Race, Healthcare, and Health Disparities: A Critical Review and Recommendations for Advancing Health Equity.

An overwhelming body of evidence points to an inextricable link between race and health disparities in the United States. Although race is best understood as a social construct, its role in health outcomes has historically been attributed to increasingly debunked theories of underlying biological and genetic differences across races. Recently, growing calls for health equity and social justice have raised awareness of the impact of implicit bias and structural racism on social determinants of health, healthcare quality, and ultimately, health outcomes.

From delay to diagnosis: Chronic invasive fungal rhinosinusitis presenting with facial and orbital complications.

Key Clinical Message: Early identification and management of chronic invasive fungal rhinosinusitis (CIFRS) is key to optimizing outcomes. A missed diagnosis can result in permanent vision loss, chronic facial pain, or death. We present a case of CIFRS and literature review.

Intimate Partner Violence and Sexual Violence.

Intimate partner violence and sexual violence represent significant public health challenges that carry many individual and societal costs. More than 1 in 3 women (35.6%) and more than 1 in 4 men (28.

Approach considerations for the management of strangulation in the emergency department.

Patients with a history of strangulation present to the emergency department with a variety of different circumstances and injury patterns. We review the terminology, pathophysiology, evaluation, management, and special considerations for strangulation injuries, including an overview of forensic considerations and legal framework for strangulation events.

Symptoms and Physical Exam Findings in Sexual Assault-related Non-fatal Strangulation.

Objective: Our goal was to investigate the frequency of specific signs and symptoms following sexual assault-related non-fatal strangulation (NFS) and to explore the interaction between assault characteristics and physical exam findings.

Methods: This retrospective observational study included all adults (>18 years) reporting strangulation during sexual assault who presented for a forensic sexual assault exam at one of six urban community hospitals contracted with a single forensic nurse agency. Demographic information, narrative elements, and physical exam findings were abstracted from standardized sexual assault reporting forms.

Between Emergency Department Visits: The Role of Harm Reduction Programs in Mitigating the Harms Associated With Injection Drug Use.

Injection drug use is a major public health problem in the United States. Cocaine, heroin, and methamphetamine are the most commonly injected illicit drugs, whereas opioids are responsible for the majority of overdose fatalities. Although recent emergency department (ED) efforts have focused on expanding capacity for buprenorphine induction for opioid use disorder treatment, the injection of illicit drugs carries specific health risks that require acknowledgment and management, particularly for patients who decline substance use treatment.

Effectiveness of SBIRT for Alcohol Use Disorders in the Emergency Department: A Systematic Review.

Introduction: Alcohol use disorders (AUD) place a significant burden on individuals and society. The emergency department (ED) offers a unique opportunity to address AUD with brief screening tools and early intervention. We undertook a systematic review of the effectiveness of ED brief interventions for patients identified through screening who are at risk for AUD, and the effectiveness of these interventions at reducing alcohol intake and preventing alcohol-related injuries.

Systems Opportunities to Reduce ED Crowding From Nonemergency Referrals.

Emergency department (ED) crowding threatens patient safety and is associated with increased mortality. This study explored the role of nonurgent referrals to the ED in crowding and collaborated on a large quality initiative with the study institution's accountable care organization (ACO) to provide timely alternatives to such referrals. Fifty-two percent of nonemergent ED patients report contacting a medical provider prior to coming to the ED, with 70% of those providers directing the patient to go to the ED.

Workplace violence in emergency medicine: current knowledge and future directions.

Background: Workplace violence (WPV) has increasingly become commonplace in the United States (US), and particularly in the health care setting. Assaults are the third leading cause of occupational injury-related deaths for all US workers. Among all health care settings, Emergency Departments (EDs) have been identified specifically as high-risk settings for WPV.

Reliability of female genital injury detection after sexual assault.

Objective: To establish inter-rater reliability for genital injury detection among experienced forensic sexual assault (SA) examiners.

Methods: Cross-sectional observational study testing inter-rater agreement of injury assessment among eight experienced SA examiners who each viewed 2-4 digital images from 50 cases. Each case was rated by 4 examiners and included images before and after toluidine blue dye application.

Sexual assault.

Sexual assault is a problem that permeates all socioeconomic classes and impacts hundreds of thousands in the United States and millions worldwide. Most victims do not report the assault; those that do often present to an emergency department. Care must encompass the patients' physical and emotional needs.

Sexual assault nurse examiners' application of statutory rape reporting laws.

Introduction: The objective of this study was to compile a list of current state laws that mandate medical providers' reporting of statutory rape and assess the subjective interpretation of such laws by sexual assault nurse examiners (SANEs) throughout the country.

Methods: We contacted an SANE representative from each state by use of the International Association of Forensic Nurses' Web site to obtain information on his or her interpretation of the respective state's statutory rape reporting laws. We compared current state laws and SANE interpretation of such laws with legal interpretation of state laws 5 years previously.

Impact of participation in a community-based intimate partner violence prevention program on medical students: a multi-center study.

Background: Physicians are generally poorly trained to recognize, treat or refer adolescents at risk for intimate partner violence (IPV). Participation in community programs may improve medical students' knowledge, skills, and attitudes about IPV prevention.

Objective: To determine whether the experience of serving as educators in a community-based adolescent IPV prevention program improves medical students' knowledge, skills, and attitudes toward victims of IPV, beyond that of didactic training.

Validation set correlates of anogenital injury after sexual assault.

Objectives: Forensic investigators remain unsure exactly why some sexual assault victims display acute injury while others do not. This investigation explores potential reasons for these differential findings among female victims.

Methods: This cross-sectional analysis examined data from consecutive female sexual assault victims, at least 12 years old, who agreed to a forensic exam between November 1, 2002, and November 30, 2006.