In this study, survival analysis is used to examine time to rearrest for both domestic violence and nondomestic violence crimes among a cohort of domestic violence offenders (N = 286) over a 10-year period. In addition, risk factors for rearrest such as demographic, offending history, and batterer treatment variables are examined to determine their influence on domestic and nondomestic violence recidivism. Overall, the results suggest that approximately half of domestic violence offenders are rearrested. Furthermore, among those who are rearrested, they are rearrested fairly quickly and for generalized (both domestic and nondomestic violence offenses) versus specialized offending. Risk factors associated with both types of rearrest included age, marriage, and domestic violence offense history. Several additional risk factors were unique to rearrest type. Study limitations are explicitly stated and policy implications are discussed.

The firearm mortality rate in West Virginia (WV) increased over the past four years and is currently 50% higher than the national rate. These alarming statistics, combined with the urban-to-rural shift in firearm injuries, prompted this 10-year epidemiologic overview. To the best of the authors’ knowledge, the current study stands alone as the only report of its kind on firearm injuries in the rural setting of southern WV. Firearm injuries were common in White males within the age range of 20–49 years. Assault, which is typically identified as an urban problem, was found to be the most common injury in the study population. In our data series, injury severity score was the strongest predictor of mortality, followed by self-inflicted cause of injury and trauma to the neck/head region.

The International Lactation Consultant Association (ILCA), International Board of Lactation Consultant Examiners, and Lactation Education Accreditation Approval Review Committee jointly hosted the 2014 Lactation Summit, “Addressing Inequities Within the Lactation Consultant Profession” following the 2014 ILCA Conference. The Summit was the first conversation as part of a genuine process to address inequities within the profession that prevent access. A summary of the proceedings will be published in the December 2014 issue.

Recent concerns have been expressed that youths are an increasingly violent segment of U.S. society. This report explores such claims by presenting alternative dimensions with which trends in youth violence can be interpreted. Using Uniform Crime Reports and U.S. Bureau of the Census data for 1958-1993, rates of arrests for murder, taken to represent absolute levels of involvement in this form of violence, are analyzed for trends among 15- to 19-year-olds. Relative involvement, operationalized as the ratio of arrest rates for those aged 15-19 to those of the remainder of the population, is also analyzed for trends. A pronounced upward trend since the mid-1980s in both rates and ratios of arrests for murder is found for ages 15-19, resulting in this group now having the highest levels of absolute and relative involvement in murder arrests of any age category, a distinct departure from previous years. As a context for interpreting these levels, the involvement of current 15- to 19-year-olds is shown to exceed by a considerable margin the involvement of similarly aged cohorts of baby boomers, a youth group formerly the object of considerable public concern. Research is encouraged that addresses the multifaceted sources contributing to this dramatic societal shift in age-related patterns of arrests for murder and, by assumption, involvement in homicide offending.

Previous studies have demonstrated a connection between intimate partner violence (IPV) and a child’s alienation from the abused parent, but little is known about the relationships between the type of IPV, aspects, and severity of a child’s alienation, and the target parent’s gender. This study assessed the presence of an IPV history (verbal and physical aspects) among parents who identify as targets of their children’s unreasonable rejection. Also investigated were associations between the form of IPV and manifestations of a child’s alienated behavior, parent’s gender and type of IPV, and parents’ gender and degree of the child’s alienation. Self-identified alienated parents (n = 842) completed an online survey that included an IPV screening measurement (Hurts, Insults, Screams, Threatens screening tool) and a measure of the parent’s perception of their child’s alienated behaviors (Rowlands Parental Alienation Scale). The majority identified as IPV victims and reported a higher level of verbal than physical abuse. More mothers than fathers identified themselves as IPV victims. As a group, IPV victims rated their child as more severely alienated than did non-IPV alienated parents. Mothers were more likely than fathers to report physical aggression by the other parent and more likely than fathers to assess their child’s alienated behaviors as more severe. Victims of physical violence reported their children were less likely to withhold positive affection from them. This knowledge may assist in earlier identification of the alienation process and greater recognition, legitimacy, funding, and opportunities for enhanced collaboration among stakeholders. This, in turn, may lead to improvements in prevention, intervention, and accountability, thus helping to interrupt alienation processes.

