I know this is a site dedicated to online education and resources, but I just want to take a minute to point out a few talks I’m giving at some of the upcoming fall conferences that might be of interest. The biggie for me is the IAFN Annual Scientific Assembly, October 21-24 in Atlanta. I’m doing 2 sessions there: Using Today’s Technologies to Deliver Clinical Education: A Guide for Technophobes will be on Friday, October 23rd. That session will examine the variety of opportunities to participate in and create clinical education and should be a great opportunity to hear from participants about what’s being done around the world. And the one I’m even more excited about, the full-day leadership workshop (technically called NSVRC Leadership, though I’m not sure why), is on October 24th.
Category: Sexual Assault
Screening for Sexual Violence
The Pennsylvania Coalition Against Rape has a tutorial available for download on screening for sexual violence in the healthcare setting. This is a topic near and dear to my heart, and probably one we don’t talk about enough. You can download both the implementation guide (PDF) and the contents of the CD-ROM on which the tutorial was originally produced (warning: big file in zip form), free of charge. In addition to the tutorial, there’s a related publication, Put Down the Chart, Pick up the Questions (PDF), which also focuses on screening for sexual violence in the healthcare setting (I saw a similar tool in Illinois from their state health department).
What an incredible week we’ve had at both sites. So much traffic, I am frankly a bit stunned. If you haven’t been over to the sustainability site, here’s what you’ll find this week
- Leadership and self-confidence, as discussed over at HarvardBusiness.org
- A pretty relevant article on nursing retention (and recruitment)
- Our semi-regular Friday Coordinator Q&A with Linda Rossman
And of course, don’t forget, we’re having our 1st giveaway on this site. Just leave me a comment here about why you do this work and Monday I’ll choose the winner of the Forensic Nursing Scope & Standards, hot off the press. If you’re training forensic nurses as part of your job, this is a seriously invaluable tool, folks.
On July 22nd, from 2-3pm ET, OVC will be hosting a web forum on addressing sexual violence against individuals with disabilities. If you’ve been a regular reader of this blog, you know how the web forums work; if you’re a new reader (welcome!), you can read about how to participate here. Heather Kamper from Austin, TX will be facilitating the session. Participation is free and no registration is required.
For previous web forums, visit their archives list on the main page.
nPEP Update
If you weren’t one of almost 300 people who attended the HIV nPEP webinar described here, have no fear: the spectacular Kim Day has made sure you can still check it out at your leisure. You can access the archived offering over at the SAFE TA site. Thanks for making that happen, Kim!
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
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.
Phaedra S. Corso, et al.
Am J Prev Med 2007;32(6)
2006
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)
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).

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.
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…
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!
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…}
The Ash Institute at Harvard’s Kennedy School has an amazing series of “expert chats” with topics near and dear to my heart. One of the archived chats is Sexual Assault on College Campuses, and it features some incredibly knowledgeable speakers, including Dr. David Lisak and Marnie Shiels from the Office on Violence Against Women. You must register with the site to access the archived materials, which is free.
OVC is hosting a web forum June 24th at 2pm on best practices for assisting lesbian, gay, bisexual, transgender, intersexed, and queer (LGBTIQ) survivors of violence. As with other OVC web forums, questions are submitted in advance and then discussed live during the foum. For information on how to participate click here. You can view previous web forum discussions here.
False Allegations
MNCASA is sponsoring a webinar on responding to false allegations of sexual assault, Monday, June 29th from 12-1:30 CDT. From the announcement: False reports of sexual assault are rare yet they attract significant attention from the media and influence public opinion about the prevalence of sexual violence. The webinar will explore this challenging issue from a number of perspectives, with the overall goal of providing tools that will help you respond effectively to difficult questions about victim credibility.
Okay, so this is one of the webinars I’ve been waiting for: IAFN is hosting a webinar on HIV PEP that should be stellar (if I wasn’t going to be flying home from California that day, I would already be registered for this one). It will be held July 2nd from 2-3:30 pm ET, and it is free, people. Free. No CEs, sadly, but good (much needed) content.
Topics to be covered during the webinar include incidence of post sexual assault HIV infection; the role of advocacy for HIV counseling and assistance for victims related to HIV; the role and responsibility of the SANE for HIV PEP; and an ‘algorithm’ approach for the programs to use for HIV PEP.
Expert Witnesses
I’m in Boise, Idaho this week speaking at their 2 Days in June conference (with the fantastic Doug Miles, one of my favorite traveling companions). One of the topics we’re presenting is Using Experts in DV and Sexual Assault Cases. I’ve actually written on the topic before, in a monograph for NDAA: The Role of Sexual Assault Nurse Examiners in the Prosecution of Domestic Violence Cases. My friend and new boss, Jennifer Long, formerly of NDAA, wrote a related monograph in that series: Introducing Expert Testimony to Explain Victim Behavior in Sexual Assault and Domestic Violence Cases. You can download both of them (along with the rest of the monographs in that series) here. Yes, they’re written for lawyers, but I think there’s valuable info there for anyone working as an expert in these types of cases.
And if you’re attending 2 Days in June, please come by and say hello!
HRSA’s Maternal Child Health Bureau has an archived webinar on the intersection of HIV/AIDS and violence against women, originally presented last spring. You can view the offering with slides and audio, or download an MP3 to listen to on your iPod later on. There are also transcripts of the session available. These guys put on a great array of webinars–a lot of topics not being presented frequently that are truly clinically relevant. Now if they would just start offering CEs with them…
Child Maltreatment
The California Clinical Forensic Medical Training Center has recently posted 7 lectures with slides from the 23rd Annual San Diego International Conference on Child and Family Maltreatment, held this past January. If you weren’t able to get out to the conference, or you just didn’t get a chance to see everything you wanted to while you were there, here’s your chance. Lectures are $1 a piece to access (yup, one dollar–not a typo).
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 issues; I have included a couple articles electronically available now in anticipation of print publication, as well (all from the last 4 weeks). 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. All links lead to PubMed abstracts (unless there isn’t one for that article); 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.
If you have not yet perused this site, Child Abuse Evaluation & Treatment for Medical Providers is a virtual one-stop for all things on this subject. It’s essentially an e-book, with chapters that are well-organized and easy to read. The site is pretty accessible and plentiful links allow you to delve more deeply into subject matter as warranted. And if you’re helping to train police and prosecutors, some of the charts and outlines would be pretty useful for them, as well. My biggest complaint so far (because I’m still working my way through the site, and admittedly, it’s not my area of specialty) is that some of the resources are out of date (read: IAFN, which according to this link still has us in NJ), or just missing (like NSVRC).