Abuse Training Research Articles

Veterinary Forensics, Animal Welfare andAnimal Abuse: Perceptions and KnowledgeofBrazilian and Colombian Veterinary Students.

Veterinarians have a fundamental role to play in the detection of animal abuse and domestic violence cases. Therefore, it is essential that veterinary colleges provide appropriate training in animal welfare and veterinary forensics. The aim of this article is to characterize the perception and knowledge of veterinary students about training in veterinary forensics, animal welfare and the association between animal abuse and human violence. An online survey was made available to veterinary students at 227 veterinary colleges in Brazil and 22 in Colombia. The Chi-square test of independence was performed to compare responses of Brazilian and Colombian students for categorical survey items. Most of the surveyed students indicated that their college offered animal welfare training. However, only 21.8% (47/216) of the Colombian and 43.1% (216/523) of the Brazilian students mentioned that their veterinary colleges offered veterinary forensics training. Deficits in training in identification of non-accidental traumas, reporting of animal abuse and awareness of the association between interpersonal violence and animal abuse were identified in both countries. Despite this, more than 90% of students were aware of the relationship between these two crimes and in the importance of receiving compulsory training in animal abuse and veterinary forensics. Likewise, most of the respondents recognized that animal abuse includes both physical and mental abuse. The results highlight the need to improve education in animal welfare, animal abuse, human violence and veterinary forensics in veterinary colleges in Brazil and Colombia.

Child Abuse Recognition Training for Prehospital Providers Using Deliberate Practice

Background In most states, prehospital professionals (PHPs) are mandated reporters of suspected abuse but cite a lack of training as a challenge to recognizing and reporting physical abuse. We developed a learning platform for the visual diagnosis of pediatric abusive versus non-abusive burn and bruise injuries and examined the amount and rate of skill acquisition. Methods This was a prospective cross-sectional study of PHPs participating in an online educational intervention containing 114 case vignettes. PHPs indicated whether they believed a case was concerning for abuse and would report a case to child protection services. Participants received feedback after submitting a response, permitting deliberate practice of the cases. We describe learning curves, overall accuracy, sensitivity (diagnosis of abusive injuries) and specificity (diagnosis of non-abusive injuries) to determine the amount of learning. We performed multivariable regression analysis to identify specific demographic and case variables associated with a correct case interpretation. After completing the educational intervention, PHPs completed a self-efficacy survey on perceived gains in their ability to recognize cutaneous signs of abuse and report to social services. Results We enrolled 253 PHPs who completed all the cases; 158 (63.6%) emergency medical technicians (EMT), 95 (36.4%) advanced EMT and paramedics. Learning curves demonstrated that, with one exception, there was an increase in learning for participants throughout the educational intervention. Mean diagnostic accuracy increased by 4.9% (95% CI 3.2, 6.7), and the mean final diagnostic accuracy, sensitivity, and specificity were 82.1%, 75.4%, and 85.2%, respectively. There was an increased odds of getting a case correct for bruise versus burn cases (OR = 1.4; 95% CI 1.3, 1.5); if the PHP was an Advanced EMT/Paramedic (OR = 1.3; 95% CI 1.1, 1.4) ; and, if the learner indicated prior training in child abuse (OR = 1.2; 95% CI 1.0, 1.3). Learners indicated increased comfort in knowing which cases should be reported and interpreting exams in children with cutaneous injuries with a median Likert score of 5 out of 6 (IQR 5, 6). Conclusion An online module utilizing deliberate practice led to measurable skill improvement among PHPs for differentiating abusive from non-abusive burn and bruise injuries.

