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B1           FORENSIC PHOTOGRAPHY OF THE INJURED CHILD: GIVING VICTIMS ANOTHER VOICE – Melissa Peters

Photographs are one of the most convincing and profound ways to document a child’s injuries.

Correct Answer: True

Explanation:
Child’s injuries may change quickly, and memorializing them in photographs is often critical to medical expert review.

B2           CURRENT ISSUES AND TRENDS FOR MEDICAL PROVIDERS IN COURT – Justin Fitzsimmons

Communication and proper preparation between attorney and the medical provider is essential to enhance the delivery of medical testimony.

Correct Answer: True

Explanation:
Whether testifying about physical or sexual abuse the testimony of a medical provider in court often presents pivotal, crucial evidence. Without the proper preparation and communication with the attorney conducting the direct examination of the medical witness court testimony may quickly ride off the rails.

C1           SERIOUS AND FATAL CHILD ABUSE – Emily Killough
According to the US Department of Health and Human Services 2016 Child Maltreatment Report, regarding child fatalities from child maltreatment all of the following are true except (choose one):

Correct Answer: b) Girls had a higher child fatality rate than boys (2.87 per 100,00 versus 2.11 per 100,000).

Explanation:
Child fatality rate is higher for boys (2.87 per 100,000) than girls (2.11 per 100,000).

C2           HOW TO READ MEDICAL LITERATURE – Christopher Greeley
Most medical articles have a standard structure. Which of the following is most reflective of that structure

Correct Answer: d) Background, Materials and Methods, Results, Discussion.

Explanation:
“Most medical research papers have a similar structure. This is often referred to as the IMRaD format. This stands for Introduction, Methods, Results, Discussion. The Introduction is usually one to two paragraphs long. The two most important items within the Introduction will be the background of why the study was undertaken, and a clear articulation of the actual research question. These items are critical for a true appreciation of the paper. If the Introduction does not include a clearly articulated research question (i.e., “We sought to demonstrate…”), it should be taken as a red flag. The most important section of the paper is the Materials and Methods. This is the section that most readers skip or simply scan. Many publishers will unfortunately make the font smaller and offset, as to give the impression that there is nothing important contained within. (I will go into more detail about the Materials and Methods section below). The Results section is the portion of the paper that will display the actual data findings of the study. In this section the reader should find the actual data displayed that the authors collected. Often, articles will have a “Table 1” that shows an overview (demographics, baseline characteristics) of the population studied. Another red flag is if the Results section does not report data that address the research question the authors proposed in the Introduction section of the manuscript. The Discussion section of the paper should be a straightforward description of what the authors believe are the implications of the results of their study. The authors should relate what they believe to be the top “take home messages,” place their results in context of prior publications, suggest future directions of research and describe the limitations of their study. If the authors do not describe the limitation to their results, it should be taken as a red flag as well. Many authors will use the Discussion section to wax philosophically about issues tangential to the focus of the research project. While it may be useful for the authors to place their results in a larger framework, the further a Discussion section wanders from the research question and data presented, the more concerning it is that the manuscript is being used as a platform to promote the author’s personal perspective.”
Taken from: Greeley, C. (2016). "Demystifying the Medical Literature." Acad For Path 6(4): 556-567.

D1           BURNS, BRUISES AND FRACTURES: HOW INJURIES COMMUNICATE HISTORY – Melissa Peters

Patterned burns and bruises may provide information about how and injury occurred.

Correct Answer: True

D2           POSSIBLE IS SELDOM DEFINITE AND ONLY SOMETIMES PROBABLE: COMMUNICATING UNCERTAINTY– Antoinette L. Laskey
There are three primary types of uncertainty that influence medical decision-making. Which of the following correctly is NOT a type of uncertainty?

Correct Answer: b) Institutional Uncertainty

Explanation:
Informational uncertainty is when someone does not have or know the necessary information to answer a question.
There is no such thing as institutional uncertainty
Intrinsic uncertainty is there is information that is not knowable by a person due to complexity, ambiguity or when the baseline probabilities make knowing something difficult or impossible.
Personal uncertainty is when an individual struggles with their ability to know or understand something based on personal beliefs.

