A large exophytic plaque on the shoulder of a skin of color patient.

A 75-year-old Black man presented for evaluation of a skin lesion on his right shoulder. The lesion had been present for 3 months and was bleeding. A physical exam demonstrated a 2.7 cm exophytic, crusted, blue-to-purple plaque. A shave biopsy was performed, and histopathological examination revealed anastomosing strands of basaloid cells in the dermis, leading to a diagnosis of fibroepithelioma of pinkus (FeP). FeP is a rare variant of basal cell carcinoma. It typically presents as a solitary, pink, pedunculated papule on the lower back, but the presentation can vary. This case contributes to the scarce literature on the occurrence of FeP in skin of color populations. Here, we raise the possibility that FeP may present differently in skin of color patients compared to white patients. Greater clinician awareness can foster improved identification, management, and understanding of FeP in diverse populations.

Persistence and Potential Lethality in Intimate Partner Violence: Evaluating the Concurrent and Predictive Validity of a Dual Risk Assessment Protocol.

This study seeks to determine the concurrent and predictive validity of a dual risk assessment protocol. It combines the risk of persistence in intimate partner violence (IPV) measured via the Domestic Violence Screening Instrument-Revised (DVSI-R) with supplemental items from the Danger Risk Assessment (DRA) bearing on the risk of potential lethality. We further test whether this assessment protocol reproduces disparities by race and ethnicity found in the larger population. Using a sample of 4,665 IPV male defendants with a female victim, analyses support both types of criterion validity. The DRA risk score is associated with felony charges, incarceration at the initial arrest, and the frequency of subsequent dangerous behavior. Results also suggest minimal predictive bias or disparate impact by race and ethnicity. Incorporating supplemental items bearing on potential lethality risk adds important information concerning the risk management strategies of those involved in IPV.

Coercive Control Between Intimate Partners: An Application to Nonfatal Strangulation.

Nonfatal strangulation between intimate partners represents an extreme controlling form of violent behavior, increasing the risk that intimate partner violence (IPV) becomes lethal. Guided by Dutton and Goodman's conceptualization of coercive control, the present research explored the relation between death threats and subsequent nonfatal strangulation to amplify the credibility of those threats, using a large sample of IPV perpetrators (n = 6,488). Logistic regression analyses determined the relation between overt threats to a partner's life during an initial incident arrest and subsequent nonfatal strangulation postincident arrest, accounting for perpetrator characteristics and assessed risk. Results showed the highly gendered nature of this violent behavior, noting that men were significantly more likely than women to persist in nonfatal strangulation. Given the potential lethality of this violent behavior, the analysis also explored whether treatment service recommendations (family violence education, counseling, and mental health evaluation) mitigate these patterns. These preliminary findings support the further exploration of treatment and intervention efforts for reducing nonfatal strangulation.

Nasolabial outcomes in a nationwide study of orofacial cleft in New Zealand.

OBJECTIVES: To (a) assess nasolabial outcomes across four main cleft subgroups, (b) assess agreement using a categorical and a continuous scoring measure and (c) compare outcomes to international studies. SETTINGS AND SAMPLE POPULATION: Analysis of 470 images of which 218 was unilateral cleft lip and palate (UCLP), 128 unilateral cleft lip (UCL), 90 bilateral cleft lip and palate (BCLP) and 34 bilateral cleft lip (BCL). Images were taken around five (n = 279) and eight-ten (n = 191) years of age. MATERIALS & METHODS: Cropped images were assessed using the Asher-McDade (AM) and a 100 mm visual analogue scale (VAS) by a panel of six raters. Scoring was undertaken for vermillion border and nasal form, symmetry and profile. Analysis was undertaken for each subscore, a total score with sensitivity analysis using a total score based on the subscores for each patient. AM intra- and inter-rater reliability was assessed using weighted kappa and for the VAS components reliability was assessed using Pearson correlation. RESULTS: The AM intra-rater reliability was moderate/substantial, whilst inter-rater reliability was fair. The VAS intra-rater correlations were high, and inter-rater correlations were moderate. Better outcomes were found with cleft lip (CL) vs cleft lip and palate (CLP). No differences were found for sex, ethnicity, age and cleft laterality (unilateral). The AM found no difference between unilateral or bilateral. The VAS found bilateral scored worse than unilateral for both CL and CLP. CONCLUSIONS: The nasolabial outcomes differ by cleft type. The correlation was relatively high for the VAS whilst the AM had relatively poor reliability.

