The Forensic Nurse

In most cases the EIA (enzyme immunoassay), used on blood drawn from a vein, is the most common screening test used to look for antibodies to HIV. A positive (reactive) EIA must be used with a follow-up (confirmatory) test such as the Western blot to make a positive diagnosis. There are EIA tests that use other body fluids to look for antibodies to HIV. These include:

• Oral Fluid Tests – use oral fluid (not saliva) that is collected from the mouth using a special collection device. This is an EIA antibody test similar to the standard blood EIA test. A follow-up confirmatory Western Blot uses the same oral fluid sample.
• Urine Tests – use urine instead of blood. The sensitivity and specificity (accuracy) are somewhat less than that of the blood and oral fluid tests. This is also an EIA antibody test similar to blood EIA tests and requires a follow-up confirmatory Western Blot using the same urine sample.

Rapid Tests:

A rapid test is a screening test that produces very quick results, in approximately 20 minutes. Rapid tests use blood from a vein or from a finger stick, or oral fluid to look for the presence of antibodies to HIV. As is true for all screening tests, a reactive rapid HIV test result must be confirmed with a follow-up confirmatory test before a final diagnosis of infection can be made. These tests have similar accuracy rates as traditional EIA screening tests. Please visit the rapid HIV testing section for details.

Every year over a million women and children become enslaved into a world of sexual slavery. This problem is not just a problem in developing countries of the world, but very much a problem here in the United States as well. By some estimates between 150,000 and 300,000 are sold for sex here in the US.

On January 25, 2010 actors Demi Moore and Ashton Kutcher launched a new charity organization called DNA aimed at putting an end to the global sex trafficking trade.

For More information visit http://demiandashton.org/

Many victims of sexual crimes live the remainder of their lives, or a good portion of it, in fear that they will be victimized again. They often want to see their attacker locked up forever as punishment for the torment they experienced.

 Some states actually do have laws on their books to do just that. Most people dont even know such laws exist. They are called civil commitment laws and basically say that when a person becomes and has repeatly shown to be an emminent threat to the community as a whole, the govenment has the ability to incarcerate that individual indefinately.   

“The primary goal is incapacitation, that is, protecting society from people who are predicted to be dangerous in the future,” said Eric Janus, author of “Failure to Protect” and dean at William Mitchell College of Law in St. Paul, Minnesota. “The second goal is to provide treatment to these individuals.”

In 1990, Washington state became the first state to pass a civil commitment law specifically for violent sex offenders. Twenty states now have civil commitment laws.

Indefinate confinement of individuals to mental hospitals or treatment centers for those with severe mental illness has been acceptable in the United States since its close to its birth as a nation. Around turn of the 20th century many laws dealing with sexual psychopaths were passed as women gained more and more rights. But as the century progressed the laws were either repealed or rarely applied.

This week the United States Supreme Court is re-evaluating its position on civil commitment based on an appeal. They have upheld the use of such laws in the past when the goal has been rehabilitation and not further punishment. These laws can mandate indefinate treatment even after their criminal time behind bars has ended. Some argue that these treatments could happen while the person is incarcerated rather than after their sentancing.

The case being heard by the Supreme Court this week centers around a lay that has been used in as many as 77 cases where inmates were held in a federal prison in North Carolina under indefinate commitment.  “The justices will decide whether the program enacted under the Adam Walsh Child Protection and Safety Act of 2006 is constitutional by infringing on a traditional state function”.

Alan DuBois, attorney for the federal prisoners, said it was wrong for the United States to claim a public safety argument when justifying continued incarceration.

“This statute is not written constitutionally,” he added. “It effectively does require no connection between the underlying criminal charge and the subsequent commitment. You can be in custody for any crime whatsoever. ”

Lawyer David Hargett convinced the Virginia Supreme Court that his client had a constitutional right to contest his civil commitment.

“I have found talking with people they are shocked to hear somebody can be sentenced by a judge, serve out that entire sentence and then say, ‘Wait a minute, we’re not going to let you go,’ ” Hargett said, calling it a legal “black hole.”

