The forensic nurse purports a trauma informed and person-centered approach, focusing on the healt... more The forensic nurse purports a trauma informed and person-centered approach, focusing on the health needs of the patient with a rape experience. Timing of evidence collection recently expanded, but with passing time, DNA detection decreases. One solution proposed for victims is to self-collect following rape. The concept of self-collection was viewed as controversial, evoking mixed provider reactions. To bring clarity to issues faced by victims in remote and rural areas, and for those not ready to report, an integrative literature review method targeted strengths and gaps in evidence necessary for perspective before action or reaction to the post-rape self-collection proposal. The integrative literature review explored PubMed, responsive article citations, and gray literature for publications with systematic- or meta-analysis about self-collection. One article was responsive for self-collection post-rape, so parallel literature about sensitive self-collected testing was used. Analysi...
COLOR ATLAS OF SEXUAL ASSAULT is a clinical resource for practitioners who assess and treat sexua... more COLOR ATLAS OF SEXUAL ASSAULT is a clinical resource for practitioners who assess and treat sexually assaulted adolescents and adults. The atlas presents color photographs of injuries of the internal and external genitalia, anus, and mouth, which are magnified for ...
Different options for a reform of the EU Emissions Trading System are discussed to ensure carbon ... more Different options for a reform of the EU Emissions Trading System are discussed to ensure carbon price incentives for mitigation options in the basic materials sector, while minimizing carbon leakage risks. This paper quantifies carbon leakage risks, distributional implications, and additional revenues associated with an import-only border carbon adjustment (BCA), a symmetric (import and export) BCA, and an excise for embodied emissions at a fixed benchmark level in combination with continued free allocation. We estimate the product-level carbon intensities for 4400 commodity groups, compute maximal implied price changes due to full carbon pricing, and calculate cost increases relative to gross value added to assess the scale of carbon leakage risks. We show, first, that around 10% of EU exports and 5% of all domestic manufacturing sales meet the criteria for carbon leakage risk under an incomplete BCA at a carbon price of 30 EUR/t. Second, the distributional implications of consistent carbon pricing of basic materials are small and progressive. Finally, an excise could generate revenues of around 20 billion euros that may be used towards climate action. Our results on potential carbon leakage risks and their mitigation can inform responsible policy making to shape the EU pathway towards climate neutrality.
Sexual assault and rape is a life-altering event, undermining an individual's confidence and ... more Sexual assault and rape is a life-altering event, undermining an individual's confidence and perception of safety, regardless of the developmental age or stage of life. When an older person is sexually assaulted, there are stress responses that jeopardize quality of life and sometimes hasten death in the older person. The design of the chapter on rape and sexual assault of older persons introduces evidence and cases to raise awareness about the complexity of sexual assault diagnosis and treatment.
Dispositif et procédé d'observation, de collecte, de stockage et de préservation d'un échantillon
La presente invention concerne des dispositifs et procedes pour faciliter l'observation, la c... more La presente invention concerne des dispositifs et procedes pour faciliter l'observation, la collecte, le transport, le stockage, et la preservation d'echantillons contenant eventuellement de l'ADN, lesdits echantillons constituant potentiellement une preuve d'agression sexuelle. Les dispositifs et procedes decrits en outre fournissent un moyen de rendre minimale la possibilite de contamination, de dilution ou de degradation d'echantillon au cours des procedes de collecte et de stockage. Les dispositifs de l'invention peuvent contenir des composants electriques qui permettent la generation et l'enregistrement d'informations (en particulier les moments, les dates et les lieux) associees aux circonstances entourant la collecte de tels echantillons. Ces informations peuvent servir comme preuve corroborant la circonstance de la collecte d'echantillon, elles peuvent aider a conserver une chaine de possession connue et identifiable, et elles peuvent de p...
