Intergenerational (Dis)continuity of Child Maltreatment: Variation by Parents' Childhood Victimization Experiences and Sex.

This longitudinal population-based study examines the association between maltreatment victimization experiences and the likelihood of intergenerational (dis)continuity of maltreatment. Our data include all individuals born in 1983/1984 in Queensland (QLD), Australia who are registered as parents via birth records and who experienced system contacts for maltreatment victimization in childhood (n = 2906). Child safety data on system contacts as a child victim and person responsible for harm to a child were obtained from the Department of Children, Youth Justice and Multicultural Affairs. Out-of-home care experiences and maltreatment frequency, timing, and type were examined. Results indicated that childhood maltreatment experiences significantly differed between parents who were not subsequently responsible for harm to a child (cycle breakers) and parents who were subsequently responsible for harm to a child (cycle maintainers). Different patterns of association were observed across sex. These findings highlight the importance of recognizing the heterogeneity of victim maltreatment experiences and associated risk of maltreatment for their children, and can inform effective and targeted interventions by tailoring these by sex and developmental period.

A semiempirical method optimized for modeling proteins.

CONTEXT: In recent years, semiempirical methods such as PM6, PM6-D3H4, and PM7 have been increasingly used for modeling proteins, in particular enzymes. These methods were designed for more general use, and consequently were not optimized for studying proteins. Because of this, various specific errors have been found that could potentially cast doubt on the validity of these methods for modeling phenomena of biochemical interest such as enzyme catalytic mechanisms and protein-ligand interactions. To correct these and other errors, a new method specifically designed for use in organic and biochemical modeling has been developed. METHODS: Two alterations were made to the procedures used in developing the earlier PMx methods. A minor change was made to the theoretical framework, which affected only the non-quantum theory interatomic interaction function, while the major change involved changing the training set for optimizing parameters, moving the focus to systems of biochemical significance. This involved both the selection of reference data and the weighting factors, i.e., the relative importance that the various data were given. As a result of this change of focus, the accuracy in prediction of heats of formation, hydrogen bonding, and geometric quantities relating to non-covalent interactions in proteins was improved significantly.

Psychiatric illness and the risk of reoffending: recurrent event analysis for an Australian birth cohort.

BACKGROUND: Psychiatric illness is a well-established risk factor for criminal justice system involvement, but less is known about the relationships between specific psychiatric illnesses and reoffending. Research typically examines reoffending as a single discrete event. We examined the relationship between different psychiatric disorders and types of reoffending while accounting for multiple reoffending events over time. METHODS: Data were drawn from a population cohort of 83,039 individuals born in Queensland, Australia, in 1983 and 1984 and followed to age 29-31 years. Psychiatric diagnoses were drawn from inpatient health records and offending information was drawn from court records. Descriptive and recurrent event survival analyses were conducted to examine the association between psychiatric disorders and reoffending. RESULTS: The cohort included 26,651 individuals with at least one proven offence, with 3,580 (13.4%) of these individuals also having a psychiatric disorder. Individuals with any psychiatric disorder were more likely to reoffend compared to those without a disorder (73.1% vs. 56.0%). Associations between psychiatric disorders and reoffending varied across age. Individuals with a psychiatric disorder only started to accumulate more reoffending events from ~ 27 years, which accelerated up to age 31 years. There were both specificity and common effects in the associations between different psychiatric disorders and types of reoffending. CONCLUSIONS: Findings demonstrate the complexity and temporal dependency of the relationship between psychiatric illness and reoffending. These results reveal the heterogeneity present among individuals who experience psychiatric illness and contact with the justice system, with implications for intervention delivery, particularly for those with substance use disorders.

WT1 complete gonadal dysgenesis with membranoproliferative glomerulonephritis: case series and literature review.

