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

Articles of Note: December 2017 Edition

It’s time once again for Articles of Note, the last one of 2017. As always, this is a review of the recent peer-reviewed literature, but is not exhaustive in nature. It’s meant to be used as a way to enhance currency and understanding of practice issues, and is not the final word on any single topic (I had a lawyer ask me about this, so now–here we are with the disclaimer). PDF with active links follows. Use in good health and share widely:

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DV/IPV

Updates from the Training Institute on Strangulation Prevention

Can I confess something? I went to put together my list of articles for the weekly Since Last We Spoke post yesterday and–I just. Couldn’t. I’m so tired of reading the catalog of sexual misconduct that is coming out every day (a wonderfully privileged thing for me to be able to do–simply ignore stories of sexual misconduct), I couldn’t bring myself to do another post dominated by it. But seriously–it’s all I’ve been reading as of late. Accounts or responses to those accounts.

So we’ll get right into the meat of the week. Starting with a webinar recapping 2017: Updates from the Training Institute on Strangulation Prevention. The session will be held January 9th at 1pm ET. From the website:

Strangulation impacts all professionals working on sexual assault, domestic violence, dating violence and stalking cases. Today, we know unequivocally that strangulation is one of the most lethal forms of domestic violence. Unconsciousness may occur within seconds and death within minutes. During this webinar, Casey Gwinn, JD, Gael Strack, JD, and Dr. William Smock will discuss lessons learned, best practices, and resources available for family violence and sexual assault professionals.

Subtopics will include:

– Findings from our survivor focus group

– New Medical Radiological Evaluation Recommendations from the Medical Advisory Board

– Best practices for identifying, documenting, investigating, and prosecuting strangulation cases

– Emerging issues in the field – medical, legal and advocacy trends

– Implementing new and existing legislation: Moving the dial in 2017

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

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

Articles of Note, November 2017 Edition

Before I depart for France, one more post for the week. I’ll be back next week with a few goodies, including my annual gift guide. In the meantime, enjoy this month’s Articles of Note, our regular romp through the peer-reviewed literature. New and improved, too–I upgraded my Adobe software and can now make linkable PDFs. You’re welcome 😉

And for those of you who are veterans, wishing you a Happy Veteran’s Day this week–thank you for your service, on this day and every day.

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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

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Child Abuse DV/IPV Sexual Assault

IAFN Pediatric Strangulation Case Review & Assessment

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

I wanted to bring to your attention the new IAFN Pediatric Strangulation Case Review and Assessment. I don’t typically post pricier options for continuing education, but this one looks comprehensive and has 20 CEs to go with it,  I think it’s worth your time and resources. Cost is $115, but if you attended the annual conference in Toronto, where it was previewed, you received a coupon code in your email that decreased the cost to $99. From the announcement:

IAFN and Evidentia Learning have jointly developed a new e-learning module on the topic of pediatric strangulation, which was officially launched at the IAFN conference in Toronto.

IAFN Pediatric Strangulation Case Review & Assessment contains a collection of living pediatric/adolescent strangulation patients evaluated and treated in the medical setting, presented in conjunction with evidence-based knowledge on pediatric strangulation evaluation and treatment. 

Learners can assess their knowledge acquisition through a review of:
– Definitions and terminology
– Anatomy and physiology
– Manner and associated signs & symptoms
– 29 interactive cases
– Post-testing

Authors:

Jennifer Pierce-Weeks, RN, SANE-P, SANE-A
COO, International Association of Forensic Nurses (IAFN)

Ralph Riviello, MD, MS, FACEP
Professor and Vice-Chair of Clinical Operations
Department of Emergency Medicine, Drexel University

Heather Rozzi, MD
Medical Director, Forensic Examiner Team
WellSpan Health

Raquel Vargas-Whale, MD, MS, MSc, FAAP
Medical Director, CARE Team
Driscoll Children’s Hospital

Kim Nash, BSN, RN, SANE-A, SANE-P
Forensic Nursing Specialist, International Association of Forensic Nurses (IAFN)

Tracy O’Brien, BSN, SANE-A, SANE-P
Forensic Examiner Program Coordinator
WellSpan Health York Hospital

