Transcontinental Dissemination of Enterobacterales Harboring blaNDM-1 in Retail Frozen Shrimp.

The global food trade provides a means of disseminating antimicrobial resistant (AMR) bacteria and genes. Using selective media, carbapenem-resistant species of Enterobacterales (Providencia sp. and Citrobacter sp.), were detected in a single package of imported frozen shrimp purchased from a grocery store in Ohio, USA. Polymerase chain reaction confirmed that both isolates harbored blaNDM-1 genes. Following PacBio long read sequencing, the sequences were annotated using the NCBI Prokaryotic Genome Annotation Pipeline. The blaNDM-1 genes were found in IncC plasmids, each with different antimicrobial resistance island configuration. We found that the blaNDM-1 AMR islands had close relationships with previously reported environmental, food, and clinical isolates detected in Asia and the United States, highlighting the importance of the food chain in the global dissemination of antimicrobial resistance.

A complex cyclical One Health pathway drives the emergence and dissemination of antimicrobial resistance.

Since their commercialization, scientists have known that antimicrobial use kills or inhibits susceptible bacteria while allowing resistant bacteria to survive and expand. Today there is widespread antimicrobial resistance (AMR), even to antimicrobials of last resort such as the carbapenems, which are reserved for use in life-threatening infections. It is often convenient to assign responsibility for this global health crisis to the users and prescribers of antimicrobials. However, we know that animals never treated with antimicrobials carry clinically relevant AMR bacteria and genes. The causal pathway from bacterial susceptibility to resistance is not simple, and dissemination is cyclical rather than linear. Amplification of AMR occurs in healthcare environments and on farms where frequent exposure to antimicrobials selects for resistant bacterial populations. The recipients of antimicrobial therapy release antimicrobial residues, resistant bacteria, and resistance genes in waste products. These are reduced but not removed during wastewater and manure treatment and enter surface waters, soils, recreational parks, wildlife, and fields where animals graze and crops are grown for human and animal consumption. The cycle is complete when a patient carrying AMR bacteria is treated with antimicrobials that amplify the resistant bacterial populations. Reducing the development and spread of AMR requires a One Health approach with the combined commitment of governments, medical and veterinary professionals, agricultural industries, food and feed processors, and environmental scientists. In this review and in the companion Currents in One Health by Ballash et al, JAVMA, April 2024, we highlight just a few of the steps of the complex cyclical causal pathway that leads to the amplification, dissemination, and maintenance of AMR.

The One Health dissemination of antimicrobial resistance occurs in both natural and clinical environments.

Once considered to be a simple cause-and-effect relationship with localized impact, the concept of how antimicrobial use drives antimicrobial resistance is now recognized as a complex, transdisciplinary problem on a global scale. While the issue of antimicrobial resistance is often studied and addressed at the antimicrobial-human or antimicrobial-animal treatment interface, the role of the environment in the One Health dynamics of antimicrobial resistance is not as well understood. Antimicrobial-resistant bacteria, including those resistant to carbapenem drugs, are emerging in veterinary clinical environments, on farms, and in natural habitats. These multidrug-resistant bacteria can colonize our livestock and companion animals and are later disseminated into the environment, where they contaminate surface waters and colonize wildlife. From here, the One Health transmission cycle of antimicrobial-resistant bacteria is completed as environmental reservoirs can serve as sources of antimicrobial resistance transmission into human or animal healthcare settings. In this review, we utilize a One Health perspective to evaluate how environments become contaminated and, in turn, become reservoirs that can colonize and infect our veterinary species, and how the veterinary field is combating environmental contamination with antimicrobial stewardship regulations and program implementation. The companion Currents in One Health by Parker et al, AJVR, April 2024, addresses the intensive research that justifies this One Health cycle of antimicrobial resistance transmission and emerging techniques that are dissecting the complex interactions at the One Health interface.

The Health and Economic Impact of Youth Violence by Injury Mechanism.

