Domestic Abuse and Suicide
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| Describe teh scope of domestic violence in our society | 2 to 12 million families; mostly wife abuse
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| risk facors for domestic violence | most common with substance abuse, especially alcohol and crack; occurs in all racial, religoious and socioeconomic groups
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| Explain the cycle of violence (3) | tension building phase; violent phase; honeymoon phase
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| explain teh barriers to women getting out of DV situations | psychological variables: past history of abuse, low self-esteem, to "save" the disturbed man; finances, shelter, children, fear, threats of retaliation, isolation, lack of family and social support, embarrassment, shame, stigma, lack of faith in system
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| Physician responses to DV situations | openings; asking hard questions; non-judgmental; safety planning; know that it takes time; no mandate to report it
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| 3 kinds of domestic abuse | spousal abuse, elder abuse, child abuse
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| Munchausen's Syndrome | mother constantly takes child for medical treatment; sometimes by making the children sick or making them look sick; mother is gratified by the clinic visit and attention
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| What are forms of Child sexual abuse | intercourse, inappropriate touch, forcing teh child to watch pornography, takin gponron pictures, sexually explicit conversations, adult having animals lick children
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| What is child-child sexual experimentation that needs intervention? | oral activity; one much older than the other, if one is mentally challenged, forceful behavior
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| How do children disclose abuse? | in stages similar to death/dying stages; begin tentitavely at first, and reveal once they feel comfortable; many recant their stories after revealing abuse
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| risk factors for child abuse | parents who were abused or were overly punished; premature children; MR; physically disabled; excessive criers; "difficult child" ADHD; views as different, slow, bad, selfish or hard to discipline
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| ARe most child abuse cases reported? | no
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| what happens to most reported child abuse cases? | unsubstantiated adn dropped
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| What sex are most child abuse victims? | women
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| Who are usually the perpertrators of child abuse? | fathers
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| What are the parent risk factors for child abuse? | PHYSICAL ABUSE: more often mother than fathers; one parent isusually the active batterer and the other passively accepts the situation; poor, socially isolated; regularly living in the home; inappropriate expectations of their children
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| what is most common form of incest? | father-daughter
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| what are teh behavioral indicator of child sexual abuse | detailed knowledge of sexual acts, sexualized play, sexual acts with peers
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| what do you do if child abuse is suspected | REPORT IT
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| How should you interview if you suspect abuse? | careful adn not ask overly in-depth questions; are you hurting anywhere in your private places today?
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| When sexual abuse is suspected... how sensitive is physical exam? | only 10%!!!! 90% of sexual abuse exam should be history!
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| Does HIPAA apply with child abuse? | NO
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| How do you analyze veracity of child's presentation? | speaks in a manner consistent; does not sound rehearsed; does not use adult-like phrasing; emotional distress, relucance to reveal; precocious sexual behavioral and knowledge
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| What makes up the Multi-disciplinary Investigative Team? | Police, Prosecuting attorney; child advocacy center; CPS;special advocates; medical professionals
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| Age of censent in WV | 16 but must be 4 years age difference or less
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| common examples of injuries seen in child abuse | bruises or marks that are symmetrical; injury to both sides of face, back or buttocks; bruise with shape of the instrument used; cigarette burns; multiple fractures
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| what kind of fractures in infants are most often from abuse? | fractures in non-ambulatory infoants
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| what is the second most common cuase of child abuse fatality? | abdominal injuries
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| what is the cause of most failure to thrive cases? | psychosocial causes (often from neglect)
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| imperturbability | ability to maintain extreme calm and steadiness
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| equanimity | ability to handle stressful situations with an undisturbed, even temper
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| birth to 4 weeks | hand to mouth; grasping reflex; visual tracking
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| 4 weeks | tonic neck reflex positions predominate; follows moving objects to the midline. visual fixation
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| 16 weeks | follows a slowly moving object well; spontaneous social smile
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| 28 weeks | one hand approach and grasp of toy; takes foot to mouth; starts to imitate mothers sounds
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| 40 weeks | separation anxiety manifest when taken from mother; feeds self cracker and holds own bottle
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| 52 weeks | walks with one hand held; stnds alone briefly
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| 15 months | toddles; creeps up stairs; points or vocalizes wants
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| 18 months | coordinated walking; seldom falls; walks up stairs with one hand held
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| 2 years | runs well; no falling; goes up and down stairs alone
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| 3 years | rides tricycle; unbuttons buttons; feeds self well; understands taking turns
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| 4 years | washes and dries own face; burshes teeth; associative or joint play
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| 5 years | counts 10 objects; dresses and undresses self; plays competitive exercise games
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| 6 years | rides two-wheel bike; prints name; ties shoelaces
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| ADHD | usually have other misbehaving kind of problems... maybe acting out to get under your skin
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| what is the order between median, mode and mean? | mean, median, mode
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| what is the mode on a chart? | top of teh "hill"; value tha tis most representing in the population
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