Emily Huggins, RN, BSN, MHA, CEN, SANE-A, SANE-P
Forensic Examiner Program Manager
WellSpan Health York Hospital

Diane Daiber, BSN, RN, SANE-A, SANE-P
Forensic Nursing Specialist, International Association of Forensic Nurses (IAFN)

 

Categories
DV/IPV

Supporting Survivor Access To Health Care

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

As is always the case with their webinars, sorry about the late notice: Futures Without Violence is hosting a webinar next week, Supporting Survivor Access to Health Care: Open Enrollment, Updates on Changes to Health Policy, and Implications for Survivors. The session will be held October 31st, at 2pm ET. It’s a good one for the policy people among you. From the announcement:

Open Enrollment is November 1st, 2017 – December 15th, 2017! Did you know…

  • Health insurance is available for survivors and their families through the marketplace (healthcare.gov) and that significant financial help is still available for the purchase of coverage?
  • Screening and brief counseling for domestic violence and behavioral health are covered benefits in all plans offered on the marketplace?
  • There are special rules that help married victims of domestic violence and their dependents to qualify for financial help when they apply for health insurance or apply for a hardship exemption if needed?
  • Open enrollment is short this year and it is critically important to enroll starting November 1st for coverage on January 1, 2018?

Join this webinar to hear key steps and strategies about signing up for health insurance and how to help clients enroll in healthcare and understand the domestic violence provisions in the Affordable Care Act.

Register here.

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

Articles of Note: September/October 2017 [plus a question/giveaway…]

Time once again for Articles of Note, my (sort of) monthly romp through the peer-reviewed literature. As always, this is not comprehensive, and most links lead back to abstracts (except where noted otherwise). Also, as always, please provide attribution if you reproduce my lists for your own purposes, don’t take my name off the document, etc., etc.

But before we get to the meat of this post, a quick question: would you be interested in an actual research digest, which provided more in-depth information about new research (including some analysis about the impact on our practice), available every 6-8 weeks–for a small fee? I would appreciate the feedback–send me a yay or nay and how much you might be willing to pay for an individual digest (downloadable electronically), if you would be so kind. In the comments, or knowing you guys, in my email, would be fine. As an incentive, there’s a $50 Amazon gift card for one lucky commenter. I’ll choose when I’m in Toronto next week, so please let me know your thoughts by 13 October, 12pm ET. Thanks!

Word doc first (active links) followed by the PDF for easy sharing (because some of you folks still want it in that format):

 

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DV/IPV

HIV & Violence in LGBTQ Relationships

The National LGBTQ Institute on IPV has a webinar coming up, HIV and Violence in LGBTQ Relationships. It will be held October 3rd from 12-1:30 PT. I do not know if it will be archived, so please contact the hosts directly if you are looking for that information. From the site:

Categories
DV/IPV Sexual Assault

US Crime Statistics, 2016

For those of you who teach, write grants, etc., the FBI has just released the US Crime Statistics for 2016. You’ll find your general violent crime stats here; human trafficking (which has been broken out from the other stats) here. There is also a specific addendum that addresses the changes in the UCR definition of rape that you can review here. It’s helpful in understanding how things have evolved, but keep in mind, we’re still only talking about reported cases…

{I’m in Germany, so postings are going to be lighter this week. I’ll try to resume a normal schedule of posting next week. Honest.}

Categories
DV/IPV Sexual Assault

Mandated Reporting Obligations When a Survivor Has a Disability

Vera’s Center on Victimization and Safety has a webinar coming up, Mandated Reporting Obligations When a Survivor Has a Disability. The session will be held October 17th at 2pm ET. Unfortunately, I cannot find any additional info on this one, other than what’s on the registration page (a search of their website using the exact title of the webinar produces nothing [insert frowny face here]). However, I include this one on the site because it is a critical issue in the work we do, and so I encourage people to consider this one for your to-do list. I’ll be out of the country the week it’s held, but I hope someone will let me know how it was (because–and I know someone will ask– I also don’t know if they will archive it). If I receive additional intel I will add it to this post.

