Categories
Uncategorized

FHO Readers Are the Best

Thank you to everyone who has already purchased the new research brief. Your response to yesterday’s post has been really incredible (about quadruple the usual traffic). Please keep trying if you have had any problems purchasing either item from the store–a few of you emailed me with issues, but based on the receipts I’ve seen it looks like those problems have worked themselves out.

I’m off for the rest of the week, but I’ll see you back here Monday with the usual fare. Enjoy the weekend!

 

In case you missed it, our new research brief: Aging Bruises Based on Color is now available for electronic download!

Categories
Testimony

Aging Bruises Based On Color: A Brief Review

I’m so pleased to announce the newest review article is now available for sale in the FHO store: Aging Bruises Based on Color. Like its predecessor, Injury Following Consensual Sex, it is a digital download, available for $4.99. When you purchase it you will be taken immediately to the download screen (it will be the same screen as your invoice), so please watch for that. You won’t be able to go back once you leave that screen.

A brief description:

This review paper will examine a specific issue related to bruising: aging or dating bruises based on color, as seen in routine clinical assessment. It is meant to assist clinicians and allied professionals with understanding the breadth of the science, but it is not a substitute for reading the articles themselves. The paper will include an overview of the physiology of bruising, review the specific challenges in assigning timeframes to bruising colors, and provide considerations for clinicians when testifying about bruising in court.

And if you’ll indulge me, a personal request: With the exception of these research briefs, which require an incredible amount of my time, everything provided at FHO over the last decade has been free. Please continue to support the work here by purchasing the brief rather than making a digital copy of someone else’s. Doing so helps defray the cost of keeping this site online and making sure FHO can continue to bring readers all over the world current science, education and news that allows for patient-centered, evidence-based forensic healthcare. Thanks for being a supporter.

Categories
Child Abuse

Toxic Stress and Adverse Childhood Experiences: Letting the Published Evidence Speak for Itself

In response to the crisis at our southern border, the American Academy of Pediatrics has opened up access to all of the articles they have published on the impact of toxic stress and adverse childhood experiences:

“We hope that by opening these articles to everyone, it will become clear that placing children abruptly separated from parents in crowded detention centers is going to not just affect these children while they are kept there, but potentially will affect them for the rest of their lives.  These articles make a compelling argument that these children should be reunited with those who can love and comfort them as soon as possible.

While providing open access to every article on toxic stress we have published in Pediatrics for the past seven years may not bring an immediate end to this tragic situation, perhaps by educating all who are responsible for these immigrant children being separated and detained, the needs of children may be prioritized before the needs of politicians and in turn, this debacle will end and hopefully never occur again at any time for any child and loving family.  Enough is enough!”

You can access the full collection here.

 

Our first offering in the FHO store, Injury Following Consensual Sex is now available. If you haven’t ordered a copy yet, you can find it here.  And coming soon–the follow-up research brief on bruising, out at the end of the month!

Categories
Uncategorized

Since Last We Spoke, 6-25-18 (and Some News)

Yesterday, I dropped the girlchild off at Georgetown for a summer program in international diplomacy (my child’s do-gooder heart has designs on the larger world, so off she goes to work on issues of human conflict and whatnot)–this meant lots of family time this weekend and very little surfing. Let’s face it–here in the US, the news continues to be pretty bleak. Honestly, living in DC is more of a circus than it’s ever been; I don’t even need to leave my neighborhood to be reminded of it right now. Sasha and I continue to support efforts of organizations like RAICES (BTW, for those of you in the San Antonio area, they hold educational sessions every Tuesday to volunteer with their organization, if you’d like to donate time). There’s a good chance we will be at the march on Saturday with hundreds of thousands of like-minded people. Not sure what more we can do right now but put dollars behind the work being done and make sure our voices are heard.

Also, a bit of news: there will be a new item for purchase in the FHO store this week (I hope). I am crossing fingers because I must rely on outside assistance to make that happen, so my hope is that happens quickly, and you will see it posted in the next couple days. Bruising is the next topic. It will be the same price as the other ($4.99), digital download, and about the same length. Feel free to make an offering to the internet gods, we’ll see how long it takes to go live.