INTRODUCTION: Violence is a leading cause of morbidity and mortality among U.S. youth. More information on the health and economic burden of the most frequent assault mechanisms-or, causes (e.g., firearms, cut/pierce)-can support the development and implementation of effective public health strategies. Using nationally representative data sources, this study estimated the annual health and economic burden of U.S. youth violence by injury mechanism. METHODS: In 2023, CDC's WISQARS provided the number of homicides and nonfatal assault ED visits by injury mechanism among U.S. youth aged 10-24 years in 2020, as well as the associated average economic costs of medical care, lost work, morbidity-related reduced quality of life, and value of statistical life. The Healthcare Cost and Utilization Project Nationwide Emergency Department Sample provided supplemental nonfatal assault incidence data for comprehensive reporting by injury mechanism. RESULTS: Of the $86B estimated annual economic burden of youth homicide, $78B was caused by firearms, $4B by cut/pierce injuries, and $1B by unspecified causes. Of the $36B billion estimated economic burden of nonfatal youth violence injuries, $19B was caused by struck by/against injuries, $3B by firearm injuries, and $365M by cut/pierce injuries. CONCLUSIONS: The lethality of assault injuries affecting youth when a weapon is explicitly or likely involved is high-firearms and cut/pierce injuries combined account for nearly all youth homicides compared to one-tenth of nonfatal assault injury ED visits. There are numerous evidence-based policies, programs, and practices to reduce the number of lives lost or negatively impacted by youth violence.

Economic Burden of US Youth Violence Injuries.

This economic evaluation study reports the annual economic burden of youth violence injuries using the most recent national data.

Associations Between Exposure to School Violence and Weapon Carrying at School.

INTRODUCTION: Among U.S. high-school students, interpersonal violence and victimizations often occur on school property. The presence of a weapon can increase the potential for injury and death resulting from interpersonal conflict. This study examines the associations between exposure to school violence and weapon carrying on school property among U.S. high-school students. METHODS: Data from the 2017 and 2019 national Youth Risk Behavior Surveys were combined (N=28,442) and analyzed in 2022. Multivariable logistic regression models were used to calculate sex-stratified, adjusted (for race/ethnicity, grade, sexual identity, current substance use, suicidal thoughts, and history of concussion) prevalence ratios. Prevalence ratios were considered statistically significant if 95% CIs did not include 1.0. RESULTS: Male students (4.7%) were more likely than female students (1.8%) to report carrying a weapon at school during the 30 days preceding the survey. Weapon carrying at school was more prevalent among students who were threatened or injured with a weapon at school (male students, adjusted prevalence ratio=3.45; female students, adjusted prevalence ratio=3.90), among students who were involved in a physical fight at school (male students, adjusted prevalence ratio=3.44; female students, adjusted prevalence ratio=3.72), among students who missed school because they did not feel safe (male students, adjusted prevalence ratio=1.98; female students, adjusted prevalence ratio=2.97), and among male students who were bullied at school (adjusted prevalence ratio=1.72) than among students who did not experience school violence. CONCLUSIONS: Increased emphasis on safe and supportive school environments, where all types of interpersonal violence are less likely to occur, and increased access to programs and services to promote mental health, prevent violence, and deter weapon use are needed.

Risk of anesthesia-related complications in draft horses: a retrospective, single-center analysis.

OBJECTIVE: To report anesthetic-related complications and determine risks associated with anesthesia in draft horses. STUDY DESIGN: Retrospective study. ANIMALS: A total of 401 anesthetic records for draft horse breeds that underwent general anesthesia from January 2010 through December 2020 were reviewed; horses euthanized during general anesthesia were excluded. METHODS: Demographics, perioperative drugs used, procedure type and duration, time to extubation, number of attempts to stand, use of sling in recovery and perioperative morbidity and mortality were investigated. Morbidity and mortality statistical evaluation included univariable logistic regression analysis and ordinal regression analysis. RESULTS: American Society of Anesthesiologists (ASA) status I-II, ASA III-V and total mortality rate for all cases was 0.69% (2/288), 6.19% (7/113) and 2.24% (9/401), respectively, with Belgian horses being overrepresented (6/9). Cardiac arrest occurred in six out of nine horses that died without euthanasia, and five out of six of these horses underwent colic surgery. Factors associated with increased mortality risk included ASA status of III-V, increased body weight, emergency status and horses presenting for colic. Hypotension, hypercarbia and hypoxemia occurred in 56% (224/401), 46% (186/401) and 14% (58/401) of horses, respectively. During recovery from anesthesia, lighter horses and horses undergoing shorter anesthetic procedures were more likely to be successful on the first or second attempt to stand and were less likely to require a sling in recovery. CONCLUSIONS AND CLINICAL RELEVANCE: Draft horses undergoing general anesthesia had a higher mortality rate than previously reported for all types and breeds of horses.

