Rape Prevention in Arizona

 

 

Rape Prevention in Arizona

 

by Dawn Pisturino

Abstract

Social services in Arizona are concentrated mainly in the Phoenix area.  Outlying areas may or may not have sufficient services.  In Mohave County, for example, domestic and sexual violence services are geared largely toward families and domestic violence.  Few services exist specific to rape prevention.  In fact, the nearest actual rape center is located in Flagstaff (Coconino County), which is two hours away.  Arizona does have a comprehensive Sexual Violence Prevention & Education Program aimed at prevention of sexual and domestic violence, but most state-funded organizations are located in southern Arizona.  National organizations like RAINN provide general guidelines and state-by-state information.

Rape Prevention in Arizona

       The Sexual Violence Prevention & Education Program in Arizona originated at the state level, conforms to CDC guidelines, and depends on funding from the CDC and other sources.

       In 2004, the Governor’s Office for Children, Youth, and Families formulated a state plan that would “increase capacity . . . to provide services, promote prevention, conduct trainings, and create public awareness activities statewide” in the area of sexual assault.  The primary goal was to “increase victim access to comprehensive crisis services” (Governor’s Office for Children, Youth, and Families, 2004).

       A statewide eight year plan was implemented through the Arizona Department of Health Services in 2010 that would “stop first time perpetration” through standardized educational curriculum in the schools, colleges, and universities; faith-based organizations; widespread media campaigns; and businesses that serve alcohol.  The mission was to achieve “the vision of a culture that supports healthy, respectful relationships through primary prevention efforts and zero tolerance of sexual violence in Arizona communities” (Arizona Department of Health Services, 2010).

       Sexual assault is a public health threat that requires preventative education and counseling before an assault occurs; interventions immediately after an incident; and long-term follow-up care, if necessary, with therapy and empowerment tools (University of Arizona, 2012).  Programs are now teaching bystander intervention skills to people who want to serve as role models and intervene when they witness a potential or actual sexual assault occurring.  The University of Arizona routinely screens students for past and recent sexual assaults and abuse so they can receive the therapy they need.  Male students learn how to evaluate their own attitudes and beliefs about male dominance and entitlement in order to gain new respect for their partners and develop more effective communication skills (University of Arizona, 2012).

       The Sexual Violence Prevention & Education Program implemented in 2012 on the campus of the University of Arizona in Tucson is also available to other campuses, organizations, and businesses through their community outreach program.  According to their research, alcohol is implicated in 50-70% of all sexual assaults.  Drug and alcohol screenings are now done on campus to screen students for substance use problems.  Students receive information about consent and the ability/inability to consent for sexual activity while intoxicated.  Freshmen are required to take an online course in sexual assault (University of Arizona, 2012).

       Research conducted at the University of Arizona supports new laws and public policies.  Researchers have found that community-based programs are most effective.  Their public awareness programs have been so effective, Governor Douglas Ducey proclaimed April 2016 Sexual Assault Awareness Month (Governor’s Office, 2016).

       According to the National Center for Injury Prevention and Control (2016), 1 in 5 women and 1 in 15 men experience rape or attempted rape.  By the age of eighteen, 40% of women have suffered some sort of sexual abuse or assault.  The long-term physical and psychological trauma can be devastating.  Family Advocacy Centers have been established in some areas of Arizona to provide post-sexual assault services, including forensic evidence collection, expert witness testimony, and legal representation.  Arizona state law allows victims to receive a forensic examination by a trained examiner within 120 hours (5 days), whether or not they plan to report the incident to police (Governor’s Office for Children, Youth, and Families, 2004).  Forensic biological evidence will be kept indefinitely in unsolved felony sexual offense cases (Arizona Revised Statute 13-4221).  There are no statutes of limitations in felony sexual offense cases (Arizona Revised Statute 13-107).  The definition of rape has been expanded in order to increase the number of convictions.  Sexual assault is a class 2 felony, but if a date rape drug was used, the sentence will be increased by three years (Arizona Revised Statutes 13-1406).  The minimum sentence for a first conviction under ARS 13-1406 is 5.25 years, but a life sentence may be imposed if intentional serious physical harm was inflicted.

       Cultural competence remains an important issue when dealing with victims of sexual assault since the United States has such a diverse population “with differing ideas about domestic violence and sexual assault” (Warrier, 2005).  Trained interpreters and bilingual educational materials must be available.  Professionals must be able to understand victims’ experiences of violence within the context of their own culture.  This is particularly crucial among the Native American population.

