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BackgroundExposure to interpersonal violence, namely verbal and physical abuse, is a highly prevalent threat to women's health and well-being. Among older, post-menopausal women, several researchers have characterized a possible bi-directional relationship of abuse exposure and diminished physical functioning. However, studies that prospectively examine the relationship between interpersonal abuse exposure and physical functioning across multiple years of observation are lacking. To address this literature gap, we prospectively evaluate the association between abuse exposure and physical functioning in a large, national cohort of post-menopausal women across 12 years of follow-up observation.MethodsMultivariable logistic regression was used to measure the adjusted association between experiencing abuse and physical function score at baseline in 154,902 Women's Health Initiative (WHI) participants. Multilevel modeling, where the trajectories of decline in physical function were modeled as a function of time-varying abuse exposure, was used to evaluate the contribution of abuse to trajectories of physical function scores over time.ResultAbuse was prevalent among WHI participants, with 11 % of our study population reporting baseline exposure. Verbal abuse was the most commonly reported abuse type (10 %), followed by combined physical and verbal abuse (1 %), followed by physical abuse in the absence of verbal abuse (0.2 %). Abuse exposure (all types) was associated with diminished physical functioning, with women exposed to combined physical and verbal abuse presenting baseline physical functioning scores consistent with non-abused women 20 years senior. Results did not reveal a differential rate of decline over time in physical functioning based on abuse exposure.ConclusionsTaken together, our findings suggest a need for increased awareness of the prevalence of abuse exposure among postmenopausal women; they also underscore the importance of clinician's vigilance in their efforts toward the prevention, early detection and effective intervention with abuse exposure, including verbal abuse exposure, in post-menopausal women. Given our findings related to abuse exposure and women's diminished physical functioning at WHI baseline, our work illuminates a need for further study, particularly the investigation of this association in younger, pre-menopausal women so that the temporal ordering if this relationship may be better understood.

Background: Elder abuse and neglect are highly under-reported in the United States. This may be partially attributed to low incidence of reporting among emergency medical technicians' (EMTs), despite state-mandated reporting of suspected elder abuse. Innovative solutions are needed to address under-reporting. The objective was to describe EMTs' experience detecting and reporting elder abuse.Methods: Qualitative data were collected from 11 EMTs and 12 Adult Protective Services (APS) caseworkers that participated in one of five semi-structured focus groups. Focus group data were iteratively coded by two coders.Results: Findings suggest a number of barriers prevent EMTs from reporting elder abuse to APS. Participants suggested that limited training on elder abuse detection or reporting has been provided to them. EMTs suggested that training, creation of an automated reporting system or brief screening tool could be used to enhance EMT's ability to detect and communicate suspected cases of elder abuse to APS.Conclusions: Results from the present study suggest that EMTs may be uniquely situated to serve as elder abuse and neglect surveillance personnel. EMTs are eager to work with APS to address the under-reporting of elder abuse and neglect, but training is minimal and current reporting procedures are time-prohibitive given their primary role as emergency healthcare providers. Future studies should seek to translate these findings into practice by identifying specific indicators predictive of elder abuse and neglect for inclusion on an automated reporting instrument for EMTs. [ABSTRACT FROM AUTHOR]

The article focuses on role of military experience on officer-involved shootings towards a constructive research agenda. Topics include the complex relationship between veteran status and the discharge of a firearm being spurious, the no longer observe this relationship were able to perfectly control confounding, and the emotionally has charged topics that have the greatest need for facts derived from empirical research.

Background: Despite veterans' preference hiring policies by law enforcement agencies, no studies have examined the nature or effects of military service or deployments on health outcomes. This study will examine the effect of military veteran status and deployment history on law enforcement officer (LEO)-involved shootings., Methods: Ten years of data were extracted from Dallas Police Department records. LEOs who were involved in a shooting in the past 10 years were frequency matched on sex to LEOs never involved in a shooting. Military discharge records were examined to quantify veteran status and deployment(s). Multivariable logistic regression was used to estimate the effect of veteran status and deployment history on officer-involved shooting involvement., Results: Records were abstracted for 516 officers. In the adjusted models, veteran LEOs who were not deployed were significantly more likely to be involved in a shooting than non-veteran officers. Veterans with a deployment history were 2.9 times more likely to be in a shooting than non-veteran officers., Conclusions: Military veteran status, regardless of deployment history, is associated with increased odds of shootings among LEOs. Future studies should identify mechanisms that explain this relationship, and whether officers who experienced firsthand combat exposure experience greater odds of shooting involvement., (© The Author(s) 2018. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)