Examining the effects of the Eckerd rapid safety feedback process on the occurrence of repeat maltreatment among children involved in the child welfare system.

BACKGROUND: The Eckerd Rapid Safety Feedback Process (ERSF) is an approach to child welfare practice that combines predictive risk modeling (PRM) with real-time quality assurance and staff coaching during a child protective services investigation. During the case investigation, quality assurance (QA) reviewers provide guidance to staff by assessing key dimensions of their investigative practices and providing coaching sessions as needed. OBJECTIVE: To determine to what degree ERSF reduced the incidence of children who experienced high severity physical, sexual, or neglect maltreatment (HS-CAN) among children known to a state child welfare agency, within 12 months of the agency's involvement in a previous investigation. METHODS: This multi-year quasi-experimental study evaluated the impact of the ERSF Process on risk of repeat high severity maltreatment among children and youth identified by a PRM algorithm as high risk for experiencing repeat maltreatment and receiving the additional QA intervention, compared to those receiving the usual standard of care. RESULTS: The ERSF Process did not lower the rate of HS-CAN among children identified as high risk. The joint odds ratio for receiving ERSF given being high risk was 1.05, i.e. a point estimate indicating higher probability of future HS-CAN. CONCLUSIONS: In this statewide implementation of ERSF, we did not find a positive effect of this particular PRM-based intervention. Future maltreatment, even within 12 months of a prior investigation, may be too distal an outcome for a PRM and QA process designed to produce a high-quality CPS investigation and safety plan.

Salmonella detection in commercially prepared livestock feed and the raw ingredients and equipment used to manufacture the feed: A systematic review and meta-analysis.

Salmonella contamination of livestock feed is a serious veterinary and public health issue. In this study we used a systematic review to assess the prevalence and characterization of Salmonella isolates detected in raw feed components, feed milling equipment and finished feed from 97 studies published from 1955 to 2020 across seven global regions. Eighty-five studies were included in a meta-analyses to estimate the combined prevalence of Salmonella detection and to compare the risk of contamination associated with different sample types. We found the overall combined prevalence estimate of Salmonella detection was 0.14 with a prevalence of 0.18 in raw feed components, 0.09 in finished feed and 0.08 in feed milling equipment. Animal based raw feed components were 3.9 times more likely to be contaminated with Salmonella than plant based raw feed components. Differences between studies accounted for 99 % of the variance in the prevalence estimate for all sample types and there was no effect of region on the prevalence estimates. The combined prevalence of Salmonella detection in raw feed components decreased from 0.25 in 1955 to 0.11 in 2019. The proportion of Salmonella isolates that were resistant to antimicrobials was largest for amikacin (0.20), tetracycline (0.18) streptomycin (0.17), cefotaxime (0.14) and sulfisoxazole (0.11). The prevalence of Salmonella contamination of animal feed varies widely between individual studies and is an ongoing challenge for the commercial feed industry. Control relies on the vigilant monitoring and control of Salmonella in each individual mill.

Efficiency of Prolonged Prone Positioning for Mechanically Ventilated Patients Infected with COVID-19.