TEACHING PSYCHIATRY RESIDENTS TO RECOGNIZE AND RESPOND TO ELDER ABUSE THROUGH A STANDARDIZED PATIENT ENCOUNTER

Introduction It is estimated that 10% of older adults in the United States experience elder abuse. There are several types of elder abuse, including physical abuse, financial abuse, and neglect. One form of neglect, self-neglect, accounts for over 40% of elder abuse cases reported to Adult Protective Services. Studies on elder abuse have highlighted the need to train physicians in the detection and reporting of abuse in the older adult population. Methods We piloted an elder abuse training with PGY-3 and PGY-4 general psychiatry residents at Baylor College of Medicine. The residents were emailed two PowerPoint presentations; the first was an introduction to elder abuse and the second focused on capacity assessment of financial decision-making in older adults. One week after receiving the training materials, the residents participated in a standardized patient (SP) encounter. The case featured a 75-year-old individual presenting with signs of self-neglect, including weight loss and poor medication adherence. The older adult was accompanied by a neighbor who was present during the encounter. The residents were paired, with one playing the role of a psychiatrist and the other playing the role of a social worker. The residents completed a knowledge assessment prior to the encounter and a post-encounter evaluation. Results 18 resident physicians participated in the encounter. On average, participants agreed or strongly agreed that identifying and reporting elder abuse were important aspects of their roles as psychiatrists, but were less confident in their abilities to recognize the signs of elder abuse based on physical examination and psychological presentation. In the post-encounter survey, 72% of participants felt that the SP encounter enhanced their ability to detect and report elder abuse. There was a significant improvement in self-reported comfort with performing these skills after completing the encounter (p = 0.01). Conclusions SP encounters can effectively teach the detection of elder abuse and increase learners’ confidence in their skills. Using feedback from this pilot study, future SP scenarios can be expanded to other groups of medical learners, including medical students. This research was funded by: This work was funded by the Norton Rose Fulbright Educational Grant Fund of the Academy of Distinguished Educators at Baylor College of Medicine.

A national educational campaign to raise awareness of child physical abuse among health care professionals.

Education is necessary to improve child physical abuse detection and management. A few studies have described national child abuse training programs, but none has measured changes in knowledge among participants. A collaboration of child abuse experts from the USA, an academic pediatric department, and a non-governmental organization in child protection aimed at (a) training hospital physicians in a train-the-trainer course for the detection and management of child physical abuse and (b) conducting workshops and measuring attendance and gain of knowledge of participants. A train-the-trainer and a national curriculum were created. A 78-item and a 20-item knowledge questionnaire were used pre and post the train-the-trainer course and all workshops, respectively. Nineteen physicians from all pediatric departments of the seven medical schools in Greece attended the course. Eight workshops in seven cities took place with a total attendance of 1220 health care professionals. Gain of knowledge was demonstrated for participants in the train-the-trainer course (p = 0.0015) and local workshops (p < 0.001).Conclusion: We successfully engaged physicians from all medical schools in Greece and conducted a train-the-trainer module and eight workshops in major cities that improved the participants' knowledge in child physical abuse. This approach may help address physician deficiencies in emerging areas of child abuse clinical practice. What is Known: • Education is necessary to improve child physical abuse detection and management. • Although national training programs have been described, none has measured participants' changes in knowledge. What is New: • A collaboration of child abuse experts, all medical schools in Greece, and a non-governmental organization resulted in a national educational campaign in child physical abuse and gains in knowledge for participants. • This approach may help address deficiencies in emerging areas of clinical practice.

\u201cFrom taboo to routine\u201d: a qualitative evaluation of a hospital-based advocacy intervention for domestic violence and abuse

BackgroundHealth services are often the first point of professional contact for people who have experienced domestic violence and abuse. We report on the evaluation of a multi-site, hospital-based advocacy intervention for survivors of domestic violence and abuse. Independent Domestic Violence Advisors (IDVAs), who provide survivors with support around safety, criminal justice, and health and wellbeing, were located in five hospitals in England between 2012 and 2015 in emergency departments and maternity services. We present views about IDVAs’ approaches to tackling domestic violence and abuse, how the IDVA service worked in practice, and factors that hindered and facilitated engagement with survivors.MethodsWe adopted a convenience sampling approach and invited participation from all who offered to take part within the study timeframe. Sixty-four healthcare professionals, IDVAs, IDVA service managers, and commissioners at all sites were interviewed. Interviews were analysed using a thematic approach: familiarising ourselves with the data through repeated readings and noting initial ideas; generating initial codes through double coding notable features of the data across the dataset; collating codes into potential themes; and reviewing themes to ensure they captured the essence of the data.ResultsTwo key themes emerged. The first was Hospital-based IDVAs fulfil several crucial roles. This theme highlighted that healthcare professionals thought the hospital-based IDVA service was valuable because it enhanced their skills, knowledge, and confidence in asking about domestic violence and abuse. It enabled them to immediately refer and provide support to patients who might have otherwise been lost along a referral pathway. It also reached survivors who might otherwise have remained hidden. The second theme was Success hinges on a range of structural factors. This theme illustrated the importance of ongoing domestic violence and abuse training for staff, the IDVA having private and dedicated space, and the service being embedded in hospital infrastructure (e.g. featuring it in hospital-wide policies and enabling IDVAs access to medical records).ConclusionHospital-based IDVAs offer a unique and valued way to respond to domestic violence and abuse in a healthcare setting. Further work must now be done to explore how to implement the service sustainably.

