Perceived Impact of COVID-19 on Cyberabuse, Sexual Aggression, and Intimate Partner Violence Among U.S. Young Adults.

Quarantine guidelines that arose with the COVID-19 pandemic limited opportunities for social interaction, raising concerns about increases in intimate partner violence and cyberabuse while simultaneously restricting access to help. The current study assessed increases in cyberabuse, sexual aggression, and intimate partner violence victimization and perpetration during the first year of the COVID-19 pandemic in a U.S. nationally representative sample of young adults ages 18 to 35, recruited from a probability-based household panel. Data were collected between November 2020 and May 2021. Descriptive analyses were conducted to assess the prevalence of any self-reported increase in cyberabuse, sexual aggression, or intimate partner victimization or perpetration during the COVID-19 pandemic. Logistic regression models were run for each outcome measuring any increase compared to no increase. Approximately one in ten U.S. young adults ages 18 to 35 reported experiencing an increase in cyberabuse victimization (12.6%) and cyberabuse perpetration (8.9%) during the pandemic. Similar proportions were observed for increased sexual aggression victimization (11.8%) and perpetration (9.0%). More than one in five respondents (21.4%) reported that their intimate partner was more physically, sexually, or emotionally aggressive toward them during the pandemic. Conversely, 16.2% of respondents reported that they were more physically, sexually, or emotionally aggressive themselves toward an intimate partner, compared to their behavior before the onset of the pandemic. Having an intimate partner and staying at home more than usual during the pandemic were protective factors for both cyberabuse and sexual aggression victimization. Respondent age, education, and race and ethnicity were not associated with increased victimization or perpetration of cyberabuse or sexual aggression. However, women reported lower odds of increased sexual aggression perpetration than men. These findings improve understanding of changes to interpersonal abuse and associated risk factors during a period of social disruption.

Estimating county-level vaccination coverage using small area estimation with the National Immunization Survey-Child.

The National Immunization Survey-Child (NIS-Child) provides annual vaccination coverage estimates in the United States for children aged 19 through 35 months, nationally, for each state, and for select local areas and territories. There is a need for vaccination coverage estimates for smaller geographic areas to support local authority planning and identify counties with potentially low vaccination coverage for possible further intervention. We describe small area estimation methods using 2008-2018 NIS-Child data to generate county-level estimates for children up to two years of age born 2007-2011 and 2012-2016. We applied an empirical best linear unbiased prediction method to combine direct estimates of vaccination coverage with model-based prediction using county-level predictors regarding health and demographic characteristics. We review the predictors commonly selected for the small area models and note multiple predictors related to barriers to vaccination.

The Victim-Offender Overlap in Technology-Facilitated Abuse: Nationally Representative Findings Among U.S. Young Adults.

There has been limited examination of the phenomenon of the victim-offender overlap in the field of technology-facilitated abuse (TFA). To design effective strategies to prevent TFA, it is important to understand which individuals are most at risk of victimization, perpetration, and to what extent a subset of people both experience victimization and engage in perpetration. This study drew on Cyber-Abuse Research Initiative (CARI) data, a nationally representative U.S. sample of adults ages 18-35. TFA measurement consisted of parallel scales for victimization and perpetration, each with 27 items assessing forms of technology-facilitated surveillance, monitoring/tracking, interference/communications, reputational harm, controlling/limiting access, and fraud. A bivariate probit of TFA perpetration and TFA victimization, as separate outcomes, was fit to allow for joint estimation of regression coefficients and robust standard errors. Analyses confirmed that TFA, similar to other forms of interpersonal aggression, is characterized by a substantial victim-offender overlap, with 30 percent of the sample reporting involvement both as a victim and as a perpetrator. Internet/social media use and social isolation did not distinguish victimization and perpetration. However, positive and negative affect as well as Lesbian, Gay, Bisexual, Queer, Asexual, or other sexual orientation (LGBQA+) were positively correlated with victimization, whereas female gender and having postsecondary education were positively associated with perpetration. These results may be used to design interventions and anticipate service needs. TFA, as a new topic of research, should capitalize on the theoretical and empirical article related to other forms of the victim-offender overlap.

Comparisons of statistical methods for handling attrition in a follow-up visit with complex survey sampling.

Design-based analysis, which accounts for the design features of the study, is commonly used to conduct data analysis in studies with complex survey sampling, such as the Hispanic Community Health Study/Study of Latinos (HCHS/SOL). In this type of longitudinal study, attrition has often been a problem. Although there have been various statistical approaches proposed to handle attrition, such as inverse probability weighting (IPW), non-response cell weighting (NRCW), multiple imputation (MI), and full information maximum likelihood (FIML) approach, there has not been a systematic assessment of these methods to compare their performance in design-based analyses. In this article, we perform extensive simulation studies and compare the performance of different missing data methods in linear and generalized linear population models, and under different missing data mechanism. We find that the design-based analysis is able to produce valid estimation and statistical inference when the missing data are handled appropriately using IPW, NRCW, MI, or FIML approach under missing-completely-at-random or missing-at-random missing mechanism and when the missingness model is correctly specified or over-specified. We also illustrate the use of these methods using data from HCHS/SOL.