BACKGROUND: Intronic WT1 mutations are usually causative of Frasier syndrome with focal segmental glomerulosclerosis as the characteristic nephropathy. Membranoproliferative glomerulonephritis is not commonly associated with disorders of sex development but has been recently identified as a WT1-associated nephropathy, but usually in cases of exonic mutations in either isolated Wilms tumor or Denys-Drash syndrome. METHODS: The clinical and genetic data from 3 individuals are reported. RESULTS: This report describes the kidney manifestations in 3 individuals from 2 unrelated families with Frasier syndrome intronic WT1 mutations, noting that 2 of the 3 individuals have histologically confirmed membranoproliferative glomerulonephritis. CONCLUSIONS: These case reports support expansion of the clinical spectrum of the kidney phenotypes associated with Frasier syndrome providing evidence of an association between WT1 mutation and an immune complex-related membranoproliferative glomerulonephritis. A higher resolution version of the Graphical abstract is available as Supplementary information.

Dual-system Involvement: Exploring the Overlap Between Domestic and Family Violence and Child Maltreatment Perpetration.

This longitudinal population-based study aimed to understand the dual-system involvement of males who engage in domestic and family violence (DFV) and child maltreatment perpetration. Specifically, this study investigates the prevalence of male perpetration of DFV, child maltreatment, and dual-system involvement, and compares the frequency and nature of perpetration by males with single-system contact and males with dual-system contact. The effect of race (Indigenous Australian/non-Indigenous Australian) and parental status on dual-system involvement is also examined. This study utilizes data from the Queensland Cross-sector Research Collaboration repository. These data contain each contact an individual male born in 1983 or 1984 had with the Queensland civil court system as a respondent to a domestic violence order (DVO) and the Queensland statutory child protection system, where, after an investigation, they were identified as the person responsible for substantiated harm to a child. The results from the study show a high level of overlap between males who perpetrate DFV and child maltreatment. Of males identified as being responsible for substantiated harm to a child, 58% have also been a respondent of a DVO, and approximately 16% of male DVO respondents were identified as being responsible for substantiated harm to a child. Differences were found in the frequency and nature of perpetration by males with dual-system involvement compared to those with single-system contact for either DFV or child maltreatment. Our results also show differences for Indigenous status, parental status, number of maltreatment events, harm type, number of DVOs, and number of breaches of a DVO. The implications of this study for both policy and practice are discussed.

Psychiatric disorders and offending in an Australian birth cohort: Overrepresentation in the health and criminal justice systems for Indigenous Australians.

OBJECTIVE: Most studies that examine psychiatric illness in people who offend have focused on incarcerated samples, with little known about the larger population of individuals with criminal justice system contact. We examine the overlap between proven offences and psychiatric diagnoses with an emphasis on experiences for Indigenous Australians. METHODS: In a population-based birth cohort of 45,141 individuals born in Queensland, Australia, in 1990 (6.3% Indigenous), psychiatric diagnoses were identified from hospital admissions between ages 4/5 and 23/24 years and proven offences were identified from court records (spanning ages 10-24 years). Prevalence rates for offending, psychiatric diagnoses and their overlap were examined for Indigenous and non-Indigenous individuals. Associations between specific psychiatric diagnoses and types of offending were examined using logistic regressions. RESULTS: There were 11,134 (24.7%) individuals with a finalised court appearance, 2937 (6.5%) with a diagnosed psychiatric disorder and 1556 (3.4%) with a proven offence and diagnosed psychiatric disorder, with Indigenous Australians significantly overrepresented across all outcomes. Compared with non-Indigenous Australians, Indigenous Australians were younger at their first court finalisation (Cohen's d = -0.62, 95% confidence interval = [-0.67, -0.57]), experienced a higher number of finalisations (d = 0.94, 95% confidence interval = [0.89, 1.00]) and offences (d = 0.64, 95% confidence interval = [0.59, 0.69]) and were more likely to receive custodial (d = 0.41, 95% confidence interval = [0.36, 0.46]) or supervised (d = 0.55, 95% confidence interval = [0.50, 0.60]) sentences. The overlap between offending and psychiatric illness was more pronounced for Indigenous Australians compared with non-Indigenous Australians (14.8% vs 2.7%). Substance use disorders were the most prevalent psychiatric diagnosis among individuals with a court finalisation (9.2%). CONCLUSIONS: Indigenous Australians were significantly overrepresented in court finalisations and psychiatric diagnoses. Indigenous Australians with a psychiatric diagnosis were at highest risk of experiencing a court appearance, emphasising the importance of culturally appropriate mental health responses being embedded into the criminal justice system.

