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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.

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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.

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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.)

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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.

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Sexual Assault

Addressing Alcohol’s Role in Campus Sexual Assault

Futures Without Violence has a webinar coming up–Addressing Alcohol’s Role in Campus Sexual Assault. The session will be held March 25th at 3pm ET. IT will be recorded and archived. From the website:

Alcohol use plays a role in 50 to 70% of campus sexual assaults, which has generated heightened consideration of the intersections of sexual assault and alcohol use on campus. This webinar will focus on evidence-based strategies for prevention and response, both in the campus health center and the wider campus community. Current NIAAA research on the intersection of violence and disabilities, and trauma-informed clinical interventions that address both alcohol use and sexual violence will be presented.  The new resource Addressing Alcohol’s Role in Campus Sexual Assault: A Toolkit by and for Prevention Specialists will also be reviewed, with special attention to how to operationalize key prevention strategies.

As a result of attending this webinar, participants will be better able to:

  • Describe student with disabilities’ experiences of campus sexual violence and alcohol prevention programming
  • Implement an evidence-based clinical intervention to prevent and respond to sexual violence in their campus health center
  • Identify at least two prevention strategies to address alcohol’s role in sexual assault
  • Identify next steps for their prevention work on their campus

Register for the session 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.

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DV/IPV Sexual Assault

Drugs and the Forensic Patient

The Tribal Forensic Healthcare project has an upcoming webinar, Drugs and the Forensic Patient. The session will be held March 28th at 1pm ET. Like all of their sessions, free CEs are available for physicians and nurses. And yes, it will be archived. From the announcement:

This presentation will include discussions on how to recognize effects of drug exposure on patients seeking forensic care, considerations for forensic exam administration, such as consent and sample collection, as well as a review of additional best practices related to drug-facilitated sexual assault. At the conclusion of this webinar, participants will have increased knowledge of expected effects of various drugs and specific intervention that will assist with adjusting their approach to a forensic exam.

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.

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Since Last We Spoke, 2-25-19

Well, the hiatus at home was lovely, but it’s back to airports for me. It won’t be the constant frenzy for the next few weeks, but we’re definitely headed in that direction by the end of March, so I am trying to frontload work on a few new projects. I spent part of the weekend working to stay ahead, but there was definitely time for reading late at night. Here’s what caught my eye since last we spoke:

A nurse is building a database of women killed by intimate partners

The Smollett case proves why we should take hate crimes more seriously

Related.

Men understand consent

Anger is contagious

There’s so much to unpack about the R. Kelly story–this is but one aspect of it all

A love story about abortion–it’s a heartbreaker

“These monsters are the men”

These are great questions for getting feedback–will immediately add to the repertoire

The deadly truth about a world built for men

You all know I don’t work on planes. On my last flight home I finished reading this (it was amazing–everyone should read it); just starting this

yes, Nike.

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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.

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DV/IPV Sexual Assault

Relationship Dynamics And Teen Dating Violence

A newly published research brief from NIJ: Relationship Dynamics And Teen Dating Violence (PDF). It addresses the following research questions:

  1. Which relationship dynamics increase the risk for TDV or protect against abuse?
  2. How does the experience of TDV in one relationship influence the dynamics in subsequent relationships?
  3. How does the association between relationship dynamics and TDV change during the transition from early teen years into young adulthood?

As is often the case, this is a pretty superficial overview of the issue, so let this give you a sense of where you want to explore further. And of course, the Endnotes are valuable in and of themselves. Worth a download.

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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.

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Child Abuse DV/IPV Sexual Assault

Inquiry and Response to Recent and Past Trauma in Adult Health Care

A newly published article (hooray for Open Access) that’s worth your attention (do mind, it’s currently in press)–From Treatment to Healing: Inquiry and Response to Recent and Past Trauma in Adult Health Care. With as much conversation as we have about trauma-informed care, it’s often difficult to nail down what it is we mean. If you’re looking for the next article to discuss amongst your team, this might be a good one.

Bonus: here’s the article they reference at the beginning about the trauma-informed framework in primary care (PDF).

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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.

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Sexual Assault

Transportation Options for Improving Access to Sexual Assault Medical Forensic Exams

EVAWI’s Kris Rose and Kim Day from IAFN will be hosting a webinar, Thinking Outside the Kit: Transportation Options for Improving Access to Sexual Assault Medical Forensic Exams. The session will be held March 7th at 1pm ET. From the announcement:

Survivors of sexual assault face numerous hurdles in the aftermath of the crime, not the least of which is ensuring they can access a medical-forensic exam conducted by a trained medical professional. These trained professionals, often referred to as Sexual Assault Nurse Examiners (SANE), Sexual Assault Forensic Examiners (SAFE), or Forensic Nurses (FN) ensure that victims’ injuries are treated, prophylaxis against infection and pregnancy are administered, and forensic evidence is expertly collected. Using a trauma-informed approach, SANEs treat victims with respect and dignity, while honoring their choices throughout the process. Research indicates that when victims receive services from a SANE, they are more likely to seek help (e.g., counseling, therapy) and participate in the criminal justice process.

