Using Latent Class Analysis to Identify Need Typologies and Recidivism Likelihood Among Women Who Perpetrate Violence.

Understanding the heterogeneity of women who engage in violence is critical to provide effective treatment and reduce the likelihood of recidivism. Existing typologies of women who engage in violence have been created using mixed methodological approaches; the field would benefit from replication using a quantitative clustering method-latent class analysis (LCA)-as it is arguably more objective than methods used to date. A LCA was conducted using archival data involving 3,773 justice-impacted women in Western Canada to identify unique subgroups of women who perpetrate violence. Three distinct profiles emerged: (a) intimate partner violence (IPV)-only (40.5%), wherein almost all women reported only perpetrating domestic violence and had zero or only one previous violent conviction, (b) patterned (19.1%), wherein violence was perpetrated toward domestic partners and unknown victims, and the majority had two or more previous violent convictions, and (c) isolated (40.4%), wherein very few perpetrated domestic violence, some perpetrated violence toward unknowns, and the majority had either zero or only one previous conviction for a violent offense. Need profiles and recidivism outcomes were further analyzed as a function of group membership. As hypothesized, the group with the greatest criminal history and use of violence reported the greatest needs. Recidivism also increased as the number of dynamic needs increased. Notably, 80.9% of the sample was predominantly low risk/low need and were identified as IPV-only or isolated women. Implications of these findings may be used to inform risk classification, treatment targets, and treatment intensity required to reduce the likelihood of recidivism among women who perpetrate violence.

Assessment of Strengths in Criminal Justice System-Impacted Youth: A Retrospective Validation Study of the SAPROF-YV.

The Structured Assessment of Protective Factors for Violence Risk-Youth Version (SAPROF-YV; de Vries Robbé et al., 2015) was designed specifically to assess strengths as a complement to risk assessment tools. We retrospectively examined its reliability and validity in 305 Canadian community-sentenced youth, both in the overall sample and in male and female, and Black and White, subgroups. In all groups, the total score had strong internal consistency, inter-rater reliability, and convergent validity, and significantly predicted general recidivism at 3-year fixed follow-up. The SAPROF-YV showed incremental validity over the YLS/CMI only in Black youth. In the total sample, a moderation effect was identified whereby strengths were protective at lower levels of risk but not for moderate or high risk youth. The SAPROF-YV shows promising reliability and validity; however, more research is needed before clear guidance can be provided regarding the use of this measure in clinical practice.

PROTOCOL: Risk and strength factors that predict criminal conduct among under-represented genders and sexual minorities: A systematic review and meta-analysis.

This is the protocol for a Campbell systematic review. The objective of this review is to synthesize the evidence to identify risk and strength factors that predict the criminal offending in underrepresented genders and sexual minorities.

Using Strength and Risk Factors to Inform Treatment Typologies Over Time for Men on Community Supervision.

This study examines treatment typologies over time and their relationship to reoffending outcomes. Latent transition analysis was conducted with 6,675 men on community supervision in Alberta, Canada using risk and strength factors measured by the Service Planning Instrument (Orbis Partners, 2003). Three timepoints were assessed: Time 1 = first assessment within 90 days of start of supervision, Time 2 = 3 to 8 months post initial assessment, and Time 3 = 9 to 14 months post initial assessment. Five profiles consistently emerged: Low risk/Low strength profile, Aggressive, complex need/Low strength profile, Moderate risk/Moderate strength profile, Low risk/High strength profile, and Non-aggressive, complex need/Low strength profile. At Time 3, a sixth profile emerged labeled Moderate complex need/Low strength. Profiles characterized as aggressive and those with complex needs had highest rates of reoffending. Results demonstrate the utility of incorporating strengths, mental health needs, and adverse childhood experiences in risk assessment protocols.

Risk Factors for Ebola Virus Persistence in Semen of Survivors in Liberia.

