Digital droplet PCR versus quantitative PCR for lipoprotein (a) kringle IV type 2 repeat polymorphism genetic characterization.

BACKGROUND: Lipoprotein(a) [Lp(a)] level variability, related to atherothrombotic risk increase, is mainly attributed to LPA gene, encoding apolipoprotein(a), with kringle IV type 2 (KIV2) copy number variation (CNV) acting as the primary genetic determinant. Genetic characterization of Lp(a) is in continuous growth; nevertheless, the peculiar structural characteristics of this variant constitute a significant challenge to the development of effective detection methods. The aim of the study was to compare quantitative real-time PCR (qPCR) and digital droplet PCR (ddPCR) in the evaluation of KIV2 repeat polymorphism. METHODS: We analysed 100 subjects tested for cardiovascular risk in which Lp(a) plasma levels were assessed. RESULTS: Correlation analysis between CNV values obtained with the two methods was slightly significant (R = 0.413, p = 0.00002), because of the wider data dispersion in qPCR compared with ddPCR. Internal controls C1, C2 and C3 measurements throughout different experimental sessions revealed the superior stability of ddPCR, which was supported by a reduced intra/inter-assay coefficient of variation determined in this method compared to qPCR. A significant inverse correlation between Lp(a) levels and CNV values was confirmed for both techniques, but it was higher when evaluated by ddPCR than qPCR (R = -0.393, p = 0.000053 vs R = -0.220, p = 0.028, respectively). When dividing subjects into two groups according to 500 mg/L Lp(a) cut-off value, a significantly lower number of KIV2 repeats emerged among subjects with greater Lp(a) levels, with stronger evidence in ddPCR than in qPCR (p = 0.000013 and p = 0.001, respectively). CONCLUSIONS: Data obtained support a better performance of ddPCR in the evaluation of KIV2 repeat polymorphism.

Is Household Unemployment Associated With Increased Verbal and Physical Child Abuse During the COVID Pandemic?

PURPOSE: The economic downturn due to the Coronavirus Disease 2019 (COVID-19) pandemic initially led to a large increase in the US unemployment rate. Being laid-off or losing a job could cause financial stress and have an impact on the relationship between parents or other adults in the home and children. We aimed to assess the effect of household unemployment on child physical and emotional abuse during the early part of the COVID-19 pandemic, with an older population of children. METHODS: Data were from a sample of 7,555 students from 51 schools that participated in a survey administered from October to December 2020. We conducted weighted multivariable logistic regression models and report adjusted odds ratio to estimate associations between recent household unemployment and emotional and physical abuse. RESULTS: Having a parent or other adult in the home with a job loss was associated with higher odds of emotional or physical abuse. CONCLUSIONS: The findings are consistent with child maltreatment prevention strategies focused on alleviating economic hardship.

What Proportion of Foster Care Children Do Not Have Child Protective Services Reports? A Preliminary Look.

It is perhaps surprising that we lack complete national information about why children enter foster care. While the annual Adoption and Foster Care Analysis Reporting System (AFCARS) report is informative, it leaves many questions unanswered, particularly "how many children enter foster care by means other than Child Protective Services (CPS) reports?" Drawing from a unique new integrated dataset, we examined foster care data (AFCARS) and CPS report data (National Child Abuse and Neglect Data System Child File). The linked dataset included 210,062 children with foster care placements in 2017 and no placements in the prior 5 years. We categorized each placed child along two dimensions of four levels each: Time since prior CPS report (if any) and stated AFCARS placement reason, ranging from clearly maltreated to clearly not maltreated. We also tracked the siblings of placed children, to see if non-maltreated children entered care because of maltreated siblings. We find that between 8-35% of children enter foster care for reasons other than maltreatment, depending how thresholds are set. These numbers decline somewhat when siblings are considered. A meaningfully large number of children are placed in foster care for reasons other than maltreatment investigated by CPS. Further research into these children is warranted to better inform foster care policy.

The Impact of the COVID-19 Pandemic on Child Protection System Referrals and Responses in Colorado, USA.

Although the coronavirus disease 2019 (COVID-19) has amplified risk factors known to increase children's vulnerability to abuse and neglect, emerging evidence suggests declines in maltreatment reporting and responding following COVID-19 social distancing protocols in the United States. Using statewide administrative data, this study builds on the current state of knowledge to better understand the volume of child protection system (CPS) referrals and responses in Colorado, USA before and during the early phase of the COVID-19 pandemic and to determine whether there were differences in referral and response rates by case characteristics. Results indicated an overall decline in referrals and responses during COVID-19 when compared to the previous year. Declines were specific to case characteristics, such as reporter and maltreatment type. Implications regarding the impact of the COVID-19 pandemic on child maltreatment reporting and CPS response are discussed.