The present study examines the controversial issue of whether women and men are equally abused in dating relationships. Undergraduate and graduate students (n = 874) completed a survey about their experiences and perpetration of psychological, sexual, and physical aggression within dating relationships. To enable a more contextualized understanding of these phenomena, motives for and outcomes of dating violence were also assessed. Women and men reported comparable amounts of overall aggression from dating partners, but differed in the types of violence experienced. Women were more likely to experience sexual victimization, whereas men were more often the victims of psychological aggression; rates of physical violence were similar across genders. Contrary to hypotheses, women were not more likely to use physical violence in self-defense than men. However, although both genders experienced similar amounts of aggressive acts from dating partners, the impact of such violence is more severe for women than men.

Dealing with hostile interpersonal relationships at work has been the topic of many popular books and workshops. Yet, with the exception of sexual harassment, there is surprisingly little mention in the organizational research literature on the nature, extent, and costs of abusive work interactions. These more frequent, more tolerated, and, thus, more damaging interpersonal interactions involve hostile verbal and nonverbal nonphysical behaviors directed by one or more persons towards another. The primary aim is to undermine the other to ensure compliance. In this study, we examined the extent to which students experienced nonsexual nonphysical abusive behavior on their jobs, the impact of this experience on job satisfaction, the characteristics of the actor and target, and responses to these behaviors, particularly turnover. The results indicate that although most of the students had very positive interactions at work, exposure to abusive behavior was familiar, was relatively frequent, and had a negative impact on the targets. The actors tended to be bosses and older than the targets. The quality of the interpersonal relationships at work was related to job satisfaction and intention to leave. The implications of these results are discussed with respect to individual, situational, and organizational factors that may be related to the presence and impact of abusive interpersonal interactions. Avenues for research on the nature, extent, and impact of these behaviors at both the individual and organizational levels are identified.

This study adds to the available literature on female-perpetrated intimate abuse by examining Dutton’s (2007) theory of the abusive personality (AP) in a sample of 914 women who had been involved in dating relationships. Consistent with the AP, recalled parental rejection, borderline personality organization (BPO), anger, and trauma symptoms all demonstrated moderate-to-strong relationships with women’s self-reported intimate psychological abuse perpetration. Fearful attachment style demonstrated a weak-to-moderate relationship with psychological abuse perpetration. A potential model for explaining the interrelationships between the elements of the AP was tested using structural equation modeling (SEM). Consistent with the proposed model, recalled parental rejection demonstrated relationships with BPO, trauma symptoms, and fearful attachment. Similarly consistent with the model, trauma symptoms demonstrated a relationship with anger; and BPO demonstrated strong relationships with trauma symptoms, fearful attachment, and anger. Additionally, anger itself had a strong relationship with women’s self-reported perpetration of intimate psychological and physical abuse. Contrary to the proposed model, fearful attachment had a nonsignificant relationship with anger when this relationship was examined using SEM.

The study of men’s violence against their intimate partners is segregated from the study of other forms of violence. Comparing intimate partner violence (IPV) to other violence, however, allows one to examine whether the motivation and the legal response are similar. I examine whether men’s assaults on partners are particularly likely to have a control motive, whether women’s assaults on partners are particularly likely to be motivated by self-defense, and whether intimate partner violence is less likely to be reported to the police and legally sanctioned. The evidence casts doubt on the feminist approach, which has dominated the study of IPV. I suggest that a theory of instrumental violence provides a better understanding of IPV. Such an approach recognizes a variety of motives and emphasizes the role of conflict in intimate relationships, sex differences in strength and violence, and the importance of chivalry. Finally, I suggest that social scientists who study IPV should be more careful in their descriptive terminology.