BACKGROUND: Long-term persistence of Ebola virus (EBOV) in immunologically privileged sites has been implicated in recent outbreaks of Ebola virus disease (EVD) in Guinea and the Democratic Republic of Congo. This study was designed to understand how the acute course of EVD, convalescence, and host immune and genetic factors may play a role in prolonged viral persistence in semen. METHODS: A cohort of 131 male EVD survivors in Liberia were enrolled in a case-case study. "Early clearers" were defined as those with 2 consecutive negative EBOV semen test results by real-time reverse-transcription polymerase chain reaction (rRT-PCR) ≥2 weeks apart within 1 year after discharge from the Ebola treatment unit or acute EVD. "Late clearers" had detectable EBOV RNA by rRT-PCR >1 year after discharge from the Ebola treatment unit or acute EVD. Retrospective histories of their EVD clinical course were collected by questionnaire, followed by complete physical examinations and blood work. RESULTS: Compared with early clearers, late clearers were older (median, 42.5 years; P < .001) and experienced fewer severe clinical symptoms (median 2, P = .006). Late clearers had more lens opacifications (odds ratio, 3.9 [95% confidence interval, 1.1-13.3]; P = .03), after accounting for age, higher total serum immunoglobulin G3 (IgG3) titers (P = .005), and increased expression of the HLA-C*03:04 allele (0.14 [.02-.70]; P = .007). CONCLUSIONS: Older age, decreased illness severity, elevated total serum IgG3 and HLA-C*03:04 allele expression may be risk factors for the persistence of EBOV in the semen of EVD survivors. EBOV persistence in semen may also be associated with its persistence in other immunologically protected sites, such as the eye.

Understanding perinatal mental illness as a governance concern in South Africa through health provider perspectives.

Women in South Africa experience a disproportionately high prevalence of common perinatal mental disorders (CPMDs). These disorders often remain a silent burden and a complex health, social, and policy concern, both nationally and globally. Moreover, policy efforts to address this concern have been fragmented. Greater understanding of the governance of perinatal mental illness is needed to address this complex issue. No research to date has focused explicitly on the importance of 'issue framing' to advance governance for perinatal mental health. We sought to achieve a more nuanced understanding of clinical governance and issue framing for perinatal mental health in South Africa by interviewing 24 key informants with expertise in perinatal mental illness. Dominant themes encompassed: framing of perinatal mental health determines its priority; perinatal mental health is not prioritised due to competition from other health concerns; and, screening policy responses are shaped by the framing. We found that understanding the varying views influencing perinatal mental illness provides insights into how experts frame the problem. Findings suggest that a better understanding of policy implementation and responses in South Africa is important in guiding research, policy, and practice, while improving the governance of perinatal mental illness.

Health care providers' perceptions of barriers to perinatal mental healthcare in South Africa.

BACKGROUND: Perinatal mental disorders are a leading contributor to morbidity and mortality during pregnancy and postpartum, and are highly treatable when identified early. However, many women, especially in low and middle-income countries, lack access to routine identification and treatment of mental illness in public health settings. The prevalence of perinatal depression and anxiety disorders, common mental disorders, is three times higher for South African women relative to women in high-income countries. The public health system has begun to integrate mental health into maternal care, making South Africa a relevant case study of perinatal mental healthcare. Yet studies are few. We sought to investigate healthcare providers' perceptions of the barriers to early identification and screening of common perinatal mental disorders in public health facilities in South Africa. METHODS: Employing qualitative methods, we used purposive sampling to identify study participants, supplemented by snowball sampling. From September 2019-June 2020, we conducted in-depth interviews with 24 key informants in South Africa. All interviews were recorded and transcribed verbatim. We used a thematic approach to generate initial analytical themes and then conducted iterative coding to refine them. We adapted a delivery systems' framework to organise the findings, depicted in a conceptual map. RESULTS: Reported barriers to early identification and treatment of mental illness in the perinatal period encompassed four levels: (1) structural factors related to policies, systems and resources; (2) socio-cultural factors, including language and cultural barriers; (3) organisational factors, such as lack of provider preparation and training and overburdened clinics; and (4) individual patient and healthcare provider factors. CONCLUSION: Barriers act across multiple levels to reduce quality mental health promotion and care, thereby creating an environment where inequitable access to identification of mental disorders and quality mental health services was embedded into systems and everyday practice. Integrated interventions across multiple levels are essential to improve the early identification and treatment of mental illness in perinatal women in South Africa. We provide recommendations derived from our findings to overcome barriers at each of the four identified levels.

Rift Valley Fever and Crimean-Congo Hemorrhagic Fever Viruses in Ruminants, Jordan.

The epidemiology of Rift Valley fever virus (RVFV) and Crimean-Congo hemorrhagic fever virus (CCHFV) in Jordan is unknown. Our investigation showed 3% of 989 tested dairy cattle, sheep, and goats were RVFV seropositive and 14% were CCHFV seropositive. Ongoing surveillance is needed to assess risk to humans and protect public health.

Experience of religion and spirituality among socially marginalised people living with HIV in Mississippi.

