Categories
DV/IPV Sexual Assault

The (Economic) Cost of Violence

Everything can be looked at in economic terms, including violence. It’s important info to have at your disposal, because it can strengthen a grant proposal or negotiations with your healthcare system for an FTE or program. Enough’s been written on the subject that I figured it would be good to review the literature. I’ve chosen to focus mainly on the costs of violence against women. [UPDATE: You can find financial cost of child abuse here.] Unless otherwise indicated, everything listed is full text (if it wasn’t available free online, you’ll have a link to free abstracts). I’m organizing these by pub date, with most recent at the beginning:

2012

Overview of Studies on the Costs of Violence Against Women and Domestic Violence (PDF) (Council of Europe, Gender Equality and Violence Against Women Division, Directorate General of Human Rights and Rule of Law)

An Estimation of the Economic Impact of Spousal Violence in Canada, 2009 (PDF) (Department of Justice Canada)

Cost of Injury Reports Application from the CDC has been updated. Using the WISQARS database, the applications allows you to “find cost of injury estimates for fatal or nonfatal injuries classified either by intent and mechanism or by body region and nature of injury”. From the site:

Important Updates: In addition to allowing user-provided data to be integrated into the cost estimation process, this new version of Cost of Injury Reports incorporates three basic changes, effective 04/25/2012:

Updated unit (per person) work loss cost estimates: These updated unit work loss cost estimates affect total and average work loss cost estimates for both fatal and nonfatal injuries. For further details regarding this update, click here.

Corrected unit medical cost estimates: These corrected unit medical cost estimates affect total and average medical cost estimates for nonfatal emergency department treated-and-released injuries. Cost estimates for fatal injuries and for nonfatal hospitalized injuries are not affected by this correction. For further details regarding this update, click here.

Average costs: For reports involving injury deaths classified by body region and/or nature of injury, average costs are now expressed per person (similar to the averages for all other types of injury outcomes and classification schemes). Such averages were previously expressed in terms of apportioned cases. For further details regarding this update, click here.

Violence Containment Spending in the United States (FULL TEXT)

Institute for Economics and Peace

The Economic Costs of Partner Violence and the Cost-Benefit of Civil Protection Orders.

Logan, T.K., Walker, R., and Hoyt, W. Journal of Interpersonal Violence 2012 Apr;27(6): 1137-54

2011

Costs and Consequences of Sexual Violence and Cost-Effective Solutions

National Alliance to End Sexual Violence

Social and economic costs of violence–workshop summary

Deepali M. Patel and Rachel M. Taylor, Rapporteurs; Forum on Global Violence Prevention; Institute of Medicine

Attributing Selected Costs to Intimate Partner Violence in a Sample of Women Who Have Left Abusive Partners: A Social Determinants of Health Approach (PDF)

Varcoe, C., et al. (Canadian study)

2010

The healthcare costs of domestic and sexual violence (fact sheet).

Futures Without Violence, updated March 2010

Changes in health care costs over time following the cessation of intimate partner violence.

Fishman PA, Bonomi AE, Anderson ML, Reid RJ, Rivara FP.

J Gen Intern Med. 2010 Sep;25(9):920-5. Epub 2010 Apr 23.

A review of cost measures for the economic impact of domestic violence.

Chan KL, Cho EY.

Trauma Violence Abuse. 2010 Jul;11(3):129-43.

2009

Health care utilization and costs associated with physical

and nonphysical-only intimate partner violence.

Bonomi AE, Anderson ML, Rivara FP, Thompson RS.                             Health Serv Res. 2009 Jun;44(3):1052-67. Epub 2009 Mar 17.

Hidden Costs in Health Care: The Economic Impact of Violence and Abuse

Dolezal, T.et al. Academy on Violence & Abuse

Intimate Partner Violence: High Costs to Households and Communities

International Center for Research on Women

See also: Bonomi & Corso’s presentation at AVA, 2009

2008

Methods for estimating medical expenditures attributable to intimate partner violence.

Brown DS, et al.

J Interpers Violence. 2008 Dec;23(12):1747-66

2007

Cost of Sexual Violence in Minnesota

Minnesota Department of Health

The Effects and Costs of Intimate Partner Violence for Work Organizations

Reeves, C. & O’Leary-Kelly, A.M.

Journal of Interpersonal Violence, Vol. 22, No. 3, 327-344

The effect of intimate partner violence on health care costs and utilization for children living in the home. (FULL TEXT)

Rivara FP, Anderson ML, Fishman P, Bonomi AE et al.

Pediatrics 2007;120(6):1270-7.

Medical Costs and Productivity Losses Due to Interpersonal and Self-Directed Violence in the United States

Phaedra S. Corso, et al.