Categories
DV/IPV Sexual Assault Testimony

Deleting Blurry and Unusable Photographs

As is often the case, I like to discuss hot topics from the IAFN community site over here, as well. In part, because FHO reaches a different audience to an extent, and in part because I have a little more flexibility on my own site. Recently a question was posed about deleting blurry or otherwise unusable photos. Kosher or no? If you delete a photo is it “destroying evidence” as some claim, or is it something less nefarious? I will repost a portion of my response to the question on the community site here and then add a bit to what I previously posted over there:

[P]hotos are taken for the purpose of documenting findings as part of the medical record. Just as our colleagues in other areas of medicine take photos to document findings (and delete photos that aren’t useful for those purposes, such as blurry ones), so too do we. Those photos may then be used, along with the rest of the medical record, in a criminal or civil proceeding. At that time I have to testify as to whether my photos are “true and accurate” depictions of what I saw on exam. I am swearing under oath that my photos display what I saw. Just as I swear under oath that the swabs were obtained from the places I say they were obtained, or that the statements in my documentation actually reflect what the patient said to me.

To be honest, the idea that we are “destroying evidence” seems to be an arbitrary one. We don’t maintain specula after female sexual assault medical-forensic exams, but certainly, we could argue there is “evidence” potentially present on them. We don’t worry about it because there are swabs that theoretically captured the same “evidence”. I view this under a similar light. And being able to discuss my (current, regularly reviewed) policies and procedures and articulate why I may have deviated from them (if in fact, I did) is what speaks to transparency, in my opinion.

People possess a variety of philosophical viewpoints about their practices, which means we will probably never achieve consensus on this issue (as is the case for many things in our field). What is true for everyone, regardless of practice philosophy, is the need, when testifying, to be able to explain the rationale for why we do what we do with patients. We probably don’t have to agree on much else, but we do need to agree on that point. And I would go a step further and say that we need to explain the clinical rationale for why we do what we do with patients. Making decisions based on what law enforcement, or prosecutors or a camera software system manufacturer think is best has the potential to put people in as uncomfortable a position as deleting the specific photos, so the question will always be, why?

  • If your response is, I didn’t delete any photos because I didn’t want to destroy “evidence”, be prepared for hard questions about who asked you not to delete photos, the purpose of the photos you took, and your general alignment with investigatory vs medical procedures.
  • If your response is, I delete any photos that don’t adequately document what I saw at the time of exam, be prepared for difficult questions about theoretically destroying evidence.

For what it’s worth, there doesn’t appear to be much in the way of consensus, or even guidance, on this issue in the texts I most frequently use in my practice. The Atlas of Sexual Violence doesn’t address it in any way; Forensic Emergency Medicine (2nd Ed) does address it, but states in regards to deleted digital images:

The photographer should be ready to openly explain why the image was deleted. Possible explanations include “the image was out of focus,” “lighting was inadequate,” “technical problems with the camera settings,” or “my fingers got in the way.” An open and honest response should quiet any ill-mannered attorney. (Smock & Besant-Matthews, Forensic Photography in the Emergency Department, pp 289-290).

There is no “gold standard” on this issue–just a variety of opinions on whether or not it should be done. Anyone wanting to forward me scholarly work on this topic, by all means, please–I will compile a lit review for the FHO community and for wider distribution. Until then, I actually do think we will have to agree to disagree.

So there you have it. Make informed decisions. Consider the rationale behind the choices you make. Know how to articulate your decision making at trial. Nothing new to see here, folks. But always interesting discussion.

{Not legal advice, not official guidance–the world as I see it. Take it for what it’s worth.}

[Add, 9/8: A couple folks have sent or asked about SWGIT‘s standards, which I appreciate and will simply say–yes, these are the standards for forensic photographers in law enforcement. We aren’t law enforcement, and our photographs are taken for a different reason. So again, I stand by the statement I made earlier, I don’t believe there is a gold standard in our profession at this point.]

