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BACKGROUND: In the UK, one in four patients are in work at the time of their hip or knee replacement surgery. These patients receive little support about their return to work (RTW). There is a need for an occupational support intervention that encourages safe and sustained RTW which can be integrated into National Health Service practice. We developed a two-arm intervention trial, based on a feasibility study, to assess whether an occupational support intervention (the OPAL (Occupational support for Patients undergoing Arthroplasty of the Lower limb) intervention) is effective in supporting a reduced time to full, sustained RTW compared with usual care in patients undergoing hip and knee replacement. METHODS AND ANALYSIS: This is a multicentre, individually randomised controlled superiority trial comparing the OPAL intervention to usual care. 742 working adults listed for elective primary hip or knee replacement, who intend to RTW, will be randomised to the OPAL intervention or usual care. The intervention comprises: (1) multimedia information resources; and (2) support from a designated RTW coordinator. The primary outcome is time until 'full' sustained RTW without sick leave for a consecutive 4-week period. Secondary outcomes are: time to any RTW, measures of functional recovery, number of 'sick days' between surgery and 'full' sustained RTW and the use of workplace modifications to facilitate their return. A health economic evaluation and a mixed methods process evaluation will assess cost-effectiveness and the implementation, fidelity and acceptability of the intervention, respectively. Outcomes will be collected at baseline, 3, 6, 9 and 12-month follow-up time points, as well as a monthly RTW questionnaire. ETHICS AND DISSEMINATION: Dissemination will focus on supporting the wider adoption and implementation of the intervention (if effective) and will target groups for whom the results will be relevant. This trial was approved by West Midlands-Edgbaston REC 23/WM/0013. TRIAL REGISTRATION NUMBER: ISRCTN13694911.

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For decades, states have passed legislation to mandate reporting of criminal conduct and the abuse of vulnerable persons. Four types of mandatory reporting laws have been enacted, including laws that require reports of injuries associated with crime or due to use of certain weapons, abuse of children, abuse of vulnerable adults, and reporting of domestic violence. While studies have been conducted to evaluate the effectiveness of mandatory reporting laws in domestic violence cases, methodological weaknesses in this body of literature make it difficult to make broad statements about whether mandatory reporting laws advance women's protection or actually place them at additional risk. This study's sample is based on 388 surveys administered in-person to women who had sought services from one of Kentucky's 15 regional domestic violence shelters. In addition to querying women regarding their own experience with mandatory reporting laws, the survey explored the factors that influenced women's views. The study advances research into women's decisions to access shelters, medical, or mental health services and how they are influenced by advance knowledge that their case would be reported if they disclosed abuse. A new and troubling finding was that almost two in five women reported they would have been less likely to contact a domestic violence shelter if they knew in advance that a mandatory report would be made. Future research on mandatory reporting is needed with an eye toward changing state policies and laws to ensure that women feel free to seek the type of assistance they need for themselves and their children.

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OBJECTIVE: Exposure to sexual assault results in ongoing harms for women. After an assault, some women engage in higher levels of externalizing behaviors, such as problem drinking, and others experience higher levels of internalizing dysfunction, such as symptoms of anxiety and depression. We sought to understand the role of premorbid factors on the different post-assault experiences of women. METHOD: We studied 1,929 women prospectively during a period of high risk for sexual assault (the first year of college): women were assessed in July before arriving at college and in April near the end of the school year. RESULTS: A premorbid personality disposition to act impulsively when distressed (negative urgency) interacted positively with sexual assault experience to predict subsequent increases in drinking behavior; a premorbid personality disposition toward internalizing dysfunction positively interacted with sexual assault experience to predict increased symptoms of anxiety and depression. CONCLUSIONS: Women with different personalities tend to experience different forms of post-assault consequences.

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Both nonsuicidal self-injury (NSSI) and purging behaviour are thought to involve harm to the self. The acquired capability for self-harm model holds that engaging in one self-harming behaviour increases the capability to tolerate harm to the self, thus increasing risk for engaging on other such behaviours. In addition, both behaviours are thought to serve the similar function of relief from distress. We thus tested whether engagement in one of these behaviours predicts the subsequent onset of the other. In a longitudinal design, 1158 first-year college women were assessed for purging and NSSI at two time points. Engagement in NSSI at time 1 predicted the college onset of purging behaviour 9 months later (OR = 2.20, p < .04, CI = 1.07-4.19) beyond prediction from time 1 binge behaviour, and purging behaviour at time 1 predicted the subsequent onset of NSSI (OR = 6.54, p < .01, CI = 1.71-25.04). These findings are consistent with the acquired capability for harm model and with the possibility that the two behaviours serve a similar function.

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Many researchers have identified impulsivity-related personality traits as correlates of and risk factors for nonsuicidal self-injury (NSSI). Using a longitudinal design, we tested the hypothesis that one such trait, negative urgency (the tendency to act rashly when distressed), predicts the onset of NSSI during the first year of college and a different trait, lack of perseverance (the disposition to fail to maintain focus on tasks that are difficult or boring), predicts the maintenance of NSSI during the first year of college. In a sample of n=1,158 college women (mean age=18.04, 95% of participants were 18 at Time 1), we found support for these hypotheses. Negative urgency, measured prior to college entry, predicted the onset of NSSI behavior across the first year of college (odds ratio=1.58). Lack of perseverance predicted the maintenance of NSSI status across the first year of college, controlling for prior NSSI behavior (odds ratio=1.73). These findings indicate that different impulsivity-related personality traits may play different roles in the risk process for NSSI.