A study on the differences in legal practices in child abuse cases with examples from different countries

Sex crimes against children is a global problem. The rate of such crimes are significant even societies with high levels of education and income. This study aimed to address necessary measures to minimize this problem by discussing the data and laws regarding sex crimes against children in five countries.The study reviewed scientific data on sex crimes against children in India, Canada, the Netherlands, UK and Turkey and the relevant penal codes in these countries, and compared the respective articles and practices. India is one of the countries with the highest number of child sexual abuse cases. The most interesting aspect of the Canadian law is that the law mentions peer relationships. It is noted that the criminal justice system in the Netherlands is, as opposed to many other countries, based on principles of rehabilitation and resocialization. The longer penalty times are striking in UK Sexual Offences Act 2003.The data from Turkish Statistical Institute shows that the number of sexual abuse cases are extremely high in Turkey.Child sexual abuse is a frequent problem in the world. Unfortunately, related studies, training and legislative regulations are not sufficient to solve this problem. It is observed that abuse cases increase in countries having weak and middle economies; however, the opposite evaluation is not completely correct. It can’t be suggested that standard education programs, increased levels of income and the securing of justice are the only solutions. Sexual abuse training through standard methods are insufficient to prevent this problem. Educational specialists need to develop new educational methods to address the problem. The rehabilitation of child victims is as important as punishment of offenders. This study advocates that necessary steps should be taken for the widespread establishment of Child Protection Centers, which play a significant role in the rehabilitation and treatment of victims.

Knowledge and opinions of child development vocational school students about child neglect and abuse

Objective: This study was planned in an attempted to find out knowledge and opinions about child neglect and abuse of child development vocational school students who has an important role in the care of 0-6 age group children, and to create an awareness in this field. Method: Our descriptive type study’s sample was formed by 197 Tokat Gaziosmanpasa University Child Development Vocational School Students. To obtain the data survey form was applied to the students in the classroom in break time between courses. 7 students who were not present in the class were excluded from the study were excluded from the study. In order to data analysis number, percentage, mean, standard deviation and chi-square test were used. Results: Regarding 190 students who participated in the study, 188 were female and 2 were male. 9.5% of the students (n: 18) stated that they had been subjected of violence, 13.8% of (n: 26) stated that they were exposed to neglect. 20 students (10.5%) received formal training in neglect and abuse. 93.1% (n: 175) of the students stated that they had to report child neglect and abuse according to the law, 88.6% (n: 164) of stated that they should report in accordance with the policies of Ministry of National Education, 95.8% (n: 181) stated that they were responsible for moral reporting. When they detect neglect or abuse, 47.3% (n: 88) think that they should report it to Social Services and 39.2% (n: 73) think that they should report it to the Security Directorate. The rate of those who think they can recognize physical abuse symptoms is 29.1% (n: 55). 94.1% of the students (n: 176) stated that they needed more information about this subject. Conclusions: As a result of our study, we found that child development students did not have sufficient knowledge about child neglect and abuse. To increase knowledge level and awareness of child developers who having close contact with children changes in the education program should be planned, and abuse and neglect should be included in the curriculum.

Perceptions of Frontline Staff to Training and Communication Tools to Support Adults with Intellectual Disabilities to Report Abuse and Neglect: “Something to Work with”

Adults with intellectual and communication disabilities are more vulnerable than the general population to becoming victims of abuse and neglect. Approaches to giving a voice to this population remain scarcely researched, while current literature highlights the need for frontline disability workers to receive training and communication resources in abuse and neglect. This study explored the perceptions of frontline staff to using a safeguard toolkit consisting of resources to raise staff awareness and communication aids to assist with client disclosure of abuse and neglect, after receiving one day of training. Qualitative methods were followed, with data collected through telephone interviews. Three themes that emerged were appreciation, uncertainty and improvements. Although the tools were received enthusiastically and participants reported a raised awareness of abuse and neglect, the tools had not been used to facilitate disclosures of abuse, even when abuse had been suspected. Although the face-to face training raised awareness about abuse and neglect of individuals communication disabilities, the staff remained uncertain of how to the use the tools or for whom they were applicable. Participants requested increased support to use the tools confidently. Alternative models of training and support may be required in order for frontline workers to be confident at supporting individuals with intellectual and communication disabilities to speak out about abuse and neglect.

