Trauma- and Violence-Informed Empowering Care for Sexual Assault Survivors.

BACKGROUND: Forensic nurse examiners, including sexual assault nurse examiners, provide care for survivors holistically through healthcare, emotional support, connection to follow-up care, safety planning, and, if desired, evidence collection to aid in the prosecution of sexual assault. There is increasing recognition that trauma-informed care must also include an understanding of the impacts of structural violence on minoritized patients to ensure health equity. AIM: To help address this guidance gap, we expanded Campbell and colleagues' empowering care model using a trauma- and violence-informed care (TVIC) lens. METHODS: We used an iterative discussion-based process that included five joint meetings between a seven-member transdisciplinary research team and a five-member nurse advisory board. RESULTS: In a TVIC-informed empowering care model, we propose behavioral examples for forensic nurses for each of Campbell et al.'s five key domains of empowering care for forensic nurse examinations (i.e., build rapport and establish trust, show compassion, provide patient-directed care, convey professionalism, and provide resource referral and follow-up). CONCLUSIONS: These behavioral examples for nurses can help guide forensic nurse training and practice to reduce disparities in treatment and follow-up support. Structures and systems are needed that enable forensic nurses to provide trauma- and violence-informed empowering care to survivors of sexual assault and, over time, increase the accessibility of forensic nurse examinations and improve patient outcomes.

Campus interpersonal violence survivor advocacy services.

Objective: Although there has been increased attention to campus interpersonal violence, there is limited information on survivor advocacy services. Participants: We recruited participants from 155 U.S. institutions of higher education responsible for advocacy services on their campus. Methods: We used a community participatory action approach in partnership with the Campus Advocacy and Prevention Professionals Association to develop and disseminate a survey regarding campus advocacy services. Results: Participants shared critical insights about (a) advocacy staffing/caseload, (b) program structure, (c) advocacy practices, and (d) connection to services for people who had caused harm. We found that advocacy programs are often providing best practice services for survivors of violence but operating with few staff and unclear privacy protections. Conclusions: This study provided crucial preliminary information about how campuses provide advocacy services, but more researcher-practitioner engagement is needed to build on this study and establish clear practice guidelines.

A Scoping Review of Human Trafficking Screening and Response.

Service providers are increasingly asked to identify individuals who are experiencing trafficking and to connect them with resources and support. Nonetheless, identification is complicated by the reality that those who are experiencing trafficking may rarely self-identify, and providers may fail to identify individuals who are experiencing trafficking due to lack of guidance on how to screen for trafficking capably and sensitively. With the aim of guiding practice, we undertook a scoping review to search for and synthesize trafficking screening tools and response protocols. Following the PRISMA extension for Scoping Reviews (PRISMA-ScR), we located 22 screening tools contained in 26 sources. We included any documents that described or tested human trafficking screening tools, screening or identification protocols, response protocols, or guidelines that were published in any year. All documents were abstracted using a standardized form. Key findings showed that most tools were developed by practice-based and non-governmental organizations located in the U.S. and were administered in the U.S. Few screening tools have been rigorously evaluated. The common types of screening questions and prompts included (a) work conditions; (b) living conditions; (c) physical health; (d) travel, immigration, and movement; (e) appearance and presentation; (f) mental health, trauma, and substance abuse; (g) associations and possessions; and (h) arrests and prior involvement with law enforcement. We were not able to locate specific response protocols that provided step-by-step guidance. Nonetheless, the review revealed available practice-based and research-based evidence to help inform guidance concerning how screening and identification of human trafficking may be administered.

Sexual and Relationship Violence Among LGBTQ+ College Students: A Scoping Review.

Although there has been increased attention to campus sexual and relationship violence (SRV) because of Title IX and the #MeToo movement, much of that attention has focused on victimization of cisgender heterosexual women. This scoping review uncovers information from empirical studies on what is known about LGBTQ+ (e.g., lesbian, gay, bisexual, transgender, queer, and nonbinary) students' experiences of campus SRV. Using rigorous scoping review methods (i.e., searches of 15 databases, searches of expert websites, hand searching, reference harvesting, and forward citation chaining), we identified 60 documents published since 2000 that contained findings from empirical studies related to LGBTQ+ students and SRV on U.S. college and university campuses. Through content analysis, we summarized findings around five key themes: (1) extent and types of victimization, (2) negative outcomes, (3) knowledge of and attitudes about SRV, (4) perspectives on SRV services and prevention education programs, and (5) recommendations from study authors based on their findings. Implications for research, practice, and policy based on these findings are discussed.