Elder abuse and neglect
Age and Ageing, 2008
Campbell Reay, A. and Browne, KD (2008) Elder Abuse and Neglect, in Handbook of the Clinical Psyc... more Campbell Reay, A. and Browne, KD (2008) Elder Abuse and Neglect, in Handbook of the Clinical Psychology of Ageing, Second Edition (eds B. Woods and L. Clare), John Wiley & Sons, Ltd, Chichester, UK. doi: 10.1002/9780470773185. ch18
Elder Abuse and Neglect
Home care providers have a professional and legal obligation to help prevent their elderly patien... more Home care providers have a professional and legal obligation to help prevent their elderly patients from being abused and neglected by family members and other home care providers. The elderly are often in a vulnerable situation because they depend on family members or others to help with personal care, housekeeping chores, and money management. A recent article in a major newspaper illustrates the problem. It reported that Mr. X, who was 84 years old, had been without food or water while he lay curled in the trunk of his car for 2 days before he was found by the police. When found, he reported that he saw daylight only when his housekeeper lifted the car trunk lid to ask him if her forgery of his check looked authentic. After he was rescued, he acknowledged that he was confused about why his housekeeper, who had befriended him, had turned on him. He expressed concern for her and hoped she would get a break in her sentencing. "She didn't kill me," he said. This situation is not that unusual. Elder abuse and neglect is a major public health problem in the United States, with most cases hidden from public scrutiny. The National center on Elder Abuse reports that cases of domestic abuse against the elderly increased from 117,000 in 1986 to 241,000 in 1994, and that represented only a fraction of older Americans who were abused and neglected in their homes. The Center estimates that 818,000 elderly Americans were victims of various types of domestic abuse in 1994. They believe the rise in reported cases illustrates a growing pattern of violence and neglect among the nation's expanding elderly population.
Wound Identification and Physical Abuse
Injury in older persons challenges health-care providers (HCPs), particularly when the cause and ... more Injury in older persons challenges health-care providers (HCPs), particularly when the cause and manner of cutaneous manifestations are unknown. Consequently, HCPs order a barrage of tests to sort differential diagnoses that are dependent on known comorbidity. The following chapter helps the HCPs initiate a forensic lens to distinguish between intentional and unintentional injury, forming a basis for reporting in institutions where older persons seek care.
1989 MCN Convention Poster Sessions in Print: Spanish-English Translation Tool
Mcn Am J Matern Child Nurs, 1989
Consensual Flogging Is Not Physical Abuse
Advanced emergency nursing journal
ABSTRACT
1989 MCN Convention Poster Sessions in Print
MCN, The American Journal of Maternal/Child Nursing, 1989
INTRODUCTION AND LITERATURE REVIEW The face of America is aging. For the first time in history, p... more INTRODUCTION AND LITERATURE REVIEW The face of America is aging. For the first time in history, people aged 65 years and older will outnumber children younger than 5 years. 1 There are many changes associated with aging, such as chronic disease, frailty, and dependency, which are beyond Disclosure statement: no author has a conflict of interest disclosure.
Journal of Pediatric and Adolescent Gynecology, 2000
tion (CMA) and suction curettage (SC). Secondary outcomes the nurse examiner were posterior fourc... more tion (CMA) and suction curettage (SC). Secondary outcomes the nurse examiner were posterior fourchette tear (36%), erythema of the labia minora, hymen, cervix or posterior included symptoms. We did an exit interview assessing patient satisfaction during the first year of the study, and fourchette (18% to 32%), and swelling of the hymen (19%). Uptake of Toluidine dye was noted in 66% of patients in have exit interview data for approximately half of the women enrolled. whom it was applied. Overall, 21% of patients were found to have no findings, and 40% had tears of the posterior We assessed the relationship of age and outcomes first by bivariate analysis using SAS (SAS Institute, Inc., Cary, fourchette or fossa. Time to examination was highly correlated with the degree of injury noted (p ϭ .000). The inci-NC). A multiple logistic regression model was constructed using age, gestational age, and measures of parity. dence of hymenal tears in self-described virgins was higher than in non-virgins (19% vs. 3%, p ϭ .008), however the Results: There were 219 women who were under 21 (18 under the age of 18). Compared to older women, adoles-total number or severity of other injuries was not significantly higher in virgins. Reported anal penetration was cents presented for abortion at the same gestational ages. Compared to older women, younger women were less likely associated with a high frequency of anal bruising, abrasions or tears (14/23, 61%), while only 2/150 victims who