Exploring dual-system involvement for domestic violence victimisation and child maltreatment perpetration: An exploration by gender and race/ethnicity.

BACKGROUND: There is an historical separation between system responses to domestic violence (DV) and child maltreatment. Concerns have been noted that DV victims may be over-represented as parents responsible for harm to children in the child protection system. Although there is a growing acknowledgement of the high overlap between DV and child maltreatment within families, little empirical research has been conducted on this relationship. OBJECTIVE: This study aims to longitudinally examine the overlap of being a victim of DV and a perpetrator of child maltreatment, along with the impact of dual-system involvement on the nature and frequency of the violence experienced. METHODS: The data are linked longitudinal administrative data from the Queensland Cross-sector Research Collaboration (QCRC) repository. These data contain each contact every individual born in Queensland in 1983 or 1984 had with the Queensland DV civil court system and the Queensland statutory child protection system. RESULTS: Of individuals identified as a perpetrator of child maltreatment, 45% have also been a victim of DV and approximately 22% of DV victims were identified as a perpetrator of child maltreatment. Our results also show differences based on Indigenous status, gender, parental status, number of substantiations, frequency of violence, harm type, and number of domestic violence orders. CONCLUSIONS: There is considerable overlap between individuals who are victims of DV and individuals who perpetrate child maltreatment. This overlap was influenced by both gender and race/ethnicity. The implications of this study for both policy and practice are discussed.

North central London elective orthopaedic network and health service innovation to improve the quality of NHS patient care.

Health service innovation is required to meet the ever-growing demands of modern medicine. This editorial discusses the transformation of the north central London elective orthopaedic network and the essential principles which future integrated care systems could incorporate.

"Who maltreats? Distinct pathways of intergenerational (dis)continuity of child maltreatment".

BACKGROUND: Maltreatment victimization history is an established risk factor for child maltreatment across generations. However, many parents with a victimization history do not maltreat, and many parents with no victimization history do have victimized children. OBJECTIVES: To understand differences in demographic and maltreatment risk factors across the following intergenerational patterns of maltreatment: cycle maintainers, cycle breakers, cycle initiators, and a comparison group (no maltreatment). PARTICIPANTS AND SETTING: Data were drawn from a large population-based cohort in Queensland, Australia and included 32,574 biological parents and their children. Maltreatment experiences as a victim or person responsible for harm towards a child were obtained from the Queensland Child Protection System. METHODS: Multinomial regression was completed with the full sample to compare the three maltreatment groups with the comparison group. Logistic regressions were conducted on all pairwise combinations of maltreatment groups. Models accounted for several demographic and maltreatment factors. RESULTS: Compared with breakers, maintainers were more likely to be Indigenous (OR = 1.86), never married (OR = 0.34), younger at first birth (OR = 0.87), have ≥3 children (OR = 1.99), be younger at first-and older at last-maltreatment victimization (ORs = 0.97 and 1.07, respectively), and experience a higher frequency of victimization (OR = 1.05). Amongst maltreaters, males were significantly more likely to be initiators while females were more likely to be maintainers (OR = .62). There were few other differences between initiators and maintainers. CONCLUSIONS: Meaningful differences among the three maltreatment groups were revealed suggesting that research should focus on the intergenerational discontinuity of maltreatment.

Prevalence of psychiatric disorders for Indigenous Australians: a population-based birth cohort study.

