Barbara Girardin - Academia.edu (original) (raw)

Papers by Barbara Girardin

The Physician and Sportsmedicine, 1986

Journal of Pediatric and Adolescent Gynecology, 2001

Objective: To document the frequency and types of genital injuries in adolescent women examined a... more Objective: To document the frequency and types of genital injuries in adolescent women examined acutely following a sexual assault, and determine any historical correlates of injury. Design: Retrospective chart review. Setting: Sexual Assault Response Team services at a community hospital in an urban setting. Patients: All female patients aged 14-19 yr who were referred by law enforcement for an acute sexual assault examination and were examined between May 1994 and May 1999. Outcome Measures: The frequency of signs of genital trauma at various anal and genital sites, as recorded by the examining clinician. Results: Charts of 214 female subjects (mean age 16.3 yr) were reviewed. The most common findings were posterior fourchette tear (36%); erythema of the labia minora, hymen, cervix, or posterior fourchette (18%-32%); and swelling of the hymen (19%). Time to examination was highly correlated with the degree of injury noted (P ϭ .000). The incidence of hymenal tears in self-described virgins was higher than in nonvirgins (19% vs. 3%, P ϭ .008); however, the total number or severity of other injuries was not significantly higher in virgins. Victims reporting anal penetration had a higher frequency of anal injuries than those who denied such contact (14/31, 61% vs. 2/150, 1%; P ϭ .000). Conclusions: Tears of the posterior fourchette or fossa were the most common findings (40%). Hymenal tears were uncommon, even in self-described virginal girls. Timely examination of adolescent victims is important to document injuries; however, many victims will still not have signs of bruising, abrasions, or tears.

Journal of Pediatric and Adolescent Gynecology, 2000

ABSTRACT The purpose of this study was to test the hypothesized relationship that neonates experi... more ABSTRACT The purpose of this study was to test the hypothesized relationship that neonates experiencing lower frequency (LF) lighting would have less sleepwakefulness frequency than neonates experiencing higher frequency (HF) lighting. Also described was sleepwakefulness frequency in neonates across three sleep periods when lighting was changed from standard nursery lighting to LF or HF and then back to standard lighting.^ Sleepwakefulness data were collected from 100 male and female, Hispanic neonates from 6.1 hours to 5.4 days of age in a well-baby nursery of a County Hospital. A two factor repeated measures experimental design was used, having LF or HF as the two levels of the grouping factor. Three sleep periods of approximately 2 1/2 hours each were the levels of the repeated measures factor. The dependent variable, sleepwakefulness frequency was based on observations from Thoman's (1985) Sleepwakefulness Instrument for clinical research. Comparable groups of 50 each, resulted from random assignment.^ The hypothesis was supported as evidenced by a significant group by sleep period linear interaction, ttt(1) = −-−2.169, $\rho

Normal Anatomy and the Human Sexual Response * Findings in Sexual Assault and in Consensual Inter... more Normal Anatomy and the Human Sexual Response * Findings in Sexual Assault and in Consensual Intercourse * Findings that Result from Non-assault Injury, Infection, and Other Non-assault Variations * Care of the Sexual Assault Patient * Analysis of Four Cases * Guidelines for Giving Effective Testimony * Appendixes * A. Myths and the Reality of Sexual Assault * B. Resources for Patient Self-Help * C. Follow-Up Care Instructions: A Model * D. Highlights of the Medical-Legal Examination * E. OCJP 923 Medical-Legal Report for Suspected Acute Adult/Adolescent Assault * F. Sexual Assault Follow-Up Examination Form * G. Resources for the Examiner * Glossary of Terms Related to Sexual Assault

S exual violence represents a large public health problem across the globe. Sexual violence is de... more S exual violence represents a large public health problem across the globe. Sexual violence is defined as any sexual act, attempt to obtain a sexual act, unwanted sexual comments or advances, or acts to traffic, or [acts] otherwise directed, against a person's sexuality using coercion, by any person regardless of their relationship to the victim, in any setting, including but not limited to home and work.