The Current State of Pediatric Health Care: Changes and Challenges.

1. Shabana Yusuf, MD* 2. Lynn Garfunkel, MD* 3. Catherine Forster, MD† 4. Janet R. Serwint, MD‡ 1. *Editorial Board Member, 2. †Editorial Fellow, and 3. ‡Associate Editor, In Brief, Pediatrics in Review > Over the years, women have prominently advanced pediatrics. Very few women were members of the original editorial board of Pediatrics in Review . That has since changed. Four prominent women on our current editorial board offer their thoughts on the current state and possible future of pediatrics. > > —JZ, HDA Although the global mortality rate of children has dropped dramatically (from 36% in 1900 to 12% in 1979 to <4% in 2017), with most children today living into adulthood, there remain significant racial, ethnic, and geographic differences. Diseases have evolved and provider perspectives have changed. Medical advances in 3 areas of pediatric care—prevention, diagnosis, and treatment—have led to substantial changes in child health. Vaccine-preventable diseases have declined remarkably. In 1977, a nationwide immunization program was established to increase vaccination rates to 90%. With development of the Haemophilus influenzae and pneumococcal vaccines, bacterial meningitis and its complications are rare, although bacterial pneumonia and otitis media still occur. More recently, vaccine refusal has increased the rates of unvaccinated children (from 0.3% in 2001 to 1.3% in 2017), causing unnecessary local epidemics and increased physician time for counseling parents. Human immunodeficiency virus infection rapidly increased in the 1980s, and peaked at epidemic proportions in …

Teaching Basic Knowledge on Substance Use Disorders: The Impact of e-Learning on Health Professionals

PurposeRecent evolution toward a medical perspective on patients with substance use disorders (SUDs) has led to a lack of medical training in substance abuse. To increase this knowledge, a distance learning course (“e-learning”) was implemented to teach the general concepts of SUDs to medical residents and health professionals before delivering on-campus courses. The purpose was to evaluate the impact on participants' basic knowledge. MethodsThe e-learning on the general concepts of SUDs was based on short voiced presentations and additional educational material. It was proposed to 2 populations: medical residents in general practice and health professionals in continuing education. All of the participants answered questionnaires before and after the distance learning course to evaluate their basic knowledge of SUDs. These questionnaires were analyzed along with a satisfaction questionnaire to assess both the acquired knowledge about SUDs and the satisfaction level. FindingsParticipants moved toward higher test scores independently of their initial background and for all the educational objectives targeted by the teachers. The mean progression on a 20-point scale between the pretest and posttest questionnaires was 5.48 (2.63) for health professionals and 5.90 (2.20) for residents in general practice. Satisfaction was rated 4 or 5 on a 5-point Likert scale by at least 84.2% of participants. ImplicationsThis study is the first evaluation of an online pedagogical tool on SUDs. The positive feedback from participants encourages pursuing development of this e-learning. Used before on-campus courses, it provides an attractive educational option to overcome the usual limitations of online classes.

Editorial introductions

Editorial introductions

Identification and management of alcohol use and illicit substance use in outpatient psychiatric clinics in Sweden: a national survey of clinic directors and staff

BackgroundSwedish national guidelines recommend that all health care settings systematically screen patients for alcohol use and illicit substance use. When hazardous use is identified, it should immediately be addressed, preferably through brief interventions (BI). It is well known that the prevalence of alcohol use and illicit substance use among psychiatric patients is high, but it is not known to what extent screening and BI are routinely carried out in such clinics.MethodsTwo online surveys investigating the use of screening and BI for alcohol and illicit substances were constructed; one for psychiatric outpatient clinic directors and one for staff at these clinics. The main analyses were calculated as simple frequencies. In secondary analyses, we investigated the associations between substance abuse training, type of clinic and screening/BI delivery. For these analyses, the Chi square test was used.ResultsMost clinic directors reported that they have guidelines to screen for alcohol (93.1%) and illicit substance use (78.9%) at initial assessment. Fifty percent reported having guidelines for delivering BI when identifying hazardous alcohol use (35.9% for hazardous illicit substance use). Among staff, 66.6% reported always screening for alcohol use and 57.8% reported always screening for illicit substance use at initial assessment. Further, 36.7% reported that they usually deliver BI when identifying hazardous alcohol use (35.7% for hazardous illicit substance use). Secondary analyses indicated that staff with substance abuse training were significantly more likely to screen for alcohol use than staff without such training. Further, staff at psychosis clinics were significantly less likely to screen for both alcohol and substance use than staff at both general and specialist psychiatric clinics.ConclusionsMost clinic directors reported having clear guidelines for staff to screen for alcohol use and illicit substance use, but fewer staff members than expected indicated that these guidelines were adhered to. Providing training about substance use disorders for staff may increase use of screening for alcohol use, and psychosis clinics may need to improve their screening routines.