But what happens if the victim doesn’t have transportation to the post assault healthcare services they need? What if the crime occurs in a rural area and the only clinic with trained SANEs is located hours away from where the assault occurred? What if the only transportation available is the bus or taxi, but the victim can’t afford to pay the fares? What if the victim lives in a rural community where there are no buses or taxis? Affordable, safe, discrete, and reliable transportation is key to ensuring that victims of sexual assault have access to medical-forensic exams

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.

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Since Last We Spoke, 2-18-19

The girlchild was in town this weekend, so there was a lot of parenting time, and less hanging out and surfing. We entertained at the house, Sasha baked, and we ate, and we just generally enjoyed having the kid home. Still, there was a little time to catch up on some reading, particularly as the evenings wound down. Here’s what caught my eye since last we spoke:

A new tool for documenting elder abuse is in the testing phase. Looking forward to seeing results.

Why being estranged from your family can be the healthy thing. Judge less.

I always enjoy writer Ashley Ford, and her take on asking for help (and self-care) is a good one

No surprise–LGBTQ+ youth are over-represented, have poorer outcomes in the child welfare system

Can you identify all of these humanitarian icons? I could not.

He says you can’t ignore emails, but maybe you can. I’m torn on this. For your own sanity, I could easily argue it’s okay to make your priorities more important than other folks’ priorities (which is generally what emails are)

This was a gut punch, but I understand their point, and who’s to say what I would do in that situation?

Women helping women is good business. This might be a whole post soon. I have a lot to say about this.

How the Justice Department’s definition of IPV could leave victims at risk

North Caroline A&T students fight back against sexual assault

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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.

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Since Parkland

Today marks one year since the shooting at Marjory Stoneman Douglas High School. This past summer, 200 teen journalists began the work of telling the stories of youth gun deaths in the US–spanning the year between the day of the shooting and this week. The remarkable piece of journalism that resulted puts an incredibly human face on the wholly preventable tragedy that is gun violence in America.

I encourage you to read the stories of those who died, but also get to know the journalists who wrote their stories. Read also how they identified their subjects, and why suicides with firearms didn’t end up being represented in this piece. There’s a lot of insight (and data) there.

Definitely worth your time.

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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.

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Child Abuse Sexual Assault

Interpretation of Medical Findings in Suspected Child Sexual Abuse

An email from a defense attorney recently made me realize that I had not ever posted the most recent update from Adams, et al. (published in June). Most of you who do this work probably already have the article, and hopefully, you also took note of the erratum published in December, but just in case you haven’t obtained a copy, links take you to the full text of both (they happily made them Open Access).

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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.

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Since Last We Spoke, 2-11-19

I have a confession: Sasha was at Ft Bragg all weekend doing soldier things, so I did nothing. Seriously, nothing. No work of any variety. I barely got myself fed if we’re going to be honest. I had a weekend of such spectacular sloth, it would be embarrassing if I didn’t know how much I had already worked in 2019, and how much work I will still do this month. That level of laying about lends oneself to a pretty decent amount of web surfing and generally catching up on the news of the day. Here’s what caught my eye since last we spoke:

An idea we should all get behind–a sensible holiday swap.

This investigative series on sexual abuse in the Southern Baptist church–whew (1st of 3 parts)

Lest we forget, the Catholic church is also in the news for some horrific behavior right now...

When teens are smarter than their parents on vaccinations

“Chief Kent spoke a half-dozen Arabic dialects and four other languages. She was one of the first women to complete the rigorous course required for other troops to accompany Navy SEALs on raids. She could run a 3:30 marathon, do a dozen full-arm-hang pull-ups and march for miles with a 50-pound rucksack.” A life lived in service, rest in peace.

Speaking of a life lived in service, we remember former Rep. John Dingell and his many contributions to health policy

Ugh, Virginia, it’s all problematic. Also, this.

BTW, all of this takes a toll

Why so many people ignore LGBTQ+ dating violence

In honor of Black History Month, 5 pioneering nurses you should know

This year’s Gun Law Score Card is now available from the Giffords Law Center

And finally, something to feel good about:

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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.

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Sexual Assault

DNA Evidence in Groping Sexual Assault Cases

Here’s a topic rarely discussed in webinars: DNA Evidence in Groping Sexual Assault Cases. The always excellent Dr. Julie Valentine will be presenting the session on February 27th at 2pm ET. From the announcement:

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.

Detailed Learning Objectives:

1. Describe background information on touch DNA in sexual assault cases and factors that influence epithelial cell deposition.