Am J Prev Med 2007;32(6)

2006

Making the Case for Domestic Violence Prevention Through the Lens of Cost-Benefit: A Manual for Domestic Violence Prevention Practitioners

Browne-Miller, A., Transforming Communities: Technical Assistance, Training and Resource Center (TC-TAT)

The welfare cost of violence across countries

Soares, R.R.

Journal of Health Economics, 25(5), September 2006, Pages 821-846

Long-term costs of intimate partner violence in a sample of female HMO enrollees.

Jones AS, et al.

Womens Health Issues. 2006 Sep-Oct;16(5):252-61.

2005

A Considerable Sacrifice: The Costs of Sexual Violence in the U. S. Armed Forces

Hansen, C. The Miles Foundation

The costs of interpersonal violence—an international review

Waters, H.R., et al.

Health Policy, 73(3) 8 September 2005, pp 303-315

Gender-Based Violence: A Price Too High

From: UNFPA State of World Population 2005

United Nations Population Fund

2004

The Economic Dimensions of Interpersonal Violence

Waters, H., et al., World Health Organization

The economic toll of intimate partner violence against women in the United States.

Max, W. et al.

Violence Vict. 2004 Jun;19(3):259-72.

2002

Economic Costs of Domestic Violence

Laing, L. & Bobic, N., Australian Domestic and Family Violence Clearinghouse, University of New South Wales

The Rape Tax: Tangible and Intangible Costs of Sexual Violence

Post, L.A., et al.

Journal of Interpersonal Violence, Vol. 17, No. 7, 773-782 (2002)

1999

Intimate partner violence against women: do victims cost health plans more?

Wisner, C.L., et al.

J Fam Pract. 1999 Jun;48(6):439-43

Costs of health care use by women HMO members with a history of childhood abuse and neglect.

Arch Gen Psychiatry. 1999 Jul;56(7):609-13.

Walker EA, Unutzer J, Rutter C, Gelfand A, Saunders K,

VonKorff M, Koss MP, Katon W.

PUB DATE UNKNOWN

The Cost of Violence/Stress at Work and the Benefits of a Violence/Stress-Free Work Environment

Hoel, H., et al. International Labour Organization

BONUS TOOL (I can’t speak to validity or reliability, but it’s a cool concept)

Texas Health Resources DV Costs Calculator

See also: Financial Cost of Child Abuse

Categories
Uncategorized

Nursing Misconduct & State Boards of Nursing

I never just post a news item on this site, but this one is so fascinating to me, I thought it was worthy of space. In California this weekend, the Governor fired 2/3rds of the state Board of Nursing for failing to discipline nurses accused of serious misconduct. It all came out after a lengthy joint investigation between the LA Times and ProPublica.

“Reporters found nurses who continued to work unrestricted for years despite documented histories of incompetence, violence, criminal convictions and drug theft or abuse. In dozens of cases, nurses maintained clean records in California even though they had been suspended or fired by employers, disciplined by another California licensing board or restricted from practice by other states.”

Categories
DV/IPV

Batterers in the Workplace

The Corporate Alliance to End Partner Violence has a webinar series as part of their S2 intiative–the next one is at the end of August and I’ll post on it soon. For now, check out the previous one, held at the end of May, on batterers in the workplace. The whole session is available on line, as are the materials from the presenters. You can also find a variety of info on this topic from the Articles section of the website, much of which is full-text.

UPDATE: The August session closed out before I could even get it posted. I will try and get the archived material up as soon as it’s available.

Categories
Uncategorized

Compassion Fatigue Podcast

One of the most commonly searched terms on this site is “compassion fatigue” (or alternately  “secondary trauma” or “burnout”). Enough of you have been searching the term lately that I’m compelled to give you a new offering on the subject. This one‘s from PESI, and while it’s not free (cost is $29), it nets nurses 1.5 CEUs in a convenient audio package.

Categories
Child Abuse Sexual Assault

New Online Courses at IAFN

Two new online courses have been announced at IAFN: SANE Dialogues: Focus Group on the Use of nPEP in SANE Programs and Patterns of Injury in Non-Accidental Childhood Fatalities. They’re free for members; non-members pay $10 each. It would appear that there are CEUs attached, but I could not find any specifics related to how many for either course. If you’re a Firefox user, be forewarned: you may not be able to complete the posttest to get credit for the course, so Internet Explorer is really the only way to access this content (which frankly sucks for Mac users like me).

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Uncategorized

Weekly Wrap-Up @ the Sustainability Blog

This week was a good one at the Sustainability site. We’re back with a new Coordinator Q&A, and a couple additional goodies for all you program managers out there:

Enjoy your weekend everyone!

Categories
Uncategorized

Cultural Competency & Disaster Response

The Department of Health & Human Services’ Office of Minority Health has a new curriculum available: Cultural Competency for Disaster Preparedness & Crisis Response. The curriculum consists of 4 courses that “are designed to equip disaster and crisis volunteers and personnel with the awareness, knowledge, and skills needed to provide culturally and linguistically appropriate services to diverse communities during all phases of disaster. The curriculum is grounded in the Office of Minority Health’s CLAS Standards, which are grouped into three themes: Culturally Competent Care, Language Access Services, and Organizational Supports.”