Journal of Emergency Nursing, 2002

B ethany, a 1-year-old girl, was brought to the emergency department by her mother, who noticed r... more B ethany, a 1-year-old girl, was brought to the emergency department by her mother, who noticed reddish-brown raised marks on Bethany's chest and abdomen ( ) during the child's morning bath. Her mother thought the marks were stains or dye acquired at day care the previous day, but the marks did not wash off. There did not appear to be any stains or dye on the sleeper that Bethany was wearing when she returned from day care. The mother called the day care facility and asked about the marks, but Bethany's provider had gone home for the weekend. The provider said that no other parents had reported seeing such marks on their children.

Advanced emergency nursing journal

... Palomar Pomerado Health, Forensic Health Services, Escondido, Calif. Corresponding author: Ba... more ... Palomar Pomerado Health, Forensic Health Services, Escondido, Calif. Corresponding author: Barbara W. Girardin, MSN, PhD, RN, CCRN, SANE, Palomar Pomerado Health, Forensic Health Services, 121 N Fig St, Escondido, CA 92025 (e-mail: dbgirardin@ispwest.com). ...

The purpose of this study was to test the hypothesized relationship that neonates experiencing lo... more The purpose of this study was to test the hypothesized relationship that neonates experiencing lower frequency (LF) lighting would have less sleepwakefulness frequency than neonates experiencing higher frequency (HF) lighting. Also described was sleepwakefulness frequency in neonates across three sleep periods when lighting was changed from standard nursery lighting to LF or HF and then back to standard lighting.^ Sleepwakefulness data were collected from 100 male and female, Hispanic neonates from 6.1 hours to 5.4 days of age in a well-baby nursery of a County Hospital. A two factor repeated measures experimental design was used, having LF or HF as the two levels of the grouping factor. Three sleep periods of approximately 2 1/2 hours each were the levels of the repeated measures factor. The dependent variable, sleepwakefulness frequency was based on observations from Thoman's (1985) Sleepwakefulness Instrument for clinical research. Comparable groups of 50 each, resulted from ...

Holistic Nursing Practice, 1992

Journal of Pediatric and Adolescent Gynecology, 2000

Advanced emergency nursing journal

ABSTRACT

Journal of Pediatric and Adolescent Gynecology, 2001

Objective: To document the frequency and types of genital injuries in adolescent women examined a... more Objective: To document the frequency and types of genital injuries in adolescent women examined acutely following a sexual assault, and determine any historical correlates of injury.Design: Retrospective chart review.Setting: Sexual Assault Response Team services at a community hospital in an urban setting.Patients: All female patients aged 14–19 yr who were referred by law enforcement for an acute sexual assault examination and were examined between May 1994 and May 1999.Outcome Measures: The frequency of signs of genital trauma at various anal and genital sites, as recorded by the examining clinician.Results: Charts of 214 female subjects (mean age 16.3 yr) were reviewed. The most common findings were posterior fourchette tear (36%); erythema of the labia minora, hymen, cervix, or posterior fourchette (18%–32%); and swelling of the hymen (19%). Time to examination was highly correlated with the degree of injury noted (P = .000). The incidence of hymenal tears in self-described virgins was higher than in nonvirgins (19% vs. 3%, P = .008); however, the total number or severity of other injuries was not significantly higher in virgins. Victims reporting anal penetration had a higher frequency of anal injuries than those who denied such contact (14/31, 61% vs. 2/150, 1%; P = .000).Conclusions: Tears of the posterior fourchette or fossa were the most common findings (40%). Hymenal tears were uncommon, even in self-described virginal girls. Timely examination of adolescent victims is important to document injuries; however, many victims will still not have signs of bruising, abrasions, or tears.

