Categories
Elder Abuse/Neglect

National Indigenous Elder Justice Initiative Healthcare Training Module

Last year I posted about the toolkit published by the National Indigenous Elder Justice Initiative, and mentioned that they anticipated publishing a module for healthcare providers. I finally revisited their site, and the module is now live. It does a nice job of tackling a variety of issues related to recognition, the interplay of culture and understanding of abuse, and diagnosis and documentation, so if you’re looking for a place to start delving into this topic, it may be just what you’re looking for.

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Have you checked out the FHO store lately? You can find our newest research brief, Aging Bruises Based On Color, plus our original guide, Injury Following Consensual Sex. Both available now for electronic download.

Categories
Sexual Assault Testimony

SANE Expert Witness Training Course

First off, sorry for being absent this week. It’s an involved week, and you know how it is sometimes. Secondly, I know that normally I only post online events, but this is our (almost always) annual testimony course at the National Advocacy Center, and it’s one of the most fun courses I get to teach, so if you’ve got the space on your calendar, and you’re eligible, you should think about joining us this year–it is free. We have a great time, it’s a fantastic networking opportunity, and very hands on. Details:

The U.S. Department of Justice’s National Indian Country Training Initiative, in partnership with the International Association of Forensic Nurses and the SAFEta Project, are pleased to announce the Sexual Assault Nurse Examiners’ Expert Witness Training.  The seminar will be held July 9-11, 2019, at the National Advocacy Center in Columbia, South Carolina.  Travel and lodging accommodations will be provided by the Office of Legal Education. There is no tuition charged for this class.

This training is designed for SANEs who are going to be providing court testimony and for prosecutors assigned to sexual assault and domestic violence cases who want to learn more about the effective use of the SANE as an expert witness in their cases.  Priority admission will go to those medical providers working on cases arising in Indian Country

This class has a mock trial component, and prosecutors and SANE(s) who work cases together are encouraged to register as a team. Training Officers/SACs/SSRAs are invited to nominate individuals from their division or department who would benefit from this training opportunity. 

If interested in attending the class you will be required to fill out a Preregistration survey. The preregistration survey will be forthcoming, please check back for further instructions. The point of contact for the training is Leslie Hagen, who can be reached via email at leslie.hagen3@usdoj.gov or Kim Day here.

More information here.

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Have you checked out the FHO store lately? You can find our newest research brief, Aging Bruises Based On Color, plus our original guide, Injury Following Consensual Sex. Both available now for electronic download.

Categories
Elder Abuse/Neglect

New Research in Elder Abuse: Developing a Geriatric Injury Documentation Tool

Sometimes with as much content contained on this site, things get lost. So I wanted to make sure I took a minute to highlight an article that has recently been published that might otherwise get missed in my usual roundup of research pubs every month. It’s in the elder abuse arena and has more of a medical-forensic focus, making it a comparatively less common finding in our world.

Developing the Geriatric Injury Documentation Tool (Geri-IDT) to Improve Documentation of Physical Findings in Injured Older Adults (Kogan, et al). The objective of the study: “To (1) use insights from experts to develop a tool to assist clinicians in appropriately and completely documenting physical findings in injured older adults for potential future forensic investigation of abuse or neglect and (2) to assess the feasibility of incorporating this tool into clinical practice.

Very excited to read this.

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Have you checked out the FHO store lately? You can find our newest research brief, Aging Bruises Based On Color, plus our original guide, Injury Following Consensual Sex. Both available now for electronic download.