U.S. Young Adults' Professional Help-Seeking in Response to Technology-Facilitated Abuse.

Widespread access to an increasing number of technology-enhanced communications channels multiplies the potential for abusive interactions (i.e., technology-facilitated abuse [TFA]). Practitioners will be better prepared to respond to the problem of TFA if more is known about how commonly victims seek help, and from whom. Through a cross-sectional, U.S. nationally representative survey of n = 1,215 young adults aged 18 to 35, respondents completed the TFA scale of the Cyber-Abuse Research Initiative. We calculated the percentage of TFA survivors who sought help for their most damaging experience of TFA, and used logistic regression to model help-seeking for health services, victim services, technological assistance, and/or criminal justice/legal assistance. For each help source, we examined risk markers including sociodemographic characteristics, online activity, the number of different forms of TFA experience, and the perpetrator's relationship to the victim. Use of a broader range of social media sites/platforms, and several indicators of more severe TFA experiences, predicted help-seeking from health services, victim services, and justice/legal assistance. Young adults who identified the TFA perpetrator as a current or ex-intimate partner were less likely than other survivors to seek two forms of help: technological assistance and/or criminal justice/legal assistance. Survivors who self-identified as Black were more likely than White survivors to seek victim services. Professionals who support survivors of interpersonal aggression may use these results to enhance their screening protocols and form cross-disciplinary partnerships to address the harms associated with TFA.

The effects of community-infused problem-oriented policing in crime hot spots based on police data: a randomized controlled trial.

Objectives: This randomized controlled trial (RCT) assessed the effectiveness of a community-infused problem-oriented policing (CPOP) intervention on reducing property/violent crime. Methods: In two mid-Atlantic cities, a total of 102 crime hot spots were randomly assigned to receive CPOP or standard patrol. Analyses examine changes in crime the year before, during, and one year after the intervention. We used hierarchical Poisson regression models. Results: We found no main effects for the CPOP intervention on property and violent crimes in either site. In site B, the violent crime count in low treatment hot spots was 200% higher than controls post-intervention but this likely reflected officers paying less attention to treatment locations with lower levels of crime. Conclusions: Our results suggest that CPOP was not effective in the unusual context of the COVID-19 pandemic and post-George Floyd killing. Given the challenges of implementing CPOP during this unique time, caution is needed in interpreting these findings.

Sexual Harassment of Law Enforcement Officers: Findings From a Nationally Representative Survey.

Sexual harassment continues to be a consistent destructive feature of American life and workplaces, especially in fields for which women are under-represented, such as law enforcement. We use one of the first nationally representative cross-sectional surveys (n = 2,867) of female and male law enforcement officers (LEOs) to assess the prevalence of workplace sexual harassment victimization. Next, we assess how risk factors are related to this harassment through multivariable modeling. We observed large differences between rates of sexual harassment for female compared to male officers on both our measures of non-physical and physical workplace sexual harassment (sexual assault). Our combined measure of non-physical sexual harassment and sexual assault of female officers (71%) was in the range found in prior research and our 41% rate for male officers is also not trivial and requires attention from law enforcement leaders. We tested two competing hypotheses on whether female officers (and possibly some male officers not meeting certain definitions of masculinity) viewed as the most threatening by virtue of their job role in the male-dominated hierarchy will have the highest probability of being a victim of workplace sexual harassment (power-threat model) or whether those viewed as the most vulnerable officers will have the highest probability of sexual harassment victimization (vulnerable-victim model). We found greater support for the vulnerable-victim model. We discuss the implications of these results for guiding training and prevention strategies to address sexual harassment in the law enforcement workplace.

Daily Reports of Aggressive Behaviors in Interpersonal Conflicts.

Interpersonal conflicts are inevitable, but the probability that conflicts involve aggressive behavior varies. Prior research that has tended to focus on victimization in intimate partnerships reported through retrospective designs. Addressing these limitations, the current study examines daily reports of behaving aggressively in any conflict across relationships in a sample of 512 young adults drawn from the nationally representative iCOR cohort. Respondent attitudes and affective measures were collected at the end of the daily data collection period. Regression methods were applied to examine the probability and frequency of aggression, investigating early and recent exposure to adversities, attitudes, self-control, affect and emotional states, and alcohol use behavior. Recent adversities and the propensity to endorse a defensive honor code attitude, consistent with theory and retrospective studies of aggression, predicted both prevalence and frequency of aggressive behavior. The associations of childhood maltreatment and self-control with the prevalence of behaving aggressively were as expected, but these constructs were significantly associated with the frequency of aggression with unexpected, inverse directionality. Moreover, respondents' affect and other emotional states were only associated with the frequency, not the prevalence, of aggressive behavior. Overall, this daily data collection constructively distinguished risk and protective factors for behaving aggressively more often. Further research is needed to disentangle the extent to which affective states drive or is a consequence of frequent aggressive behavior.

