Victims\u27 Perspectives on the Process of Seeking a Protective Order: Predictors of Perceived Empowerment

This study examined victims\u27 perceived sense of empowerment during the process of seeking a Preliminary Protective Order. A cross sectional survey design with stratified sampling was used to gather information from women seeking Preliminary Protective Orders in Richmond City, Virginia. During a six month period 89 women agreed to participate, for a response rate of 83 percent. In general, the sample consisted of women who identified themselves as African-American, single, with either a high school/GED degree, and/or some college education.Overall, the women found the steps during the process of seeking an Order, either easy or very easy. In general, the participants responded positively to the steps outlined in the process index. Exceptions to the largely positive results included: getting help preparing a safety plan, explaining what you wanted to the judge, and learning about how to seek a Protective Order. The empowerment sub-scales\u27 results suggest that overall the participants felt empowered during the process of seeking an Order. The final mean for each sub-scale was higher than the minimum score necessary to be considered a high score. The results of the multivariate analysis suggest that the process of seeking an Order was an empowering act on two of the three levels of empowerment studied. The two sub-scales found to have a positive and statistically significant relationship with the process index were the self-efficacy, and collective advocacy level. Alternatively, when utilizing the self-advocacy sub-scale as the dependent variable, only marital status was found to be significant. Implications for social work practice include practitioners educating themselves on legal protections for abused women and educating clients about the process of seeking an Order. Additionally, social workers should incorporate empowerment theory concepts while working with clients. Social work educators should incorporate empowerment theory throughout the curriculum and increase content on intimate partner violence and interdisciplinary teams. Additionally, social workers should consider partnering with other disciplines, such as criminal justice departments to offer cross-listed courses and certificate programs to prepare future professionals who will work in the domestic violence field. Policies to enhance victim-witness advocates\u27 ability to assist victims and specialized courts are recommended

Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570

Social Work Case Histories: Foundation Year

Gain insight into the daily experiences of social workers with Social Work Case Studies: Foundation Year. This collection of case studies highlights work with individuals, families, groups, and organizations and aligns with topics and modules commonly covered during the foundation year of a Master of Social Work program.Each case study offers a detailed description of the client’s background and presenting problem, as well as the approaches used by the social worker to address the identified concern. Case-specific reflection questions highlight the social worker’s personal experiences, professional responses, and occasional struggles in the field. Social Work Case Studies: Foundation Year is an exceptional resource for integrating and connecting theoretical concepts to social work practic

Social Work Case Histories: Foundation Year

Gain insight into the daily experiences of social workers with Social Work Case Studies: Foundation Year. This collection of case studies highlights work with individuals, families, groups, and organizations and aligns with topics and modules commonly covered during the foundation year of a Master of Social Work program.Each case study offers a detailed description of the client’s background and presenting problem, as well as the approaches used by the social worker to address the identified concern. Case-specific reflection questions highlight the social worker’s personal experiences, professional responses, and occasional struggles in the field. Social Work Case Studies: Foundation Year is an exceptional resource for integrating and connecting theoretical concepts to social work practic

Developing Vulnerability: A Situational Response to the Abuse of Women with Mental Disabilities

In this paper I present a critical analysis of the English law relating to the safeguarding of vulnerable adults, in particular how the law impacts on the sexual lives of adult women with mental disabilities. I consider the discourses of vulnerability that surround the different legal regimes and whether the emerging theoretical vulnerability literature can assist in developing more nuanced legal responses. I argue that the inherent jurisdiction and Care Act 2014 provide an opportunity to move away from the focus on inherent features of vulnerability such as mental disability towards a more nuanced, situational and embodied account of what it means to safeguard ‘vulnerable adults’. This has the potential to be developed in England through the new legal framework of the Care Act and can be achieved through targeting interventions against the situational causes of vulnerability, for example the perpetrators of sexual violence

Coronal Heating as Determined by the Solar Flare Frequency Distribution Obtained by Aggregating Case Studies

Flare frequency distributions represent a key approach to addressing one of the largest problems in solar and stellar physics: determining the mechanism that counter-intuitively heats coronae to temperatures that are orders of magnitude hotter than the corresponding photospheres. It is widely accepted that the magnetic field is responsible for the heating, but there are two competing mechanisms that could explain it: nanoflares or Alfv\'en waves. To date, neither can be directly observed. Nanoflares are, by definition, extremely small, but their aggregate energy release could represent a substantial heating mechanism, presuming they are sufficiently abundant. One way to test this presumption is via the flare frequency distribution, which describes how often flares of various energies occur. If the slope of the power law fitting the flare frequency distribution is above a critical threshold, $\alpha=2$ as established in prior literature, then there should be a sufficient abundance of nanoflares to explain coronal heating. We performed $>$600 case studies of solar flares, made possible by an unprecedented number of data analysts via three semesters of an undergraduate physics laboratory course. This allowed us to include two crucial, but nontrivial, analysis methods: pre-flare baseline subtraction and computation of the flare energy, which requires determining flare start and stop times. We aggregated the results of these analyses into a statistical study to determine that $\alpha = 1.63 \pm 0.03$. This is below the critical threshold, suggesting that Alfv\'en waves are an important driver of coronal heating.Comment: 1,002 authors, 14 pages, 4 figures, 3 tables, published by The Astrophysical Journal on 2023-05-09, volume 948, page 7