Hypoxemia of the acute respiratory distress syndrome can be reduced by turning patients prone. Prone positioning (PP) is labor intensive, risks unplanned tracheal extubation, and can result in facial tissue injury. We retrospectively examined prolonged, repeated, and early versus later PP for 20 patients with COVID-19 respiratory failure. Blood gases and ventilator settings were collected before PP, at 1, 7, 12, 24, 32, and 39 h after PP, and 7 h after completion of PP. Analysis of variance was used for comparisons with baseline values at supine positions before turning prone. PP for >39 h maintained PaO2/FiO2 (P/F) ratios when turned supine; the P/F decrease at 7 h was not significant from the initial values when turned supine. Patients turned prone a second time, when again turned supine at 7 h, had significant decreased P/F. When PP started for an initial P/F ≤ 150 versus P/F > 150, the P/F increased throughout the PP and upon return to supine. Our results show that a single turn prone for >39 h is efficacious and saves the burden of multiple prone turns, and there is no significant advantage to initiating PP when P/F > 150 compared to P/F ≤ 150.

The effects of protein supplementation and pasture maintenance on the growth, parasite burden, and economic return of pasture-raised lambs.

The objective of this experiment was to evaluate the impact of protein supplementation and pasture contamination with gastrointestinal nematodes on the mitigation of parasitic infection in grazing lambs. We hypothesized that there would be no difference between protein supplementation and newly sown pasture in evaluating lamb growth and health parameters associated with parasitism. Furthermore, we questioned if there would be an interaction between protein supplementation and pasture type. A total of 192, 60-d-old lambs (28.3 ± 5.1 kg) were randomly assigned to one of four treatments: 1) new pasture without supplementation (NN); 2) new pasture with supplementation (NS); 3) established pasture without supplementation (EN); and 4) established pasture with supplementation (ES) and grazed for 112 d. Lambs were supplemented at a rate of 1% body weight/d. Supplemented lambs had greater body weight (BW) and average daily gain (ADG) when compared with non-supplemented lambs (P < 0.04). Additionally, lambs on newly sown pasture demonstrated greater BW and ADG when compared with lambs grazing on established pasture (P < 0.05). For lamb health, lambs in the EN treatment group had the greatest FAMACHA eye scores and lowest packed cell volume (PCV) over the course of the 112-d grazing period (P < 0.05). Moreover, NS and ES treatment lambs demonstrated similar FAMACHA eye scores when compared with NN treatment lambs; however, NN treatment lambs showed lower PCV when compared with NS and ES treatment lambs (P < 0.05). In evaluating fecal egg counts (FEC), lambs on new pasture or given supplement demonstrated lesser FEC when compared with those lambs on established pasture or not given supplement (P < 0.05). Sixty-four lambs were harvested to evaluate total abomasum nematode counts which demonstrated that Haemonchus contortus represented approximately 80% of total nematodes. Furthermore, based upon gross margin analysis, lambs given a protein rich supplement on pasture had a 9.3 kg increase in lamb BW whereas newly sown pasture had a 1.3 kg increase in lamb BW. A protein rich supplement given to lambs grazing pastures contaminated primarily with H. contortus or placing lambs on newly sown pasture increases lamb BW and improves parasite resiliency. Selection of parasite management strategies may be influenced by cost of production and market opportunities.

Residential instability, running away, and juvenile detention characterizes commercially sexually exploited youth involved in Washington State's child welfare system.

BACKGROUND: Federal policy in 2015 expanded the definition of "child abuse" to include human trafficking. As a result, child welfare agencies are newly responsible for identifying and providing services for youth in state care who are or at-risk of commercial sexual exploitation. OBJECTIVE: To describe the demographics, state-dependent living situations, and juvenile detention usage of state-dependent commercially sexually exploited youth. PARTICIPANTS AND SETTING: Eighty-three state-dependent youth (89.2 % female, mean age at identification = 15.5 years, SD = 1.5, Range = 11.7-19.1 years) who were confirmed or strongly suspected of commercial sexual exploitation. METHODS: Secondary analysis of lifetime administrative record data from child welfare and juvenile justice systems using descriptive statistics. RESULTS: Youth experienced early and frequent contact with the child welfare system. Youth experienced an average of 27 living situation disruptions while in the care of child welfare, with a disruption an average of every 71 days, primarily due to running away. Nearly 9 out of 10 youth had at least one runaway episode, and for these youth, there were an average of 8.6 runaway episodes. Three out of four youth had at least one juvenile detention episode, and for these youth, the average number of detention episodes was 9.2. CONCLUSIONS: We provide the context of a cycle of multisystem entanglement, whereby running away may be both a response to and cause of further system involvement and commercial sexual exploitation, and call for evidence-based interventions focused on reducing running away for these youth.