AIMS: Limited information exists about the prevalence of psychiatric illness for Indigenous Australians. This study examines the prevalence of diagnosed psychiatric disorders in Indigenous Australians and compares this to non-Indigenous Australians. The aims were to: (1) determine prevalence rates for psychiatric diagnoses for Indigenous Australians admitted to hospital; and (2) examine whether the profile of psychiatric diagnoses for Indigenous Australians was different compared with non-Indigenous Australians. METHODS: A birth cohort design was adopted, with the population consisting of 45 141 individuals born in the Australian State of Queensland in 1990 (6.3% Indigenous). Linked administrative data from Queensland Health hospital admissions were used to identify psychiatric diagnoses from age 4/5 to 23/24 years. Crude lifetime prevalence rates of psychiatric diagnoses for Indigenous and non-Indigenous individuals were derived from the hospital admissions data. The cumulative incidence of psychiatric diagnoses was modelled separately for Indigenous and non-Indigenous individuals. Logistic regression was used to model differences between Indigenous and non-Indigenous psychiatric presentations while controlling for sociodemographic characteristics. RESULTS: There were 2783 (6.2%) individuals in the cohort with a diagnosed psychiatric disorder from a hospital admission. The prevalence of any psychiatric diagnosis at age 23/24 years was 17.2% (491) for Indigenous Australians compared with 5.4% (2292) for non-Indigenous Australians. Indigenous individuals were diagnosed earlier, with overrepresentation in psychiatric illness becoming more pronounced with age. Indigenous individuals were overrepresented in almost all categories of psychiatric disorder and this was most pronounced for substance use disorders (SUDs) (12.2 v. 2.6% of Indigenous and non-Indigenous individuals, respectively). Differences between Indigenous and non-Indigenous Australians in the likelihood of psychiatric disorders were not statistically significant after controlling for sociodemographic characteristics, except for SUDs. CONCLUSIONS: There is significant inequality in psychiatric morbidity between Indigenous and non-Indigenous Australians across most forms of psychiatric illness that is evident from an early age and becomes more pronounced with age. SUDs are particularly prevalent, highlighting the importance of appropriate interventions to prevent and address these problems. Inequalities in mental health may be driven by socioeconomic disadvantage experienced by Indigenous individuals.

Measuring Engagement in Antisocial Behavior During Late Adolescence and Early Adulthood for Typically Developing Youth.

Research examining the nature and extent of participation in antisocial behavior (ASB) in typically developing individuals during late adolescence and early adulthood remains rare. A self-report instrument for measuring participation in ASB was developed and administered to an Australian sample of 404 youth (64.9% females) aged 17 to 22-years using item-response theory methods. All participants reported involvement in multiple forms of ASB, although this involvement was skewed toward less serious behaviors, suggesting that engagement in these behaviors were common for typically developing youth. Unlike previous research, few sex differences were detected, with females' self-reported involvement in ASB similar to that of males. A need for ongoing longitudinal research in typically developing samples was highlighted, particularly on the transition to adulthood.

Are Dual-System Offenders Different? An Examination of Prevalence and Specialization in Criminal Offending and Child Maltreatment Perpetration.

Although most theoretical and policy approaches treat criminal behavior and child maltreatment as different issues, we examine the prevalence of those involved in both the criminal justice system and child protective services as perpetrators, assessing how several criminal career characteristics differ between dual-system and single-system offenders. Using longitudinal cohort data from the Queensland Cross-Sector Research Collaboration (QCRC), we found that while dual-system-involved offenders made up only 4% of the population, their proportion was much higher among those with a delinquent history, especially among females (males = 21%, females = 38%). Those involved with both systems were more serious offenders and child maltreatment perpetrators with respect to the number and versatility of system contacts. These findings suggest involvement in both the criminal justice and child welfare systems are part of an underlying vulnerability or predisposition toward antisocial behavior and represent an important overlap of service delivery that must be managed effectively.

Executive Functions in Late Adolescence and Early Adulthood and Their Relationship with Risk-Taking Behavior.

Executive functions (EF) continue developing throughout adolescence, with immaturity in EF theorized to underlie risk-taking. 129 older adolescents and young adults (aged 17 to 22 years) were assessed using a battery of cool and hot EF tasks, and a behavioral measure of risk-taking propensity. Minimal age-related differences in EF performance were evident, confirming they were largely functionally mature by mid-adolescence. Inconsistent with the predictions of imbalance models of adolescent development, weaker EF was not associated with greater risk-taking propensity. The findings suggest that during later adolescence and early adulthood, not all forms of risk-taking are associated with EF.