The full story can be viewed on cnn.com

Victims Assistance Services of WestCOP, Inc. in collaboration with Barbara Rome, RN, SANE-A will be providing a four-day, 40-hour Adult/Adolescent SANE training course based on the New York State DOH protocol, the National protocol and the IAFN standards for SANE education.

Victims Assistance Services coordinates the Westchester County SANE Program.  This training will take place at their main office in Elmsford from 8am-6pm, on January 28^th, 2010 through January 31^st, 2010.  If you are a RN, NP or PA interested in taking this training, in order to specifically work as a SANE in our county-wide program, please send a cover letter and resume via email to mlaaksonen@westcop.org or via fax to 914-345-3513 to the attention of Michele Laaksonen, Sexual Assault Program Manager I.    The training fee is $250.  The deadline for training registration is January 1^st, 2010.  Due to space limitations, we will be accepting a restricted number of applicants.   

 About the trainer:  Barbara Rome is an Assistant Professor at Westchester Community College and emergency room nurse and nursing supervisor at Northern Westchester Hospital.  She is a nationally and New York state certified Sexual Assault Nurse Examiner and has been practicing as a SANE in both Putnam and Westchester County for over ten years.  Barbara has been called to testify in criminal trial and before the grand jury on numerous occasions.  She holds a Master of Science degree from Mercy College.  

Victims Assistance Services is a component of Westchester Community Opportunity Program Inc., a private not-for-profit, multipurpose social service agency dedicated to helping people and changing lives.

Victims Assistance Services (VAS) of WestCOP, Inc. coordinates the Sexual Assault Nurse Examiner (SANE) Program. The SANE has the responsibility to respond to any one of our nine participating hospitals in Westchester County to provide direct-services to victims of sexual assault, ages 12 and older. The SANE provides immediate, specialized, patient-centered medical care and performs comprehensive forensic medical examinations, including evidence collection, health-related education, and referrals; the SANE may also be called to testify in court as an expert witness regarding the quality of the evidence he/she collects, documentation, and the preservation and custody of physical evidence. The SANE utilizes an interdisciplinary approach through collaboration with hospital staff, advocates, law enforcement, and the DA’s office. The SANE will also attend mandatory continuing education trainings and case review meetings. 

Other Information About This Job:  SANEs will provide on-call services for at least three full shifts a month (shifts are weekdays and weekends, 8am-5pm or 5pm-8am) and commit to the program for a minimum of one year.  The nurses in our SANE program work in all different fields of nursing and choose to work as a SANE during their free time – in order to give back to their communities.  While they do receive a flat stipend per case, our SANEs volunteer their on-call time.  To apply for this position, please send a cover letter and resume via email to mlaaksonen@westcop.org or via fax to 914-345-3513 to the attention of Michele Laaksonen, Sexual Assault Program Manager I.   

For well over two hours outside a school gymnasium in Richmond, a 15 year old california girl was allegedly beaten and gang raped while a a crowd of approximately 20 people stood by and watched. The crowd managed to stand by and watch, snicker, and even “tweet” about the incident on twitter, the popular social networking site. Not one of them intervened or called the authorities to report the crime.

The reasoning behind why no one got involved gets a little more complex. Some say there was fear of repercussions from the gang conducting the rape and beating. Others say the crowd was overcome with what is known as the bystander effect. The bystander effect is when individuals in a crowd see that everyone else in the crowd is doing or not doing something, and that behavior becomes the accepted social norm. In essense, because no one else was doing anything, it must be ok for me to do nothing.

Some of you may remember the story of Kitty Genovese who was brutally raped, beaten, robbed, and eventually stabbed to death in Queens New York back in 1964. The story gained national attention when it was later revealed that several witnesses heard her scream during the attack during the night, and no one notified the police. One man shouted from his window to leave the girl alone, and the attacker fled, only to return a few minutes later when the police never arrived, and dragged her into a stairwell and stabbed her again leaving her to bleed out in a stairwell.

California has a law that makes it illegal to witness a crime against a child and not report it to police. But in this case technically the crowd did not violate the law which specifies that age of the minor child is 14 or less. The victim in the California gang-rape case was 15 years old.