The role of the outer setting in implementation: associations between state demographic, fiscal, and policy factors and use of evidence-based treatments in mental healthcare.

BACKGROUND: Despite consistent recognition of their influence, empirical study of how outer setting factors (e.g., policies, financing, stakeholder relationships) influence public systems' investment in and adoption of evidence-based treatment (EBT) is limited. This study examined associations among unmodifiable (e.g., demographic, economic, political, structural factors) and modifiable (e.g., allocation of resources, social processes, policies, and regulations) outer setting factors and adoption of behavioral health EBT by US states. METHODS: Multilevel models examined relationships between state characteristics, an array of funding and policy variables, and state adoption of behavioral health EBTs for adults and children across years 2002-2012, using data from the National Association for State Mental Health Program Directors Research Institute and other sources. RESULTS: Several unmodifiable state factors, including per capita income, controlling political party, and Medicaid expansion, predicted level of state fiscal investments in EBT. By contrast, modifiable factors, such as interagency collaboration and investment in research centers, were more predictive of state policies supportive of EBT. Interestingly, level of adult EBT adoption was associated with state fiscal supports for EBT, while child EBT adoption was predicted more by supportive policies. State per capita debt and direct state operation of services (versus contracting for services) predicted both child and adult EBT adoption. CONCLUSIONS: State-level EBT adoption and associated implementation support is associated with an interpretable array of policy, financing, and oversight factors. Such information expands our knowledge base of the role of the outer setting in implementation and may provide insight into how best to focus efforts to promote EBT for behavioral health disorders.

Measurement Based Care in Child Welfare-Involved Children and Youth: Reliability and Validity of the PSC-17.

This study evaluates whether the psychometric properties of the Pediatric Symptoms Checklist-17 (PSC-17), a common behavioral health measure typically used as a dichotomous screening tool for mental health needs, support its use as a continuous measure for tracking behavioral health over time. A total of 6492 foster parents of children and youth aged 5.5-17 completed the PSC-17. Convergent and discriminant validity was assessed by comparing raw PSC-17 subscale scores with associated outcomes (e.g. psychiatric diagnoses). Long-term test-retest reliability was assessed over 6 months. Scores on the PSC-17 demonstrated good convergent and divergent validity. PSC-17 subscale scores were most strongly associated with analogous diagnoses. Test-retest reliability was moderate, as expected for a time window of this length. This study provides moderate support for the psychometric qualities of the PSC-17 when used with children and youth in the child welfare system as a continuous measure of psychosocial functioning over time.

Identifying Psychosocial Problems Among Children and Youth in the Child Welfare System Using the PSC-17: Exploring Convergent and Discriminant Validity with Multiple Informants.

Youth who enter foster care are at risk of mental health need, but questions arise as to the validity of their self-reported symptomatology. This study examines the screening validity of the youth-report version of the Pediatric Symptom Checklist-17 (PSC-17) in a child welfare population. Data come from 2389 youth who completed a version of the PSC-17 adapted for youth report, and their biological and foster parents who completed the parent-report version. Youth also completed a shortened version of the Screen for Child Anxiety Related Disorders (SCARED). Convergent and discriminant validity of the PSC-17 was assessed using multi-trait multi-method matrices. The PSC-17's internalizing subscale was strongly correlated, attention subscale was moderately correlated, and externalizing subscale was weakly correlated with the SCARED's anxiety and PTSD subscales. Comparing youth and foster parent scores, the PSC-17 had moderate convergent validity and weak/fair discriminant validity. Comparing youth, foster parent, and biological parent scores, the PSC-17 had moderate convergent validity and weak/fair discriminant validity. The current study provides some support for the validity of the PSC-17 for the population of youth in foster care.