Journal of Pediatric and Adolescent Gynecology, 2000

Background: Adolescent females are the most frequent victims of sexual assault, but studies to do... more Background: Adolescent females are the most frequent victims of sexual assault, but studies to document the presence of genital findings in patients examined within 72 hours, using magnification and dye, have not been published. This study was designed to document the frequency and types of genital injuries in adolescent women following acute sexual assault, using chart and photograph review.Methods: A retrospective chart review was done of examination records of all female patients age 14 to 19 years of age who were evaluated at a Sexual Assault Response Team program over a 5 year period. Data was abstracted from charts by the nurse examiners, and photographs were evaluated by the physician reviewer. Analysis was done to determine the frequency, location, and severity of genital and anal injuries, and any historical factors correlating with injury, using Pearson correlation and two-tailed t tests.Results: Charts of 214 female subjects (mean age 16.3 years) were reviewed. The most common findings recorded by the nurse examiner were posterior fourchette tear (36%), erythema of the labia minora, hymen, cervix or posterior fourchette (18% to 32%), and swelling of the hymen (19%). Uptake of Toluidine dye was noted in 66% of patients in whom it was applied. Overall, 21% of patients were found to have no findings, and 40% had tears of the posterior fourchette or fossa. Time to examination was highly correlated with the degree of injury noted (p = .000). The incidence of hymenal tears in self-described virgins was higher than in non-virgins (19% vs. 3%, p = .008), however the total number or severity of other injuries was not significantly higher in virgins. Reported anal penetration was associated with a high frequency of anal bruising, abrasions or tears (14/23, 61%), while only 2/150 victims who denied anal penetration had tears (1%, p = .000). Victims who reported multiple physical symptoms such as pain, nausea, or vomiting were significantly more likely to be older (p = .034) and to have an increased number of non-genital injuries such as bruising, abrasions, and bite marks (p = .001). A higher number of non-genital injuries was also correlated with a higher number of total genital injuries (p = .003).Conclusions: Adolescent victims of sexual assault who were examined within 72 hours, using a magnification and dye were found to have tears of the posterior fourchette or fossa in 40% of cases. Hymenal tears were rare, even in self-described virginal girls. Timely examination of adolescent victims is important to document injuries, however, many victims will still have non-specific examination findings.

The Physician and Sportsmedicine, 1986

Journal of Pediatric and Adolescent Gynecology, 2001

Objective: To document the frequency and types of genital injuries in adolescent women examined a... more Objective: To document the frequency and types of genital injuries in adolescent women examined acutely following a sexual assault, and determine any historical correlates of injury. Design: Retrospective chart review. Setting: Sexual Assault Response Team services at a community hospital in an urban setting. Patients: All female patients aged 14-19 yr who were referred by law enforcement for an acute sexual assault examination and were examined between May 1994 and May 1999. Outcome Measures: The frequency of signs of genital trauma at various anal and genital sites, as recorded by the examining clinician. Results: Charts of 214 female subjects (mean age 16.3 yr) were reviewed. The most common findings were posterior fourchette tear (36%); erythema of the labia minora, hymen, cervix, or posterior fourchette (18%-32%); and swelling of the hymen (19%). Time to examination was highly correlated with the degree of injury noted (P ϭ .000). The incidence of hymenal tears in self-described virgins was higher than in nonvirgins (19% vs. 3%, P ϭ .008); however, the total number or severity of other injuries was not significantly higher in virgins. Victims reporting anal penetration had a higher frequency of anal injuries than those who denied such contact (14/31, 61% vs. 2/150, 1%; P ϭ .000). Conclusions: Tears of the posterior fourchette or fossa were the most common findings (40%). Hymenal tears were uncommon, even in self-described virginal girls. Timely examination of adolescent victims is important to document injuries; however, many victims will still not have signs of bruising, abrasions, or tears.