A nationally representative study of law enforcement shiftwork and health outcomes.

The purpose of this study was to estimate the effect of past and current rotating shift assignments on U.S. law enforcement officers' health outcomes. In a nationally representative sample of 2,867 officers, with an oversample of female officers, we estimated models of sleep quality and fatigue, physical health outcomes, and psychological health outcomes. Further, we examined individual and agency-level factors associated with officers who reported currently working a rotating shift, to investigate what patterns there may be in shift assignments. A history of rotating shift assignments was positively associated with lower sleep quality, and with hypertension, diabetes, and high cholesterol, but not with gastrointestinal disorders, perceived stress, emotional well-being, or suicidality. The associations of shiftwork with health outcomes did not vary by gender. Demographic characteristics did not predict current rotating shift assignments, but a longer history of shiftwork and more working hours did predict a current shift assignment. Attention to mitigating shift system designs as well as the effect of cumulative years of working a rotating shift for the benefit of officer health outcomes is warranted.

Multiplicative rates model for recurrent events in case-cohort studies.

In large prospective cohort studies, accumulation of covariate information and follow-up data make up the majority of the cost involved in the study. This might lead to the study being infeasible when there are some expensive variables and/or the event is rare. Prentice (Biometrika 73(1):1-11, 1986) proposed the case-cohort study for time to event data to tackle this problem. There has been extensive research on the analysis of univariate and clustered failure time data, where the clusters are formed among different individuals under case-cohort sampling scheme. However, recurrent event data are quite common in biomedical and public health research. In this paper, we propose case-cohort sampling schemes for recurrent events. We consider a multiplicative rates model for the recurrent events and propose a weighted estimating equations approach for parameter estimation. We show that the estimators are consistent and asymptotically normally distributed. The proposed estimator performed well in finite samples in our simulation studies. For illustration purposes, we examined the association between prior occurrence of measles on acute lower respiratory tract infections (ALRI) among young children in Brazil.

Global Longitudinal Strain as a Predictor of First and Subsequent Arrhythmic Events in Remotely Monitored ICD Patients With Structural Heart Disease.

OBJECTIVES: This study sought to assess speckle-tracking-derived parameters as predictors of first and subsequent ventricular events in patients with structural heart disease and implantable cardioverter-defibrillators (ICD). BACKGROUND: Left ventricular ejection fraction (LVEF), the current primary parameter of risk stratification for ventricular arrhythmias (VAs) in structural heart diseases is burdened by many limitations. METHODS: In this retrospective, observational study, all consecutive patients with structural heart disease were admitted for ICD implantation. Patients not followed by a home-monitoring system were excluded. Two-dimensional (2D) speckle-tracking analysis was used to derive global longitudinal strain (GLS), mechanical dispersion (MD), and delta contraction duration (DCD) of all patients at enrollment. Home monitoring was checked weekly to detect all VAs and ICD therapies. A recurrent event statistical approach (Prentice, Williams, and Peterson model) was applied to evaluate subsequent events after the first ones. RESULTS: A total of 203 patients were consecutively enrolled and followed for a median of 2.2 years. Kaplan-Meier curves showed an increased risk of antitachycardia pacing or shock (log-rank p = 0.003) and VAs (log-rank p = 0.001) associated with lower quartiles of GLS. An impaired GLS was independently associated with an increased risk for the first ICD therapy (hazard ratio [HR]: 1.94; 95% confidence interval [CI]: 1.30 to 2.91; p = 0.001) and (HR: 1.42; 95% CI: 1.01 to 1.98; p = 0.04) for the first VA. GLS impairment was not significantly associated with an increased risk of recurrent ICD therapies or VAs. LVEF, MD, and DCD were not associated with an increased risk of first, second, and third ICD therapies or VA. CONCLUSIONS: Impaired GLS is associated with an increased risk of VAs and appropriate ICD therapies in a consecutive "real-world," unselected population of remotely monitored patients with structural heart disease, although it does not seem reliable in predicting further arrhythmic events after the first one. MD and DCD do not predict first or subsequent arrhythmic events in ICD patients with structural heart disease.

Effect of renin-angiotensin-aldosterone system blocking agents on progression of glomerulopathy in sickle cell disease.