       Kathryn Patricelli, MA (2005), educates women on what to do after an assault or rape.  First off, they should not bathe or cleanse themselves.  Secondly, they should call the police and report what happened. Third, women should go the emergency room and ask to be examined.  A forensic examination should be performed.  If a date rape drug was used, they should have a urine toxicology screen done.  Fourth, they should go stay in a safe place or have someone stay with them.  Fifth, victims should get help from a counselor to ease the shock, pain, and guilt.  If symptoms do not ease in a reasonable amount of time, the victim should get ongoing therapy for post-traumatic stress disorder.

Method

Process

       Research was conducted online through EBSCO and Google Scholar using the keywords “rape prevention,” “rape prevention in Mohave County,” and “rape prevention in Arizona.”  Other research was done in person and by telephone.

Results

       The best online results were found in Arizona government websites and publications.  Kingman Aid to Abused People/Sarah’s House did not answer their door or telephone.  Their primary focus is on family abuse and domestic violence.  Calling the Mohave Victim Witness Program phone number connected me to a pager.  There was no local rape prevention literature available at the Mohave County Library in Kingman; their resource list was out-of-date; and the librarian could only find two young adult books in the system related to teen dating safety and sexual harassment.

Discussion

       Local programs funded by the state of Arizona must provide “education on sexual harassment, definitions of rape, teen dating violence, assertive communication, and strategies to increase reporting and awareness of sexual violence” (Arizona Department of Health Services, 2016).  Some organizations also explain consent and Arizona law.

       Most programs and organizations in Mohave County provide post-incident crisis intervention, shelter, and hotlines for victims of domestic violence and sexual assault.  Mohave Community College has policies dealing with campus safety and sexual harassment and assault.  Mohave Mental Health and Southwest Behavioral provide long-term therapy services for depression, anxiety, and PTSD.  Local hospitals have trained forensic examiners, social workers, and counselors available for immediate care after a sexual assault.  The Mohave County Health Department performs confidential testing for STDs/HIV.

       Charles P. Nemeth (2012) defines rape as sexual intercourse with another person through the use of force, without consent, and with intent.  His guidelines for dealing with an attack include trying to dissuade the attacker from completing the act; pretending to have an STD or AIDS; acting insane; yelling; struggling and fighting back; using self-defense skills; using pepper spray or mace; avoiding resistance in order to survive (Nemeth, 2012).

       The Governor’s Office for Children, Youth, and Families (2004) describes rape “as a crime of power and control . . . motivated by aggression and hatred, not sex.”  The state of Arizona has implemented a statewide plan to address the problem through standardized educational programs, increased availability of services to victims, and expanded tools for prosecutors and police to increase the number of convictions for sexual assault.  But most comprehensive services are concentrated in the Phoenix/Tucson metropolitan areas.  More needs to be done for less populated counties like Mohave County.

References

Arizona Department of Health Services. (2016). Sexual violence prevention and education

       program. Retrieved from http://www.azrapeprevention.org.

Arizona Department of Health Services, The Bureau of Women’s and Children’s Health.

       (2010). Arizona sexual violence primary prevention and education eight year program plan.

       Phoenix, AZ: State of Arizona.

Arizona Legislature. (2016). Arizona revised statutes. Retrieved from http://www.azleg.gov.

Centers for Disease Control, National Center for Injury Prevention and Control, Division of

       Violence Prevention. (2016). Stop SV: A technical package to prevent sexual violence.

       Atlanta, GA: Centers for Disease Control.

Governor’s Office. (2016). State of arizona proclamation. Phoenix, AZ: State of Arizona.

Governor’s Office for Children, Youth, and Families, Division for Women. (2004). The state

       plan on domestic & sexual violence: A guide for safety & injustice in arizona. Phoenix,

       AZ: State of Arizona.

Nemeth, C.P. (2012). Criminal law. Boca Raton, FL: Taylor & Francis.

Patricelli, K., MA. (2005, December 15). Abuse – If you have been assaulted or raped.

       Retrieved from http://www.mentalhelp.net.

RAINN. (2016). State-by-state definitions. Retrieved from http://rainn.org.

University of Arizona, Mel and Enid Zuckerman College of Public Health. (2012). Sexual

       violence prevention & education program orientation manual & annual summary. Tucson,

       AZ: University of Arizona.

Warrier, S. (2005). Culture handbook. San Francisco, CA: Family Violence Prevention Fund.       

Dawn Pisturino
Administration of Justice 109, Mohave Community College,
Kingman, Arizona
Copyright 2016 Dawn Pisturino. All Rights Reserved.                                                  
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Health Information Technology Security

 

 

Health Information Technology Security

 

by Dawn Pisturino

 

Abstract

       Due to threats of cybercrime and malware infestations, healthcare organizations all across the world are now forced to upgrade and monitor their cybersecurity systems on a constant basis for the sake of protected patient health information, financial stability, and uninterrupted operations.  Money that would normally be spent on patient care is being diverted to IT professionals, who are hired to keep cybersecurity systems intact.