Categories
Child Abuse DV/IPV Elder Abuse/Neglect Sexual Assault

New HIV Data from CDC

A few things of which to be aware from CDC on HIV in the US that may impact your forensic practice:

Understanding the Impact of HIV: Diagnoses, Incidence and Prevalence (PDF)

HIV Among Women Fact Sheet (PDF)

HIV Infection Risk, Prevention, and Testing Behaviors Among Men Who
Have Sex With Men—National HIV Behavioral Surveillance, 23 U.S. Cities, 2017
(PDF)

Transmission Patterns in a Low HIV-Morbidity State — Wisconsin, 2014–2017

*And your reminder for assessing risk for HIV following sexual assault:

Recommendations for postexposure HIV risk assessment of adolescent and adult survivors within 72 hours of sexual assault

  • Assess risk for HIV infection in the assailant, and test that person for HIV whenever possible.
  • Use the algorithm to evaluate the survivor for the need for HIV nPEP (Figure) (312).
  • Consult with a specialist in HIV treatment if nPEP is being considered.
  • If the survivor appears to be at risk for acquiring HIV from the assault, discuss nPEP, including benefits and risks.
  • If the survivor chooses to start nPEP (312), provide enough medication to last until the follow-up visit at 3–7 days after initial assessment and assess tolerance to medications.
  • If nPEP is started, perform CBC and serum chemistry at baseline.
  • Perform an HIV antibody test at original assessment; repeat at 6 weeks, 3 months, and 6 months.

Assistance with nPEP-related decisions can be obtained by calling the National Clinician’s Post Exposure Prophylaxis Hotline (PEP Line) (telephone: 888–448–4911).

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Have you checked out the FHO store lately? You can find our newest research brief, Aging Bruises Based On Color, plus our original guide, Injury Following Consensual Sex. Both available now for electronic download.

Categories
Uncategorized

Since Last We Spoke, 3-18-19

I’m heading to ATL in the morning to teach for a few days, but before I head out, it’s worth mentioning a couple things. One, it’s spring here in the District, which is a gift. Every damn year this city takes my breath away. The cherry blossoms are out, and well–you know the rest if you’ve seen them, and if you haven’t, might I suggest putting it on your to-do list. Two, we are in the throws of college notifications around here, so everyone’s just a bit on edge in my house. I don’t know who’s more anxious–the girlchild or my wife. It’s a toss-up really. Prayers would be appreciated that we all make it through this with our faculties intact. (I know she will end up where she’s supposed to be, and she’s already been accepted to one school, so we know the kid is going somewhere. Four more to go.) Anyway, the sun was out, the wife was baking this weekend, and I had a few projects of my own going on, but here’s what caught my eye since last we spoke:

Speaking of college admissions

Related (but in the best possible way)

What happened in Christchurch is unspeakable, yet terribly familiar at this point. A lot has been written, but 2 things worth mentioning: Not debating with Islamophobes and a piece from the folks at the Capital Gazette (who have seen their own terrible violence)

EMRs haven’t been the revolution we were promised

Tattoos as therapy

I am ready to vote for her if she runs

How Inuit parents raise their children without yelling

In the South, many gay and bisexual black men don’t know the extent of the HIV problem… And, if they do, they may not have access to the tools to prevent and treat the disease.

10 life lessons horrible bosses taught me

Some of the best (condensed) presentation tips

A pretty important ruling against nurses in this case. Some lessons for practice that shouldn’t be ignored (whether you agree with the Board decision or not).

“A beautiful woman dies and a man feels bad about it” A perfect 2(ish) minute animated monologue by the crime writer Laura Lippman on the problem with dead women.

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Have you checked out the FHO store lately? You can find our newest research brief, Aging Bruises Based On Color, plus our original guide, Injury Following Consensual Sex. Both available now for electronic download.

Categories
Sexual Assault

DNA Evidence Collection in Groping Sexual Assault Cases: Practice Implications for SANEs

If you missed Julie Valentine’s webinar last month on DNA in groping cases, you’re in luck–aside from listening to the archived version of *that* presentation, Dr. Valentine is presenting a SANE-specific talk for SAFEta. The webinar will be held April 11th at 2pm ET. From the registration page:

Improving the overall response to sexual assault includes understanding how touch DNA evidence impacts groping sexual assault cases. This webinar will illustrate the importance of these cases and highlight proposed guidelines for evidence collection

Register here.

