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The incidence of neonatal abstinence syndrome (NAS), a withdrawal syndrome associated with prenatal opioid or other substance exposure (1), has increased as part of the U.S. opioid crisis (2). No national NAS surveillance system exists (3), and data about the accuracy of state-based surveillance are limited (4,5). In February 2018, the Pennsylvania Department of Health began surveillance for opioid-related NAS in birthing facilities and pediatric hospitals* (6). In March 2019, CDC helped the Pennsylvania Department of Health assess the accuracy of this reporting system at five Pennsylvania hospitals. Medical records of 445 infants who possibly had NAS were abstracted; these infants had either been reported by hospital providers as having NAS or assigned an International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) hospital discharge code potentially related to NAS.† Among these 445 infants, 241 were confirmed as having NAS. Pennsylvania's NAS surveillance identified 191 (sensitivity = 79%) of the confirmed cases. The proportion of infants with confirmed NAS who were assigned the ICD-10-CM code for neonatal withdrawal symptoms from maternal use of drugs of addiction (P96.1) was similar among infants reported to surveillance (71%) and those who were not (78%; p = 0.30). Infants with confirmed NAS who were not assigned code P96.1 typically had less severe signs and symptoms. Accurate NAS surveillance, which is necessary to monitor changes and regional differences in incidence and assist with planning for needed services, includes and is strengthened by a combination of diagnosis code assessment and focused medical record review.

Introduction The purpose of this study was to examine the perceptions of institutional policies and practices for the prevention of and response to gender inequities as experienced by female faculty working in the health sciences at a US research university. Methods Data from the institution's Faculty Campus Climate Survey (n = 260 female faculty) were coupled with qualitative interviews (n = 14) of females in leadership positions, exploring campus climate, and institutional policies and practices aimed at advancing women. Results Two-thirds (59%) of the female faculty respondents indicated witnessing sexual harassment and 28% reported experiencing sexual harassment. Several organizational themes emerged to address this problem: culture, including cultural change, transparency, and accountability. Conclusions The findings reveal the ways in which university culture mimics the larger societal context. At the same time, the distinct culture of higher education processes for recruitment, career advancement – specifically tenure and promotion – are identified as important factors that require modifications in support of reductions in gender inequalities.

Addressing sexual assault on university and college campuses in the United States is a national priority. To date, research on campus sexual assault overwhelmingly focuses on students as objects of study: as survivors, perpetrators, and bystanders of sexual assault. This focus has largely overlooked students who act as agents of change, mobilizing to alter campus norms around consent, prevention, survivor support, and institutional response. In this article, we encourage feminist scholars to incorporate students as advocates against sexual assault and to invite students to be collaborators in research. We discuss a student-led organization and our ongoing collaborative study with the organization to illustrate how feminist researchers can feature student engagement with campus sexual assault at the grass roots. We conclude with recommendations to expand the national research agenda on campus sexual assault.

Objective To provide the first study in Vietnam of how gendered social learning about violence and exposure to non-family institutions influence women's attitudes about a wife's recourse after physical IPV. Method A probability sample of 532 married women, ages 18-50 years, was surveyed in July-August, 2012 in Mỹ Hao district. We fit a multivariate linear regression model to estimate correlates of favoring recourse in six situations using a validated attitudinal scale. We split attitudes towards recourse into three subscales (disfavor silence, favor informal recourse, favor formal recourse) and fit one multivariate ordinal logistic regression model for each behavior to estimate correlates of favoring recourse. Results On average, women favored recourse in 2.8 situations. Women who were older and had witnessed physical IPV in childhood had less favorable attitudes about recourse. Women who were hit as children, had completed more schooling, worked outside agriculture, and had sought recourse after IPV had more favorable attitudes about recourse. Conclusions Normative change among women may require efforts to curb family violence, counsel those exposed to violence in childhood, and enhance women's opportunities for higher schooling and non-agricultural wage work. The state and organizations working on IPV might overcome pockets of unfavorable public opinion by enforcing accountability for IPV rather than seeking to alter ideas about recourse among women.

Background Our objective was to examine the multilevel correlates of women9s justification of wife beating in Bangladesh, a form of intimate partner violence (IPV). We focus on individual-level schooling, community-level media exposure among women and their interaction. Methods A cross-sectional study using data from the 2011 Bangladesh Demographic and Health Survey. Our sample included 17 749 ever-married women 15–49 years in 600 communities. We fit 6 multilevel logistic regression models to examine factors associated with justifying IPV; focusing on a woman9s completed grades of schooling; frequent (at least once weekly) community-level media exposure among women via newspaper/magazine, television and radio; and their cross-level interaction. Results At the individual level, completing more grades of schooling than the community average was negatively associated with justifying IPV (0.95, 95% CI 0.94 to 0.97). The main effects of women9s community-level media exposure were not significant, but suggested that frequent exposure to newspaper/magazine or television was negatively associated with justifying IPV, while exposure to radio was positively associated. In cross-level interactions, a woman9s completed grades of schooling above the community average was protective against justifying IPV, even in communities where women9s exposure to radio would otherwise increase the odds of justifying IPV. Conclusions Different forms of media likely send different messages about gender and IPV. Girls9 schooling should remain a priority, given its protective effect against justifying wife beating. Targeting girls and women who do not receive any schooling for intervention may yield the most benefit in terms of normative change regarding IPV against women.