And with that, here’s what’s caught my eye since last we spoke:

Hey Winnipeg, I see you 🙂

Smart homes have become tools of digital abuse

What closing the door on the asylum process would mean for some of our patients

Flight attendants need training on sexual abuse and harassment response because the numbers are climbing

The randomness of bail

Many of you have shared this, and although I am not a Texas voter, I am so impressed with this ad (and with her story), it’s worth space here. Just because you can’t vote for her, doesn’t mean you can’t support here campaign:

 

Our first offering in the FHO store, Injury Following Consensual Sex is now available. If you haven’t ordered a copy yet, you can find it here.  And coming soon–the follow-up research brief on bruising, out at the end of the month!

 

 

Categories
Articles of Note Child Abuse DV/IPV Elder Abuse/Neglect Sexual Assault

Articles of Note: June 2018 Edition

It’s time once again for Articles of Note, our monthly romp through the peer-reviewed literature. I found it to be a particularly fruitful review–there was a lot I bookmarked to read, much for upcoming work I have. Pay attention to the notes for free full-text articles, too, because there are a few in this crop. Otherwise, as always, links lead to abstracts in PubMed. Happy reading!

 

 

Our first offering in the FHO store, Injury Following Consensual Sex is now available. If you haven’t ordered a copy yet, you can find it here.  And coming soon–the follow-up research brief on bruising, out at the end of the month!

Categories
Sexual Assault

The SART Toolkit Update Webinar

NSVRC and IAFN are co-hosting a webinar on the newly updated SART toolkit, to be released in August. The session will be held July 12th at 2pm ET. From the announcement:

The collaborative team approach to sexual assault is a recommendation contained in the US DOJ’s National SAFE Protocol. Forensic Nurses are often intimately involved in the creation of Sexual Assault Response Team’s (SARTs) and in sustaining them. Since the original Toolkit was created in 2009 there have been updates to the SAFE Protocol, the creation of a new Pediatric SAFE Protocol and other guiding documents for response teams to use. This webinar will introduce forensic nurses to the updated Sexual Assault Response Team (SART) Toolkit, hosted by the National Sexual Violence Resource Center. The new SART Toolkit is the result of collaborative efforts to provide evidence-based information on best practices to SARTs.

Register for the session here.

 

Our first offering in the FHO store, Injury Following Consensual Sex is now available. If you haven’t ordered a copy yet, you can find it here.  And coming soon–the follow-up research brief on bruising, out at the end of the month!

Categories
Sexual Assault

2019 ICD-10-CM Codes for Human Trafficking

Perhaps with all of the horror swirling about in the news, you missed this information: the National Center for Health Statistics at the CDC added new codes for patients experiencing sexual and labor trafficking to be used beginning October 1st, 2018. This will allow for more accurate data collection, differentiating human trafficking patients from other types of abuse patients.

T codes to report for cases of suspected and confirmed forced labor and sexual exploitation:

Under Adult and child abuse, neglect and other maltreatment, confirmed

T74.5 – Forced sexual exploitation, confirmed
T74.51 – Adult forced sexual exploitation, confirmed
T74.52 – Child sexual exploitation, confirmed
T74.6 – Forced labor exploitation, confirmed
T74.61 – Adult forced labor exploitation, confirmed
T74.62 – Child forced labor exploitation, confirmed

Under Adult and child abuse, neglect and other maltreatment, suspected

T76.5 – Forced sexual exploitation, suspected
T76.51 – Adult forced sexual exploitation, suspected
T76.52 – Child sexual exploitation, suspected
T76.6 – Forced labor exploitation, suspected
T76.61 – Adult forced labor exploitation, suspected
T76.62 – Child forced labor exploitation, suspected

Z codes for the examination and observation of human trafficking victimization:

Under Encounter for examination and observation for other reasons

Z04.81 – Encounter for examination and observation of victim following forced sexual exploitation
Z04.82 – Encounter for examination and observation of victim following forced labor exploitation

Under Problems related to upbringing: Personal history of abuse in childhood

Z62.813 – Personal history of forced labor or sexual exploitation in childhood

Under Personal risk factors, not elsewhere classified: Personal history of psychological trauma, not elsewhere classified

Z91.42 – Personal history of forced labor or sexual exploitation

You can find the full 2019 addenda to the ICD-10-CM List of Diseases and Injuries here (PDF)

 

Our first offering in the FHO store, Injury Following Consensual Sex is now available. If you haven’t ordered a copy yet, you can find it hereAnd coming soon–the follow-up research brief on bruising, out at the end of the month!