  “This just gets worse and worse the more you dig into it,” Lt. Mark Gagan of the Richmond Police Department. “It was like a horror movie. I can’t believe not one person felt compelled to help her.”

To date the AP is reporting that five people have been arrested so far in connection with the crime. Three juveniles and two adults.  Richmond police spokesman, Lt. Mark Gagan said that  the three juveniles will be charged as adults. While the complete list of charges is not final yet, the suspects will be facing felony charges like “rape in concert” which can carry a life sentance.

The police were eventually notified when a person called in who had overheard others who were at the scene of the assault talking about the incident. The girl was found unconscious and “brutally assaulted” under a bench shortly before midnight Saturday 

Police have posted a $20,000 reward for anyone who comes to them with information that helps arrest and convict those involved in the attack.

TheForensicNurse.com is pre-releasing a program for fundraising groups looking to help create revenue to fund their local SANE/SART programs.

We realize that funding for programs are under more pressure than ever to come up with alternative ways to pay for services rendered. Thats why TheForensicNurse.com is working on trying to help programs find solutions as well as create our own solutions to help.

So please visit our Fundraising pages at:

http://www.theforensicnurse.com/fundraising

* State only pays for abortions when necessary to protect the woman’s life.

Source: Guttmacher Institute 2009

Source: http://www.ncsl.org/programs/health/aborlaws.htm

Often SANE programs go unnoticed and unpraised for their efforts. Most people would tell you that its not really polite conversation to talk about the needs for such programs.  

But the Chicago Tribune recently published an article about a SANE program in cook county. There is a phenominal qoute in the article by Tom Fleming Jr of the Park Forest Police department:

“We know that a SANE nurse who is trained in evidence collection has done the correct work for us,” he said. “Our goal is to not have a trial. Our goal is to get a confession from that offender. And we’re best equipped to do that with medical evidence. If we can do that, if we can get an offender to take a plea and not go to trial, then we’ve served that victim right at that very moment.”

Read the Full Article here:

http://www.chicagotribune.com/news/local/chi-sex-assault-treatment-sw-zon.ar0apr08,0,7944054.story

Background on the National Sex Offenders Registry Our Crimes Against Children Unit at FBI Headquarters coordinated the development of the National Sex Offenders Registry (NSOR) and continues to lead its implementation.

The Pam Lychner Sexual Offender Tracking and Identification Act of 1996 (Lychner Act) required the Attorney General to establish a national database at the FBI to track the whereabouts and movements of certain convicted sex offenders under Title 42 of the United States Code Section 14072. The National Crime Information Center (NCIC) run by the FBI enables the NSOR to retain the offender’s current registered address and dates of registration, conviction, and residence.

The Lychner Act imposed two major obligations on the FBI that became effective October 3, 1997:

1. To establish a national database that tracks the location and movements of each person who has been convicted of a criminal offense against a victim who is a minor, has been convicted of a sexually violent offense, or is a sexually violent predator.

2. To register and verify the addresses of sex offenders who reside in states without a “minimally sufficient” sex offender registry (SOR) program. Today, all 50 states have minimally sufficient SOR programs.

Under the Act, the FBI may release relevant information to federal, state, and local criminal justice agencies for law enforcement purposes only. Public notification will only be made if it is necessary to protect the public. However, the Act specifically states that in no case shall the FBI release the identity of any victim of an offense that required registration of a sex offender.

The legislation also made it a criminal offense for a registered sex offender to move to another state and knowingly fail to notify the FBI and authorities in the new state. Notification to the FBI and state authorities must be made within 10 days upon moving to a new state and/or establishing residence following release from prison or placed on parole, supervised release, or probation. Upon release, each sex offender is notified of their lawful duty to register with the FBI and appropriate local authorities.

The Jacob Wetterling Crimes Against Children and Sexual Violent Offender Registration Program, enacted in 1994, provides a financial incentive for states to establish registration programs for persons who have been convicted of certain sex crimes.

Megan’s Law, enacted in May 1996, amended the Wetterling Program legislation to give states broad discretion to determine to whom notification should be made about offenders, under what circumstances, and about which offenders.