denied to have finished college (2.8% vs. 38.7%), and were less likely to have had previous pregnancies (45.4% vs 76.6%) anal penetration had tears (1%, p ϭ .000). Victims who reported multiple physical symptoms such as pain, nausea, and live births (20.2% vs. 51.3%) The distribution of symptoms during abortion, such as or vomiting were significantly more likely to be older (p ϭ .034) and to have an increased number of non-genital injur-bleeding and cramping, was the same across age groups; the only symptom which was more frequently found in ies such as bruising, abrasions, and bite marks (p ϭ .001). A higher number of non-genital injuries was also correlated younger women was headache. Overall younger women had a slightly higher rate of with a higher number of total genital injuries (p ϭ .003). Conclusions: Adolescent victims of sexual assault who were CMA as older women (90.2% vs. 86.5%). However, the multiple regression (MR) model did not show an effect of examined within 72 hours, using a magnification and dye were found to have tears of the posterior fourchette or the woman's age on CMA. MR demonstrated an adverse effect of prior live birth, and advancing gestational age on fossa in 40% of cases. Hymenal tears were rare, even in selfdescribed virginal girls. Timely examination of adolescent rates of CMA; younger women were less likely to have had prior live births. victims is important to document injuries, however, many victims will still have non-specific examination findings. Younger women were just as likely to report overall satisfaction (86.7% vs. 84.6%) with the abortion procedure and other questions of satisfaction,
In recent years, drugs including flunitrazepam, gamma-hydroxybutyrate, ketamine, and ethanol, hav... more In recent years, drugs including flunitrazepam, gamma-hydroxybutyrate, ketamine, and ethanol, have become popularly associated with drug-facilitated sexual assault. Other drugs are also candidates as factors in ''drug facilitated sexual assault'' (DFSA). The true extent of DFSA is not known, and is difficult to estimate. We recruited sexual assault complainants at four clinics in different parts of the U.S. to anonymously provide urine and hair specimens, and to answer questions about suspected drugging, drug use, and the sexual assault incident. Urine and hair specimens were tested for 45 drugs, including ethanol, and those pharmacologically capable of inducing sedation, amnesia, or impairment of judgment. Analytical test results were used to estimate the proportion of subjects, and the proportion of all complainants to the clinic in the same time period, who were victims of DFSA. Overall, cases of 43% of 144 subjects, and 7% of 859 complainants, were characterized as DFSA. Subjects underreported their use of drugs. The role of toxicological results and history in characterizing DFSA cases is discussed.
Jake, Brian and Mike go to the movies with Chrissy, Maria and Soledad. They all know each other f... more Jake, Brian and Mike go to the movies with Chrissy, Maria and Soledad. They all know each other from one of their classes. Afterwards, they go back to Mike's place to listen to some music and kick it. After some drinks, Mike and Soledad start hanging out on the couch. Their other friends leave. One thing leads to another and they start kissing. After a while, Soledad finds Mike forcing himself on her. She didn't mind kissing him, but she didn't want to do
Strangulation is one of the most dangerous forms of interpersonal violence (IVP), yet it is often... more Strangulation is one of the most dangerous forms of interpersonal violence (IVP), yet it is often not reported and missed by the health care provider because of lack of visible injury. The victim of strangulation can have critical injuries and a late onset symptoms. Victims of IVP should be directly asked whether they were choked or whether during the assault they felt like they could not breathe because of pressure on their neck. The objective of this article is to summarize "best practice" for health care providers so that they are better prepared to care for victims who report a history of strangulation. A summary of how to perform a forensic examination of the strangled patient is provided along with important documentation takeaways and useful forms to ensure that the severity of the strangulation is assessed, that critical injuries are identified, and that all injuries and findings are accurately documented for legal proceedings.
O ne of the current issues facing sexual assault nurse examiners (SANEs) is that of advocacy. Is ... more O ne of the current issues facing sexual assault nurse examiners (SANEs) is that of advocacy. Is the SANE an advocate or an unbiased scientist? This question encompasses 3 issues. What is the SANE's role, and is it nursing care that the SANE is giving? What are the legal implications of the term "advocate" or "advocacy," and how do these implications affect the SANE in the courtroom? What are the boundaries between the SANE and the advocate? Clinical nursing role issues
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Papers by Diana Faugno