Adult mental health and child maltreatment: An ecological study across rural-urban and economic continua with implications for post-pandemic human services.

This ecological, county-level, cross-sectional study examines relationships between the mental health of adults (IV) and child maltreatment report rates (DV), as they vary by socioeconomic distress and rurality (n = 3015 counties), using the most recent available data from several linked sources. In a two-way model, maltreatment reports increased 20.1% for each additional half day of poor mental health in metro counties, 11.7% in nonmetro counties, and 13% in rural counties. Our zero-inflated negative binomial model, moderated by rurality and economic distress, showed a significant relationship between the number of poor mental health days and increased child maltreatment report rates in counties (χ2 = 145.52, p < 0.0001). Investment in prevention and treatment of adult mental health concerns is imperative, especially in light of the increase in mental health problems caused by the coronavirus disease 2019 pandemic and increased tension within national political debate. Our results indicate successful support of adult mental health will prevent child maltreatment and reduce the cyclical financial burden of child maltreatment and mental health concerns.

Child, Family, and Case Characteristics Associated With Reentry Into Out-of-Home Care Among Children and Youth Involved With Child Protection Services.

Many children and youth with child protection services (CPS) involvement enter out-of-home care. The aims of this study were to examine rates of reentry and risk factors associated with reentry into out-of-home care among children and youth involved in the child protection (reported for abuse/neglect) and youth-in-conflict (reported for behavioral issues) programs. This study used administrative data from Colorado's Statewide Automated Child Welfare Information System, which contains information on all children and youth who enter Colorado's CPS. Of the 14,461 children and youth in the child protection program and 2,353 children and youth in the youth-in-conflict program, 14.7% and 35.1%, respectively, reentered into out-of-home care. Families' prior history of CPS involvement and current CPS case characteristics better explained reentry into out-of-home care than child and family demographic characteristics alone. Understanding risk factors associated with reentry into out-of-home care is critical to inform the prevention of child maltreatment recurrence and ensure the safety, permanency, and well-being of children and youth.

Traumatic injury and access to care in rural areas: leveraging linked data and geographic information systems for planning and advocacy.

INTRODUCTION: The purpose of this ecological study was to apply Geographic Information System (GIS) methods to patterns of traumatic injury and access to trauma care to facilitate system planning and advocacy. METHODS: Four US state (Colorado) and national data sources were linked to examine county-level disparities. Average ambulance drive times to trauma centers for populated places in each county were estimated and mapped. RESULTS: Independent samples t-tests demonstrated Colorado's rural counties had significantly higher injury hospitalization rates (mean (M)=685.4 v M=566.3; p=0.005)) and fatality rates (M=93.8 v M=71.6, p<0.001), indicating residents with the least access to care are the most impacted by the burden of injury; this finding was supported by GIS analyses of drive times to level I and II trauma centers and underlying injury rates, which are visually displayed. CONCLUSIONS: These methods are useful tools for rural public health professionals to conduct system optimization, identify training and resource needs, assess prevention priorities, and advocate for trauma system support.

Adverse childhood experiences and their relationship to complex health profiles among child welfare-involved children: A classification and regression tree analysis.

OBJECTIVE: To identify the clustering of adverse childhood experiences (ACEs) that best characterize child welfare-involved children with known complex health concerns. DATA SOURCE: Multi-informant data were obtained from Wave I of the National Survey of Child and Adolescent Well-Being (NSCAW II). STUDY DESIGN: This study used a cross-sectional design and classification and regression tree (CART) analyses. DATA COLLECTION: Data were collected from families with children, aged birth to 17, investigated for child maltreatment and their child protective services caseworkers, including demographic characteristics of the children, their histories of adversity, and a wide range of health concerns. PRINCIPAL FINDINGS: Results indicate that for children between the ages of six and 17, experiences of physical abuse alone, as well as experiences of physical abuse combined with having a caregiver with mental illness, are most strongly associated with complex health concerns. For children aged 2-5 years, results suggest that caregiver mental illness is a key adverse experience associated with complex health concerns. CONCLUSIONS: Identifying specific combinations of ACEs may be a critical next step for child- and youth-serving agencies to allow providers to better calculate risk of health problems among children exposed to adversity.

Understanding work enjoyment among older workers: The significance of flexible work options and age discrimination in the workplace.

