians to meaningfully participate in addressing an alarming public health issue, while still working within existing legal frameworks.

Is it time to identify which mammals make suitable pets? Josh Loeb and Alexia Yiannouli report., (British Veterinary Association.)

Objectives. To estimate the number of lives saved from firearms suicide with expansions of gun restrictions based on mental health compared with the number who would be unnecessarily restricted. Methods. Agent-based models simulated effects on suicide mortality resulting from 5-year ownership disqualifications in New York City for individuals with any psychiatric hospitalization and, more broadly, anyone receiving psychiatric treatment. Results. Restrictions based on New York State Office of Mental Health-identified psychiatric hospitalizations reduced suicide among those hospitalized by 85.1% (95% credible interval = 36.5%, 100.0%). Disqualifications for anyone receiving psychiatric treatment reduced firearm suicide rates among those affected and in the population; however, 244 820 people were prohibited from firearm ownership who would not have died from firearm suicide even without the policy. Conclusions. In this simulation, denying firearm access to individuals in psychiatric treatment reduces firearm suicide among those groups but largely will not affect population rates. Broad and unfeasible disqualification criteria would needlessly restrict millions at low risk, with potential consequences for civil rights, increased stigma, and discouraged help seeking.

Some fundamental biotechnologies hold unprecedented potential to eradicate many incurable diseases. However, in absence of regulations, the power of patent makes the future use of some important biotechnology in few institution's hands. The excessive patents restrict researcher access to the fundamental technologies. It generates concerns and complaints of deteriorating the public health and social welfare. Furthermore, intellectual curiosities, funding, respect among colleagues etc., rather than patents, are the real motivations driving a major ground-breaking discoveries in biotechnology. These phenomena reveal that some biotechnology patents are alienated from the purpose of patent system. Therefore, it is necessary to take some approaches to stop over-patenting these fundamental biotechnology inventions. This article proposes a model regulatory framework for controlling biotechnology patent alienating from the purpose of patent system.

Firearm legislation is associated with statewide suicide rates; however, prior research has often relied upon older data and categorical legislative grades while also failing to consider the nuanced role of firearm ownership. Therefore, the robust literature base on legislation and suicide has not directly examined regarding the extent to which the value of legislation hinges upon the rate of firearm ownership in a given state. The current study examined 2015 US statewide firearm legislation strength scores from Giffords Law Center to Prevent Gun Violence and 2016 statewide suicide rates from the Centers for Disease Control and Prevention. Firearm legislation strength was inversely associated with statewide overall and firearm suicide rates, but not with non-firearm suicide rates. Firearm ownership rates moderated the association between firearm legislation strength and statewide overall suicide rates. Specifically, firearm legislation strength was inversely associated with statewide overall suicide rates at mean and high levels of firearm ownership. Findings support the potential utility of firearm legislation as part of a national effort to decrease US suicide deaths, particularly in areas with higher firearm ownership rates., (© 2019 John Wiley & Sons, Ltd.)

Introduction: Firearm safety instructors and public health professionals are natural allies in the quest to prevent firearm injuries. We audited basic firearm classes to provide information that can help familiarise public health professionals and others with the content covered., Methods: With the advice of expert instructors, we created an audit form. Volunteers audited 20 basic firearm classes in seven north-eastern states., Results: All trainers covered a wide variety of safety issues. Some specific basics were covered in 90+% of the classes, including how to safely load/unload a gun, keeping your finger off the trigger until ready to shoot, and being aware of your target and what is behind it. In 50%-75% of the classes, the trainer covered topics such as operating a safety, clearing jams and cartridge malfunctions, and recommended storing guns unloaded and locked when not in use. Few instructors covered firearm suicide prevention (10%) or domestic violence (10%). Most encouraged gun ownership, gun carrying, gun use in self-defence and membership in a gun rights group., Discussion: From a public health standpoint, we would like to see more instructors covering topics such as firearm suicide and alternatives to gun use in self-defence, and to recommend safer storage of firearms., Competing Interests: Competing interests: None declared., (© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2019. All rights reserved. No commercial use is permitted unless otherwise expressly granted.)

Gun violence has increased in Mexico since the mid-2000s, but little is known about patterns of gun ownership. We examine the size and composition of the privately held urban firearm stock in Mexico, motivations for ownership, and attitudes about gun laws. To this end, a household telephone survey of 1361 adults living in nine Mexican cities was conducted in the summer of 2017. We find that few urban Mexican households contain guns. Most of those who report ownership possess one gun, having purchased it recently for self-defense. Few urban Mexican citizens plan to purchase a gun in the future. Respondents are more likely to believe that crime in Mexico would increase if guns were allowed in more places (ie, workplaces and motor vehicles). Evidence suggests urban Mexico has relative low rates of firearm ownership. Few city dwellers plan on obtaining a firearm in the near future., Competing Interests: Competing interests: None declared., (© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2019. All rights reserved. No commercial use is permitted unless otherwise expressly granted.)