#MeToo reminds health-care providers: trauma survivors carry experiences with them and need 'trauma informed care'

As millions of men and women joined the #MeToo social medial campaign to tell their stories of sexual abuse, harassment or domestic violence, Elizabeth Starr, a licensed clinical social worker, reminded caregivers that people who have had these experiences carry them with them into their health care settings.

In an opinion piece for the Louisville Courier Journal, Starr, who is also WellCare of Kentucky's manager of advocacy and community based programs, wrote: "Most of us know that if someone is in a bad accident, they may be scared to drive. And soldiers who experienced battleground trauma may be anxious during fireworks celebrations. But have you thought about the anxiety a rape victim may feel even years later, sitting alone, in a paper gown, in an exam room – or during the exam itself."

Star noted that health-care providers and others who attended a recent WellCare-sponsored conference learned how to create an environment where everyone is as comfortable as they can be when seeking care.

She used the term "trauma informed care," a phrase she said is used by those who work in mental health care to talk about ways doctors' offices, health clinics and hospitals can learn to recognize the signs of past trauma, understand that those traumas affect current mental and physical health, and to find ways to create a safe environment for everyone who seeks care .

For example, she notes the importance of making sure trauma survivors are comfortable enough to get the routine care everyone needs, like mammograms, pap smears and blood pressure checks: "We must eliminate all the barriers that keep people from these types of screenings - including the discomfort and fear that trauma survivors may feel."

Several Kentucky hospitals are now certified as 'Sexual Assault Nurse Examiner' ready facilities

Three Kentucky hospital systems have become the first in the state to obtain certification that demonstrates their ability to provide 24 hour response for sexual assault victims.

The newly certified "Sexual Assault Nurse Examiner" facilities include all of the St. Elizabeth Hospitals in Northern Kentucky, Fleming County Hospital in Flemingsburg and Meadowview Regional Medical Center in Maysville. They have a SANE nurse on call 24 hours a day, seven days a week.

"This designation demonstrates a commitment to providing a higher standard of care for sexual assault victims by ensuring they will be examined and treated by someone with skills and expertise necessary when dealing with this type of crime. This is certainly step forward for victims' rights in Kentucky," Health Secretary Vickie Yates Brown Glisson said in a news release.

SANE nurses have advanced training in the forensic examination of sexual assault victims and are credentialed by the Kentucky Board of Nursing. The certification was made possible by the "Sexual Assault Forensic Evidence Act," which passed the 2016 General Assembly with bipartisan support. The SAFE Act also addressed the backlog of untested sexual assault evidence kits in the state. Following its passage, Gov. Matt Bevin proposed an additional $4.5 million for the state crime lab to help it meet new testing deadlines set by the bill.

"Making sure sexual assault victims receive quality, compassionate care in the immediate hours following an assault can help them begin the long journey toward healing," Eileen Recktenwald, executive director of the Kentucky Association of Sexual Assault Programs, said in the release. "KASAP commends these hospitals for recognizing the importance of SANE readiness and seeking the certification, and we hope others follow suit."

The state Cabinet for Health and Family Services is required to certify SANE-ready hospitals annually and to post the list on its website. This list is also provided to the Kentucky Board of Emergency Medical Services, which then shares it with local EMS providers.

Is pervasive pornography the newest public-health crisis?

Gail Dines, a professor of sociology at Wheelock College in Boston and author of Pornland: How Porn has Hijacked our Sexuality, argues in an essay for The Washington Post that "porn is a public health crisis rather than a private matter."

The internet has made pornography generally accessible, to the point that porn sites get more visitors than Netflix, Amazon and Twitter combined" (a Huffington Post headline from 2013), some researchers estimate the average age of first viewing porn at 11, and "free and widely available pornography is often violent, degrading and extreme."

Gail Dines

Dines notes studies that have found correlations between porn viewing and sexual harassment and toleration of sexual assault, and that college-age women whose partners use porn "suffered diminished self-esteem, relationship quality and sexual satisfaction."

"As the evidence piles up, a coalition of academics, health professionals, educators, feminist activists and caregivers has decided that they can no longer allow the porn industry to hijack the physical and emotional well-being of our culture," Dines writes. "Culture Reframed, an organization I founded and currently chair, is pioneering a strategy to address porn as the public health crisis of the digital age. We are developing educational programs for parents, youth and a range of professionals that aim to help shift the culture from one that normalizes a pornographic, oppression-based sexuality to one that values and promotes a sexuality rooted in healthy intimacy, mutual care and respect."

Dines concludes, "Parents and educators at every level need to know that if porn is not discussed in a research-based, age-appropriate sexual health curriculum, its effects will surely show up as sexual harassment, dating violence and inadvertent “child pornography” on students’ phones. Pornography can cause lifelong problems if young people are not taught to distinguish between exploitative porn sex and healthy, safe sex. As the research shows, porn is not merely a moral nuisance and subject for culture-war debates. It’s a threat to our public health."

Legislative freshmen's bipartisan bill, now law, lets tax refund to go to pediatric cancer research, or part of it to rape crisis centers

Gov. Steve Beshear held a ceremonial signing Aug. 12 of a bill that creates a option on individual state income-tax returns to divert refunds for the study and treatment of pediatric cancer. “Cancer is the second leading cause of death in children,” Beshear noted.

From 2008-2012, Kentucky had approximately 200 cases each year of cancer among people up to the age of 19, according to the National Cancer Institute.

“This legislation will fuel innovative pediatric cancer research being done here at the University of Kentucky and will directly benefit some of the sickest children in the Commonwealth,” said Dr. Michael Karpf, UK's executive vice president for health affairs. “Thanks to this bill, now all Kentuckians will have the opportunity to advance pediatric cancer research.”

The bill was sponsored by freshman Sen. Max Wise, R-Campbellsville, whose young son is a pediatric cancer survivor. It became law June 24. Wise said he dedicated the bill “to the families who have been affected or are dealing with pediatric cancer,” and called it a testament to legislative bipartisanship.

The bill also allows individuals to designate a portion of their tax refund to a new trust fund to support rape crisis centers, incorporating legislation sponsored by freshman Rep. Chris Harris, D-Forest Hills (Pike County).