Physical punishment (PP), which may involve the use of physical force, has been linked to negative effects in children and can escalate to abusive or harsh PP, resulting in injury or death.
To ...examine characteristics associated with fatal abuse involving caregiver use of harsh PP.
Data were from the National Violent Death Reporting System in 40 states, the District of Columbia, and Puerto Rico for years 2012–2018. Qualitative analysis was used to code textual material into categorial data, and logistic regression was used to examine associations between various characteristics and harsh PP.
Approximately 4 % (n = 87) of the 2414 abuse-related homicides were known to have been precipitated by caregiver use of harsh PP. In adjusted models, homicides had greater odds of being harsh PP-related when incidents involved mothers' male companions (versus fathers), victims had a previous nonfatal injury (versus no previous nonfatal injury), and another adult participated in the fatal incident or had awareness of prior abuse/neglect (versus those without this characteristic). Two common precipitators of caregivers' use of harsh PP were: 1) child had a bathroom-related accident/soiled clothes (23.0 %; n = 20), and 2) child disobeyed a directive given by the perpetrator (17.2 %; n = 15).
This study highlights characteristics associated with fatal abuse precipitated by caregiver use of harsh PP. Children were physically punished for developmentally normative behaviors. Ensuring caregivers are aware of and use effective parenting practices that focus on use of nonphysical discipline and promote healthy child development, may help decrease harsh PP and physical abuse-related homicides among children.
Homicide is a leading cause of death among children in the US.
To examine trends in child homicide rates and characteristics most commonly associated with these deaths.
In this cross-sectional study, ...the study team used National Vital Statistics System WONDER mortality data for 38 362 homicide victims aged 0 to 17 years for 1999 to 2020 and National Violent Death Reporting System data for child homicide victims for 2003 to 2019 in 45 states, Washington, DC, and Puerto Rico. WONDER data are based on death certificates for US residents. National Violent Death Reporting System data include characteristics of violent deaths, linking information from death certificates, and law enforcement, coroner, and medical examiner reports.
Child homicide was defined using underlying cause-of-death codes U01 to U02, X85 to Y09, and Y87.1 from the International Classification of Diseases, Tenth Revision, Clinical Modification.
Trends in homicide rates per 100 000 children were tested using joinpoint regression analysis; differences in rates from 2019 to 2020 were evaluated using z tests. Circumstances of child homicides were described.
This study included 38 362 homicide victims (69.4% male). The overall child homicide rate (per 100 000 children) has increased annually, on average 4.3% since 2013, with a precipitous rise from 2019 to 2020 (2019 rate, 2.2; 2020 rate, 2.8; overall increase of 27.7%). Homicide rates recently increased significantly for boys (2018 rate, 2.9; 2020 rate, 4.1; overall increase of 16.1%), 6- to 10-year-olds (2014 rate, 0.5; 2020 rate, 0.8; overall increase of 5.6%), 11- to 15-year-olds (2018 rate, 1.3; 2020 rate, 2.2; overall increase of 26.9%), 16- to 17-year-olds (2018 rate, 6.6; 2020 rate, 10.0; overall increase of 19.0%), Black children (2012 rate, 5.9; 2018 rate, 6.8; 2020 rate, 9.9; overall increase of 16.6% from 2018 to 2020), Hispanic children (2014 rate, 1.6; 2020 rate, 2.2; overall increase of 4.7%), children in the South (2013 rate, 2.1; 2020 rate, 3.5; overall increase of 6.4%), and in rural (2011 rate, 1.8; 2020 rate, 2.4; overall increase of 3.2%) and urban areas (2013 rate, 1.9; 2020 rate, 2.9; overall increase of 4.4%). Since 1999, homicide rates have decreased for girls (1999 rate, 1.9; 2020 rate, 1.5; overall decrease of 1.4%), infants (1999 rate, 8.7; 2020 rate, 6.6; overall decrease of 1.3%), 1- to 5-year-olds (1999 rate, 2.1; 2020 rate, 1.8; overall decrease of 1.0%), Asian or Pacific Islander children (1999 rate, 2.0; 2020 rate, 0.5; overall decrease of 4.4%), White children (1999 rate, 1.5; 2020 rate, 1.3; overall decrease of 0.7%), and children in the Northeast (1999 rate, 2.0; 2020 rate, 1.7; overall decrease of 1.4%). Homicides of children 10 years or younger were most commonly precipitated by abuse/neglect, perpetrated by parents/caregivers. Homicides of 11- to 17-year-olds were most commonly precipitated by crime and arguments and perpetrated by someone known to them, especially friends and acquaintances.