E1           WHY I HATE MUNCHAUSEN SYNDROME BY PROXY: WHAT TO DO WHEN CHILD ABUSE OCCURS IN A MEDICAL SETTING – John Stirling
True or False?   The DSM-5 does not include the diagnosis “Munchausen Syndrome by Proxy.

Correct Answer: True

Explanation:
It does not include the diagnosis. It’s now “Factitious Disorder Imposed on Another.”

E2           HIDDEN ABUSE: WHY NEGLECT IS MORE THAN MEETS THE EYE – Ryan Brown
An unplanned pregnancy has been linked to:
Correct Answer: d) A and B
Explanation:
Lack of a paternal desire for a child has been shown to be associated with physical abuse towards the child, whereas maternally, neglect and psychological maltreatment can manifest.

G1          WHY ARE WE NEGLECTING NEGLECT? HOW TO IMPROVE INVESTIGATIONS THROUGH UNDERSTANDING – Ryan Brown
The most common age for abuse is

Correct Answer: a) less than 12 months of age

Explanation:
The most common age for child maltreatment is less than 12 months of age. These children can be very stressful to deal with and thus increase the likelihood of abuse.

G2          OUTSTANDING CHILD ABUSE RESEARCH SELECTIONS (O.S.C.A.R.S) – Stephen Boos, Presented by The Helfer Society and The Quarterly Report
Studies that map abuse rates in space have shown the following
Correct Answer: b) The impact and relative importance of predictor variables change with time and context.
Explanation:
The impact and relative importance of predictor variables change with time and context

H1           MEDICAL ASPECTS OF SEXUAL ABUSE OF CHILDREN AND ADOLESCENTS – Allan De Jong
What is the most important type of evidence in prepubertal sexual abuse or assault cases?

Correct Answer: c) History of the abuse event provided by the child.

Explanation:
Most sexually abused children will not have signs of anal or genital injury, sexually transmitted infections, or any forensic evidence found in an evidence collection kit. Most sexually abused children are not evaluated acutely, and the literature indicates anogenital injury and forensic evidence is very time dependent. Highest likelihood of finding either signs of injury or forensic evidence is when the child is evaluated within the first 24 hours following the abuse. Absence of anogenital injury is both a reflection of the less violent dynamic of prepubertal sexual abuse compared to adolescent sexual assault, and delay in seeking medical care that allows minor injury to heal completely. Some sexually transmitted infections can be important evidence of sexual contact, but infections are found in only a small percentage of sexually abused children. Most sexually abused children disclose their abuse to some adult or other child prior to presenting for investigation. Although this disclosure is an important step in the investigation of suspected abuse, it is often excluded as “hearsay” during legal proceedings. The detailed history of the abuse event is often the only, and therefore the most important evidence prepubertal child abuse cases. The detailed history may be collected and documented by medical professionals, during a forensic interview, or presented in the form of the child’s testimony in the courtroom. Even when other types of evidence are present, the lack of a detailed history of the abuse event from the child may limit the ability to prosecute the case.

H2           DEMONSTRATIVE MODELING IN CHILD ABUSE – Steve Boos, Daniel Vinocur, Presented by The Helfer Society and The Quarterly Report
Technologically based demonstrative aids do which of the following

Correct Answer: d) All of the above.

J1            "GenCAPs"– CAREERS IN CHILD ABUSE PEDIATRICS (FOR THE REST OF US) – Michele Evans, Tricia Tayama
Which of the following are ways GenCAPs can serve their communities?

Correct Answer: e) All of the above.

Explanation:
GenCAPs can serve numerous functions in their communities, including, but not limited to, the ones listed here. Court expertise can be established through one's training and experience, SCAN team coordination can provide a vital link between medical and social services, Child Death Review Teams benefit from medical providers with experience in general pediatrics and child abuse, and forensic medical exams can be performed by many levels of providers with the appropriate training, experience, and oversight. Additionally, GenCAPs can also serve a significant role in consultation to colleagues on suspected child maltreatment cases.