LGBTQ+-Affirming Campus Sexual and Relationship Violence Prevention: A Qualitative Study.

LGBTQ+ (e.g., lesbian, gay, bisexual, transgender, nonbinary, queer) people are often left out of campus sexual and relationship violence (SRV) prevention efforts despite experiencing higher rates of SRV. To inform LGBTQ+-affirming prevention efforts, we use a practice-to-research approach to aggregate wisdom from 32 LGBTQ+ professionals working to address campus SRV among LGBTQ+ college students garnered through semi-structured interviews. Participants shared four approaches to including or excluding LGBTQ+ students in campus SRV prevention programs as well as recommendations to cultivate more LGBTQ+-affirming campus SRV prevention efforts. We summarize recommendations for possible action steps at individual, relationship, community, and policy levels of the social ecological model for LGBTQ+-affirming campus SRV prevention.

Alcohol's Role in Campus Sexual Assault Bystander Behavior: A Systematic Review.

Between 50% and 70% of campus sexual assaults (SA) involve alcohol and campuses frequently promote bystander intervention strategies to prevent SA in student party contexts. This systematic review evaluates the measurement and outcomes of quantitative studies on how alcohol affects campus SA bystander outcomes. Using four search strategies and rigorous systematic review methods, we conducted a review of 36 studies. We included studies published after 2,000 conducted with college students in the United States, its territories, and Canada which contained information on alcohol use and SA bystander outcomes (behaviors and upstream proxies). Only a third of included studies measured bystander behavior directly, the majority measured upstream proxies (e.g., intentions, self-efficacy). Most studies considered the influence of victim intoxication on bystander outcomes. No studies assessed the pharmacological or physiological effects of alcohol on bystander outcomes. A single study examined hypothetical bystander responses when intoxicated, one-third examined bystander's typical alcohol use in relation to bystander outcomes. Many findings are contradictory, including fundamental details such as how often students encounter SA involving alcohol or whether bystanders' alcohol use predicts outcomes. Findings suggest that students are less likely help intoxicated victims compared to sober victims, but there are clear moderating factors. Perpetrator intoxication was not studied in relation to bystander behavior and did not influence any upstream proxies. Evaluations of interventions on alcohol and bystander topics are promising yet more research is required. This review illuminates key gaps in the literature, including the need for validated measures and scenarios, event-level studies, and alcohol administration trials.

Introduction to the Special Issue on Common Goals, Different Needs: Improving Communication and Collaboration Between Researchers and Practitioners to End Interpersonal Violence.

Rates of interpersonal violence have largely remained stagnant over the past three decades, despite the magnitude of prevention and response efforts to address this issue. Although interpersonal violence researchers have stressed the importance of partnerships between researchers and campus and community-based practitioners, there is still a disconnect between the work done by researchers and those engaged in direct practice in the field. This special issue brings together researchers and practitioners to explore a variety of challenges and successes in identifying common goals, building relationships, and improving strategies for addressing interpersonal violence using researcher-practitioner models.

Intimate Partner Violence Survivors' Housing Needs and Preferences: A Brief Report.

Intimate partner violence (IPV) victimization contributes to homelessness and housing insecurity for survivors and their children. Despite growing interest in expanding strategies for addressing the housing needs of survivors, there is a dearth of knowledge regarding survivors' preferences and recommendations. To begin to address knowledge gaps, this article reports findings from a qualitative study examining the housing needs of IPV survivors and survivors' preferences and recommendations for addressing their housing needs. In-depth interviews with 19 adult IPV survivors in a southeastern community determined three key themes: (a) IPV housing needs and challenges, (b) domestic violence shelter strengths and concerns, and (c) recommendations for addressing survivors' housing needs. The findings highlight the need for flexibility and variability in housing services as opposed to a one-size-fits-all strategy, and stress the importance of centering the voices of survivors as the field explores new housing directions.

Addressing alcohol's role in campus sexual assault: Prevention educator perspectives.

OBJECTIVE: Alcohol use is implicated in 50 to 70% of campus sexual assaults (CSA). Despite research, practice, and policy guidance that campus prevention efforts should address alcohol's role in CSA, there is limited guidance for prevention educators and administrators on how to actually do so. Participants: Campus-based sexual assault prevention educators (n = 23) were recruited between May and July 2017 from the Campus Advocacy and Prevention Professionals Association (CAPPA) listserv using purposive sampling. Methods: A qualitative study design using a critical feminist participatory action approach was used to conduct in-depth semi-structured phone interviews. Results: Participants described six key steps forward to address alcohol's role in CSA (a) proactivity; (b) consistency; (c) nuance; (d) equity; and (e) authenticity. Conclusions: To address alcohol's role in CSA, prevention educators need (a) concrete messaging, (b) evidence-based interventions, and (c) evaluation of campus culture change efforts.