Disentangling the risk assessment and intimate partner violence relation: Estimating mediating and moderating effects.

To manage intimate partner violence (IPV), the criminal justice system has turned to risk assessment instruments to predict if a perpetrator will reoffend. Empirically determining whether offenders assessed as high risk are those who recidivate is critical for establishing the predictive validity of IPV risk assessment instruments and for guiding the supervision of perpetrators. But by focusing solely on the relation between calculated risk scores and subsequent IPV recidivism, previous studies of the predictive validity of risk assessment instruments omitted mediating factors intended to mitigate the risk of this behavioral recidivism. The purpose of this study was to examine the mediating effects of such factors and the moderating effects of risk assessment on the relation between assessed risk (using the Domestic Violence Screening Instrument-Revised [DVSI-R]) and recidivistic IPV. Using a sample of 2,520 perpetrators of IPV, results revealed that time sentenced to jail and time sentenced to probation each significantly mediated the relation between DVSI-R risk level and frequency of reoffending. The results also revealed that assessed risk moderated the relation between these mediating factors and IPV recidivism, with reduced recidivism (negative estimated effects) for high-risk perpetrators but increased recidivism (positive estimate effects) for low-risk perpetrators. The implication is to assign interventions to the level of risk so that no harm is done. (PsycINFO Database Record

A pilot randomized trial of community-based parent training for immigrant Latina mothers.

This paper reports on the development and piloting of the Madres a Madres (Mothers to Mothers) program, a new, community-based parent training program designed for immigrant Latina mothers and their children. Promotoras, or female community health workers of Latina background, delivered the program in a home visitation format. A total of 194 mothers and 194 focal children (87 male, 107 female) ages 7-12 were randomized to the intervention (113 mother-child dyads) or wait-list control condition (81 mother-child dyads) over the study period. Outcomes of interest were mother-reported parenting skills, broad family functioning, and child externalizing and internalizing behaviors. Data collection occurred at pretest, 3-month posttest, and 9-month follow-up periods. Multilevel growth models revealed increases in intervention mothers' reported parenting skills, family support, and family organization, and reductions in child internalizing behavior from pretest to follow-up, relative to the control condition. Outcomes did not vary by focal child age, gender, nativity status, or mother acculturative status (years in the United States). Findings are discussed in the context of future directions for research on the Madres a Madres program and on the implementation and dissemination of empirically-supported parent training practices to culturally diverse families.

Gender and intimate partner violence: does dual arrest reveal gender symmetry or asymmetry?

Research on Intimate Partner Violence (IPV) has ignited considerable controversy about gender and IPV. Feminist scholars have viewed IPV as a manifestation of male dominance and control, with women primarily the victims and men primarily the perpetrators of this behavior (gender asymmetry). Conversely, family violence researchers have viewed IPV as emerging from conflicts in relationships, with both men and women being involved (gender symmetry). The present study was framed within the context of this controversy using new empirical evidence on one person arrested (single arrest) or both persons arrested (dual arrest) in IPV incidents. Data were acquired on the assessed risk of IPV recidivism immediately after arrest and actual IPV recidivism over an 18-month period postassessment across the state of Connecticut involving heterosexual partners (N = 2,155). Though not definitive, the findings showed persistent gender asymmetry on these behavioral characteristics across arrest categories.

Family violence risk assessment: A predictive cross-validation study of the Domestic Violence Screening Instrument-Revised (DVSI-R).

This research was a cross-validation study of the Domestic Violence Screening Instrument-Revised (DVSI-R), using a diverse, statewide sample of 3,569 family violence perpetrators in Connecticut, assessed in February and March of 2007. It analyzed re-arrest data collected during an 18-month period post assessment. Three issues were central, which have been ignored in previous research on family violence risk assessment: (1) analyzing five refined measures of behavioral recidivism, (2) determining whether perpetrator characteristics and types of family and household relationships (beyond just heterosexual intimate partners) moderate the empirical relations between the DVSI-R and the behavioral recidivism measures, and (3) determining whether structured clinical judgment about the imminent risk of future violence to the victim or to others corresponds with recidivism predicted by the DVSI-R total numeric risk scores. The empirical findings showed that the DVSI-R had significant predictive accuracy across all five measures of recidivism. With one exception, these relations did not vary by gender, age, or ethnicity; and again with one exception, no significant evidence was found that types of family or household relationships moderated those empirical relations. In short, the evidence suggested that the DVSI-R was a robust risk assessment instrument, having applicability across different types of perpetrators and different types of family and household relationships. Finally, the empirical findings showed that structured clinical judgment about imminent risk-to-victim and risk-to-others corresponded with the prediction of recidivism by the DVSI-R total numeric risk scores, but the effects of those scores were significantly stronger than the perceived risk-to-victim or the perceived risk-to-others.