Most interventions for men who batter are standardized and “one-size-fits-all,” neglecting individual differences in readiness to change. A multimedia expert system intervention based on the transtheoretical model (the “stage model”) was developed as an adjunct to traditional court-mandated programs. The expert system assesses stage of change, decisional balance, self-efficacy, and processes of change and provides immediate individualized stage-matched feedback designed to increase readiness to end the violence. Fifty-eight male batterer intervention program clients were invited by agency staff to complete an expert system session and an evaluation of the program; 33 men were recruited at program intake and the remainder from ongoing groups. Responses to the intervention were very positive. For example, 87% of participants reported that they found the program to be easy to use, and 98% said it could probably or definitely help them change their attitudes or behaviors. Findings provide encouraging evidence of the acceptability of this stage-matched approach to intervention for domestic violence offenders.

Partner aggression is a major public health concern. Batterers’ intervention programs (BIPs) are commonly used as an alternative to incarceration for offenders who have been arrested for domestic assault. Historically, BIPs have shown little effectiveness in reducing partner aggression. This article presents a new BIP based on acceptance and commitment therapy (ACT; Hayes, Strosahl, & Wilson, 1999). ACT is a third-wave therapy that builds on the cognitive-behavioral tradition, focusing on increasing psychological flexibility by promoting acceptance and mindfulness processes. Several lines of evidence support the use of ACT in the treatment of partner aggression. Achieving Change Through Values-Based Behavior (ACTV; Lawrence, Langer Zarling, & Orengo-Aguayo, 2014) was developed based on ACT principles with a specific focus on feasibility and transferability to the community correctional setting and court-adjudicated treatment. ACTV incorporates experiential skills training and uses innovative methods to engage participants and teach the ACT processes. This article details the components of ACTV, including a case study to illustrate one participant’s journey through the program. We also present preliminary pilot data, which look promising with respect to reductions in domestic assault and violent recidivism.

This study examined the relationship between personal characteristics (gender, acculturation, belief in gender stereotypes, recent dating experiences), and attitudes and knowledge about dating violence in urban Latino youth (N = 678). All participants completed self-administered surveys at school. Relative to girls, boys held more problematic (proviolence) attitudes about dating violence and reported less knowledge about dating violence and its consequences. Teens who were more traditional (less acculturated), those who endorsed gender stereotypes, and those who reported recent fearful dating experiences tended to report less knowledge about abuse and lower endorsement of nonviolent attitudes. Multivariate analyses revealed that all four personal variables predicted dating violence knowledge. By contrast, attitudes were predicted by endorsement of gender stereotypes only, or gender stereotypes and gender. Implications for dating violence interventions and future directions for research are explored.

The goal of this project was to determine if a nurse practitioner (NP) designed and managed primary care based asthma quality improvement (QI) program titled Asthma Control and Elimination of Symptoms (ACES) could improve asthma outcomes in a high-morbidity pediatric population. A convenience sample of 31 children age 2 to 17 years with persistent asthma were recruited from a private practice in a rural community to participate in this prospective study with 3 months of follow-up. The primary outcome measures were symptom improvement and use of symptom prevention medication. The secondary outcome measures were reduced ED visits and hospitalizations. Participants in the ACES program had significant improvement in daytime asthma symptoms, nighttime asthma symptoms, use of rescue medication, activity tolerance, missed school days, attacks lasting longer than 24 hr, and use of symptom prevention medication. There was a decrease in ED visits and no change in rate of hospitalizations. One hundred percent of participants completed the program and the QI project improved health outcomes of all children in the program.