 

Health Information Technology Security

       Protecting patient health information, as mandated by law, has become a priority for healthcare facilities all around the world.  From doctors’ offices to medical devices to ransomware, the healthcare industry is under attack by cyber threats that compromise the health, safety, and privacy of patients everywhere.

       Nurses are at the forefront in efforts to secure patient and employee information, promote responsible use of computer technology, and report possible threats and violations in a timely manner.

Cybersecurity is Crucial

       Almost every day, a news story comes out that a corporation, nonprofit organization, or government agency has been hacked.  The healthcare industry is no different, and the attacks are becoming more frequent and more serious.  This is such an important issue at the hospital where I work, it seemed pertinent to write a paper on it.  Our IT department frequently makes us aware of e-mail threats, blocks blog sites, mandates automatic logoffs and timed reboots, requires frequent password changes, and regularly reminds us to turn off our computers, log off when finished, and to not share passwords.  Cybersecurity is crucial to protecting patient health information and network systems.

All Healthcare Organizations are at Risk

       Smaller healthcare clinics and doctors’ offices must follow the same mandates as larger organizations when it comes to protecting patient health information.  Healthcare personnel divulging protected information to unauthorized people and hackers using stolen information in identity theft scams are huge concerns that must be addressed (Taitsman, Grimm, & Agrawal, 2013).  Not only must these smaller organizations take appropriate measures to secure patient health information, but personnel must strictly follow policies and protocols.  Simple safeguards, such as screening phone calls, logging off computers, shredding documents, background checks for employees, automatic logouts, and activity audits, protect and safeguard patients and organizations alike (Taitsman, Grimm, & Agrawal, 2013).  Insurance companies, too, must safeguard patients against fraudulent claims.  Consumers must be educated in ways to protect their own healthcare information (Taitsman, Grimm, & Agrawal, 2013).

       Nurses all across the healthcare spectrum are increasingly required to use computer technology, and they must honor patient privacy, confidentiality, and consent while doing so.  Use of the Internet opens the doorway to viruses, worms, adware, spyware, and other forms of malware (Damrongsak & Brown, 2008).  Something as simple as using a shared address book can infect an entire system.  Logging off the computer when the nurse has finished and frequently backing up data can prevent unauthorized intrusions and corrupted data (Damrongsak & Brown, 2008).  Most medical facilities use an intranet, or closed system, in addition to the Internet, that restricts data to a smaller group of people.  Firewalls, encryption, and the use of virtual private networks provide additional security (Damrongsak & Brown, 2008).

       Large government agencies, such as the Veterans Administration, have increased efforts to stave off cyber-attacks, which compromise patient health information and medical devices.  IT specialists have removed medical devices from the VA hospital’s main network systems and connected them to virtual-local area networks (VLANs) (Rhea, 2010).  Without access to the Internet, these devices can be used without fear of attack.  In the past, the main focus has been on identity theft.  But with the rise of international terrorism, there is a growing fear that medical devices may be hacked and used to intentionally harm patients (Rhea, 2010).  Healthcare IT systems have already been crippled by hackers looking to profit from cybercrime.  In 2009, healthcare facilities around the world found medical devices infected with the Conficker virus (Rhea, 2010).  Downtime caused by malware is expensive and inconvenient.  Hospitals are forced to spend money on security that normally would have gone to patient care (Rhea, 2010).  FDA regulations are also a hindrance to quick development of security patches (Rhea, 2010).

       According to author W.S. Chee (2007), a member of the Department of Diagnostic Imaging at K.K. Women’s and Children’s Hospital in Singapore, medical devices connected to a hospital’s network system can lead to critical threats and infestations of malware in these devices.  Hospitals need to act proactively to prevent intrusions and respond immediately if a system becomes infected (Chee, 2007).  Equipment vendors play a huge role because they supply the security measures which protect medical devices (Chee, 2007).  But they can be slow in providing updates and patches.  The FDA, furthermore, determines when and how changes can be made to biomedical equipment systems.  This places the burden on hospitals to protect themselves (Chee, 2007).

       Thomas Klein (2014), managing editor of Electronic Medical Device Technology, asserts that intentional sabotage of medical devices is only a matter of time.  According to researchers, vulnerabilities have been found in infusion pumps, x-ray machines, cardiac defibrillators, and other devices (Klein, 2014).  Since these devices are frequently connected to the Internet, they are vulnerable to malware.  If the network systems are not fully protected, the devices are subject to malicious attack.  The use of USB ports opens a doorway to security breaches and malware

(Klein, 2014).  The risk is so great the FDA became involved and now requires that manufacturers consider cybersecurity risks when developing new products (Klein, 2014).