African Americans in Mississippi have the highest HIV-related mortality and poverty rates in the USA, and they tend to be religious. Attitudes toward gender and sexuality are changing, yet few studies have investigated religion and spirituality among special populations living with HIV. Using grounded theory and qualitative methods, we investigated the experience of health and illness of a low-income, socially marginalised population living with HIV in two locations of Mississippi in 2015. In a context of high stigma and HIV-related health disparities, individuals turned, or returned, to religion, church and spirituality as sources of community and strength, which also motivated safer health behaviours. Findings underscore how religion and spirituality are enabling social determinants of health that are under-explored, untapped, potentially culturally acceptable, sustainable interventions at the community-level. We posit, given diminished funding for community-based services, the most significant influence churches could exert is in decreasing HIV stigma. Given the current US plan to end HIV by 2030, with appropriate stakeholder participation, the role of religion, spirituality and clergy could be further amplified via linkage to care providers and the 'normalisation' of the HIV discourse, to address disparities and improve the health of African Americans.

Characteristics of Ebola Virus Disease Survivor Blood and Semen in Liberia: Serology and Reverse Transcription Polymerase Chain Reaction (RT-PCR).

INTRODUCTION: Ebola virus (EBOV), species Zaire ebolavirus, may persist in the semen of male survivors of Ebola virus disease (EVD). We conducted a study of male survivors of the 2014-2016 EVD outbreak in Liberia and evaluated their immune responses to EBOV. We report here findings from the serologic testing of blood for EBOV-specific antibodies, molecular testing for EBOV in blood and semen, and serologic testing of peripheral blood mononuclear cells (PBMCs) in a subset of study participants. METHODS: We tested for EBOV RNA in blood by quantitative reverse transcription polymerase chain reaction (qRT-PCR), and for anti-EBOV-specific immunoglobulin M (IgM) and immunoglobulin G (IgG) antibodies by enzyme-linked immunosorbent assay (ELISA) for 126 study participants. We performed PBMC analysis on a subgroup of 26 IgG-negative participants. RESULTS: All 126 participants tested negative for EBOV RNA in blood by qRT-PCR. The blood of 26 participants tested negative for EBOV-specific IgG antibodies by ELISA. PBMCs were collected from 23/26 EBOV IgG-negative participants. Of these, 1/23 participants had PBMCs that produced anti-EBOV-specific IgG antibodies upon stimulation with EBOV-specific glycoprotein (GP) and nucleoprotein (NP) antigens. CONCLUSIONS: The blood of EVD survivors, collected when they did not have symptoms meeting the case definition for acute or relapsed EVD, is unlikely to pose a risk for EBOV transmission. We identified 1 IgM/IgG negative participant who had PBMCs that produced anti-EBOV-specific antibodies upon stimulation. Immunogenicity following acute EBOV infection may exist along a spectrum, and absence of antibody response should not be exclusionary in determining an individual's status as a survivor of EVD.

Seoul Virus Infection and Spread in United States Home-Based Ratteries: Rat and Human Testing Results From a Multistate Outbreak Investigation.

BACKGROUND: During 2017, a multistate outbreak investigation occurred after the confirmation of Seoul virus (SEOV) infections in people and pet rats. A total of 147 humans and 897 rats were tested. METHODS: In addition to immunoglobulin (Ig)G and IgM serology and traditional reverse-transcription polymerase chain reaction (RT-PCR), novel quantitative RT-PCR primers/probe were developed, and whole genome sequencing was performed. RESULTS: Seventeen people had SEOV IgM, indicating recent infection; 7 reported symptoms and 3 were hospitalized. All patients recovered. Thirty-one facilities in 11 US states had SEOV infection, and among those with ≥10 rats tested, rat IgG prevalence ranged 2%-70% and SEOV RT-PCR positivity ranged 0%-70%. Human laboratory-confirmed cases were significantly associated with rat IgG positivity and RT-PCR positivity (P = .03 and P = .006, respectively). Genomic sequencing identified >99.5% homology between SEOV sequences in this outbreak, and these were >99% identical to SEOV associated with previous pet rat infections in England, the Netherlands, and France. Frequent trade of rats between home-based ratteries contributed to transmission of SEOV between facilities. CONCLUSIONS: Pet rat owners, breeders, and the healthcare and public health community should be aware and take steps to prevent SEOV transmission in pet rats and to humans. Biosecurity measures and diagnostic testing can prevent further infections.

A Right-to-Health Lens on Perinatal Mental Health Care in South Africa.