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Have you checked out the FHO store lately? You can find our newest research brief, Aging Bruises Based On Color, plus our original guide, Injury Following Consensual Sex. Both available now for electronic download.

Categories
Sexual Assault

Buried Abuse

Last week, Latino USA (in conjunction with Rewire. News) reported on this story of sexual abuse in US immigration detention centers. It is powerful and raw, and much of what you’ll hear is sadly familiar:

“There’s a long and extensive pattern of sexual abuse and harassment in immigration detention facilities, even though the Prison Rape Elimination Act (PREA) was introduced in DHS facilities in 2014. Over a ten-month period, Latino USA partnered with Rewire.Newsand dug into one specific case: that of Laura Monterrosa’s sexual abuse allegations at the T. Don Hutto Detention Center. What we learned after reviewing documents obtained through a Freedom of Information Act (FOIA) request raised questions about the efficacy of internal investigations at immigration facilities across the country and the safety of thousands of people detained there.”

It’s an important news story, and incredibly well reported. Take the time to listen if you are able.

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Have you checked out the FHO store lately? You can find our newest research brief, Aging Bruises Based On Color, plus our original guide, Injury Following Consensual Sex. Both available now for electronic download.

Categories
Uncategorized

Medical-Forensic Evaluation of Asylum Seekers: Physical Exam & Utilizing the Istanbul Protocol

IAFN is hosting the continuation of their series,  Medical Forensic Evaluation of Asylum Seekers; part 3 of 5 will take place next month, Physical Exam and Utilizing the Istanbul Protocol. The session will be held April 17th at 1pm ET. CEs will be available. The live session will be capped at 200 participants, but it will be archived in the Online Learning Center.

Still to come (dates TBA):

  • Specific Forms of Torture & Corresponding Clinical Findings
  • Writing a Medical-Legal Affidavit & Providing Oral Testimony

Register for the webinar here.

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Have you checked out the FHO store lately? You can find our newest research brief, Aging Bruises Based On Color, plus our original guide, Injury Following Consensual Sex. Both available now for electronic download.

Categories
Uncategorized

Since Last We Spoke, 3-11-19

Well, I’m heading off to Michigan State University for a few days, kicking off the next major travel cycle. March has me bouncing all over this country, ending in the Seattle area, with some ATL and Ft Bragg in between. I’ll be glad to catch spring where I can find it–it seems to be teasing us here in DC, but I’m not certain it’s much more than that–a tease. There was still snow this weekend, and that was ok since I worked most of it in anticipation of being gone quite a bit. So this week’s list isn’t the most extensive, but I’ll give it to you anyway– here’s what caught my eye since last we spoke:

A long wait for justice comes to an end

Whatever the opposite of patient-centered care is, I believe this qualifies

AMA comes out swinging on the Title X restrictions. Good for them.

Sherrod Brown’s likability problem. Brilliant (for the record, I am a huge Sherrod Brown stan)

Sen McSally’s sexual assault disclosure will not be investigated

Two of my favorite authors in conversation. If you have the time, it’s so good. They go all over the place, but there’s a lot there.

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Have you checked out the FHO store lately? You can find our newest research brief, Aging Bruises Based On Color, plus our original guide, Injury Following Consensual Sex. Both available now for electronic download.

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

Articles of Note, March 2019 Edition

Since we’re in a research frame of mind, I figured I might as well go ahead with this month’s Articles of Note, and there’s a lot to work through. I don’t want to completely nerd out on everyone, but man, there is some good reading to be done. As always, links generally take you to PubMed abstracts except where indicated.

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Have you checked out the FHO store lately? You can find our newest research brief, Aging Bruises Based On Color, plus our original guide, Injury Following Consensual Sex. Both available now for electronic download.

