The Association Between Repealing the 48-Hour Mandatory Waiting Period on Handgun Purchases and Suicide Rates in Wisconsin.

IMPORTANCE: Suicide is a significant public health burden in the United States. There is little understanding how policies regarding gun purchasing affects suicide rates. Wisconsin state legislature rescinded a 48-hour waiting period for handgun purchases, which took effect in June 2015. OBJECTIVE: To determine whether firearm-related suicide increased with the repeal of the 48-hour waiting period for handgun purchases in 2015. METHOD: We obtained data through the Wisconsin Department of Health Services via the Wisconsin Interactive Statistics on Health Query System. Suicide rates were compared by Comparative Mortality Figures (CMF). RESULTS: We reviewed all suicides in Wisconsin between 2012-2014 and 2016-2018. The rate ratios (R) and second generation P values (pδ) comparing deaths between 2012-2014 and 2016-2018 indicate significant increases in firearm-related suicide among people of color (R = 1.927; pδ = 0.0) and among Wisconsinites residing in urban counties (R = 1.379, pδ = 0.0). There was no significant increase in non-firearm-related suicide (R = 1.117, pδ = 0.092), nor in firearm-related suicide among White non-Hispanics (R = 1.107, pδ = 0.164) or Wisconsinites residing in rural counties (R = 1.085, pδ = 0.500). CONCLUSION: Our findings suggest that the repeal of the 48-hour waiting period on handgun purchases in 2015 is correlated with the increase of firearm-related suicides among Wisconsin residents of color and Wisconsinites residing in urban counties.Key Messages:Firearm policies are associated with changes in suicide rates.

Professional Address during Obstetrics and Gynecology Grand Rounds Introductions: Setting the Stage, Setting the Standard.

OBJECTIVE: This study aimed to assess gender dynamics during Obstetrics and Gynecology (Ob/Gyn) Grand Rounds. DESIGN: This was an observational cohort study of Ob/Gyn Grand Rounds introductions at a large academic center. Ob/Gyn Grand Rounds introductions from December 2016 to February 2020 were included. Audio and video components of introductions for those with doctorate degrees were reviewed. Each named reference to the presenter and use of descriptors were collected. Statistical analyses included Fisher's exact test for categorical variables and Student's t-test for continuous variables. SETTING: This study was completed at the University of Wisconsin in the Department of Ob/Gyn PARTICIPANTS: Ob/Gyn Grand Rounds introducers who had complete audio and video components of introductions for those with doctorate degrees. RESULTS: Sixty-four Grand Rounds introductions were reviewed; 57 met inclusion criteria. The majority of introducers and presenters were women. Consistent use of "doctor" was similar by men and women introducers (50% vs. 29%, p = 0.427). Assistant professors were more likely to maintain professional address during introductions, compared to associate or full professors (86% vs. 0% vs. 10%, p < 0.001). Trainees were less likely than faculty to be addressed professionally at any time during introductions (42% vs. 81%, p = 0.017). Descriptors were used for men and women presenters, though men received more female-gendered descriptors than women (5 vs. 1, p = 0.011). Women introducers used productivity descriptors less often than men introducers (8 [15.1%] vs. 5 [55.6%] (p = 0.015)). CONCLUSIONS: Use of professional address was associated with academic rank, but not gender. Men endorsed and received more descriptors emphasizing accomplishments, highlighting qualifications as an expert. Given the professional environment, all Grand Rounds presenters should be introduced using professional titles.