Extent of Elder Abuse Training in Dental Hygiene Curricula and Program Directors' Perceptions of Importance of and Barriers to Implementation.

Research published in 2002 reported limited elder abuse training in U.S. dental hygiene curricula although its importance has increased with an aging population. The aims of this study were to determine the current extent of elder abuse training in U.S. dental hygiene curricula and to explore dental hygiene program directors' perspectives on the topic. A 25-item online survey was distributed to all 361 program directors, coordinators, and/or department chairs of Commission on Dental Accreditation (CODA)-accredited dental hygiene programs via email in August 2017. A response rate of 27.2% (n=98) was achieved. A large percentage of the respondents (83.3%) included elder abuse training in their program curricula; for most (58.7%), one to three curriculum hours were spent on the topic. A large percentage (89%) agreed the topic was at least somewhat important to include, and 29.5% said a personal or professional elder abuse experience influenced the depth of instruction at their program. Various barriers to inclusion were identified. At least 40% of these educators perceived their graduates to be appropriately competent in their ability to recognize elders' oral neglect (63.5%) and general neglect (48.7%) and to document potential signs of elder abuse (43.8%). Lower percentages perceived that their graduates were competent in the areas of communication regarding elder abuse (21.9%) and reporting suspected abuse (32.4%). Despite rising awareness about elder abuse among dental hygienists and widespread incorporation of the subject in dental hygiene curricula, these results suggest that there are still deficiencies in training. To prepare dental hygiene graduates to confidently recognize and respond to elder abuse, educators should seek to overcome barriers by modifying instruction and embracing interprofessional collaboration.

Cost-effectiveness of a domestic violence and abuse training and support programme in primary care in the real world: updated modelling based on an MRC phase IV observational pragmatic implementation study

ObjectivesTo evaluate the cost-effectiveness of the implementation of the Identification and Referral to Improve Safety (IRIS) programme using up-to-date real-world information on costs and effectiveness from routine clinical practice. A...

Medical students' knowledge, attitudes and behaviours related to substance use in Lebanon: a cross-sectional survey.

The study aims were to explore the knowledge, attitudes and behaviours of Lebanese medical students related to substance use and to determine prevalence and psychosocial predictors. A cross-sectional survey of 231 medical students (48.6% male; 53.1% preclinical, 46.9% clinical) was conducted during June 2012-July 2013. The questionnaire addressed knowledge and attitudes about substance use, religiosity, depression, anxiety and demographic characteristics. The knowledge score was 52.7% (standard deviation 14.4%), and was significantly lower in 2nd year students (48.53%) than in 3rd and 4th year students (57.5% and 57.4%) (P < 0.05). Students reported more training in drug abuse than alcohol abuse (38.2% vs. 34.4%). One-fourth reported smoking, 57.7% using alcohol and 46.8% using drugs. Significant predictors of lower substance use included intrinsic religiosity and interest in working in the field. The findings reveal inadequate knowledge and considerable substance use in Lebanese medical students. Therefore, training in substance use and counseling of students are necessary.

Stewards of children education: Increasing undergraduate nursing student knowledge of child sexual abuse

BackgroundChild sexual abuse and exploitation are an increasing public health problem. In spite of the fact that nurses are in a unique position to identify and intervene in the lives of children suffering from abuse due to their role in providing health care in a variety of settings, nursing curricula does not routinely include this focus. ObjectivesThe goal was to document the effectiveness of the Stewards of Children child sexual abuse training as an effective educational intervention to increase the knowledge level of undergraduate nursing students on how to prevent, recognize, and react responsibly to child sexual abuse and trafficking. DesignUndergraduate nursing students were required to take the Stewards of Children training in their last semester prior to graduation. Data SourcesStudents in the study were given a pre-test prior to the class and a post-test following the class. Review MethodsPre- and post-tests were graded and the results were compared along with an item indicating the participants' perception of the educational intervention in improving their confidence and competence in this area. ResultsData analysis revealed that post-test scores following training were significantly improved: pre-test mean=45.5%; post-test mean score=91.9%. The statistical significance of the improvement was marked, p<0.01, N=119. The mean response for the perceived values scale was 1.65 from a potential score of 2. ConclusionsThis study found a statistically significant increase in the knowledge level of undergraduate nursing students on how to prevent, recognize, and react responsibly to child sexual abuse and trafficking following the Stewards of Children training. Students also reported a high level of confidence in how to prevent abuse and react skillfully when child sexual abuse had occurred. The authors concluded that Stewards of Children is an effective option to educate nursing students on this topic.

