Barriers to successful treatment completion in child sexual abuse survivors

Child sexual abuse (CSA) often requires psychological treatment to address the symptoms of victim trauma. Barriers to entry and completion of counseling services can compromise long-term well-being. An integrated medical and mental health evaluation and treatment model of a child advocacy center (CAC) has the potential to reduce barriers to mental health treatment. Objective: (a) to describe characteristics between CSA patients who engage versus those who do not engage in mental health treatment and (b) to identify factors associated with successful completion of mental health treatment goals. For design/setting, a retrospective cohort study was conducted of CSA patients (ages 3-16 years) referred to mental health services following a CAC assessment. Outcome variables included linkage with treatment and completion of treatment. Independent variables included demographics, abuse characteristics, and therapist characteristics. Data were abstracted from the CAC and billing databases. Results: Four hundred ninety subjects were evaluated. Subjects were as follows: predominately female (74%), White (60%), and more than half received Medicaid (56%). Mean age was 8.4 years. About 52% linked with mental health services and 39% of patients that successfully linked with mental health services completed therapy. Successful linkage was independently associated with referrals to other counseling services (AOR 8.4 [2.5, 27.7]). Successful completion of therapy was independently associated with caregiver participation in therapy (AOR 3.2 [1.8, 6.0]) and if the patient was referred to other counseling services (AOR 4.1 [1.9, 8.5]). There were no differences between subjects that linked and/or completed therapy and those that did not with regard to demographic characteristics or abuse severity. Conclusion: In contrast to previous reports, efforts at our CAC seem to overcome linkage barriers in this population. However, there remain challenges in achieving successful completion of treatment goals in this population. Engaging caregivers' involvement in therapy services had a positive effect with successfully achieving treatment goals.     

What's in a name: the Vermont Genetically Engineered Food Labeling Act

On May 8, 2014, Vermont passed the Vermont Genetically Engineered Food Labeling Act (Act) requiring labels on certain genetically engineered foods. Once the bill takes effect July 1, 2016, all Vermont-retailed foods with more than 0.9% of their total weight in genetically modified ingredients must be labeled with language stating, “may be partially produced with genetic engineering.” As genetically engineered food are considered scientifically equivalent to their traditional counterparts and are not subject to federal labeling by the FDA, the Act presents several legal questions. Several of the legal questions have been raised in a recent lawsuit filed by the Grocery Manufactures Association that claims the Act violates the First Amendment, Supremacy Clause, and Commerce Clause. This paper will discuss why the Second Circuit could strike down the Act as unconstitutional as to each claim.     

Political ideology and nuclear energy: Perception,proximity, and trust

Political ideology is an increasingly powerful force in support of public policy. Historically, nuclear energy has found more support among political conservatives. This study updates the literature on political ideology and support for nuclear energy by examining how political ideology is associated with perceptions of nuclear energy and trust of nuclear information sources. After excluding participants with incomplete data, and participants within 50 miles of a nuclear reactor, the analytical sample size for the analysis examining political ideology and perceptions of nuclear energy was 4153. The analytical sample includes a total of 1035 participants within a 50-mile radius of INL, 710 participants from within Idaho who lived further than 50 miles from INL, 1899 participants from other states (more than 50 miles from a nuclear reactor), and 509 Non-Idaho participants living within 50 miles of a nuclear reactor. Logistic regression was used to determine how political ideology was associated with perceptions of nuclear energy and trust in different sources regarding radioactive waste, after controlling for demographics and location. While liberal participants near INL were less favorable towards nuclear energy, and more trusting in impact scientists to tell the truth about radioactive waste than their conservative counterparts, this was not consistent across the US. Our findings reveal the complexity of political ideology and the perceptions of nuclear issues and how proximity influences perceptions. The perceptions of political moderates were particularly important in providing a more complex understanding of political ideology and nuclear energy issues.     

