A Single-Case Study of Resiliency After Extreme Incest in an Old Order Amish Family.

This exploratory research brief presents a single case study of the resiliency of "Mary B." She grew up in an Old Order Amish family where isolation, secrecy, and patriarchy masked repeated sexual assaults by her older brothers that began at age 7. By the age of 20, Mary alleged she had been raped on more than 200 separate occasions by members of her Amish family. After years of pleading with her mother and church officials to intervene, she sought therapy outside the Amish community. This led to three of her brothers being incarcerated. Her family disowned her and she was banned from the Amish community, leaving with an 8th grade education and little more than the clothes she was wearing. In less than 2 years, Mary had moved to a new town, completed her GED, obtained a car and driving license, maintained a small home, and worked as a certified nursing assistant. She consented to tape recorded interviews and completed several quantitative diagnostic measures. Scores on the diagnostic measures placed her within the normal range on self-esteem, competency, depression, stress, social support, and life skills. Analysis of interviews revealed Mary rebounded from her past by reframing her experiences. Themes identified within the interviews supported 6 of the 7 types of resiliencies (insight, independence, initiative, relationships, humor, and morality) outlined in the therapeutic Challenge Model.

Physical neglect in childhood as a predictor of violent behavior in adolescent males.

Research has established that childhood maltreatment experiences are associated with negative outcomes in adolescence, including violent and antisocial behavior (Chapple et al., 2005). Neglect is the most prevalent form of childhood maltreatment (U.S. DHHS, 2012), the consequences of which require further investigation. This study used archival data to explore whether childhood physical neglect increased the likelihood of violent behavior in a random sample of 85 males between the ages of 12-19 held at a long-term detention facility in the Northeastern United States. An anonymous survey gathered background information and data regarding childhood physical neglect and violent behavior in adolescence. A step-wise hierarchal regression model controlled for the effects of age, self-esteem, personal competency, depression, chemical drug use, family violence and a childhood history of physical abuse. Results showed that a history of childhood physical neglect was the strongest predictor of violent adolescent behavior in this sample when the data was tested for all moderator and mediator effects.

The role of community in facilitating service utilization.

Guided by an integrated theory of parent participation, this study examines the role community characteristics play in influencing a parent's decision to use voluntary child abuse prevention programs. Multiple regression techniques were used to determine if different community characteristics, such as neighborhood distress and the community's ratio of caregivers to those in need of care, predict service utilization levels in a widely available home visiting program. Our findings suggest that certain community characteristics are significant predictors of the extent to which families utilize voluntary family supports over and above the proportion of variance explained by personal characteristics and program experiences. Contrary to our initial assumptions, however, new parents living in the most disorganized communities received more home visits than program participants living in more organized communities. The article concludes with recommendations on how community capacity building might be used to improve participant retention.

Lens-Coupled CCD Detector for X-ray Crystallography.

An x-ray crystallography detector (Blue-1) has been built based upon a Fairchild 486 back-illuminated CCD and a custom lens system designed by Optics One Inc. The advantages of our Blue-1 lens system over more conventional fiber-optic tapers are: lower noise and higher efficiency; improved point spread function; negligible spatial distortion; and lack of "chicken-wire" patterns. Also, the engineering is simpler because the CCD is not bonded to the fiber-optic taper. A unique mechanical design has been employed to accurately focus the image on the CCD. The detector software is based on MATLAB and takes advantage of its powerful imaging and signal processing libraries. The CCD timing can be updated on the fly by using a "CCD controller language" to specify timing.

Understanding maternal intentions to engage in home visiting programs.

Little is known as to why some parents choose to engage in voluntary home visitation services while others refuse or avoid services. To address this knowledge gap, this study tests several hypotheses about the factors that influence maternal intentions to engage in home visitation services and the link between these intentions and the receipt of a home visit. The sample consists of an ethnically diverse group of mothers identified as at-risk for parenting difficulties (N = 343). These mothers were offered home visitation services from nine home visiting programs located across six states. Regardless of service acceptance or refusal, all mothers were interviewed within 2 weeks of the service offer and 3 months later.The findings suggest that mothers who intend to use services look substantially different from those who do not state an intention to participate in home visitation. The results indicate that lower infant birth weight and greater comfort with a provider in one's home are significant predictors of maternal intentions to utilize home visiting services. The study results also support the connection between intent and behavior as the expressed intention to engage in home visitation services was a key predictor of the receipt of a visit.

The Simoa HD-1 Analyzer: A Novel Fully Automated Digital Immunoassay Analyzer with Single-Molecule Sensitivity and Multiplexing.

Disease detection at the molecular level is driving the emerging revolution of early diagnosis and treatment. A challenge facing the field is that protein biomarkers for early diagnosis can be present in very low abundance. The lower limit of detection with conventional immunoassay technology is the upper femtomolar range (10(-13) M). Digital immunoassay technology has improved detection sensitivity three logs, to the attomolar range (10(-16) M). This capability has the potential to open new advances in diagnostics and therapeutics, but such technologies have been relegated to manual procedures that are not well suited for efficient routine use. We describe a new laboratory instrument that provides full automation of single-molecule array (Simoa) technology for digital immunoassays. The instrument is capable of single-molecule sensitivity and multiplexing with short turnaround times and a throughput of 66 samples/h. Singleplex and multiplexed digital immunoassays were developed for 16 proteins of interest in cardiovascular, cancer, infectious disease, neurology, and inflammation research. The average sensitivity improvement of the Simoa immunoassays versus conventional ELISA was >1200-fold, with coefficients of variation of <10%. The potential of digital immunoassays to advance human diagnostics was illustrated in two clinical areas: traumatic brain injury and early detection of infectious disease.

Sexual abuse in childhood and interpersonal violence in adulthood: a cumulative impact on depressive symptoms in women.

This study investigates the cumulative impact of sexual abuse in childhood and adult interpersonal violence in the past year on depressive symptoms in a nonclinical sample of 265 primarily African American (74%) women. The frequency of depressive symptoms, measured by the Center for Epidemiologic Studies Depression Scale (CES-D), was highest for women who experienced both forms of victimization. Women who reported greater stress over life's daily hassles reported more depressive symptoms. Women with higher levels of family support and a sense of personal mastery reported fewer depressive symptoms. The final model explained 42% of the variance in CES-D scores. Implications for practitioners are discussed.

Multi-level determinants of retention in a home-visiting child abuse prevention program.

OBJECTIVE: This exploratory study investigated how attributes from multiple domains influence retention in a voluntary home-visiting child abuse prevention program. METHOD: A sample of 1093 "at-risk" families participated in a home-visiting child abuse prevention program. A total of 71 Family Support Workers (FSWs) provided home visitation services in 12 different communities. Hierarchical general linear modeling (HGLM) was used to examine the community, home visitor, and maternal attributes that predicted retention in the program beyond 1 year. RESULTS: Multi-level analyses (HGLM) revealed significant community, home visitor, and maternal level effects. Families were less likely to remain in a home-visiting child abuse prevention program for at least 1 year if they lived in an area with high community violence. Families were more likely to remain when the home visitor received more hours of direct supervision. Older mothers were more likely to remain for at least 1 year than were younger mothers. Hispanic mothers were more likely to remain than were White non-Hispanic mothers. CONCLUSIONS: These findings demonstrate the utility of looking across multiple levels of influence when examining retention in home-visiting child abuse prevention programs. To increase retention rates home visitors will need to be adaptable to fit the needs of families in violent communities. Supervisors can influence retention rates by providing more hours of direct supervision. Other strategies that may contribute to program retention include meeting the scheduling needs of younger mothers and involving the families of younger mothers more effectively.