Categories
DV/IPV Testimony

Radiologic Findings in Intimate Partner Violence (and also, a few words about research)

Folks, I am happy to share a new study recently published in the journal, Radiology. But before I go there, let me remind readers of a couple things–the research I share is to help inform clinical practice and the opinions that we may or may not give on the stand. To give us a better understanding of what is knowable in our field, and what is still yet to be figured out. It is going to be a very rare occurrence indeed when any one article I post can be taken wholesale and generalized to a broad audience. In our discipline, we just don’t see a lot of studies like that. You’ll know this (apart from reading the Limitations section of the article, which will probably say so in black and white) because of the small sample size of the study, for instance, or the fact that all of the subjects in the sample represent a relatively homogenous population.

What I mean is that if you have an article that states that in a study of 100 people in my community, 50% of them hate dogs (what?!), you can’t take that study and say that means that half of all people hate dogs. No, half of the weird people in that particular study from that particular community hate dogs. But that’s all you can say. Especially if there are no other studies that have reproduced those results with other populations. Or larger populations. Or if there are studies that have found contrary results. Etc. Forgive me, because this is an oversimplification of a more complex issue, but it gets to the point, which is–read studies for what they are, but also for *what they are not*.

Why am I telling you this? Because this inappropriate generalizing of data happens a lot in our profession. Because I get emails and texts and frantic phone calls about it. Because FHO aims to help make people the best clinicians and the best expert witnesses they can be (regardless of which side they’re working for) and I would be remiss if I didn’t mention what seems to be an obvious problem with the way testimony may be going down in certain circumstances. This is not a nurse-specific phenomenon, BTW–many healthcare and healthcare-adjacent disciplines are taking the data in this area and using it in ways it shouldn’t be used at trial. Drawing conclusions you cannot draw. Anyway, you get the picture. [Rant complete.]

So with that, I bring you this very intriguing study by our colleagues out of Boston, Radiologic Findings in Intimate Partner Violence. Read it for what it tells us, and for what it doesn’t. It’s available free full text, at least right now, so before the nice people at Radiology change their mind, go ahead and download it and add it to your read pile. It’s worth your time.

(Add: based on a phone call I received, not 4 hours after posting this, let me also say, the whole generalizability conversation includes thinking long and hard about whether you can apply results in specific circumstances and apply them equally in similar, but not the same, circumstances. The answer is probably, no. Just because something is found to be likely in an intimate partner violence case, for instance, doesn’t mean it will also be likely in a human trafficking case or a child abuse case. One article, one study isn’t going to give you that.)

Categories
Uncategorized

Since Last We Spoke, 3-4-19

Here’s the thing–this is the last week I am home before I am on the road for some or all of the next 16 consecutive weeks (I feel somewhat lightheaded just typing that). That’s not to say some things couldn’t change, as there’s not a lot of stability in my calendar. Also, weeks 14-16 will be spent in Japan, purely for pleasure, as we celebrate the girlchild’s graduation from high school (we have promised her for almost 10 years now that we would take her to Asia for her graduation gift), so this is not 100% work. But to be clear, I have a lot of airport lounges in my future, which means that I am spending as much of *this* week parked in front of my fireplace as possible, cooking my own meals, and generally enjoying being home. I can’t promise things will be as regular as they usually are, but I will do my best to keep content coming. For now, check out what’s caught my eye since last we spoke:

Emma Thompson will not be working with sexual harassers

We do not have the luxury of being tired of the 2020 election already

“What would I have done if I had killed her that night?”

We should be tracking the impact of the Title X gag rule, if not personally, certainly because our patients access to all the healthcare legally allowed in the country.

We knew this, but it’s good to see others in healthcare acknowledge it too

This seems relevant to my circumstances

How the media covered for Michael Jackson

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Have you checked out the FHO store lately? You can find our newest research brief, Aging Bruises Based On Color, plus our original guide, Injury Following Consensual Sex. Both available now for electronic download.