Categories
DV/IPV

New Research on the Intergenerational Transmission of Abuse

Battered Women’s Justice Project has a webinar coming up, New Research on the Intergenerational Transmission of Abuse. The session will be held September 20th at 2pm CT. Note: the registration is capped, so sign up sooner rather than later. From the site:

The “cycle of violence” hypothesis is deeply engrained in the domestic violence movement and is often invoked without a solid understanding of the limitations and challenges involved with testing this hypothesis. As such, this webinar will provide a methodological review and critique of the ‘Intergenerational Transmission of Violence’ literature. It will also discuss findings from a 20-year study on life course and intergenerational continuity of intimate partner aggression and physical injury. Implications and future research directions will be discussed.

Register here.

 

Categories
DV/IPV Sexual Assault

The Economic Cost of Intimate Partner Violence, Sexual Assault, and Stalking

If you’ve been reading FHO for awhile, you know I am hugely interested in the economics of the work we do. So I was pleased to see this new report from the Institute for Women’s Policy ResearchThe Economic Cost of Intimate Partner Violence, Sexual Assault, and Stalking. From the website:

Intimate partner violence (IPV), sexual assault, and stalking have profound economic effects on victims and survivors. The physical aspects of violence often result in significant medical costs and time off from work. The long-term psychological consequences may hinder victims’ ability to study or hold a job; in some cases, perpetrators directly sabotage their victims’ employment. Economic abuse, which can take a range of forms—including preventing access to financial resources and generating unauthorized debt—can leave victims facing economic insecurity and poor credit. Seeking safety is often financially prohibitive, reducing a victim’s ability to leave the abuser and recover.

This fact sheet summarizes findings from research literature on the economic consequences and costs of IPV, sexual assault, and stalking for victims and survivors. The costs highlighted include medical expenditures, lower wages resulting from diminished educational attainment, lost wages from missed work and job loss, debt and poor credit, and costs associated with housing instability.

Download the full report here (PDF).

[H/t VAWnet]

Categories
DV/IPV

Respect Effect: A New Tool for Teen Dating Violence Prevention

Let’s highlight some prevention today, since we spend so much time on response. That’s Not Cool, in conjunction with Break the Cycle, has an upcoming webinar, Respect Effect: A New Tool for Teen Dating Violence Prevention. The session will be held August 31st at 1pm ET. From the announcement:

That’s Not Cool is proud and excited to announce the release of a brand new mobile app: Respect Effect. Respect Effect was developed in partnership with teens! Respect Effect is an innovative NEW mobile application that encourages users to learn and practice healthy relationship skills, all while earning points for completing fun challenges with their friends. The app focuses on developing the skills young people need to keep themselves safe, promote positivity and respect (online and off!), and create and sustain healthy relationships.

We hope you’ll join us, and our friends Break the Cycle, as we give you a full introduction to Respect Effect. We will explain exactly how you can easily integrate this tool into your violence prevention work with teens. We will also touch on:

  • Digital dating abuse and the tenants of organizing youth in digital spaces
  • Best practices for the development of new digital tools
  • Tips and tricks for social media engagement and promotion

Register here.

Categories
DV/IPV

Racial and Ethnic Differences in Homicides of Adult Women and the Role of Intimate Partner Violence

The CDC looked at the issue of homicides in adult women in last week’s MMWR: Racial and Ethnic Differences in Homicides of Adult Women and the Role of Intimate Partner Violence–United States, 2003-2014. I don’t think it requires any explanation, nor do I think it will contain too many surprises. You may have seen press reports on it last week (alternatively). It’s as bleak as you probably expected. It’s also a must read, because although it’s brief, it raises critical discussion points for practice.

Categories
DV/IPV

Updated Clinical Guide: ALS for Subclinical Bruising

Just an alert that the clinical guide that addresses alternate light source use and subclinical bruising has been updated with additional research. So here’s your periodic reminder that ALS to identify subclinical bruising in strangulation patients does not have the evidence yet to support its use. There continue to be issues, particularly related to specificity. 

Categories
DV/IPV

Strangulation Medical Imaging Protocols

The Training Institute on Strangulation Prevention is hosting a webinar next month, Medical Imaging Protocols. The session will be held July 10th at 1pm ET. From the announcement:

This webinar features the Medical Advisory Board of the Training Institute on Strangulation Prevention, recognized as the leading experts in the field on non-fatal strangulation. These experts will be discussing new imaging recommendations they have developed and released for Emergency Room professionals.