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The literature has documented the widespread nature of sexual assault victimization among college women. While the aftermath of violence against university women has also received focus, that is, documenting trauma-related sequelae; risk factors; reporting patterns; and legal interventions, the impact on academic performance has not received adequate attention in the literature. The primary purpose of this study was to explore the association of rape and sexual assault with academic performance among college women. Its specific aims included the following: to compare high school and college sexual assault experiences with collegiate grade point averages (GPAs) at key points in time; to examine any differences in GPA by type of sexual assault; to urge researchers studying retention and persistence patterns or sexual assault among college students to ensure that the relationship between the two is included in research designs; and to recommend that academic institutions expand programming on retention to include rape and sexual assault among the risk factors associated with a lack of persistence.

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For some women, the experience of being sexually assaulted leads to increases in externalizing behaviors, such as problem drinking and drug use; for other women, the experience of being assaulted leads to increases in internalizing distress like depression or anxiety. It is possible that pre-assault personality traits interact with sexual assault to predict externalizing or internalizing distress. We tested whether concurrent relationships among personality, sexual assault, and distress were consistent with such a model. We surveyed 750 women just prior to their freshman year at a large public university. Consistent with our hypotheses, at low levels of negative urgency (the tendency to act rashly when distressed), sexual assault exposure had little relationship to problem drinking and drug use. At high levels of negative urgency, being sexually assaulted was highly associated with those externalizing behaviors. At low levels of internalizing personality traits, being assaulted had little relationship to depression and anxiety symptoms; at high levels of the traits, assault experience was highly related to those symptoms. Personality assessment could lead to more person-specific post-assault interventions.

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Research in the violence against women area has been undertaken for more than 30 years, but individual researchers who have made these scholarly contributions have not been advantaged by adequate attention, funding, or organizational structure within the university setting. This article offers a detailed description of a model of an interdisciplinary research center designed to provide an academic architecture within which research on intimate partner violence, sexual assault, stalking, and other forms of violence against women can flourish and advance. The article describes the impetus for creation of the University of Kentucky Center for Research on Violence Against Women, its current mission, organizational structure, financial operations, and initiatives related to research, education, and public service. Practical strategies for establishing and sustaining a center of this type are offered.

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Vaccinia virus is an orthopoxvirus used in the live vaccine against smallpox. Vaccinia virus infections can be transmissible and can cause severe complications in those with weakened immune systems. We report on a cluster of 4 cases of vaccinia virus infection in Maryland, USA, likely acquired at a martial arts gym.

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Research has shown that respondents to protective orders have robust criminal histories and that criminal offending behavior often follows issuance of a protective order. Nonetheless, the specific nature of the association between protective orders and criminal offending remains unclear. This study uses two classes of statistical models to more clearly delineate that relationship. The models reveal factors and characteristics that appear to be associated with offending and protective order issuance and provide indications about when a victim is most at risk and when the justice system should be most ready to provide immediate protection.

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The reach of violence against women (VAW) has been profoundly felt by women across the United States and around the globe. VAW has been documented for decades as a legal and social justice problem, but as illuminated in this review, it is also a substantial mental health concern. A full understanding of the phenomenon must include discussion of how often it occurs, in what forms, and to whom. This review defines violence against women in its variant forms and examines the literature on the mental health effects associated with these abuse experiences. The effectiveness of the mental health system's response to the complex needs of women suffering battering, rape, stalking, and psychological aggression is also examined. The future of research and the important role of the discipline of psychology in the future of this field of study are discussed.

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This article reviews the complex relationship between child maltreatment and later psychosocial difficulties among adult women. Specifically addressed are (a) the various forms of childhood maltreatment, (b) the range of potential long-term psychological outcomes, and (c) important contextual variables that mediate or add to these maltreatment-symptom relationships. Among the latter are characteristics of the abuse and/or neglect; effects of impaired parental functioning; premaltreatment and postmaltreatment psychobiology; qualities of the parent-child attachment; abuse and/or neglect-related affect dysregulation that may lead to further symptomatology; the extent to which the child responds with significant emotional or behavioral avoidance; and whether later traumas are also present. Also relevant are sociocultural contributors to both child maltreatment and maltreatment effects, especially poverty and marginalization. Clinical and research implications are considered.

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Decades of research produced by multiple disciplines has documented withering rates of violence against women in the United States and around the globe. To further an understanding of gendered violence, a field of research has developed, but recent critiques have highlighted weaknesses that inhibit a full scientific exploration of these crimes and their impacts. This review extends beyond prior reviews to explore the field's unique challenges, its community of scientists, and the state of its written knowledge. The review argues for moving beyond "research agendas" and proposes creation of a transdisciplinary science for the field of study of violence against women.

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Despite the importance of civil orders of protection as a legal resource for victims of intimate partner violence, research is limited in this area, and most studies focus on the process following a court's initial issuance of an emergency order. The purpose of this study is to address a major gap in the literature by examining cases where victims of intimate partner violence are denied access to temporary orders of protection. The study sample included a review of 2,205 petitions that had been denied by a Kentucky court during the 2003 fiscal year. The study offers important insights into the characteristics of petitioners and respondents to denied orders and outlines individual, contextual, structural, qualitative/perceptual, and procedural factors associated with the denial of temporary or emergency protective orders. Recommendations for statutory changes, judicial education, and future research to remedy barriers to protection are offered.

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