Alcohol availability and youth homicide in the 91 largest US cities, 1984-2006.

The aggregate relationship between homicide and alcohol availability is well established across a number of national and sub-national settings in North America, Europe and some parts of Asia. However, results linking youth homicide and alcohol availability at the retail level are largely absent from the literature, especially at the city level and across longer time periods. In a multivariate, pooled time series and cross-section study, youth homicide offending rates for two age groups, 13-17 and 18-24, were analysed for the 91 largest cities in the USA between 1984 and 2006. Data for social and economic characteristics, drug use, street gang activity and gun availability were also used as time series measures. Data on the availability of alcohol for each city were gathered from the US Census of Economic Activity, which is conducted every 5 years. These data were used to construct an annual time series for the density of retail alcohol outlets in each city. Results indicated that net of other variables, several of which had significant impacts on youth homicide, the density of alcohol outlets had a significant positive effect on youth homicide for those aged 13-17 and 18-24. Such positive effects have been found for adults in national and neighbourhood level studies, but this is the first study to report such evidence for teenagers and young adults. An important policy implication of these findings is that the reduction of the density of retail alcohol outlets in a city may be an effective tool for violent crime reduction among such youth.

Understanding bullying and victimization during childhood and adolescence: a mixed methods study.

In the present study, quantitative and qualitative data are presented to examine individual and contextual predictors of bullying and victimization and how they vary by age and gender. Two waves of survey data were collected from 2,678 elementary, middle, and high school youth attending 59 schools. In addition, 14 focus groups were conducted with 115 youth who did not participate in the survey. Changes in both bullying and victimization were predicted across gender and age by low self-esteem and negative school climate, with normative beliefs supporting bullying predicting increases in bullying only. Focus group comments provided insights into the dynamics of bullying, highlighting its connection to emergent sexuality and social identity during adolescence. Findings are discussed in terms of their implications for preventive antibullying interventions in schools.

Preventing children's aggression in immigrant Latino families: a mixed methods evaluation of the Families and Schools Together program.

The effectiveness of the evidence based program, Families and Schools Together (FAST), was examined in two inter-related studies with immigrant Latino (Mexican) families in the U.S. In Study 1, we reported findings from pre-test, 3-month post-test, and 12-month follow-up surveys of parents and children participating in the FAST program. Families were selected from communities that were randomly assigned to either intervention or control groups. A total of 282 parents (263 mothers and 19 fathers) participated in either the intervention (140 parents) or control (142 parents) condition over the course of 3 years. Each of the parents had a participating focal child; thus, 282 children (144 females and 138 males; average age = 9.5 years) participated in the study. A primary focus of the research was to determine whether participation in FAST led to reductions in children's aggression. Using linear growth models, no differences were noted on aggression between intervention and control groups, although intervention children did show significant improvements in social problem-solving skills and perceptions of collective efficacy. In Study 2, we conducted two focus groups with ten FAST participants to explore whether other unmeasured outcomes were noted and to understand better the mechanisms and impact of FAST. All of the parents in the focus groups reported that FAST had helped them better relate to and communicate with their children, and that the greatest effect was on the behavior of their older children. Results are discussed in terms of cultural fit of the FAST program for immigrant Latino families and future directions.

Preventing youth problem behaviors and enhancing physical health by promoting core competencies.

OBJECTIVES: The purpose of the present study was to investigate the longitudinal relations between specific core competencies, problem behaviors, and physical health among adolescents. METHODS: The study used two waves of data collected 1 year apart from the Add Health data set. The Add Health data set is a nationally representative sample of adolescents in grades 7 to 12. A total of 14,010 respondents were included in this study. There were two outcomes that were examined in this study: problem behavior (as observed by seven different behaviors), and health (general health and physical problems). RESULTS: We found that problem behavior and health outcomes were two distinct behavioral patterns that were related to one another. The two outcomes also shared common developmental predictors. CONCLUSIONS: Our findings suggest that a focus on core competencies is an important target for preventive interventions; among the competencies measured low self-control was the strongest single predictor of problem behaviors and adverse health outcomes.