2. Explain evidence collection practice implications from groper case study and research findings.

3. Identify possible suggestions and opportunities to expand evidence collection in groping sexual assault cases in their jurisdictions.

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.

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

Articles of Note: February 2019 Edition

It’s time once again for Articles of Note, our monthly waltz through the newly published peer-reviewed literature. I have to tell you, it’s a pretty glorious selection this month. Links lead to PubMed abstracts except where indicated.

Thinking about having a journal club for your team (or just looking for the next article to assign)? Here are some suggestions based on this month’s review:

For adult/adolescent SANE programs: Ectopic pregnancy following oral levonorgestrel emergency contraception use. or Vulnerabilities Relevant for Commercial Sexual Exploitation of Children/Domestic Minor Sex Trafficking: A Systematic Review of Risk Factors.

For CAC/peds programs: Barriers and facilitators affecting self-disclosure among male survivors of child sexual abuse: The service providers’ perspective. or Estimating the probability of abusive head trauma after abuse evaluation.

For expanded programs: Acquired Brain Injury in the Context of Family Violence: A Systematic Scoping Review of Incidence, Prevalence, and Contributing Factors. or Childhood maltreatment and intimate partner violence victimization: A meta-analysis.

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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.

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Child Abuse

Improve the Care of Pediatric Patients with Mild Traumatic Brain Injury

CDC has a new online course available on improving the care of pediatric patients with mild traumatic brain injury (mTBI). CEs/CMEs are available upon completion (NAPNAP/AAP), so for those of you in need of continuing education credits, this is worth checking out. The corresponding website also has a number of resources for clinicians and patients.

Description of the online course:

HEADS UP to Healthcare Providers is a free online training developed by CDC and the American Academy of Pediatrics. The goal of the training is to provide an overview of the evidence-based recommendations outlined in the CDC Pediatric mTBI Guideline and to equip healthcare providers with practical strategies to integrate these recommendations into clinical practice.

By the end of the training, you will be prepared to:

  • Discuss what happens to the brain during and after an mTBI.
  • Identify at least three best practices related to diagnosis of mTBI.
  • Devise an appropriate management plan for pediatric patients with mTBI.
  • Describe prevention strategies for pediatric mTBI.

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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.

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Since Last We Spoke, 2-4-19

I cannot describe how happy I am to look at my calendar and see no travel for 3 weeks. I’m delirious at the prospect of being home that long. I spent most of the weekend doing mundane things like grocery shopping, catching up on bad tv, and reminding my wife I live here, so I have nothing profound to report. But I did get a chance to read a bit. Here’s what caught my eye since last we spoke:

A new blog post from NSVRC that’s an important read

This survey out of the military academies…”a cultural rot”

We’re just beginning to fully understand the impact of witnessing domestic violence

How Planned Parenthood became a safe haven for queer women

Women: how to be the perfect victim of sexual violence

We don’t know the entire Lorena Bobbitt story

Humanity at its best

And finally 🙂 She ran 19 miles of a marathon carrying a lost puppy

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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.

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And the Winner Is…

Drumroll please…

Our winner is #33

Aimee Falkenberg you are our winner! I am super pleased to offer you one registration to this year’s IAFN conference in New Orleans. And your resolution: My professional goal for 2019 is to push for and assist in the creation of a strangulation protocol that can be used within our emergency departments. I also aspire to find a wee bit of wellness time for me-maybe explore some restorative yoga…I say this every year but 2019 is the year 

Perhaps some of that time for yourself will be spent in the Big Easy this Fall? Email me so we can chat details. Congratulations, Aimee! And for all FHO readers, don’t forget there’s still a few days left to take advantage of the 10% code (FHOIS10) for the research digests in the store. It will be good through January 31st.

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Since Last We Spoke, 1-28-18

First, thanks to everyone who participated in the giveaway. I randomized the responses and had the generator choose a winner for me. Come back tomorrow for the big announcement.

I’m at Ft. Bragg this week and then [carefully looks around to make sure no one is listening] I am home for 3 entire, glorious weeks. I am beyond thrilled and am very much looking forward to seeing many of you for the IAFN Advocacy Day.

I worked most of the weekend after sneaking back to the CLE to see the girlchild, so I haven’t had much time to read. But there were a few things that caught my eye since last we spoke:

Her school banned her from writing about a classmate’s sexual assault arrest

Turns out, if you love research, academia might not be the place for you

Yoga mats in the squad room

Speaking black dialect in courtrooms can have dire consequences: “Beyond negative stereotypes or lack of familiarity, a court reporter’s own discomfort with some of the terminology used in black dialect could also lead to incorrect transcriptions…”

How to manage your fear of public speaking–some good tips in here, some of which I employ myself

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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.