Journal of Pediatric and Adolescent Gynecology, 2000

ABSTRACT The purpose of this study was to test the hypothesized relationship that neonates experi... more ABSTRACT The purpose of this study was to test the hypothesized relationship that neonates experiencing lower frequency (LF) lighting would have less sleepwakefulness frequency than neonates experiencing higher frequency (HF) lighting. Also described was sleepwakefulness frequency in neonates across three sleep periods when lighting was changed from standard nursery lighting to LF or HF and then back to standard lighting.^ Sleepwakefulness data were collected from 100 male and female, Hispanic neonates from 6.1 hours to 5.4 days of age in a well-baby nursery of a County Hospital. A two factor repeated measures experimental design was used, having LF or HF as the two levels of the grouping factor. Three sleep periods of approximately 2 1/2 hours each were the levels of the repeated measures factor. The dependent variable, sleepwakefulness frequency was based on observations from Thoman's (1985) Sleepwakefulness Instrument for clinical research. Comparable groups of 50 each, resulted from random assignment.^ The hypothesis was supported as evidenced by a significant group by sleep period linear interaction, ttt(1) = −-−2.169, $\rho

Normal Anatomy and the Human Sexual Response * Findings in Sexual Assault and in Consensual Inter... more Normal Anatomy and the Human Sexual Response * Findings in Sexual Assault and in Consensual Intercourse * Findings that Result from Non-assault Injury, Infection, and Other Non-assault Variations * Care of the Sexual Assault Patient * Analysis of Four Cases * Guidelines for Giving Effective Testimony * Appendixes * A. Myths and the Reality of Sexual Assault * B. Resources for Patient Self-Help * C. Follow-Up Care Instructions: A Model * D. Highlights of the Medical-Legal Examination * E. OCJP 923 Medical-Legal Report for Suspected Acute Adult/Adolescent Assault * F. Sexual Assault Follow-Up Examination Form * G. Resources for the Examiner * Glossary of Terms Related to Sexual Assault

S exual violence represents a large public health problem across the globe. Sexual violence is de... more S exual violence represents a large public health problem across the globe. Sexual violence is defined as any sexual act, attempt to obtain a sexual act, unwanted sexual comments or advances, or acts to traffic, or [acts] otherwise directed, against a person's sexuality using coercion, by any person regardless of their relationship to the victim, in any setting, including but not limited to home and work.

Journal of Emergency Nursing, 2002

B ethany, a 1-year-old girl, was brought to the emergency department by her mother, who noticed r... more B ethany, a 1-year-old girl, was brought to the emergency department by her mother, who noticed reddish-brown raised marks on Bethany's chest and abdomen ( ) during the child's morning bath. Her mother thought the marks were stains or dye acquired at day care the previous day, but the marks did not wash off. There did not appear to be any stains or dye on the sleeper that Bethany was wearing when she returned from day care. The mother called the day care facility and asked about the marks, but Bethany's provider had gone home for the weekend. The provider said that no other parents had reported seeing such marks on their children.

Advanced emergency nursing journal

... Palomar Pomerado Health, Forensic Health Services, Escondido, Calif. Corresponding author: Ba... more ... Palomar Pomerado Health, Forensic Health Services, Escondido, Calif. Corresponding author: Barbara W. Girardin, MSN, PhD, RN, CCRN, SANE, Palomar Pomerado Health, Forensic Health Services, 121 N Fig St, Escondido, CA 92025 (e-mail: dbgirardin@ispwest.com). ...

The purpose of this study was to test the hypothesized relationship that neonates experiencing lo... more The purpose of this study was to test the hypothesized relationship that neonates experiencing lower frequency (LF) lighting would have less sleepwakefulness frequency than neonates experiencing higher frequency (HF) lighting. Also described was sleepwakefulness frequency in neonates across three sleep periods when lighting was changed from standard nursery lighting to LF or HF and then back to standard lighting.^ Sleepwakefulness data were collected from 100 male and female, Hispanic neonates from 6.1 hours to 5.4 days of age in a well-baby nursery of a County Hospital. A two factor repeated measures experimental design was used, having LF or HF as the two levels of the grouping factor. Three sleep periods of approximately 2 1/2 hours each were the levels of the repeated measures factor. The dependent variable, sleepwakefulness frequency was based on observations from Thoman's (1985) Sleepwakefulness Instrument for clinical research. Comparable groups of 50 each, resulted from ...