South African women experience some of the highest rates of depression and anxiety globally. Despite South Africa's laudable human rights commitments to mental health in law, perinatal women are at high risk of common mental disorders due to socioeconomic factors, and they may lack access to mental health services. We used a right to mental health framework, paired with qualitative methods, to investigate barriers to accessing perinatal mental health care. Based on in-depth interviews with 14 key informants in South Africa, we found that (1) physical health was prioritized over mental health at the clinic level; (2) there were insufficient numbers of antenatal and mental health providers to ensure minimum essential levels of perinatal mental health services; (3) the implementation of human rights-based mental health policy has been inadequate; (4) the social determinants were absent from the clinic-level approach to mental health; and (5) a lack of context-specific provider training and support has undermined the quality of mental health promotion and care. We offer recommendations to address these barriers and improve approaches to perinatal mental health screening and care, guided by the following elements of the right to mental health: progressive realization; availability and accessibility; and acceptability and quality.

Towards ending the US HIV epidemic by 2030: Understanding social determinants of health and HIV in Mississippi.

The disproportionate burden of HIV-related inequities borne by African Americans in the US South amplifies the role of social determinants of health (SDH) in shaping social patterning of illness. Despite some attention, SDH remain overlooked in a biomedically oriented, federal HIV policy. Mississippi is the poorest state with the worst HIV outcomes, nationally. Using qualitative methods, we investigated how primarily African American, HIV-positive Mississippians experienced SDH and health inequities in their daily lives. Employing grounded theory and in-depth interviews (n = 25) in an urban and rural site in 2015 yielded these findings: (1) absence of an enabling structural environment; (a) HIV-stigma constructed via social discourse; (b) lack of psycho-social support and HIV education; (c) insufficient economic and social support resources; and (2) presence of family support for coping. Due to stigma, being HIV-positive seemed to lead to further status loss; diminished social position; reduced life chances; and contractions in particular freedoms. Stigma further compounded existing inequalities - contributing to the moral, social experience of those living with HIV. Trump's plan to end HIV by 2030 creates the opportunity to rethink the biomedical-paradigm and fully engage SDH - using social science theory and methods that address multi-level social determinants in ways that are also policy-responsive.

Marburg virus disease outbreak in Kween District Uganda, 2017: Epidemiological and laboratory findings.

INTRODUCTION: In October 2017, a blood sample from a resident of Kween District, Eastern Uganda, tested positive for Marburg virus. Within 24 hour of confirmation, a rapid outbreak response was initiated. Here, we present results of epidemiological and laboratory investigations. METHODS: A district task force was activated consisting of specialised teams to conduct case finding, case management and isolation, contact listing and follow up, sample collection and testing, and community engagement. An ecological investigation was also carried out to identify the potential source of infection. Virus isolation and Next Generation sequencing were performed to identify the strain of Marburg virus. RESULTS: Seventy individuals (34 MVD suspected cases and 36 close contacts of confirmed cases) were epidemiologically investigated, with blood samples tested for MVD. Only four cases met the MVD case definition; one was categorized as a probable case while the other three were confirmed cases. A total of 299 contacts were identified; during follow- up, two were confirmed as MVD. Of the four confirmed and probable MVD cases, three died, yielding a case fatality rate of 75%. All four cases belonged to a single family and 50% (2/4) of the MVD cases were female. All confirmed cases had clinical symptoms of fever, vomiting, abdominal pain and bleeding from body orifices. Viral sequences indicated that the Marburg virus strain responsible for this outbreak was closely related to virus strains previously shown to be circulating in Uganda. CONCLUSION: This outbreak of MVD occurred as a family cluster with no additional transmission outside of the four related cases. Rapid case detection, prompt laboratory testing at the Uganda National VHF Reference Laboratory and presence of pre-trained, well-prepared national and district rapid response teams facilitated the containment and control of this outbreak within one month, preventing nationwide and global transmission of the disease.

Infection with New York Orthohantavirus and Associated Respiratory Failure and Multiple Cerebral Complications.

We report a case of infection with New York orthohantavirus in a woman who showed renal impairment and hemorrhage, complicated by hydrocephalus, in Long Island, New York, USA. Phylogenetic analysis showed that this virus was genetically similar to a New York orthohantavirus isolated in the same region during 1993.

First Laboratory-Confirmed Outbreak of Human and Animal Rift Valley Fever Virus in Uganda in 48 Years.

In March 2016, an outbreak of Rift Valley fever (RVF) was identified in Kabale district, southwestern Uganda. A comprehensive outbreak investigation was initiated, including human, livestock, and mosquito vector investigations. Overall, four cases of acute, nonfatal human disease were identified, three by RVF virus (RVFV) reverse transcriptase polymerase chain reaction (RT-PCR), and one by IgM and IgG serology. Investigations of cattle, sheep, and goat samples from homes and villages of confirmed and probable RVF cases and the Kabale central abattoir found that eight of 83 (10%) animals were positive for RVFV by IgG serology; one goat from the home of a confirmed case tested positive by RT-PCR. Whole genome sequencing from three clinical specimens was performed and phylogenetic analysis inferred the relatedness of 2016 RVFV with the 2006-2007 Kenya-2 clade, suggesting previous introduction of RVFV into southwestern Uganda. An entomological survey identified three of 298 pools (1%) of Aedes and Coquillettidia species that were RVFV positive by RT-PCR. This was the first identification of RVFV in Uganda in 48 years and the 10th independent viral hemorrhagic fever outbreak to be confirmed in Uganda since 2010.