Categories
Uncategorized

Since Last We Spoke, Crisis Edition

Friends, it seems like everything I’m reading right now is about the crisis at our borders. And not the garbage, build-a-wall crisis that the president would like us to focus on, but the real crisis of children and parents being separated. I understand you may not see yourself as political, but as a forensic nurse, this is antithetical to the work that we do. The real trauma that this causes is undeniable (here’s just one example of a powerful account of what separating kids from parents does). Perhaps you are educating yourself about this issue by reading about the experience of the president of the American Academy of Pediatrics after she visited one of the shelters for children; maybe you’ve seen the official statements released by her organization,  Physicians for Human Rights (to which IAFN signed on), the National Association of Pediatric Nurse Practitioners, or the American Public Health Association; perhaps you read the op-ed by former first lady Laura Bush, calling the practice immoral, or this op-ed from some of our smart nursing colleagues on toxic stress; maybe you saw that more than 2,500 women in the faith community called on this administration to stop this policy once and for all; or the first-hand account of the immigration experts dealing with this issue daily.

But forensic nursing practice is about action, and in whatever way you feel you can do that, now is the time. Because this is not a made up, partisan crisis. This is a serious, humanitarian crisis. So voices need to be raised in protest and action must be taken. Here are some ideas:

  • Slate did a great piece on all of the ways you can help. It’s a comprehensive list of organizations and actions around the US.
  • On June 30th, there will be Families Belong Together rallies all around the US. You can check their website to see what’s happening in your own area, sign their petition, or donate money (and believe me, donating money is no insignificant thing–all causes need cash, so if you have it to donate consider giving it to one of the organizations working to overturn this terrible policy).
  • Call/email/tweet your senator (especially your Republican ones, since as of this morning, not a single one has yet to sign on) to support the Keep Families Together Act. Contrary to what the president keeps saying, he has the power to stop this at his fingertips and barring that, the Republicans are in control of the House and the Senate. They could stop separating families. Let them know this is not okay.

It’s time (again) to use your privilege for good. Figure out what action looks like in your own life and take it. This is a bleak time for us here in the US, but for everyone who says, it’s not who we are, sadly, that’s not true. It is who we are, it is who we’ve been–open your history books, let’s talk about boarding schools, or internment camps. Or consider the entire shameful history of slavery in this country. It is definitely who we have been. We as a nation have a terrible history of separating children from their parents. But we can put an end to it this time around. I encourage you not to be complacent.

BTW, If you didn’t see AAP President Dr. Colleen Kraft on CBS This Morning, here’s just a brief clip of her interview with Gayle King:

Categories
Sexual Assault

Human Trafficking and Toxicology

IAFN is hosting an upcoming webinar, Human Trafficking and Toxicology. The session will be held July 10th at 2pm ET. It is limited to 200 people, but will be archived (f0r IAFN members)–if you want to attend the live session I encourage you to register ASAP. 1.5 CEUs will be available. From the announcement:

This presentation will identify common dynamics in sex and labor trafficking and describe how drugs and alcohol are used to assert and maintain control over victims and perpetrate trafficking and trafficking-related crimes. The presenter will discuss the importance of and strategies for collaborating with medical professionals to identify drug-facilitated human trafficking, provide much-needed care, and educate other allied professionals about the effects of drug use in human trafficking.

Jane Anderson, Attorney Advisor from AEquitas will be the featured speaker.

Register here.