Although the number of older workers in the U.S. is increasing, there is a gap in knowledge on whether or not they actually enjoy working. This study, based on a conceptual framework focusing on job resources and demands, explored likely workplace determinants of work enjoyment among older workers aged 50 or over. Using the 2012 wave of the Health and Retirement Study, a partial proportional odds model was used to detect determinants of work enjoyment. Results showed that higher levels of work enjoyment were significantly and negatively associated with the level of perceived retirement pressure and promotion preference for younger workers, and positively associated with moving to less demanding positions. Self-employment showed a noticeable enhancement of work enjoyment. This study highlights the significance of flexible work options and age discrimination in the workplace in understanding work enjoyment later in life.

Drug overdose and child maltreatment across the United States' rural-urban continuum.

This national study of US counties (n = 2963) investigated whether county-level drug overdose mortality is associated with maltreatment report rates, and whether the relationship between overdose mortality and maltreatment reports is moderated by a county's rural, non-metro or metro status. Data included county-level 2015 maltreatment reports from the National Child Abuse and Neglect Data System, modeled drug-overdose mortality from the Centers for Disease Control, United States Department of Agriculture Rural-Urban Continuum Codes, US Census demographic data and crime reports from the Federal Bureau of Investigation. All data were linked across counties. Zero-inflated negative binomial (ZINB) regression was used for county-level analysis. As hypothesized, results from the ZINB model showed a significant and positive relationship between drug overdose mortality and child maltreatment report rates (χ = 101.26, p < .0001). This relationship was moderated by position on the rural-urban continuum (χ=8.76, p = .01). For metro counties, there was a 1.9% increase in maltreatment report rate for each additional increment of overdose deaths (IRR=1.019, CI=[1.010, 1.028]). For non-metro counties, the rate of increase was 1.8% higher than for metro counties (IRR=1.018, CI=[1.006, 1.030]); for rural counties, the rate of increase was 1.2% higher than for metro counties (IRR=1.012, CI=[0.999, 1.026]). Additional research is needed to determine why the relationship between drug overdose mortality and maltreatment reports is stronger in non-metro and rural communities. One potential driver requiring additional inquiry is that access to mental and physical health care and substance use treatment may be more limited outside of metropolitan counties.

A systematic review of socioeconomic status measurement in 13 years of U.S. injury research.

OBJECTIVE: The purpose of this review was to assess the impact of socioeconomic status (SES) on injury and to evaluate how U.S. injury researchers have measured SES over the past 13years in observational research studies. DESIGN & METHODS: This systematic review included 119 US injury studies indexed in PubMed between January 1, 2002 and August 31, 2015 that used one or more individual and/or area-level measures of SES as independent variables. Study findings were compared to the results of a previous review published in 2002. RESULTS: Findings indicate SES remains an important predictor of injury. SES was inversely related to injury in 78 (66%) of the studies; inverse relationships were more consistently found in studies of fatal injury (77.4%) than in studies of non-fatal injury (58%). Approximately two-thirds of the studies (n=73, 61%) measured SES along a gradient and 59% used more than one measure of SES (n=70). Studies that used a gradient measure of SES and/or more than one measure of SES identified significant relationships more often. These findings were essentially equivalent to those of a similar 2002 review (Cubbin & Smith, 2002). CONCLUSIONS: There remains a need to improve measurement of SES in injury research. Public health training programs should include best practices for measurement of SES, which include: measuring SES along a gradient, selecting SES indicators based on the injury mechanism, using the smallest geographic region possible for area-level measures, using multiple indicators when possible, and using both individual and area-level measures as both contribute independently to injury risk. Area-level indicators of SES are not accurate estimates of individual-level SES. PRACTICAL APPLICATIONS: Injury researchers should measure SES along a gradient and incorporate individual and area-level SES measures that are appropriate to the injury outcome under study.

College students' experiences of hedonia and eudaimonia in their everyday activities: Degrés d'hédonisme et d'eudémonisme éprouvés par des étudiants du niveau universitaire au fil de leurs activités quotidiennes.

BACKGROUND: Experiences of hedonia (i.e., seeking pleasure) and eudaimonia (i.e., actualizing human potential in pursuit of meaningful goals) are central to the study of human well-being. PURPOSE: This study sought to examine levels of hedonia (pleasure) and eudaimonia (productivity) in a convenience sample of college (university) students' ( n = 264) daily activities, controlling for levels of perceived stress. METHOD: Data were gathered using a 24-hr time-use recall diary designed to assess objective and subjective information about everyday activities. Descriptions of self-reported everyday activities were coded into 20 activity types. FINDINGS: Activities reported high in pleasure were eating, listening to music/watching movies, and exercise. Activities reported as high in productivity were studying and working. Activities reported as high in both pleasure and productivity were reported less frequently and often had a recognizable outcome or provided social connection. IMPLICATIONS: Developing a greater understanding of how college students experience their daily activities could strengthen programs designed to enable students to manage stress and sustain their well-being.