The Relationship Between Trauma, Recidivism Risk, and Reoffending in Male and Female Juvenile Offenders.

Elevated rates of traumatic experience in the juvenile justice population are well established. Nevertheless, the role of trauma and its application to rehabilitation and recidivism in a criminal justice context remains hotly debated, particularly for female youth. The Risk-Need-Responsivity framework, the predominant model for risk assessment and case management in juvenile justice, does not consider trauma to be a risk factor for offending. This study examined- Posttraumatic Stress symptomology, maltreatment history, and childhood adversity - in relation to RNR risk factors for reoffending (criminogenic needs) and recidivism in a sample of female and male juvenile offenders. Rates of PTS symptomology, maltreatment, and childhood adversity were significantly higher in this sample compared to prevalence in the general population. Females were more likely to have experienced maltreatment. Several maltreatment and childhood adversity types were significantly related to criminogenic needs. PTS symptomology and adversity were not significant predictors of recidivism when entered alongside criminogenic needs; however, maltreatment was the strongest predictor of recidivism for both male and female youth in a model that included criminogenic needs. Gender did not moderate the relationship between maltreatment and recidivism. The importance of considering youths' maltreatment history in their rehabilitative care is discussed.

Risks, strengths, gender, and recidivism among justice-involved youth: A meta-analysis.

OBJECTIVE: Debate ensues regarding female-specific risk and strength factors among adolescent offenders. Using meta-analysis, we examined whether risk and strength factors predicted recidivism differentially between male and female youth. METHOD: Database searches identified 22 studies, representing 50,601 justice-involved youth (11,952 females and 38,649 males) and a total of 584 effect sizes. RESULTS: For the global risk domains, there is some evidence for gender neutrality (i.e., risk factors predict to the same degree for both males and females) among most domains (e.g., antisocial peer relations, problematic family circumstances and parenting, substance abuse, antisocial personality/behavior, and antisocial attitudes/orientation). Although the global domains of mental health and child abuse were not significantly predictive for either gender, the global child abuse results trended in favor of predicting recidivism for females. When global risk domains were broken into indicators, some evidence for gender differences emerged (e.g., chronic alcohol use and family substance abuse predicted more strongly for females than for males). Last, gender comparisons among the global strength domains revealed that prosocial peers and the absence of substance abuse predicted success (i.e., no recidivism) for both genders, though a stronger effect emerged for males. In addition, education/employment strengths predicted success for males, whereas prosocial values predicted success for females. Limitations such as the lack of studies that defined constructs from the female experience, and the small number of primary studies are discussed. CONCLUSIONS: Advancing the future of gender informed practice with justice-involved youth will require careful consideration of both gender similarities and differences. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

A Case of Lassa Fever Diagnosed at a Community Hospital-Minnesota 2014.

BACKGROUND: In April 2014, a 46-year-old returning traveler from Liberia was transported by emergency medical services to a community hospital in Minnesota with fever and altered mental status. Twenty-four hours later, he developed gingival bleeding. Blood samples tested positive for Lassa fever RNA by reverse transcriptase polymerase chain reaction. METHODS: Blood and urine samples were obtained from the patient and tested for evidence of Lassa fever virus infection. Hospital infection control personnel and health department personnel reviewed infection control practices with health care personnel. In addition to standard precautions, infection control measures were upgraded to include contact, droplet, and airborne precautions. State and federal public health officials conducted contract tracing activities among family contacts, health care personnel, and fellow airline travelers. RESULTS: The patient was discharged from the hospital after 14 days. However, his recovery was complicated by the development of near complete bilateral sensorineural hearing loss. Lassa virus RNA continued to be detected in his urine for several weeks after hospital discharge. State and federal public health authorities identified and monitored individuals who had contact with the patient while he was ill. No secondary cases of Lassa fever were identified among 75 contacts. CONCLUSIONS: Given the nonspecific presentation of viral hemorrhagic fevers, isolation of ill travelers and consistent implementation of basic infection control measures are key to preventing secondary transmission. When consistently applied, these measures can prevent secondary transmission even if travel history information is not obtained, not immediately available, or the diagnosis of a viral hemorrhagic fever is delayed.