Stigma, Learning and Inheritance: An Ecocultural Study of Adaptation and Resource use among Families of Children with Down Syndrome in Thailand

Purpose : This study explored family adjustment and access to rehabilitative services for children with Down syndrome, between 0-5 years of age, in the ecoculture of Petchaburi Province, Thailand. Methods : The study used a family systems genogram in focus group sessions at Pra Chom Klao Hospital, and made home visits to the eight participants from five families in Petchaburi Province, Thailand. Qualitative data collection included field notes, pictures and video recordings of the 7 focus group discussions. The analysis used rigorous procedures for constant comparison, analysis of space, content, domains and critical discourse analysis. Results : Participating families had adjusted to emotional ruptures at home by moving out. They were resilient in the face of health, culture, economic and educational stress. Cultural and religious resources, especially from the mother’s side of the family, contributed most during and after health crises in the first 2 years of childhood. Parents were concerned about seriously delayed development of communication skills when their children were in the 2 ½ - 5 years age group. Parent conviction that the children would be lifelong dependants limited the possibilities for fostering independent living and occupations for these children. Conclusion and Implications: This study contributes to family and community-based rehabilitation strategies, stigma reduction and promotion of early childhood intervention for children with Down syndrome in Thailand. It found moderate public stigma, obstacles in educational transitions and resource use, and limited parental understanding of children’s inheritance and future quality of life. The recommendations made are: better development of family support groups and rehabilitation counselling services, language and communication strategies, abuse training for mothers, and discussion on inheritance rights which offer insight into sibling relations and employability. Service provision can consider reducing hospital stigma, advocacy for inclusive public and work-based play areas, increased support and professional development for community-based counsellors and special education centre extension services.

Radiologists' Training, Experience, and Attitudes About Elder Abuse Detection.

Elder abuse is underrecognized, and identification of subtle cases requires a high index of suspicion among all health care providers. Because many geriatric injury victims undergo radiographic imaging, diagnostic radiologists may be well positioned to identify injury patterns suggestive of abuse. Little is known about radiologists' experience with elder abuse. Our goal was to describe knowledge, attitudes, training, and practice experience in elder abuse detection among diagnostic radiologists. We conducted 19 interviews with diagnostic radiologists at a large urban academic medical center using a semistructured format. Data from these sessions were coded and analyzed to identify themes. Only two radiologists reported any formal or informal training in elder abuse detection. All subjects believed they had missed cases of elder abuse. Even experienced radiologists reported never having received a request from a referring physician to assess images for evidence suggestive of elder abuse. All subjects reported a desire for additional elder abuse training. Also, subjects identified radiographic findings or patterns potentially suggestive of elder abuse, including high-energy injuries such as upper rib fractures, injuries in multiple stages of healing, and injuries inconsistent with reported mechanism. Radiologists are uniquely positioned to identify elder abuse. Though training in detection is currently lacking, providers expressed a desire for increased knowledge. In addition, radiologists were able to identify radiographic findings suggestive of elder abuse. On the basis of these findings, we plan to conduct additional studies to define pathognomonic injury patterns and to explore how to empower radiologists to incorporate detection into their practice.

Former RCN Nurse of the Year to be honoured for her victim abuse training.

Award-winning nurse Amanda Burston, pictured, will be fêted for her work supporting victims of domestic abuse at the Women of the Year lunch in October, an event celebrating women's achievements. 'I am delighted to to be invited on behalf of every victim of abuse,' she said. 'I accept every opportunity to keep this vital conversation going.'

We need abuse training for all.

I support mandatory domestic abuse training for all healthcare workers (news, June 22). I attended an emergency department aft er my ex-partner had att acked me. No one asked if I was okay - it was more a case of clean me up, check for injuries and send me on my way. Clearly, the 6Cs were not implemented during my visit.