 

Our first offering in the FHO store, Injury Following Consensual Sex is now available. If you haven’t ordered a copy yet, you can find it here

Categories
Sexual Assault

Cochrane Review of the HPV Vaccine

If your sexual assault medical-forensic exam does not include offering the HPV vaccine to eligible patients, perhaps it’s worth considering. And if you’re looking for the evidence base to support its inclusion in your comprehensive exam, last month the nice folks over at Cochrane obliged us and contributed to said evidence base by publishing a review on the HPV vaccine to prevent cancerous and pre-cancerous changes to the cervix. According to the CDC, vaccine coverage data published in the National Immunization Survey (NIS) states that about 6 out of 10 adolescents received at least 1 dose of the HPV vaccine, which means there are a substantial number of young women who aren’t vaccinated at all or completely. The medical-forensic exam is a potential opportunity to start or continue the series, and some programs have been offering the HPV vaccine, particularly for patients who have limited access to routine healthcare services.

Obviously, this review doesn’t speak to all of our patients, but we’ll take it to start.

 

Our first offering in the FHO store, Injury Following Consensual Sex is now available. If you haven’t ordered a copy yet, you can find it here

 

Categories
Testimony

Trials and Social Media…

…Don’t mix. Resist the urge to post anything* about trials in which you are involved. Before, during or after. Particularly commenting on the results of trials. I love social media, and I use it all the time; there’s a lot about my life I discuss online, both personally and professionally. But not cases in which I am involved.

I mention this all the time, so many of you have heard me say this before, but periodically it needs to be repeated. One of these days I am going to write formally on this topic, but for now, please, take my word for it and just don’t comment on any aspect of a trial on your social media feeds. There is literally no upside and plenty of potential down-. And yes, I know other professions do it–I’m not talking to them. I’m talking to us, clinicians.

 

*I say anything because I cannot define what the bright line is between what is okay and what isn’t. I cannot tell you when something will be used in a way that will make you look unprofessional or biased. I cannot refer you to official guidance on this because there is none. All I can tell you is that there is no reason to mention this aspect of your professional life in a tweet, Facebook update or beautifully composed Instagram pic. Seriously. Let this part of your life be a bit of a mystery.

 

Our first offering in the FHO store, Injury Following Consensual Sex is now available. If you haven’t ordered a copy yet, you can find it here

Categories
Uncategorized

Since Last We Spoke, 6-11-18

It was a reasonable weekend for Capital Pride (weather-wise), and we had a lovely time here in our household. Our synagogue holds an annual Pride Shabbat service Friday evening to kick off the festivities, and you never know who’s going to show up to speak or deliver a reading, but it’s always inspiring and an excellent way to decompress after a long week. This year she said the blessing over the candles and did a reading about inclusion to begin the evening, which was perfection. We skipped the parade Saturday night (one of these years we’ll go, but it was threatening rain, so we didn’t chance it– instead we lived our best life by going to see Ocean’s 8 with our daughter), but made it to the festival yesterday, where we were joined by thousands of our closest, queerest friends and allies. Because it was a full weekend, I didn’t spend much time inside online, but last night over pints of Ben & Jerry’s it’s possible we surfed en famille for a bit. Here’s what caught my eye since last we spoke:

Sigh. Handmaid’s Tale looking more and more like a documentary these days

Not surprisingly, stigma is hurting our response to the opioid epidemic

If you interview with me someday, I promise I will ask you #19

In the wake of last week’s high profile suicides, many good pieces were written, but my favorites include:

Thinking about survivors

Bourdain and masculinity

Bourdain and the power of telling the truth

Raising sons in the #MeToo era

The NFL seems to be failing in the DV prevention arena

Oh yes, I’ve been there (and many of you have, too)

The upside of chronic anxiety

Categories
Elder Abuse/Neglect

Coordinated Community Responses and Beyond: Collaborations to Address Crimes Against Older Adults

In observance of World Elder Abuse Day, the American Society on Aging is hosting a webinar, Coordinated Community Responses and Beyond: Collaborations to Address Crimes Against Older Adults. The session will be held June 14th at 10am PT. Free CEUs are available, but I am unclear what type of CEUs they are. From the site:

This web seminar will provide participants with practical tips on creating and maintaining a coordinated community response (CCR) to address issues of elder abuse and financial exploitation. Attendees will learn strategies to bridge common gaps seen between senior service providers, victim advocates at community-based organizations, and other partners involved in the response to survivors of abuse later in life. In addition to providing a blueprint for building comprehensive coalitions to address crimes against older adults in a holistic way, this presentation will offer tips on how to ensure the sustainability of a coordinated community response.