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Uncategorized

Evidence-Based Medicine, Pt. II

Time once again for another installment of evidence-based medicine. The issue gets brought up in emails to me from time to time, and recently I’ve had a spate of them. So here’s another tutorial for your learning pleasure– this time, from the University of North Carolina and Duke University.

I think this issue is an important one, because as I’ve expressed many a time, one of the most critical questions you should be able to answer as a clinician is “Why?”. “Because that’s the way I was taught” or “That’s how we’ve always done it” probably isn’t going to cut it.

Categories
Sexual Assault

Guest Post: Evaluating SANE Trainers

I’m pleased to welcome Jennifer Pierce Weeks to Forensic Healthcare Online. As a clinician, administrator, national trainer and President of IAFN, she is another one of those folks who spends a lot of time talking with people in the field, and has a great perspective on healthcare-focused, patient-centered, sustainable programming.

We’ve been talking a lot lately about the issue of quality in SANE/SAFE education. There are no mandated qualifications for who provides the education, so caveat emptor is the rule of the day. IAFN does not police training, but provides education guidelines that describe the minimum body of knowledge all SANEs/SAFEs should possess (there are also training standards for sexual assault forensic examiners (PDF) around the National Protocol). Needless to say, some of the education out there is definitely better than others.

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

Articles of Note: July Edition

Time once again for a run down of some of the new and noteworthy articles in the current literature. Most of these are from the June/July/August issues. As always, please keep in mind this in no way a comprehensive list; simply items that have caught my attention from a selection of peer-reviewed journals. Most links lead to PubMed abstracts (except for one, which goes to Ingenta); from there you can choose what’s worth a.) paying for; b.) a pilgrimage to your nearest medical library;  or c.) downloading via the full-text access you possibly have at your disposal.

Just a warning: it’s a lengthy list this month. There’s all kinds of good stuff being published right now…

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Uncategorized

My New Gig

So about that announcement of mine…

I have been teaching and consulting for prosecutors for many years now. It’s really one of the parts of my professional life I enjoy most. So I am beyond grateful to be able to announce that today is the 1st day of my new job, as medical advisor for a brand new prosecution institute: Aequitas, the Prosecutor’s Resource on Violence Against Women. Our new website is just about ready to launch (we’re only about a month old, now); for a few more days you may still get the “under construction” notice. I will continue to oversee the National SANE Sustainability Technical Assistance project, as well–essentially splitting my time between those two gigs. You can check the updated About for all the details.

Categories
Sexual Assault

Weekly Wrap-Up @ the Sustainability Blog

I’m back from the desert and looking forward to a long weekend. I’m going to take part of the day off, so just an abbreviated warp-up (wow, now that’s a typo!) wrap-up today. Because I was gone all week, only a couple things on the sustainability site:

  • A fascinating article about the current freefall of the Memphis SANE program–heartbreaking when you run a national sustainability project
  • A beginner’s guide to online marketing and fundraising webinar announcement

Have a safe and happy 4th for all of my American readers (and for my Canadian readers, a belated happy Canada Day!). I’ll be back Monday with new content, the July edition of Articles of Note, and a big announcement!

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Uncategorized

Workplace Violence: The Nurse Victim

ANA has a recently updated CE offering on nurse victims of workplace violence. It’s your standard article-posttest format. Cost is $20 ($15 for ANA members) for 1.52 CEUs. The focus of this course is a bit different than what you might initially think–there’s more of a secondary trauma bent following victimization (rather than a lateral violence focus, as is often the case with a lot of these offerings).

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Uncategorized

STD Clinical Intensive

Because the topic is so popular on this site, another online STD clinical course, this one from Boston University’s School of Medicine. It’s free of charge, but requires registration to participate. CMEs available (natch), but the course info specifies nurses as part of the target audience, as well. For those of you running sexual assault programs, this might be a good one to have your team members complete as a part of annual competency efforts–just have them print off the certificate of completion at the end (or whatever they provide for CMEs), and you can add it to their personnel files.

I haven’t done this one yet, so I’ll be interested in feedback…

Categories
Uncategorized

Suicide in the Elderly

Medscape has a short CME offering on suicide in the geriatric population: Sedatives & Hypnotics May Increase Risk for Suicide in Elderly Patients. 0.25 AMA PRA Category 1 Credit(s)™ available (Family Physicians – maximum of 0.25 AAFP Prescribed credit(s)). This is a standard article-posttest format, based on a study published this month in BMC Geriatrics.