Building social capital through neighborhood mobilization: challenges and lessons learned.

This paper describes a neighborhood-level intervention to promote the well-being of children up to five years old and their families in the City of Riverside, California. As a case study, the narrative presented here conveys how, in 2002, this city addressed the problem of youth violence through a theoretically informed approach to neighborhood mobilization. The approach is grounded in the assumption that such violence can ultimately be prevented by rebuilding social capital depleted by rapid and extensive neighborhood changes during the past decade. The theoretical premises underlying the mobilization approach are briefly summarized. Additionally, the challenge of blending theory and practice, as well as the fiscal, political, and social issues encountered in the initial implementation of this initiative, are discussed.

Prevalence and predictors of internet bullying.

PURPOSE: With the Internet quickly becoming a new arena for social interaction, it has also become a growing venue for bullying among youth. The purpose of the present study was to contrast the prevalence of Internet bullying with physical and verbal bullying among elementary, middle, and high school boys and girls, and to examine whether key predictors of physical and verbal bullying also predicted Internet bullying. METHODS: As part of an ongoing, statewide bullying prevention initiative in Colorado, 3,339 youth in Grades 5, 8, and 11 completed questionnaires in 78 school sites during the fall of 2005, and another 2,293 youth in that original sample participated in a follow-up survey in 65 school sites in the spring of 2006. Questionnaires included measures of bullying perpetration and victimization, normative beliefs about bullying, perceptions of peer social support, and perceptions of school climate. RESULTS: The highest prevalence rates were found for verbal, followed by physical, and then by Internet bullying. Physical and Internet bullying peaked in middle school and declined in high school. Verbal bullying peaked in middle school and remained relatively high during high school. Males were more likely to report physical bullying than females, but no gender differences were found for Internet and verbal bullying. All three types of bullying were significantly related to normative beliefs approving of bullying, negative school climate, and negative peer support. CONCLUSIONS: Preventive interventions that target school bullying by changing norms about bullying and school context may also impact Internet bullying, given the shared predictors.

Empirically examining the risk of intimate partner violence: the revised Domestic Violence Screening Instrument (DVSI-R).

OBJECTIVE: This study extends recent research on assessing the risk of intimate partner violence by determining the concurrent and predictive validity of a revised version of the Domestic Violence Screening Instrument (DVSI-R) and whether evidence of such validity is sustained independent of perpetrator demographic characteristics and forms of intimate violence. The analyses highlight violent incidents involving multiple victims as an indicator of "severe" violence. Previous research did not address these issues. METHODS: Data were analyzed on 14,970 assessments conducted in the State of Connecticut from September 1, 2004 through May 2, 2005. Hierarchical regression and receiver operating characteristic analyses were used to address the objectives of this research. RESULTS: The empirical findings support the concurrent and predictive validity of the DVSI-R and show that it is robust in its applicability. The findings further show that incidents involving multiple victims are highly associated with DVSI-R risk scores and recidivistic violence. CONCLUSION: Validating and demonstrating the robustness of a risk assessment instrument is only a first step in preventing violence involving intimate partners or others in family or family-like relationships. The challenge is to train professionals responsible for addressing the problem of such violence to link valid risk assessments to well-crafted strategies of supervision and treatment so that the victimized or other potential victims are protected and perpetrators are held accountable for their actions.

Assessing the risk of domestic violence reoffending: a validation study.

Little research has been conducted to validate available instruments for assessing the risk of domestic violence reoffending, especially research using some form of prospective design. This study uses a prospective design to determine the reliability and validity of the Domestic Violence Screening Instrument (DVSI). The analysis is based on a sample of 1,465 male domestic violence offenders selected consecutively over a 9-month period. Data on reoffending were collected in a 6-month follow-up period from a subsample of the victims (N = 125) of these perpetrators and from official records for all perpetrators during an 18-month follow-up period. The empirical results suggest that the DVSI was administered reliably, and they provide significant evidence of the concurrent, discriminant, and predictive validity of this instrument. Implications for further research and utilization of the DVSI are discussed.