Register here.

 

Our first offering in the FHO store, Injury Following Consensual Sex is now available. If you haven’t ordered a copy yet, you can find it here

Categories
Child Abuse

Tales from the U.K. of the Trafficking of Men and Boys for Forced Labour

Oh hey, Canada–I promise I know you guys are up there (and my, how particularly lovely your country looks from down here). I also recognize that I don’t do a very good job of sending training your way, mostly because I don’t stumble across it very often. But look! A webinar just for you, with the complicated, if not incredibly specific title, Stories and Signs: Tales from the U.K. of the Trafficking of Men and Boys for Forced Labour, with Questions for Canada. The session is being offered by the Online Training Initiative to Address Human Trafficking on July 26th at 3pm EDT. From the site:

Human trafficking takes many forms, but most of the time people tend to focus on the trafficking of women and girls for sexual exploitation. Particularly within Canada, the emphasis on domestic sex trafficking, while crucial, may detract from identifying, preventing and responding to other forms of exploitation. Drawing on six years of experience in the UK, this webinar will highlight personal stories of encounters with survivors and frontline responders: from a Nigerian boy forced into domestic servitude by his aunt, to an Indian student tricked into working at a restaurant without pay; from Romanian boys coerced into begging and street crime, to Chinese men who drowned picking shellfish on the beach; from a Vietnamese boy trafficked around the world to cultivate cannabis, to homeless young men kept as slaves and forced into construction work. Do these forms of trafficking occur in Canada? Would we notice if they did? Let us know what you think. Bring your questions and insights, and we look forward to having you join us.

Register for the webinar here.

BTW, they have a host of archived webinars, so if you’re in Canada and this is a topic of interest, I suggest checking out their full library.

 

Our first offering in the FHO store, Injury Following Consensual Sex is now available. If you haven’t ordered a copy yet, you can find it here

Categories
DV/IPV

Looking at the Opioid Epidemic in the Context of Trauma and Domestic Violence

The National Indigenous Women’s Resource Center has an upcoming webinar, Looking at the Opioid Epidemic in the Context of Trauma and Domestic Violence. The session will be held June 13th at 3pm ET. From the registration page:

This timely and important webinar will provide an overview of what is known about the opioid epidemic and will focus on the specific concerns of Indian communities and tribal domestic violence programs and shelters. It will lay the foundation for the exploding opioid epidemic and will examine the intersections between trauma, domestic violence, and the opioid epidemic and explore innovative approaches to addressing these complex issues.

NIWRC archives their webinars so if you can’t make it for the live session you can visit their archive page to listen later on.

 

Our first offering in the FHO store, Injury Following Consensual Sex is now available. If you haven’t ordered a copy yet, you can find it here

Categories
Uncategorized

Since Last We Spoke, 6-4-18

Well, here’s the thing–Friday was my birthday, and we are a family that does birthdays over an entire weekend. My folks came in, and my kiddo comes today, so I did a whole lot of play this weekend and not much in the way of work. Not really even much in the way of reading. But last night as I started to think about what this week brings (travel, projects, some house stuff, and then Pride), my brain kept me awake and I ended up perusing my social media feeds. So I managed to catch up a bit on what’s going on in the world–here’s what caught my eye since last we spoke:

The persistence of racist medical beliefs, and their association with ongoing racial disparities in treatment and patient outcomes, represents a major challenge for 21st-century American medicine.” Believe it.

The NFL has a serious problem with its priorities

A glossary for the #metoo movement

One of the best takes on the Roseanne Barr garbage

Sports media doesn’t know what to do about sexual violence

This weekend’s long read (hello, Brock Turner)

Decades of doing this work made this story feel terribly familiar

This report (well, mostly the photos) pretty well gutted me

A look at the shifting death stats in the wake of Hurricane Maria

For those of you who are Alexa users

 

Our first offering in the FHO store, Injury Following Consensual Sex is now available. If you haven’t ordered a copy yet, you can find it here