Categories
Child Abuse

Pediatric Burns

Children’s Healthcare of Atlanta has a streaming Grand Rounds webcast available: Burns in Pediatrics–Abuse, Accident or Outlier? It’s available free of charge, but requires registration with the site. Unfortunately, this one is also CMEs only, but is certainly relevant for clinicians across the board. (I’m working on finding some new relevant nursing CEs, but there are a lot less of those, sorry.)

Categories
Uncategorized

Caring for Pediatric/Adolescent LGBT Patients

The Children’s Hospital of Denver has an archived grand rounds presentation on caring for LGBT patients and their families in pediatric and adolescent medicine that was initially presented last November. It’s a 40 minute video with Powerpoint slides, and I particularly like that it’s focused on peds, since that subset of this specialized patient population is even less well represented in the online continuing education offerings.

Sadly, they don’t provide CEs for video archives, so no love there.

Categories
Uncategorized

Disaster Mental Health

I have had what could be benignly called a very long travel day (involving groundstops, flying through thunderstorms, airport power outages, and the like). It’s far later than I planned to be posting for today (actually yesterday now), so this is a short and simple one for those of you interested in traumatic stress and emotional trauma: from David Baldwin’s Trauma Information Pages, his comprehensive listing of online disaster mental health resources. I don’t normally just highlight a page of links as the sole content for a post, but this one is so exhaustive, I figured it’s a great resource to add to the arsenal.

Categories
Uncategorized

Weekly Wrap-Up @ the Sustainability Blog

Next week I will be traveling to the surface of the sun Bakersfield, CA and will be gone most of the week, so posts may be a bit lighter, depending on how my time ends up being use while I’m there. But that’s next week. This week, over at the sustainability site:

Have a great weekend, everyone!

Categories
Child Abuse Sexual Assault

Clinical Guide: Toluidine Blue Dye

Research

There’s been very little written about TB dye in the peer reviewed literature over the past 30 years, so I have included all of it (that I could find) here. Some discuss the utility of TB dye in greater depth than others. As with any research, it is imperative that you read these articles (particularly the older ones) with a critical eye toward the methodology used and the relevance of their findings in light of advances in the science. All links go to PubMed abstracts.

Factors that influence the variability in findings of anogenital injury in adolescent/adult sexual assault victims: a review of the forensic literature. (Laitinen, et al., 2013)

Reliability of female genital injury detection after sexual assault. (Sachs, et al., 2011)

Comparison of methods for identifying ano-genital injury after consensual intercourse. (Zink, et al., 2009)

Validation set correlates of anogenital injury after sexual assault. (Drocton, et al. 2008)

Significance of toluidine blue positive findings after speculum examination for sexual assault. (Jones, et al., 2004)

Signs of genital trauma in adolescent rape victims examined acutely. (Adams, et al., 2000)

Effects of toluidine blue and destaining reagents used in sexual assault examinations on the ability to obtain DNA profiles from postcoital vaginal swabs. (Hochmeister, et al., 1997)

Medical assessment of children who have been recently raped. (Kaufhold, 1993. No abstract available; full citation: Journal of Child Sexual Abuse, Volume 2, Issue 1, 1993, Pages 105 – 112)

Toluidine blue in the detection at autopsy of perineal and perianal victims of sexual abuse. (Bays & Lewman, 1992)

Toluidine blue in the detection of perineal lacerations in pediatric and adolescent sexual abuse victims. (McCauley, et al., 1986)

Use of toluidine blue for documentation of traumatic intercourse. (Lauber & Souma, 1982)

(See also: NIJ’s Sexual Assault Medical Forensic Examination Research Forum: Examination Technology for current research questions about TB Dye)

Books

Some of the textbooks make mention of TB dye and its application. I’ve included links to them via Google Books. Just like with the research articles, read with a critical eye–I’m not endorsing any particular textbook, just giving you the particulars of where to find the information.

Atlas of Sexual Violence (Henry, pp. 100-101)

Forensic Emergency Medicine (2nd Ed.). (Olshaker, et al. pp. 99-101)

Obstetric & Gynecologic Emergencies. (Pearlman, et al., p. 478)

Forensic Nursing. (Pyrek, p. 164)

Clinical Forensic Medicine. (Stark, pp. 92-93).

Manual of Forensic & Emergency Medicine. (Riviello, pp. 115-116)

Color Atlas of Sexual Assault (Girardin, et al., pp. 102, 120-121)

Sexual Assault Across the Lifespan (Girardin, et al. starting on p. 661)

Sexual Assault (Crowley, pp. 85-86: no page views in Google Books)

 

National Protocol for Sexual Assault Medical Forensic Examinations*

Search toluidine blue dye to find the various areas where TB dye is mentioned

*many state and local protocols address TB dye use, but those are too numerous to include here

To Purchase:

Single dose applicators (25 or 50/box): National Forensic Nursing Institute

{and some general commentary here…}