Does gang membership pay? Illegal and legal earnings through emerging adulthood*

Gang membership is believed to impede success in the legitimate economic market while simultaneously supporting success in the illegal market. We extend the study of the economic effects of gang membership by using a within‐ and between‐individual analytic design, decomposing gang membership into multiple statuses (i.e., entering a gang, continuously in a gang, leaving a gang, and inactive gang membership), examining legal and illegal earnings simultaneously, and accounting for factors endogenous to gang membership that may contribute to economic achievement. By using panel data from 1,213 individuals who participated in the Pathways to Desistance Study to conduct a multilevel path analysis, we find that active gang membership status is unrelated to legal earnings. Alternatively, entering a gang is associated with increased illegal earnings, attributable to changes in delinquent peers and drug use, whereas leaving a gang has a direct relationship with decreased illegal earnings. Our results indicate that the positive economic effect of gang membership (i.e., illegal earnings and total earnings) is short‐lived and that, on balance, the sum of the gang membership experience does not “pay” in terms of overall earnings.     

Patella sex determination by 3D statistical shape models and nonlinear classifiers

Sex determination is one of the essential steps in personal identification of an individual from skeletal remains. Most elements of the skeleton have been subjected to discriminant function analysis for sex estimation, but little work has been done in terms of the patella. This paper proposes a new sex determination method from the patella using a novel automated feature extraction technique. A dataset of 228 patellae (95 females and 133 males) was amassed from the William M. Bass Donated Skeletal Collection from the University of Tennessee and was subjected to noninvasive high resolution computed tomography (CT). After the CT data were segmented, a set of features was automatically extracted, normalized, and ranked. The segmentation process with surface smoothing minimizes the noise from enthesophytes and ultimately allows our methods to distinguish variations in patellar morphology. These features include geometric features, moments, principal axes, and principal components. A feature vector of dimension 45 for each subject was then constructed. A set of statistical and supervised neural network classification methods were used to classify the sex of the patellar feature vectors. Nonlinear classifiers such as neural networks have been used in previous research to analyze several medical diagnosis problems, including quantitative tissue characterization and automated chromosome classification. In this paper, different classification methods were compared. Classification success ranged from 83.77% average classification rate using labels from a Fuzzy C-Means (FCM) clustering step, to 90.3% for linear discriminant classification (LDC). We obtained results of 96.02% and 93.51% training and testing classification rates, respectively, using feed-forward backpropagation neural networks (NN). These promising results using newly developed features and the application of nonlinear classifiers encourage the usage of these methods in forensic anthropology for identifying the sex of an individual from incomplete skeletons retaining at least one patella.     

Bringing Community Based Participatory Research to Domestic Violence Scholarship: an Online Toolkit

In the absence of ongoing involvement in the communities that are the subjects of research, even well-intentioned researchers can develop questions that are not relevant to community needs, employ methods that hurt community members, or disseminate findings in ways that are inaccessible to those most affected. Recognizing these harms, a growing number of domestic violence (DV) researchers have embraced community-based participatory research (CBPR), an approach in which researchers and community members share power at every level of the research process, co-creating knowledge that can be applied to enhance community well-being. Despite growing interest in this approach, however, there are insufficient opportunities for interested researchers to learn how to actually engage in it, especially in the DV context. To remedy this gap, the authors of this paper collaborated to develop an online toolkit for emerging researchers interested in CPBR. This brief report frames the need for CBPR in DV research using short vignettes that come from our own research experience; introduces Power Through Partnerships: A CBPR Toolkit for Domestic Violence Researchers; and presents recommendations for developing, promoting, and disseminating future CBPR research. We chose to announce the development and availability of this toolkit in an academic journal in order to highlight its scholarly and practical relevance for researcher audiences who might be less familiar with the CBPR approach.     

Evaluating integrative services in edge-of-care work

Children living on ‘the edge-of-care’ are typically known to local safeguarding authorities and are considered likely to face risks to their safety. Many are subject to a child protection plan and/or involved in ‘pre-proceedings’ processes. A growing number of their parents face (un)diagnosed mental health difficulties as well as economic and social precarity. This article draws on a mixed methods evaluation of a pilot service in the East of England offering a therapeutically led attachment-based intervention for families. The service cross-cuts health and social care, allowing psychologists and psychotherapists to work alongside social workers and other practitioners. The evaluation examined psychological and safeguarding outcomes and explored practitioner perspectives. A key outcome was that 85.4% of families were enabled to remain, or reunite with their child, compared with an estimated 50% of ‘edge-of-care’ cases nationally. This supports the need for similarly oriented interventions that could help lower the incidence of child removals.