Impact of a Web-Based Electronic Health Record on Behavioral Health Service Delivery for Children and Adolescents: Randomized Controlled Trial.

BACKGROUND: Electronic health records (EHRs) have been widely proposed as a mechanism for improving health care quality. However, rigorous research on the impact of EHR systems on behavioral health service delivery is scant, especially for children and adolescents. OBJECTIVE: The current study evaluated the usability of an EHR developed to support the implementation of the Wraparound care coordination model for children and youth with complex behavioral health needs, and impact of the EHR on service processes, fidelity, and proximal outcomes. METHODS: Thirty-four Wraparound facilitators working in two programs in two states were randomized to either use the new EHR (19/34, 56%) or to continue to implement Wraparound services as usual (SAU) using paper-based documentation (15/34, 44%). Key functions of the EHR included standard fields such as youth and family information, diagnoses, assessment data, and progress notes. In addition, there was the maintenance of a coordinated plan of care, progress measurement on strategies and services, communication among team members, and reporting on services, expenditures, and outcomes. All children and youth referred to services for eight months (N=211) were eligible for the study. After excluding those who were ineligible (69/211, 33%) and who declined to participate (59/211, 28%), a total of 83/211 (39%) children and youth were enrolled in the study with 49/211 (23%) in the EHR condition and 34/211 (16%) in the SAU condition. Facilitators serving these youth and families and their supervisors completed measures of EHR usability and appropriateness, supervision processes and activities, work satisfaction, and use of and attitudes toward standardized assessments. Data from facilitators were collected by web survey and, where necessary, by phone interviews. Parents and caregivers completed measures via phone interviews. Related to fidelity and quality of behavioral health care, including Wraparound team climate, working alliance with providers, fidelity to the Wraparound model, and satisfaction with services. RESULTS: EHR-assigned facilitators from both sites demonstrated the robust use of the system. Facilitators in the EHR group reported spending significantly more time reviewing client progress (P=.03) in supervision, and less time overall sending reminders to youth/families (P=.04). A trend toward less time on administrative tasks (P=.098) in supervision was also found. Facilitators in both groups reported significantly increased use of measurement-based care strategies overall, which may reflect cross-group contamination (given that randomization of staff to the EHR occurred within agencies and supervisors supervised both types of staff). Although not significant at P<.05, there was a trend (P=.10) toward caregivers in the EHR group reporting poorer shared agreement on tasks on the measure of working alliance with providers. No other significant between-group differences were found. CONCLUSIONS: Results support the proposal that use of EHR systems can promote the use of client progress data and promote efficiency; however, there was little evidence of any impact (positive or negative) on overall service quality, fidelity, or client satisfaction. The field of children's behavioral health services would benefit from additional research on EHR systems using designs that include larger sample sizes and longer follow-up periods. TRIAL REGISTRATION: ClinicalTrials.gov NCT02421874; https://clinicaltrials.gov/ct2/show/NCT02421874 (Archived by WebCite at http://www.webcitation.org/6yyGPJ3NA).

Associations Between Adolescents' Perceptions of Alcohol Norms and Alcohol Behaviors: Incorporating Within-School Variability.

BACKGROUND: Social norm interventions have been implemented in schools to address concerns of alcohol use among high school students; however, research in this area has not incorporated measures of variability that may better reflect the complexity of social influences. PURPOSE: To examine the association between perceived alcohol norms, the student and school-level variability of those norms, and alcohol use behaviors among high school students. METHODS: A sample of 25,824 students from 58 high schools completed an online self-report survey. Hierarchical linear regression models were fit to examine the relationships between student- and school-level alcohol norm predictors, within school variability, and current alcohol use and binge drinking. RESULTS: Individual- and school-level norms were predictive of both current alcohol use and binge drinking. Whereas measures of norm diversity at the school-level were not predictive of alcohol use behaviors, individual norm proximity was predictive of both current alcohol use and binge drinking. DISCUSSION: The study findings were both consistent with prior research and support assertions that variability measures should be incorporated into social norms research approaches. TRANSLATION TO HEALTH EDUCATION PRACTICE: The findings support the incorporation of student-level variability measures, which could assist in identifying students who are susceptible to peer influence.