Background: Congenital heart disease (CHD) is the leading cause of death within the first year of life because of birth defects. Complications related to respiratory infection caused by respiratory syncytial virus (RSV) increase risks in the CHD population. Prevention is key to minimizing risk, and administration of RSV prophylaxis, palivizumab, is recommended for infants with hemodynamically significant heart disease. Objective: Use the electronic medical record (EMR) to identify and ensure appropriate referral of CHD patients eligible for RSV prophylaxis. Design: Comparative, cross-sectional study design. Setting: Cardiac specialty clinic of a regional children’s hospital. Population: CHD patients younger than 24 months of age eligible for RSV prophylaxis. Intervention: Use the EMR to develop a method for identifying CHD patients eligible for RSV prophylaxis and implement a referral process. Results: Similar number of patients in the 2 RSV seasons studied. Rates of eligibility for RSV prophylaxis over the 2 seasons were the same. Improvements in documentation of eligibility by the provider from the first season to the second. Limitations: Inability to determine referral rates. Initial EMR search did not identify patients eligible for RSV prophylaxis. Inconsistent EMR data entry. Conclusions: Ongoing education on eligibility for RSV prophylaxis. Need for automated EMR referral. Ongoing evaluation of EMR systems identifying patients eligible for RSV prophylaxis.

There are 19 million workers and retirees and $3 trillion of assets in state pension plans. However, questions have arisen about the long-run ability of the plans to pay promised benefits to retirees. Consequently, proposals have been made to reduce promised pension payments or alter other terms of the pension contracts. Yet another heretofore unexplored alternative is to reduce state pension plan management fees by moving from actively managed portfolios to low-fee passively managed accounts. Using state pension plan data for the 2003-2012 decade and returns from three alternative low fee portfolios, it is found that all states could have increased after-fee earnings and improved their long-run ability to pay retirees by moving to the low-fee investment accounts. While clearly relevant for workers and retirees in state pension plans, the findings also have implications for all investors regarding the ongoing debate between active and passive investment management strategies.

Background: The literature is clear that adults who are currently homeless also have higher rates of intentional injuries, such as assault and suicide attempts. No study has assessed whether intentional injuries are exacerbated because of substance use among adults with a history of homelessness. Methods: Data were obtained from a cohort of adults admitted to 3 urban emergency departments (EDs) in Texas from 2007 to 2010 (N = 596). Logistic regression analyses were used to determine whether a history of homelessness was associated with alcohol use at time of injury in intentional violent injuries (gunshot, stabbing, or injury consistent with assault). Results: 39% adults with a history of homelessness who were treated at trauma centers for a violent injury. Bivariate analyses indicated that adults who had ever experienced homelessness have 1.67 increased odds, 95% confidence interval (CI) [1.11, 2.50], of any intentional violent injury and 1.95 increased odds (95% CI [1.12, 3.40]) of a stabbing injury than adults with no history of homelessness. Conclusions: Adults who experienced homelessness in their lifetime were more likely to visit EDs for violence-related injuries. Given our limited knowledge of the injuries that prompt ED use by currently homeless populations, future studies are needed to understand the etiology of injuries, and substance-related injuries specifically, among adults with a history of homelessness.

As hospitals face increasing practice management challenges, as in decreased staffing, decreased reimbursement, increased malpractice, rising costs, and increased quality and safety demands, many hospitals today have turned toward increased use of nurse practitioners (NPs). Utilization of NPs within hospitals has been safe, effective, and profitable and is increasingly accepted. Hospitals are now developing defined clinical leadership roles to oversee the daily practice management of advanced practice providers. A doctor of nursing practice (DNP) is the ideal clinical leader to develop and implement such innovative practice solutions for hospital-based NP programs. This article will address the basic principles of building a practice billing model for acute care NPs at a major medical center in Houston, Texas. Creating new models requires comprehensive analysis and continued evaluation as the complexities in providing health care continuously shift. The direct benefit of NP utilization will become evident through direct reimbursement or practice improvement.