The decline in homicide rates for some geographic and child demographic groups is encouraging; however, rates recently increased across several subpopulations, with some racial and ethnic disparities persisting for more than 20 years. More targeted strategies are needed to (1) protect 6- to 10-year-olds, 11- to 17-year-olds, and children in certain geographic areas and (2) urgently address firearm violence, racism, and inequities at the root of youth violence.
Risk for sexual violence begins early in the lifespan; thus, interventions are needed to decrease the risk for sexual violence among high school youth. The current study evaluates the Your Voice Your ...View (YVYV) sexual violence prevention program using a school‐based cluster trial among 26 high schools in the Northeastern United States. YVYV, includes: 1) a series of four classroom workshops designed to engage students as allies in violence prevention through bystander intervention skills training, address risks for sexual aggression, and reduce risk for victimization; 2) a Lunch and Learn teacher training workshop; and 3) a 4‐week social norms poster campaign based on normative data from the school. Schools were matched based on size and demographics and randomly assigned to the intervention group or a wait‐list control group. A sample of 2685 10th grade students enrolled in the research and completed assessments at baseline, 2‐month and 6‐month follow‐up periods. The magnitude of the difference in sexual aggression did not vary by condition at either follow‐up period. The magnitude of 6‐month differences in experiencing unwanted sexual intercourse varied significantly by condition (IRR = 0.33 0.14–0.76), demonstrating a small protective effect favoring intervention schools (Cohen's f2 = 0.012). These findings highlight the promise of multicomponent interventions grounded in bystander intervention skills training, risk reduction, and social norms theory as a promising, comprehensive approach for sexual violence prevention among youth.
Research has demonstrated the effectiveness of family-based programs for reducing adolescent risk behaviors and promoting adolescent health; however, parent engagement, specifically in terms of ...recruitment and retention, remains a consistent challenge. Recruitment rates for family-based prevention programs range from 3 to 35%, while, on average, 28% of caregivers drop out before program completion. Thus, engagement of parents in prevention programming is of utmost concern to ensure families and youth benefit from implementation of family-based programs. In this manuscript, two Centers for Disease Control and Prevention-funded projects share their experiences with engagement of parents in violence prevention programs. Problems related to parent engagement are reviewed, as are structural, attitudinal, and interpersonal barriers specific to recruitment and retention. Examples of successful implementation strategies identified across urban and rural sites are also analyzed and lessons learned are provided.
Pancreas volume derived from imaging may objectively reveal volume loss relevant to identifying sequelae of acute pancreatitis (AP) and ultimately diagnosing chronic pancreatitis (CP). The purposes ...of this study were to: (1) quantify pancreas volume by imaging in children with either (a) a single episode of AP or (b) acute recurrent pancreatitis (ARP), and (2) compare these volumes to normative volumes.
This retrospective study was institutional review board approved. A single observer segmented the pancreas (3D Slicer; slicer.org) on n = 30 CT and MRI exams for 23 children selected from a prospective registry of patients with either an index attack of AP or with ARP after a known index attack date. Patients with CP were excluded. Segmented pancreas volumes were compared to published normal values.
Mean pancreas volumes normalized to body surface area (BSA) in the index AP and ARP groups were 38.2 mL/m
(range: 11.8-73.5 mL/m
) and 27.9 mL/m
(range: 8.0-69.2 mL/m
) respectively. 43 % (6/14) of patients post-AP had volumes below the 25th percentile, 1 (17 %) of which was below the 5th percentile (p = 0.3027 vs. a normal distribution). Post-ARP, 44 % (7/16) of patients had volumes below the 5th percentile (p < 0.001).
A significant fraction (40 %) of children with ARP have pancreas volumes <5th percentile for BSA even in the absence of CP. A similar, but not statistically significant, fraction have pancreas volumes <25th percentile after an index attack of AP. Pancreatic parenchymal volume deserves additional investigation as an objective marker of parenchymal damage from acute pancreatitis and of progressive pancreatitis in children.