Assessing emotional and social health using photographs: An innovative research method for rural studies and its applicability in a care-farming program for youth.

A framework for assessing photographs for the emotional and social health of young people (SHAPE) is described and tested, within the context of a rural program. Two independent raters assessed the photographs of participants. To assess inter-rater reliability, Cohen' K and Kendall's W were calculated. The two reviewers' assessments of photographs were in agreement. The assessment of emotional/behavioural display showed 82% agreement. Agreement between reviewers' judgements of proxemics (W = .866), interaction (W = .722), engagement (W = .932) and overall impression (W = .804) were all significant (p < .005). The method yielded results indicating that participants found gardening immediately engaging but their approach to equines exhibited a change from fascination to confidence during the program. The visual-diary method is a useful and sensitive method for research: where resources are limited; to complement traditional measures; for use with people who lack appropriate verbal communication or literacy skills to complete questionnaires; young children; other underrepresented groups.

Fixed-rate insulin for adult diabetic ketoacidosis is associated with more frequent hypoglycaemia than rate-reduction method: a retrospective cohort study.

OBJECTIVE: To assess whether hypoglycaemia incidence during management of adult diabetic ketoacidosis (DKA) differed following transition from a fixed-rate insulin protocol to a protocol using an empiric insulin rate reduction after normoglycaemia. METHODS: We retrospectively reviewed charts from adult patients managed with a DKA order set before and after order set revision. In cohort 1 (n = 77), insulin rate was 0.1 unit/kg/h with no adjustments and dextrose was infused at 12.5 g/h after glucose reached 250 mg/dl. In cohort 2 (n = 78), insulin was reduced to 0.05 unit/kg/h concurrent with dextrose initiation at 12.5 g/h after glucose reached 200 mg/dl. The primary outcome was hypoglycaemia (glucose < 70 mg/dl) within 24 h of the first order for insulin. KEY FINDINGS: The 24-h incidence of hypoglycaemia was 19.2% in cohort 2 versus 32.5% in cohort 1; the adjusted odds ratio was 0.46 (95% confidence interval (CI) [0.21, 0.98]; P = 0.047). The 24-h use of dextrose 50% in water (D50W) was also reduced in cohort 2. No differences were seen in anion gap or bicarbonate normalization, rebound hyperglycaemia or ICU length of stay. In most patients who became hypoglycaemic, the preceding glucose value was below 100 mg/dl. CONCLUSIONS: The insulin rate-reduction protocol was associated with less hypoglycaemia and no obvious disadvantage. Robust intervention for low-normal glucose values could plausibly achieve low hypoglycaemia rates with either approach.

Restorative Justice Conferencing: Not a Panacea for the Overrepresentation of Australia's Indigenous Youth in the Criminal Justice System.

Restorative justice conferencing is a police diversionary strategy used extensively in Australian jurisdictions to channel young offenders away from formal court processing. Advocates view conferencing as culturally appropriate and a means to reduce the overrepresentation of Indigenous young people because it is rooted in Indigenous justice traditions. However, whether conferencing is effective at reducing recidivism by Indigenous young people compared with non-Indigenous young people remains unknown. We examine this using a longitudinal cohort of youth offenders from Australia. Propensity score matching was used to match Indigenous and non-Indigenous young people at their first conference and examined reoffending outcomes to explore its efficacy at reducing recidivism ( n = 394). Results indicate that, despite statistically controlling for factors related to reoffending, recidivism levels postconference were significantly higher for Indigenous young people. These results suggest that conferencing is unlikely to address the problem of Indigenous overrepresentation within Australia's youth justice system.

New Methods to Address Old Challenges: The Use of Administrative Data for Longitudinal Replication Studies of Child Maltreatment.