The purpose of this article is to assess the prevalence of Acute Stress Disorder (ASD) following violent assault in victims who come to the emergency ward, and compare the effects with degrees of injury. Two hundred and fourteen victims of violence completed a questionnaire 1 to 2 weeks after the assault. Measures included the Harvard Trauma Questionnaire, the Trauma Symptom Checklist and the Crisis Support Scale. Results: Twenty-four percent met the full ASD diagnosis and 21% a subclinical ASD diagnosis. Childhood sexual and physical abuse and shock due to a traumatic event that happened to someone close increased the likelihood of ASD four to ten times. Feeling of security and ability to express feelings reduced the likelihood of ASD by one-quarter, while feeling let down by others and hopelessness increased the likelihood of ASD respectively 1.4 and 2.6 times.

There is a controversy about the origin, definition, and types of acute mastitis, breast pain, and their clinical management. This article reviews current definitions, bacteriological findings, their possible meanings, and their use in clinical settings as well as the latest evidence-based clinical management guidelines.

Interventions for men who perpetrate intimate partner violence (IPV) have historically been relatively ineffective at reducing or stopping subsequent IPV. However, there are several strong theoretical reasons that suggest Acceptance and Commitment Therapy (ACT), an intervention that emphasizes the use of mindfulness and aims to foster psychological flexibility, may be particularly well-suited to interrupting the factors that maintain IPV. The goal of the present article is to review the evidence for the application of ACT to target IPV. In addition, empirical studies that have, to date, shown promising initial support for a targeted intervention (Achieving Change Through Values-Based Behavior; ACTV) are reviewed. The implications for using ACT-based skills with perpetrators of IPV are discussed, along with potential future directions and further applications of ACT to hard-to-treat populations.

Dating violence prevention programs, which originated in the United States, are beginning to be implemented elsewhere. This article presents the first adaptation of a violence prevention program for a European culture, Francophone Switzerland. A U.S. dating violence prevention program, Safe Dates (Foshee & Langwick, 1994), was reviewed in 19 youth and 4 professional focus groups. The most fundamental program concepts—“dating” and “violence”—are not the same in Switzerland and the United States. Swiss youth were not very focused on establishing monogamous romantic relationships, and there is no ready translation for “dating.” Violence has not become the focus of a social movement in Switzerland to the same extent that it has in the United States, and distinctions among terms such as “dating violence” and “domestic violence” are not well known. Psychoeducational approaches are also less common in the Swiss context. As the movement to prevent violence extends worldwide, these issues need greater consideration.

Interpersonal violence is known to lead to both short- and long-term health effects. Victims of sexual abuse tend to have higher healthcare costs and higher rates of physical and mental health issues than nonvictims. In this study, we investigate whether the comorbidity of mental illness and a personal history of adult physical and sexual abuse (HAPSA) results in higher healthcare costs and length of emergency department (ED) stay among Florida residents. A Negative Binomial and Log-Linear Regression Analysis suggest increased ED visit duration for those with a history of abuse, Hispanics, the uninsured, and those with multiple comorbidities. In addition, increased costs were found to be associated with White race, the uninsured, those with multiple comorbidities, and the facility type (for-profit hospitals).

Women who are verbally abused by their intimate male partners suffer serious mental health consequences and often experience physical violence in their relationship. Despite the importance of studying verbal abuse, no previous research has investigated the specific content of the insults men use to derogate their partners. We present the development and initial validation of a new measure designed to assess the specific content of insults used by men against their intimate partners. In a preliminary study, we used feedback from battered women, along with a review of the relevant literature, to identify specific insults for inclusion in the Partner-Directed Insults Scale (PDIS). We administered the PDIS to a sample of United States participants (Study 1) and a sample of New Zealand participants (Study 2), allowing for a cross-national investigation of the specific insults that men use to derogate their partners. The results demonstrate the practical need for such a scale and provide evidence for the discriminant validity of the PDIS by documenting that men’s use of insults predicts their use of controlling behaviors and physical violence.