Housing Interventions for Intimate Partner Violence Survivors: A Systematic Review.

Intimate partner violence (IPV) survivors are much more likely to experience housing insecurity or homelessness than those who have not experienced IPV. However, little comprehensive research has evaluated the effectiveness of interventions used to address IPV survivors' housing insecurity. To address this knowledge gap, our team conducted a systematic review guided by three questions: (a) What are current interventions for addressing IPV survivors' housing needs? (b) What are the methodological strengths and limitations of the research evaluating those interventions? (c) How effective are the identified interventions? We identified potentially relevant peer-reviewed and gray literature using variations of predetermined search terms and four search methods. Twelve articles met inclusion criteria. Accordingly, this study showed that there is an overall dearth of research concerning interventions that address IPV survivors' housing insecurity and needs. Shelter is the most commonly assessed and available housing intervention for IPV survivors, but only limited empirical evaluation is available of shelter effectiveness. In addition, findings indicate both traditional shelter services and innovative interventions (e.g., rapid rehousing, flexible funding) would benefit from rigorous evaluation including examining survivor and situation characteristics contributing to housing strategy effectiveness.

Sexual Harassment of College and University Students: A Systematic Review.

Increased attention to Title IX and the #MeToo movement has led to more interest in developing strategies to prevent forms of gender-based violence beyond acquaintance rape, including sexual harassment (SH). This study reviewed the extant literature published since 2000 on SH of college/university students (n = 24) to determine (a) study methods, (b) sample sociodemographic characteristics, (c) prevalence, (d) risk and protective factors, and (e) consequences of campus SH. These studies shared the view that overall SH rates are high, but their findings were difficult to cross-evaluate due to variations in their study designs. Generally, unwanted sexual attention and gender harassment were more commonly experienced in campus SH occurrences than sexual coercion. Findings indicated that being White, a woman, or a sexual minority increased a student's likelihood of experiencing SH while at a college/university. Student SH survivors rarely filed official reports but often faced a variety of mental and physical health consequences. Women of color experienced lower rates of SH but more severe consequences in the aftermath. This review concludes by detailing several implications for future research, as well as possible campus SH prevention, intervention, and policy protocols.

Leveraging Data to Strengthen Campus Sexual Assault Policies.

The U.S. Department of Education recently announced that existing legislation and guidance on campus sexual assault (CSA) policies had created a "failed system" in institutions of higher education. This announcement raises the question of how CSA legislation and guidance should be evaluated and applied in practice. We believe researchers are well situated to not only leverage data and empirically evaluate the success (or failure) of CSA federal and university policies but also to facilitate development of improved, more effective CSA policy. This commentary first chronicles the pivotal role of federal policy and guidance in driving the collection of CSA data and increasing research efforts in this domain. Second, we present recommendations for increased collaboration among researchers, practitioners, and policy makers aimed at measuring the effectiveness of current CSA policies and promoting data-driven policy. These recommendations focus on (a) establishing a CSA data repository, (b) analyzing existing CSA data to gain knowledge and identify opportunities for improved data collection, and

Long and medium chain triglycerides increase plasma concentrations of ketone bodies in suckling rats.

The potential of medium chain triglyceride (MCT) and long chain triglyceride (LCT) as sources of plasma ketones was investigated in suckling rats. Initially high concentrations of plasma ketones in 6-, 10, and 17-day-old rats increased 2- to 3-fold after acute feeding of MCT. This feeding had the same effect in fed or fasted adult rats. Corn oil (as a source of LCT) induced a large increase in the plasma ketone concentration of suckling rats and a relatively small but significant increase in fasted adult rats. The LCT treatment did not affect plasma ketone levels in fed adult rats. The results show clearly that feeding either LCT or MCT will enhance hyperketonemia in suckling rats. In the livers of all animals, regardless of age, the capacity for incorporation of [1(-14C)]octanoate into CO2 and acetoacetate far exceeded that for [1(-14C)]palmitate. The hyperketonemic action of LCT in suckling rats was accompanied by an increased activity of carnitine palmityltransferase and increased level of carnitine.