J2            TIMEFRAMES FOR FORENSIC EVIDENCE COLLECTION - WHAT IS THE EVIDENCE? – Allan De Jong
Forensic evidence is less likely to be found in acute sexual assault cases when

Correct Answer: d) When the victim of the assault is prepubertal.

Explanation:
Forensic evidence is more likely present in cases where collections are performed acutely, when collections include clothing worn at the time of or subsequent to the abuse event in addition to body samples, or when the assault involves vaginal penetration. Multiple studies have shown that regardless of the age of the individual, and the type of forensic evidence sought the closer in time to the abuse/assault event the higher the likelihood of finding forensic evidence because normal activities help remove the evidence and degradation of the evidence begins shortly after it is deposited. Evidence on clothing persists for longer duration than evidence within body openings or on body surfaces. This is particularly important in cases involving prepubertal children, but has also been described in the adult literature. The literature indicates evidence persists longer in vaginal samples than in oral or rectal/anal samples, therefore positive samples are more likely present in sexual abuse involving vaginal penetration than oral or anal penetration. DNA evidence processed using Y chromosomal or Y-STR techniques has been shown to persist for longer timeframes and can identify even smaller amounts of DNA in collected samples than evidence processed using nuclear (autosomal) STR techniques. Prepubertal victims in general have a lower rate of positive forensic evidence than adolescents or adults, and an even lower rate of positive samples when the evidence kits are collected more than 24 hours after the event than the older victims.

L1            WE ARE BETTER TOGETHER: CHILD ABUSE PEDIATRICIANS & THE DISTRICT ATTORNEY'S CHILD ABUSE UNIT – Pak Kouch, Sandra Murray
Are child abuse pediatricians, prosecutors, law enforcement, and social workers legally allowed to work together and share information with each other about a child abuse and neglect case as the case unfolds?

Correct Answer: a) Yes.

Explanation:
Yes; California Penal Code section 11166.3(a) and 11167(d)(1) allow law enforcement and public child welfare agencies to work together and share information in child abuse and neglect cases.

L2            FIVE PILLARS THAT BUILD RECOVERY-ORIENTED FOSTER CARE HEALTH CARE – Anu Partap
True or false
Integrated health care should maintain strict guidelines to not share information between professionals in order to protect patient privacy.

Correct Answer: False

Explanation:
Integrated care teams should create a culture, policies, and work flows that allow sharing of information to benefit patient experience, treatment planning, and monitoring that complies with privacy laws and institutional requirements.

M1         MULTIDISCIPLINARY FOSTER CARE CASE REVIEWS: BUILDING A BRIDGE OVER TROUBLED WATERS – Anu Partap
Which of the following factors likely protects the collaborative nature of proceedings of case reviews:

Correct Answer: e) All of the above

M2         FASD AND NAS DIAGNOSIS AND MANAGEMENT IN NEWBORNS AND FAMILIES AFFECTED BY SUBSTANCE USE – Vincent C. Smith
True or False
One can predict which infants will be affected by prenatal alcohol exposure based on the mother’s drinking pattern and the type of alcohol she drank (e.g. beer, wine, liquor, etc.).

Correct Answer: False

Explanation:
Drinking alcohol during pregnancy is one of the leading preventable causes of birth defects, intellectual disabilities, and other developmental disorders in newborns. The more alcohol a woman drinks the higher the risk is for the developing fetus to have alcohol-related brain and organ damage. Binge drinking (having four or more drinks at one time) is the worse pattern of drinking. However, even low to moderate amounts of alcohol can have adverse effects on the developing fetus’s brain and organs.
•              There is no amount of alcohol during pregnancy that is risk-free
•              There is no kind of alcohol during pregnancy that is risk-free
•              There is no time during pregnancy when alcohol consumption is risk-free
Thus, the best advice is to abstain from drinking alcohol while pregnant or trying to become pregnant.

34th Maltreatment Conference Moc 2 Questions