Although renin-angiotensin-aldosterone system (RAAS) blocking agents decrease albuminuria in short-term studies, there is no evidence confirming their long-term efficacy in sickle cell disease (SCD). In a single-centre, retrospective study, we evaluated the long-term effect of RAAS blocking agents on proteinuria and declining estimated glomerular filtration rates (eGFR). Eighty-six patients on RAAS blocking agents for proteinuria, followed for a median of 2·28 years, were compared with 68 patients with proteinuria followed for 2·24 years who were not receiving such treatment. The log odds of proteinuria decreased over time in patients on RAAS blocking agents (ß: -0·23, P = 0·03) and in the non-treatment group (ß: -0·54, P < 0·0001), but was not statistically different between both groups (ß: 0·31, P = 0·063). The eGFR declined over time in patients on RAAS blocking agents (ß: -2·78, P < 0·0001) and in those not on such treatment (ß: -4·7, P < 0·0001), and was statistically different between both groups (ß: 1·9, P = 0·0002). Baseline eGFR was associated with mortality (Hazard rato: 0·97, P < 0·0001), but RAAS blocking agents had no significant effect on mortality. These data suggest that RAAS blockade may slow the loss of kidney function in SCD.

Risk factors for mortality in adult patients with sickle cell disease: a meta-analysis of studies in North America and Europe.

Although recent studies show an improved survival of children with sickle cell disease in the US and Europe, for adult patients mortality remains high. This study was conducted to evaluate the factors associated with mortality in adult patients following the approval of hydroxyurea. We first evaluated the association between selected variables and mortality at an academic center (University of North Carolina). Data sources were then searched for publications from 1998 to June 2016, with meta-analysis of eligible studies conducted in North America and Europe to evaluate the associations of selected variables with mortality in adult patients. Nine studies, combined with the UNC cohort (total n=3257 patients) met the eligibility criteria. Mortality was significantly associated with age (per 10-year increase in age) [7 studies, 2306 participants; hazard ratio (HR): 1.28; 95% confidence interval (CI): 1.10-1.50], tricuspid regurgitant jet velocity 2.5 m/s or more (5 studies, 1577 participants; HR: 3.03; 95%CI: 2.0-4.60), reticulocyte count (3 studies, 1050 participants; HR: 1.05; 95%CI: 1.01-1.10), log(N-terminal-pro-brain natriuretic peptide) (3 studies, 800 participants; HR: 1.68; 95%CI: 1.48-1.90), and fetal hemoglobin (7 studies, 2477 participants; HR: 0.97; 95%CI: 0.94-1.0). This study identifies variables associated with mortality in adult patients with sickle cell disease in the hydroxyurea era.

Albuminuria Is Associated with Endothelial Dysfunction and Elevated Plasma Endothelin-1 in Sickle Cell Anemia.

BACKGROUND: The pathogenesis of albuminuria in SCD remains incompletely understood. We evaluated the association of albuminuria with measures of endothelial function, and explored associations of both albuminuria and measures of endothelial function with selected biological variables (vascular endothelial growth factor [VEGF], endothelin-1 [ET-1], soluble fms-like tyrosine kinase-1 [sFLT-1], soluble vascular cell adhesion molecule-1 [soluble VCAM-1] and plasma hemoglobin). METHODS: Spot urine measurements for albumin-creatinine ratio (UACR) and 24-hour urine protein were obtained. Endothelial function was assessed using brachial artery ultrasound with measurements of flow-mediated dilation (FMD), nitroglycerin-mediated dilation (NTMD) and hyperemic velocity. RESULTS: Twenty three subjects with varying degrees of albuminuria were evaluated. UACR was significantly correlated with FMD (ρ = -0.45, p = 0.031). In univariate analysis, UACR was correlated with VEGF (ρ = -0.49; 95% CI: -0.75 --0.1, p = 0.015), plasma hemoglobin (ρ = 0.50; 95% CI: 0.11-0.75, p = 0.013) and ET-1 (ρ = 0.40; 95% CI: -0.03-0.69, p = 0.06). Multivariable analysis showed significant associations of ET-1 (estimate: 455.1 [SE: 198.3], p = 0.02), VEGF (estimate: -1.1 [SE: 0.53], p = 0.04) and sFLT-1 (estimate: -1.14 [SE: 0.49], p = 0.02) with UACR. Only ET-1 (estimate: -8.03 [SE: 3.87], p = 0.04) was significantly associated with FMD in multivariable analyses. Finally, UACR was correlated with both 24-hour urine protein (ρ = 0.90, p < 0.0001) and urine aliquots for albumin-creatinine ratio obtained from the 24-hour urine collection (ρ = 0.97, p < 0.0001). CONCLUSION: This study provides more definitive evidence for the association of albuminuria with endothelial dysfunction in SCD. Elevated circulating levels of ET-1 may contribute to SCD-related glomerulopathy by mediating endothelial dysfunction.