'Whether it's your weapon or not, it's your home': US military spouse perspectives on personal firearm storage.

INTRODUCTION: In the USA, an estimated 45% of veterans personally own firearms. Firearm access increases the risk of suicide, so suicide prevention efforts in the US Department of Defense (DoD) focus on lethal means safety, including reducing firearm access. Spouse input may enhance effective messaging and intervention delivery of lethal means safety. This study used qualitative methods to explore the perspectives of military spouses or partners on personal firearm storage, including at-home decisions, on-base storage and existing messaging from the DoD. MATERIALS AND METHODS: Qualitative data were obtained using 1:1 interviews and focus groups with spouses/partners of US military service members (active duty, Reserve, National Guard, recently separated from the military) and representatives from military support organisations. Sessions focused on personal firearm storage (at home or on military installations) and military messaging around secure firearm storage and firearm suicide prevention. Data were analysed using a team-based, mixed deductive-inductive approach. RESULTS: Across 56 participants (August 2022-March 2023), the themes were variability in current home firearm storage and spousal participation in decision-making; uncertainty about firearm storage protocols on military installations; mixed awareness of secure firearm storage messaging from the military; and uncertainty about procedures or protocols for removing firearm access for an at-risk person. CONCLUSION: US military spouses are important messengers for firearm safety and suicide prevention, but they are currently underutilised. Tailored prevention campaigns should consider spousal dynamics and incorporate education about installation procedures.

Suicide-Specific Training Experiences and Needs Among Military Mental Health Providers.

BACKGROUND: Military suicide rates have risen over the past two decades, with a notable spike in recent years. To address this issue, military mental health providers must be equipped with the skills required to provide timely and effective care; yet little is known about the suicide-specific training experiences or needs of these professionals. METHODS: Thirty-five mental health care providers who treat active duty personnel at military treatment facilities participated in this mixed-methods study. All participants completed a survey assessing training and clinical experiences, comfort and proficiency in working with patients at risk for suicide, and perceived barriers to obtaining suicide-specific training. A sub-set of participants (n = 8) completed a telephone interview to further describe previous experiences and perceived challenges to obtaining training. RESULTS: The majority of participants (79.4%) had 6+ years of clinical experience, had a patient who had attempted suicide (85.3%), and completed at least one suicide-related training since finishing their education (82.4%). Survey results showed the leading barrier to enrolling in suicide-specific trainings was perceived lack of training opportunities (40.7% reported it was a barrier "quite often" or more), followed by lack of time (25%). Interview results revealed lack of time, location and logistical issues, and low perceived need for additional training among providers could impede enrollment. CONCLUSIONS: Study results identified several modifiable barriers to receiving suicide-specific continuing education among military mental health providers. Future efforts should develop accessible training programs that can be easily integrated into routine clinical operations to mount the best defense against suicide. HIGHLIGHTSMilitary mental health providers report significant experience and relatively high degrees of comfort and proficiency working with patients at high risk for suicide.Most providers reported receiving training in suicide assessment and screening; few reported prior training in management of suicidality.Study results identified several modifiable barriers to receiving suicide-prevention continuing education among military mental health care providers; future efforts should seek to develop accessible training programs that can be easily integrated into routine clinical operations to mount the best defense against suicide.

Impact of sildenafil on marital and sexual adjustment in patients and their wives after radiotherapy and short-term androgen suppression for prostate cancer: analysis of RTOG 0215.

PURPOSE: The Radiation Therapy Oncology Group (RTOG) 0215 investigated the efficacy of sildenafil in improving erectile dysfunction following radiotherapy and neoadjuvant/concurrent androgen deprivation therapy among prostate cancer patients and found a significant improvement on drug but only in 21% of study participants. This paper reports on a secondary aim to investigate the effect of sildenafil on overall sexual and marital adjustment among both patients and their wives. METHODS: RTOG 0215 was a placebo-controlled, double-blind, crossover trial of sildenafil. Participation of wives was optional. Twenty-four married heterosexual couples (33% of heterosexual couples in study) completed the Sexual Adjustment Questionnaire and Locke's Marital Adjustment Test. Treatment differences in mean change scores were evaluated by paired t-tests, and the proportion of patients achieving a clinically meaningful change was evaluated using chi-square tests. Spearman's correlation coefficients were used to determine the association of adjustment between patients and wives. RESULTS: There was no significant change in either sexual or marital adjustment for patients. For wives, there was a trend for improvement in sexual adjustment but no significant change in marital adjustment. Change in marital adjustment between patients and wives was weakly related (r(s) = 0.15, p = 0.48), and for sexual adjustment, there was a moderate, but nonsignificant relationship (r(s) = 0.40, p = 0.09). CONCLUSIONS: Larger studies are warranted to further examine possible differences in sexual experiences and treatment needs between prostate cancer patients and their wives, as well as to assess predictors of sildenafil response.

Protein movement across cultured guinea pig trachea: specificity and effect of transcytosis inhibitors.

Airway surface liquid (ASL) is a complex fluid with solutes including electrolytes, lipids, mucins, and proteins. The proximal airways are absorptive for most solutes, including proteins. We investigated the process of protein movement across confluent primary cultures of guinea pig trachea grown on filters using fluorescent-labeled bovine serum albumin (BSA), ovalbumin (OA), and 70-kDa dextran (Dex). We found marked asymmetry of BSA and OA transepithelial flux, with apical-to-basolateral flux (JA-->B) 10 times greater than the opposite direction (JB-->A) for both proteins. The apparent permeability for Dex was the same as that for proteins in the basolateral-to-apical direction and showed no asymmetry. Increasing concentrations of unlabeled BSA, OA, or transferrin inhibited JA-->B for both BSA and OA without affecting Dex movement. Cooling reduced JA-->B for BSA without affecting JB-->A. Monensin and nocodazole each reduced JA-->B for BSA and OA without affecting JB-->A. Monensin eliminated all asymmetry for BSA movement. Brefeldin A did not affect JA-->B for either protein but did increase JB-->A for BSA. Treatment with the protease inhibitors increased JA-->B for BSA. Western immunoblotting demonstrated immunologically intact protein in the downstream compartment. We conclude that there is transcytosis of proteins across cultured trachea epithelium in the apical-to-basolateral direction, which is monensin sensitive, involves microtubules, is not dependent on proteolysis, and is not protein species specific. This process may be important for maintenance of the ASL, and defects in this process may contribute to the abnormally thickened airway secretion seen in airway diseases.