Women’s Cigarette and Marijuana Use in Pregnancy: Identifying the Role of Past Versus Recent Violence Exposure

Both cigarette smoking and marijuana use during pregnancy pose serious risks to healthy fetal development, yet little is known about the comparative contribution of recent versus past traumatic experiences to women’s smoking behavior. The current study aimed to examine the relative contributions of childhood adversity and past year intimate partner violence (IPV) to women’s cigarette and marijuana use during pregnancy in a high-risk, low-income sample. Participants (n = 101) were interviewed to evaluate past year IPV, childhood adversity, and cigarette and marijuana use. Results indicated that approximately one in four pregnant women in the sample reported that they were currently smoking cigarettes. Only a minority of those who reported prepregnancy smoking (22.5%) were able to quit smoking once pregnant. Regarding marijuana use, 6.9% of women reported use during pregnancy, with 68.1% of women using prior to pregnancy ceasing use once pregnant. Results of multinomial regressions controlling for income and education indicated that past year physical abuse by a partner was associated with light cigarette use during pregnancy whereas high rates of childhood adversity were associated with moderate cigarette use during pregnancy. Sexual IPV was associated with marijuana use during pregnancy. Comprehensive assessment of women’s history of exposure to violence, including both past and recent exposure, provides insight into which women may have the most difficulty with unassisted cessation in the prenatal period. Providing better intervention and support around cigarette and marijuana cessation for women exposed to violence is a critical need, especially among groups that are at sociodemographic risk for substance use in pregnancy

Direct and Indirect Effects of Maltreatment and Social Support on Children’s Social Competence Across Reporters

Children’s social competence is a key characteristic of resilience, yet little research has assessed contributing factors to this construct. The objectives of this study were to examine direct and indirect effects of maltreatment on children’s social competence, the promotive role of child and caregiver social support, and factors contributing to reports of child social competence across informants. Structural equation modeling evaluated the influence of CPS report history, child adjustment, and child and caregiver social support on child social competence in n = 783 caregiver-child dyads. CPS report history (age 0–8) was indirectly related to low social competence through child adjustment problems. Social support was a significant promotive factor of child social competence, with caregiver social supports predicting higher levels of parent-reported child social competence. Child social support predicted self-reported child social competence. Findings reinforce the assertion that both caregiver and child social support networks are critical to promoting child well-being after adversity

The association of patient complexities with antibiotic ordering

BackgroundAntibiotic treatment decisions for medically complex patients are complicated, as the risk of undertreatment may be severe, whereas overtreatment may be associated with adverse effects and the emergence of antibiotic resistant pathogens.ObjectiveTo determine the influence of patient complexities on providers' decisions to prescribe antibiotics in 3 common hospital-based clinical vignettes.DesignA physician survey.SettingThree urban medical centers in Los Angeles County, California.ParticipantsHospital-based physicians.MeasurementsPhysicians were presented 3 clinical vignettes, with variations by patient age, comorbidity burden, functional status, and follow-up, and asked to choose the best antibiotic regimen. We described the association of additional patient complexity on the proportion of guideline-adherent antibiotic choices.ResultsIn the survey, 28% to 49% of physicians recommended antibiotics that were inconsistent with national guidelines. This percentage increased to 48% to 63% for medically complex patients, defined as those with either older age, high medical comorbidity burden, poor functional status, or limited follow-up after hospital discharge (P < 0.01).ConclusionsIn 3 vignettes depicting common clinical scenarios among hospitalized adults, inappropriate antibiotic use was prevalent and occurred more often for patients with medical complexities. Treatment guidelines should consider addressing medically complex patients in the context of infection management

Optics and Quantum Electronics

Contains table of contents for Section 3, reports on eighteen research projects and a list of publications.Defense Advanced Research Projects Agency Grant F49620-96-0126U.S. Air Force - Office of Scientific Research Grant F49620-98-1-0139Defense Advanced Research Projects AgencyJoint Services Electronics ProgramU.S. Air Force - Office of Scientific ResearchNational Science FoundationU.S. Navy - Office of Naval ResearchCharles S. Draper LaboratoryNational Science Foundation/MRSECJoint Services Electronics Program Grant DAAH04-95-1-0038U.S. Air Force - Office of Scientific Research Contract F49620-95-1-0221U.S. Navy - Office of Naval Research (MFEL) Contract N00014-91-J-1956U.S. Navy - Office of Naval Research (MFEL) Contract N000014-97-1-1066National Institutes of Health Grant 9RO1 EY11289-12National Institutes of Health Grant 1R01 CA75289-01U.S. Navy - Office of Naval Research/MFEL Contract N00014-94-1-071