Warning behaviors and leaked intent: Potential new avenues to prevent mass shootings.

On March 12, 2018, John Laubscher, owner of AJ's Archery in Nelson, NY, had a gut feeling and refused to sell a rifle to a Syracuse University student-disrupting a mass shooting (https://www.syracuse.com/crime/2018/04/how_gun_shop_owner_thwarted_on_the_edge_su_student_from_buying_high-capacity_rif.html. Accessed 10 Nov 2021). Prompted by this, we surveyed the opinions, beliefs, attitudes, and current practices of gun sellers in Onondaga County, NY, in regard to safe gun sales. The primary outcome was to determine which types of "concerning behaviors" are more likely to cause a seller to intervene in some manner. Secondary outcomes included the following: ascertaining the frequency of denials of customer purchases, frequency of reporting to law enforcement, and identifying any gaps that make it difficult for gun sellers to report behaviors to the authorities. Follow-up interviews were conducted with those who were willing to speak with the authors in more depth. A response rate of 12.9% was achieved. Sixty-two percent (62.5%) of respondents had some experience in uniformed services, with specialized training in mental or emotional crises, as well as deception detection. The majority found the training helpful in their gun selling career. Reasons for personal denials were reported as: "interest in illegal fittings," "information revealed during conversation," and "lack of basic knowledge of using the firearm looking to purchase." Two respondents stated that due to a lack of a "reporting protocol," they would not report any concerns to law enforcement. The study helps inform future research in regard to surveying more sellers across NY state and nationwide.

The primary care pediatrician's influence on medical student's performance of smoking assessments and counseling.

BACKGROUND: American medical schools lack significant educational programs for teaching medical students about counseling parents and children on smoking prevention and cessation. Thus, the objectives of this study were to describe medical student's self-reported behaviors in the assessment of parents and children's use of tobacco and to compare these practices with well-accepted pediatric activities: injury prevention and developmental assessment. METHODS: Third year medical students in a pediatric clerkship at Boston University, all of whom spend part of their clerkship with pediatricians in their offices, completed six weekly surveys (2001-2002) recording their clinical activities in counseling parents and children about smoking, injury prevention, and performing developmental assessments. RESULTS: Of the 150 third year students completing the pediatric orientation, 108 (72%) completed all six feedback surveys and the general cancer prevention survey. Of the 108 students, 77% completed smoking assessments with at least one family per week during their 6-week clerkship compared with performance of injury prevention (85%, P = 0.09) and developmental assessment (91%, P = 0.006). Among all smoking cessation and prevention recommendations, students were most likely to discourage parents from smoking in the house and least likely to offer tips for parents to counsel their children about smoking. All variables related to primary care pediatricians' role modeling and feedback for optimal tobacco counseling practices were significantly associated with student counseling practice. CONCLUSIONS: Third year medical students were less likely to complete smoking assessments than those for developmental assessment and injury prevention counseling. However, primary care pediatricians' strong expectations and modeling of smoking counseling were uniformly associated with improved self-perceived student performance. Future educational activities should engage the primary care pediatrician preceptors of students completing pediatric rotations.