Use of multiple cluster analysis methods to explore the validity of a community outcomes concept map.

Concept mapping is now a commonly-used technique for articulating and evaluating programmatic outcomes. However, research regarding validity of knowledge and outcomes produced with concept mapping is sparse. The current study describes quantitative validity analyses using a concept mapping dataset. We sought to increase the validity of concept mapping evaluation results by running multiple cluster analysis methods and then using several metrics to choose from among solutions. We present four different clustering methods based on analyses using the R statistical software package: partitioning around medoids (PAM), fuzzy analysis (FANNY), agglomerative nesting (AGNES) and divisive analysis (DIANA). We then used the Dunn and Davies-Bouldin indices to assist in choosing a valid cluster solution for a concept mapping outcomes evaluation. We conclude that the validity of the outcomes map is high, based on the analyses described. Finally, we discuss areas for further concept mapping methods research.

Life Course and Intergenerational Continuity of Intimate Partner Aggression and Physical Injury: A 20-Year Study.

The objective of this study is to examine continuity of intimate partner aggression (IPA), which is defined as repeated annual involvement in IPA, across respondents' life course and into the next generation, where it may emerge among adult children. A national, longitudinal, and multigenerational sample of 1,401 individuals and their adult children is analyzed. Annual data on IPA severity and physical injury were collected by the National Youth Survey Family Study across a 20-year period from 1984 to 2004. Three hypotheses and biological sex differences are tested and effect sizes are estimated. First, findings reveal evidence for life course continuity (IPA is a strong predictor of subsequent IPA), but the overall trend decreases over time. Second, intergenerational continuity is documented (parents' IPA predicts adult children's IPA), but the effect is stronger for female than for male adult children. Third, results from combined and separate, more restrictive, measures of victimization and perpetration are nearly identical except in the intergenerational analyses. Fourth, evidence for continuity is not found when assessing physical injury alone. Together, these findings imply that some but not all forms of IPA are common, continuous, and intergenerational. Life course continuity appears stronger than intergenerational continuity.

Predicting re-involvement for children adopted out of a public child welfare system.

Some of the approximately 400,000 children currently placed out-of-home in a public child welfare system will not reunify with their family of origin. They may instead be adopted into a new family. Adoption placements can be characterized by poor adjustment for children; some such placements even result in disruption or dissolution. We conducted a stratified Cox regression of 4,016 children from the Colorado public child welfare system. All of the children had a finalized adoption during the years 2002 through 2006. The two outcomes analyzed were new child protection and youth-in-conflict referrals and assessments for these previously adopted children. New child welfare referrals and assessments may be early indicators of poor adjustment for adopted children within the adoptive family. Study results indicate that older children and Hispanic children had higher rates of referral and assessment. Children with a pre-adoption history including longer time out-of-home or a larger number of out-of-home placements also experienced higher referral and assessment rates. Additional factors which predicted subsequent system re-involvement included presence of paid adoption assistance, adoption by a non-relative foster parent and younger adoptive parent age. Several study results were moderated by the presence or absence of an ethnic match between the child and the adoptive parents. We provide an overview of the statistical model used for analysis and we discuss implications of the study results for child welfare practice.

Predictors of family preservation outcomes and child welfare success in Colorado.

A sample of 4,589 Colorado child welfare cases that closed between October 2007 and September 2009 was analyzed. All cases involved child abuse or neglect. Permanency and follow-up outcomes were scored using a methodology developed for the study. Scores were used to create an ordinal measure of success for the case. A cumulative logit statistical model examined the relationship between the newly-developed ordinal success measure and six predictor variables: number of caregivers, risk of abuse, poverty, risk of neglect, age of primary caregiver, and substance abuse issues. Case profiles are provided. Limitations and implications for practice are discussed.

Exploring survey participation, data combination, and research validity in a substance use study: an application of hierarchical linear modeling.

A sound decision regarding combination of datasets is critical for research validity. Data were collected between 1996 and 2000 via a 99-item survey of substance use behaviors. Two groups of 7th-12th grade students in predominately White communities are compared: 166,578 students from 193 communities with high survey participation and 41,259 students from 65 communities with lower participation. Hierarchical logistic models are used to explore whether the two datasets may be combined for further study of community-level substance use effects. "Scenario analysis" is introduced. Results suggest the datasets may reasonably be combined. Limitations and further research are discussed.