Parent–Child Interaction Therapy (PCIT) has been used successfully in the United States and in other countries around the world, but its use in Asian countries has been more limited. The present ...study is the first of its kind to examine the predictors of treatment attrition and length in a sample of Taiwanese caregivers and their children. It is also the first to examine PCIT outcomes in Taiwanese families. Maladaptive personality characteristics of the caregiver were the best predictor of attrition, followed by single-parent, removal of the child from the home, and lower levels of caregiver education. Treatment length was predicted by child minority status and parent–child interactions (i.e., parent commands and negative parent talk). In terms of outcomes, statistically significant treatment changes were noted for all treatment outcome variables at post-treatment and at 3-month follow-up. These findings suggest that PCIT is a promising intervention for this population. The predictors of treatment attrition and length can be used when Taiwanese caregiver–child dyads present for services so that additional assistance can be provided prior to or during treatment to increase adherence to the recommended number of treatment sessions for maximal impact. Future studies may replicate the present study with a larger clinical sample to examine the long-term effects of PCIT and to include a no-treatment control condition to afford a more robust empirical evaluation.
•We examined treatment attrition and length in a sample of Taiwanese families.•Caregiver psychopathology was the best predictor of attrition.•Child ethnicity and negative parent verbalizations predicted treatment length.•Caregiver and child behavior improved after participation in PCIT.•The findings suggest that PCIT is a promising intervention for Taiwanese families.
Galaxy clusters might be sources of TeV gamma rays emitted by high-energy protons and electrons accelerated by large-scale structure formation shocks, galactic winds, or active galactic nuclei. ...Furthermore, gamma rays may be produced in dark matter particle annihilation processes at the cluster cores. We report on observations of the galaxy clusters Perseus and A2029 using the 10 m Whipple Cerenkov telescope during the 2003-2004 and 2004-2005 observing seasons. We apply a two-dimensional analysis technique to scrutinize the clusters for TeV emission. In this paper we first determine flux upper limits on TeV gamma-ray emission from point sources within the clusters. Second, we derive upper limits on the extended cluster emission. We subsequently compare the flux upper limits with EGRET upper limits at 100 MeV and theoretical models. Assuming that the gamma-ray surface brightness profile mimics that of the thermal X-ray emission and that the spectrum of cluster cosmic rays extends all the way from thermal energies to multi-TeV energies with a differential spectral index of-2.1, our results imply that the cosmic-ray proton energy density is less than 7.9% of the thermal energy density for the Perseus Cluster.
Despite the high risk for sexual assault among adolescents, few sexual assault prevention programs designed for implementation in high schools have sustained rigorous evaluation. The present study ...sought to better understand the factors that influenced the implementation of Your Voice Your View (YVYV), a four‐session sexual assault prevention program for 10th grade students, which includes a teacher “Lunch and Learn” training as well as a 4‐week school‐specific social norms poster campaign. Following program implementation, eight school partners (i.e., health teachers, guidance counselors, teachers, and principals) participated in an interview to provide feedback on the process of program implementation. The Consolidated Framework for Implementation Research was utilized to examine site‐specific determinants of program implementation. Participants discussed the importance of the design quality and packaging of the program, as well as the relative advantage of offering students a violence prevention program led by an outside team, as opposed to teachers in the school. School partners highlighted the importance of intensive preplanning before implementation, clear communication between staff, the utility of engaging a specific champion to coordinate programming, and the utility of offering incentives for participation. Having resources to support implementation, a desire to address sexual violence in the school, and a positive classroom climate in which to administer the small‐group sessions were seen as school‐specific facilitators of program implementation. These findings can help to support the subsequent implementation of the YVYV program, as well as other sexual assault prevention programs in high schools.
Sexual assault is a preventable problem that is widespread and particularly prevalent for certain populations (e.g., female college students, Native American women). Despite the gravity of this ...public health priority, most individuals tasked with the primary prevention of sexual assault are not adequately trained for the job (e.g., professionals often trained solely in sexual assault response). To achieve optimal outcomes, professionals responsible for implementing sexual assault prevention must possess certain core competencies, or knowledge and skills essential for job performance, which include those needed for any primary prevention effort in addition to those specific to sexual assault prevention. The purpose of this study was to develop and assess the construct validity of a competency assessment tool for sexual assault prevention practitioners. An existing assessment tool, which was designed for injury and violence prevention practitioners, was tailored to reflect competencies needed by sexual assault prevention practitioners as informed by the literature. The newly tailored measure was pilot tested with 33 individuals with varying levels of expertise with sexual assault prevention. These individuals were categorized into three groups based on self-rated sexual assault prevention expertise (low, medium, or high) to assess group differences. As expected, the high expertise group rated higher knowledge in all the competencies than the medium and low expertise groups (except for the competency pertaining to developing and maintaining competency). Data collection and analyses were conducted in 2020. Implications for how the assessment tool can be used to identify gaps among individual practitioners and teams of practitioners are discussed.
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