Register here.

Categories
DV/IPV

When the Man Who Abuses You Is Also a Cop

I don’t often give mainstream media articles their own post (we wait for Mondays to do that), but 1.) this one is worth it, and 2.) I will be stepping away from FHO until next Thursday, as I take the girlchild on her 1st round of college visits (!). Huffington Post has a terrific article on police-perpetrated intimate partner violence that, while a long read, is definitely worth your time. I encourage you to spend some time with it and consider how your own programs handle patients who present after being assaulted by law enforcement. I’m proud to say in my former program, we had a very specific process for working with this particular patient group that included a unique law enforcement reporting pathway and 2 person team completing the exam (as these cases were always complex and the extra set of eyes and hands was welcomed). The whole piece is a great jumping off point for a team discussion. Even if you only provide sexual assault care, there’s still a conversation to be had about the unique needs and concerns of patients who present after police-perpetrated violence.

 

Categories
DV/IPV

Responding to Mental Health Crisis: Trauma-Informed Approaches to Conversations About Diagnosis, Treatment and Medication

The National Center on Domestic Violence, Trauma and Mental Health has a webinar coming up at the end of the month that I think could be very informative for forensic clinicians as we talk to our patients about their health status and needs for follow-up care and referrals. Responding to Mental Health Crisis: Trauma-Informed Approaches to Conversation About Diagnosis, Treatment and Medication will be held June 28th at 2pm CT. From the announcement:

In our services it sometimes feels uncomfortable to initiate conversations with survivors about mental health challenges and psychiatric diagnosis and about medication and other approaches to treatment. Our own views and our experiences with mental health systems can contribute to misunderstandings and disconnection for people we intend to assist. This webinar will consider ways to approach these conversations that are transparent about our intentions, support learning about individual preferences, and are respectful of the range of views.

Register for the session here.

Categories
DV/IPV

Intimate Partner Violence and Strangulation in the Deaf Community

The Training Institute on Strangulation Prevention is hosting a webinar, Intimate Partner Violence and Strangulation in the Deaf Community. It will be held May 31st at 1pm ET. From the announcement:

This previously recorded webinar will provide an in-depth look at intimate partner violence and strangulation with the deaf community. Several case studies will be used to demonstrate the importance of understanding the unique differences between hearing and deaf and hard of hearing peoples’ experience of intimate partner violence and strangulation. Special concerns and challenges such as the use of interpreters, interviews, and working with deaf people who may have language deprivation (little or no sign language) will also be addressed.

Register for the webinar here.

Categories
DV/IPV

Patient-Centered Approach to Domestic Violence in Health Settings

Sorry about no post yesterday–I have no excuse, I just flaked (I was playing catch up after being gone all last week). But I’m back, with a new webinar from Futures Without Violence, and it’s a good topic. Patient-Centered Approach to Domestic Violence in Health Settings is being offered May 25th at 3pm ET. The session will be reviewing some new resources, specifically http://ipvhealth.org/ and http://ipvhealthpartners.org/. CMEs are available for physicians {and it looks like CEs for nurses licensed in CA(?)}. From the announcement:

With the screening and brief counseling recommendations in the US Preventive Service Task Force, many are looking for the best evidence-based screening tool for domestic violence to use in health settings. However, research suggests that disclosure-based responses to domestic violence are limiting because they constrain our opportunities for prevention and limits education to only those who are ready to disclose and who have been screened appropriately. Additionally, in the quest for the right screening question, the intervention is often overlooked. This webinar offers an approach that incorporates patient-centered brief interventions that are evidence-based and easy-to-implement as well as domestic violence advocacy partnership-building strategies. This webinar will feature new online tools for health providers and advocates, www.IPVhealth.org and www.IPVhealthpartners.org.

I haven’t reviewed the new sites they’re highlighting, but I’m always in favor of looking at how we better serve these patients and collaborate with community partners, so my hope is these will be valuable. Don’t forget, IAFN also has education guidelines that “select a standardized body of scientific knowledge for the medical/forensic evaluation of the patient experiencing IPV”. If you don’t have a copy, you can download the IPV Education Guidelines here.