Teen Dating Violence Victimization Among High School Students: A Multilevel Analysis of School-Level Risk Factors.

BACKGROUND: Much etiologic research has focused on individual-level risk factors for teen dating violence (TDV); therefore, less is known about school-level and neighborhood-level risk factors. We examined the association between alcohol outlet density around high schools and TDV victimization and the association between markers of physical disorder around schools and TDV victimization among adolescents. METHODS: Data come from high school students participating in the Maryland Safe and Supportive Schools Initiative. Alcohol outlet density was calculated using walking distance buffers around schools. An observational tool was used to assess indicators of physical disorder on school property (eg, alcohol and drug paraphernalia). Hierarchical linear modeling was used to identify student- and school-level predictors associated with TDV victimization. RESULTS: Overall, 11% of students reported experiencing physical TDV and 11% reported experiencing psychological TDV over the past year. Recent alcohol use was a risk factor for TDV victimization for both sexes, whereas feeling safe at school was protective against TDV victimization for both sexes. Greater alcohol outlet density was associated with decreased TDV victimization for males, however, it was nonsignificant for females. Physical disorder around schools was not associated with TDV victimization for either sex. CONCLUSION: Although the school-level predictors were not associated with TDV victimization, alcohol use and perceptions of safety at school were significantly associated with TDV victimization. Prevention efforts to address alcohol use may affect TDV victimization.

Intimate Partner Violence and Patterns of Safety Strategy Use Among Women Seeking Temporary Protective Orders: A Latent Class Analysis.

This study examined use of safety strategies, experience of violence, and perception of danger from intimate partner violence (IPV) among 197 women seeking temporary protective orders against their abusive partners/ex-partners. Latent class analysis was used to group women into classes based on their use of safety strategies. Five classes of strategy use were identified: two high-activity classes, two moderately active classes, and one low-activity class. More severe abuse, increased perception of danger, and unemployment were associated with being in the higher activity classes. More effective interventions and outreach tools are needed to help women in IPV situations.

Exploring the Link Between Alcohol and Marijuana Use and Teen Dating Violence Victimization Among High School Students: The Influence of School Context.

BACKGROUND: Adolescence is a developmental period when dating behavior is first initiated and when the risk of abuse by or against a dating partner begins to emerge. It is also one in which experimentation with alcohol and illicit substances typically begins. The current study examined the association between recent alcohol use and recent marijuana use and the experience of physical and verbal teen dating violence (TDV) victimization while considering the potential influence of school contextual variables. METHOD: Data came from 27,758 high school students attending 58 Maryland public high schools. Hierarchical linear modeling was used to identify student- and school-level predictors associated with TDV. RESULTS: Results indicated that approximately 11% of students reported experiencing physical TDV and 11% of students reported experiencing verbal TDV over the past year. In addition, 33% of students reported recent alcohol use and 21% reported recent marijuana use. Hierarchical linear modeling results revealed that students who reported frequent recent alcohol or recent marijuana use were at increased odds of experiencing physical (adjusted odds ratio [AOR]alcohol = 2.80, p < .001; AORmarijuana = 2.03, p < .001) or verbal TDV (AORalcohol = 2.63, p < .001; AORmarijuana = 2.20, p < .001) victimization compared to students who reported little or no alcohol or marijuana use. School support was a protective factor for both physical TDV (AOR = 0.74, p < .001) and verbal TDV (AOR = 0.76, p < .001) victimization. CONCLUSIONS: Findings suggested that prevention efforts to address alcohol and marijuana use may have an effect on TDV victimization. Results also highlight the potential utility of enhancing student perceptions of school support as an approach for reducing TDV victimization.