Administrative data are crucial to the "big data" revolution of social science and have played an important role in the development of child maltreatment research. These data are also of value to administrators, policy makers, and clinicians. The focus of this paper is the use of administrative data to produce and replicate longitudinal studies of child maltreatment. Child protection administrative data have several advantages. They are often population-based, and allow longitudinal examination of child maltreatment and complex multi-level analyses. They also allow comparison across subgroups and minority groups, remove burden from individuals to disclose traumatic experiences, and can be less biased than retrospective recall. Finally, they can be linked to data from other agencies to explore comorbidity and outcomes, and are comparatively cost and time effective. The benefits and challenges associated with the use of administrative data for longitudinal child maltreatment research become magnified when these data are used to produce replications. Techniques to address challenges and support future replication efforts include developing a biographical understanding of the systems from which the data are drawn, using multiple data sources to contextualize the data and research results, recognizing and adopting various approaches to replication, and documenting all data coding and manipulation processes. These techniques are illustrated in this paper via a case study of previous replication work.

Transitions and turning points revisited: A replication to explore child maltreatment and youth offending links within and across Australian cohorts.

In this study we examined the consistency of life-course child maltreatment trajectories and youth offending links across birth cohorts. In so doing we demonstrated the value of replication studies for maltreatment research. We applied the methodology of Stewart et al. (2008) and linked population-based (1990 birth cohort) child protection and youth justice administrative data from Queensland, Australia. We performed a group based trajectory analysis to identify distinct maltreatment trajectory groups distinguishable by maltreatment timing and frequency across the life-course. We explored group-based youth offending outcomes with consideration of variations in maltreatment chronicity, timing, and frequency, multi-type maltreatment, gender and race (Indigenous Australian versus non-Indigenous Australian youths). To determine the consistency of maltreatment trajectories and offending links across cohorts (1983/84 versus 1990) we compared our results with those of Stewart et al. (2008). Consistent with Stewart et al. (2008): (1) We identified six distinct maltreatment trajectory groups; (2) Trajectory groups characterised by chronic maltreatment and/or adolescent maltreatment had the largest proportion of young offenders; and (3) Maltreatment frequency commonly peaked at transition points. Extending beyond Stewart et al. (2008) we noted considerable overlap between maltreatment dimensions and a potential impact of race and multi-type maltreatment on maltreatment and offending links. We endorse replication studies as a valuable tool to advance child maltreatment policy and practice and recommend further research on interactions between maltreatment dimensions, gender, race, and youth offending.

Testing the sexually abused-sexual abuser hypothesis: A prospective longitudinal birth cohort study.

The sexually abused-sexual abuser hypothesis posits that persons, especially males, who are sexually abused as children are at particular risk of sexually abusing others later in life. We tested this hypothesis by prospectively examining associations between maltreatment and offending in a birth cohort of 38,282 males with a maltreatment history and/or at least one finalized offense. We examined these associations within the context of the wider birth population. Proportionally few boys were the subject of official notifications for sexual abuse (14.8% of maltreated boys, and 1.4% of the birth population); proportionally very few of these sexually abused boys (3%) went on to become sexual offenders; and, contrary to findings typically reported in retrospective clinical studies, proportionally few sexual offenders (4%) had a confirmed history of sexual abuse. Poly-victimization (exposure to multiple types of maltreatment) was significantly associated with sexual offending, violent offending, and general (nonsexual, nonviolent) offending. We found no specific association between sexual abuse and sexual offending, and nor did we find any association between sexual abuse and sexual offending specifically within the poly-victimized group. The total number of sexual abuse notifications did make a small unique contribution to the variance in sexual offending compared to other offending. Implications concerning maltreated boys and male sexual offenders are discussed.

Micronutrients and dengue.

Dengue virus infection is the most widespread mosquito-borne viral infection in humans and has emerged as a serious global health challenge. In the absence of effective treatment and vaccine, host factors including nutritional status, which may alter disease progression, need investigation. The interplay between nutrition and other infections is well-established, and modulation of nutritional status often presents a simple low-cost method of interrupting transmission, reducing susceptibility, and/or ameliorating disease severity. This review examines the evidence on the role of micronutrients in dengue virus infection. We found critical issues and often inconsistent results across studies; this finding along with the lack of sufficient literature in this field have limited our ability to make any recommendations. However, vitamins D and E have shown promise in small supplementation trials. In summary, the role of micronutrients in dengue virus infection is an exciting research area and needs to be examined in well-designed studies with larger samples.