Holistic Nursing Practice, 1992

Journal of Pediatric and Adolescent Gynecology, 2000

Advanced emergency nursing journal

ABSTRACT

Journal of Pediatric and Adolescent Gynecology, 2001

Objective: To document the frequency and types of genital injuries in adolescent women examined a... more Objective: To document the frequency and types of genital injuries in adolescent women examined acutely following a sexual assault, and determine any historical correlates of injury.Design: Retrospective chart review.Setting: Sexual Assault Response Team services at a community hospital in an urban setting.Patients: All female patients aged 14–19 yr who were referred by law enforcement for an acute sexual assault examination and were examined between May 1994 and May 1999.Outcome Measures: The frequency of signs of genital trauma at various anal and genital sites, as recorded by the examining clinician.Results: Charts of 214 female subjects (mean age 16.3 yr) were reviewed. The most common findings were posterior fourchette tear (36%); erythema of the labia minora, hymen, cervix, or posterior fourchette (18%–32%); and swelling of the hymen (19%). Time to examination was highly correlated with the degree of injury noted (P = .000). The incidence of hymenal tears in self-described virgins was higher than in nonvirgins (19% vs. 3%, P = .008); however, the total number or severity of other injuries was not significantly higher in virgins. Victims reporting anal penetration had a higher frequency of anal injuries than those who denied such contact (14/31, 61% vs. 2/150, 1%; P = .000).Conclusions: Tears of the posterior fourchette or fossa were the most common findings (40%). Hymenal tears were uncommon, even in self-described virginal girls. Timely examination of adolescent victims is important to document injuries; however, many victims will still not have signs of bruising, abrasions, or tears.

Journal of Pediatric and Adolescent Gynecology, 2000

Background: Adolescent females are the most frequent victims of sexual assault, but studies to do... more Background: Adolescent females are the most frequent victims of sexual assault, but studies to document the presence of genital findings in patients examined within 72 hours, using magnification and dye, have not been published. This study was designed to document the frequency and types of genital injuries in adolescent women following acute sexual assault, using chart and photograph review.Methods: A retrospective chart review was done of examination records of all female patients age 14 to 19 years of age who were evaluated at a Sexual Assault Response Team program over a 5 year period. Data was abstracted from charts by the nurse examiners, and photographs were evaluated by the physician reviewer. Analysis was done to determine the frequency, location, and severity of genital and anal injuries, and any historical factors correlating with injury, using Pearson correlation and two-tailed t tests.Results: Charts of 214 female subjects (mean age 16.3 years) were reviewed. The most common findings recorded by the nurse examiner were posterior fourchette tear (36%), erythema of the labia minora, hymen, cervix or posterior fourchette (18% to 32%), and swelling of the hymen (19%). Uptake of Toluidine dye was noted in 66% of patients in whom it was applied. Overall, 21% of patients were found to have no findings, and 40% had tears of the posterior fourchette or fossa. Time to examination was highly correlated with the degree of injury noted (p = .000). The incidence of hymenal tears in self-described virgins was higher than in non-virgins (19% vs. 3%, p = .008), however the total number or severity of other injuries was not significantly higher in virgins. Reported anal penetration was associated with a high frequency of anal bruising, abrasions or tears (14/23, 61%), while only 2/150 victims who denied anal penetration had tears (1%, p = .000). Victims who reported multiple physical symptoms such as pain, nausea, or vomiting were significantly more likely to be older (p = .034) and to have an increased number of non-genital injuries such as bruising, abrasions, and bite marks (p = .001). A higher number of non-genital injuries was also correlated with a higher number of total genital injuries (p = .003).Conclusions: Adolescent victims of sexual assault who were examined within 72 hours, using a magnification and dye were found to have tears of the posterior fourchette or fossa in 40% of cases. Hymenal tears were rare, even in self-described virginal girls. Timely examination of adolescent victims is important to document injuries, however, many victims will still have non-specific examination findings.