Intimate partner violence (IPV) harms the health of women and their children. In Vietnam, 31% of women report lifetime exposure to physical IPV, and surprisingly, women justify physical IPV against wives more often than do men. We compare men’s and women’s rates of finding good reason for wife hitting and assess whether differences in childhood experiences and resources and constraints in adulthood account for observed differences. Probability samples of married men ( n = 522) and women ( n = 533) were surveyed in Vietnam. Ordered logit models assessed the proportional odds for women versus men of finding more “good reasons” to hit a wife (never, 1-3 situations, 4-6 situations). In all situations, women found good reason to hit a wife more often than did men. The unadjusted odds for women versus men of reporting more good reasons to hit a wife were 6.55 (95% confidence interval [CI] = [4.82, 8.91]). This gap disappeared in adjusted models that included significant interactions of gender with age, number of children ever born, and experience of physical IPV as an adult. Having children was associated with justifying wife hitting among women but not men. Exposure to IPV in adulthood was associated with justifying wife hitting among men, but was negatively associated with justification of IPV among women. Further study of the gendered effects of resources and constraints in adulthood on attitudes about IPV against women will clarify women’s more frequent reporting than men’s that IPV against women is justified.

Creating a normative campus environment intolerant to sexual violence is important for prevention. While prevention initiatives focusing on students are vital, faculty and staff have a central role in supporting and sustaining a comprehensive strategy for preventing campus sexual violence. Nationwide, colleges and universities recently implemented campus climate surveys. At Emory, we decided to survey faculty and staff as well as students, motivated by our use of an ecological framing of campus sexual violence. Faculty and staff are long-term members of the community, and can provide stability and continuity that reinforces prevention efforts prioritized for students. We recommend that schools use a trauma-informed approach to guide the involvement of faculty and staff in prevention. We encourage colleges and universities to consider the experiences and needs of their faculty and staff, as professionals who serve as leaders on campus and as those who guide students through their academic experiences.

Purpose: We assess the association of men’s exposure to violence in childhood—witnessing physical violence against one’s mother and being hit or beaten by a parent or adult relative—with their attitudes about intimate partner violence (IPV) against women. We explore whether men’s perpetration of IPV mediates this relationship and whether men’s attitudes about IPV mediate any relationship of exposure to violence in childhood with perpetration of IPV.Methods: Five hundred twenty-two married men 18-51 years in Vietnam were interviewed. Multivariate regressions for ordinal and binary responses were estimated to assess these relationships.Results: Compared with men experiencing neither form of violence in childhood, men experiencing either or both had higher adjusted odds of reporting more reasons to hit a wife (aOR, 1.43; 95% CI, 1.03-2.00 and aOR, 1.66; 95% CI, 1.05-2.64, respectively). Men’s lifetime perpetration of IPV accounted fully for these associations. Compared with men experiencing neither form of violence in childhood, men experiencing either or both had higher adjusted odds of ever perpetrating IPV (aOR, 3.28; 95% CI, 2.15-4.99 and aOR, 4.56; 95% CI, 2.90-7.17, respectively). Attitudes about IPV modestly attenuated these associations.Conclusions: Addressing violence in childhood is needed to change men’s risk of perpetrating IPV and greater subsequent justification of it.

Background Comprehensive data that address current HIV nonoccupational postexposure prophylaxis (nPEP) practices in the emergency care of sexual assault patients are limited. The U.S. Centers for Disease Control and Prevention released HIV nPEP guidelines in 2005 and updated guidelines for Sexually Transmitted Disease Treatment in 2006 and 2010, each of which support providing nPEP to sexual assault patients. This study examined the offer, acceptance, and adherence rates of nPEP among sexual assault patients treated at an emergency department (ED). Methods We conducted a retrospective review between January 1, 2008, and December 31, 2011, of women, aged 16 years and older, treated for sexual assault in an academic ED that participates in the sexual assault nurse examiner program. Findings One hundred seventy-one female patients were treated in the ED for 179 sexual assault events. nPEP was not indicated in 19 cases and was offered to all 138 of patients for whom nPEP was appropriate. Five patient cases that exceeded the 72-hour exposure window were offered nPEP. Of the 143 patient cases offered nPEP, 124 (86.7%) initiated nPEP. Of the 124 who accepted PEP, 34 (27.4%) had documented completion of the 28-day course. Conclusions nPEP was offered in all 138 cases where patients were eligible for treatment. Of patients who accepted nPEP, a minority are documented to have completed a course of treatment. Systems to improve postassault follow-up care should be considered.

Methods Recombinant Ad5 with seven HVRs derived from Ad48 and expressing the VRC EnvA test antigen (rAd5HVR48. ENVA) was made. 48 healthy volunteers who were seronegative to Ad5, Ad48, HIV-1, and HIV-2 were enrolled in a randomized, double-blind, placebo-controlled, doseescalation phase 1 study. The first three groups of 12 subjects received doses of 10, 10, or 10 vp of rAd5HVR48.ENVA vector (n=10/group) or placebo (n=2/ group) at weeks 0, 4, and 24 and the fourth group received a single injection of 10 vp or placebo. We performed pre-specified blinded immunogenicity analyses at day 56 and day 196 after the first immunization.