       The expansion of healthcare information technology improves profitability while exposing healthcare facilities to greater risks (Elliot, 2005).  Facilities must create and enforce policies that secure patient health information across all forms of networks and technology.  One solution for managing remote devices is the use of on-demand security services that cease to work once the remote device is no longer in use (Elliot, 2005).  The problem, then, is security on the other end, where patient health information can be leaked or accessed by the user.  This is called post-delivery security (Elliot, 2005).  Solutions include user malware protection, restrictions on use of data, and audits on computer use.  Developing and enforcing security policies that protect patient health information, especially information transmitted to remote devices, is tantamount to avoiding security breaches and corrupted data (Elliot, 2005).

       The latest, and most serious, threat comes in the form of professional IT criminals who use ransomware to extort money from hospitals (Conn, 2016).  One such threat, Locky, acts through ordinary-looking e-mail (Conn, 2016).  When opened, a virus activates software that encrypts the hospital’s IT system.  Then, a window pops up with a ransom demand.  Samas, another threat, uploads encryption ransomware through a hospital’s Web server (Conn, 2016).  A more sophisticated ransomware, CryptoLocker, demands bitcoin as payment because it is nearly impossible to trace (Conn, 2016).  Once paid, the criminals unlock the data in an infected system.  But, should hospitals pay in the first place?  Cybersecurity has become a booming business, with medical facilities now being forced to employ their services.  There is a major concern that medical devices will be the next systems to be hit by cybercriminals (Conn, 2016).

Topic Availability

       This topic, as it relates to Nursing Informatics, is too important to ignore.  I used seven resources from scholarly and peer-reviewed publications for this paper.  I pulled my resources primarily from CINAHL and ProQuest.  I found enough materials to give me a broad overview of the topic, but I was disappointed that more current articles could not be found.  Technology changes so rapidly that even a few months can make a difference in security innovations.  I used both the basic and advanced search features and the key words “medical device malware security.”

Information Availability 

       This information is available in scholarly and peer-reviewed journals and other publications.  Although the information was geared toward professionals, some publications include short articles that educate the general public about cybersecurity and protecting patient health information.  Nurses benefit from all of these resources because many do not understand the extent of the threat.

Personal Views 

       The information I read shocked me (cyberterrorism), confirmed what I see our IT specialists changing at my hospital, and disturbed me (ransomware cybercrime.)  The general public does not seem to be aware of these threats.  As a nurse who uses computer technology every day, I was not aware of the seriousness of this problem.  It never occurred to me that a glucometer or infusion pump could be infected with a virus or that an unscrupulous person would deliberately sabotage somebody’s pacemaker.  When I mention this to other nurses, they are equally dismayed by the possibilities.  They always ask, “Why would somebody maliciously hack into a medical device?”  For people who devote their lives to saving people, the idea is unthinkable.

       The changing landscape in healthcare makes it crucial that ALL medical personnel understand the seriousness of the threats.  As technology becomes more sophisticated, so do the means by which cybercriminals hack into and infect network systems.  Information is compromised, and patient health and well-being are put at risk.

Conclusion

       In conclusion, whether it’s a small private practice or a large healthcare system, the increased use of technology poses significant threats to protected patient health information,medical devices, and cybersecurity systems.  Users all across the healthcare spectrum have a duty to behave responsibly when accessing patient records, divulging information, searching the Internet, managing e-mail and faxes, and interacting with colleagues.  Nurses should provide feedback and input about vulnerabilities in security policies and protocols for the protection of themselves and their patients.  They must educate themselves about current threats so they can adapt their practice to avoid unintentional security breaches.  Nurses can also educate their patients in the use of computer technology, accessing patient portals, and protecting patient health information. 

       Technology will continue to be a driving force in healthcare.  Along with the downside comes the possibility of lower costs to facilities and patients, improved outcomes, more accurate measurements, increased research, and greater opportunities for nurses to expand their involvement and role in improving healthcare and healthcare informatics.  Requiring nursing students to study nursing informatics increases their awareness of the problems and benefits of  technology.  Hopefully, our physicians and administrators are being trained in this area, as well.  Health information technology specialists are enjoying a surge in employment opportunities as

healthcare systems realize the importance of their specialty.  Technology is expensive, but the threats of cybercrime and cyber-attacks are more damaging. 

 

References

Chee, W.S. A. (2007). IT security in biomedical imaging informatics: The hidden

        vulnerability. Journal of Mechanics in Medicine and Biology, 7(1), 101-106.

Conn, J. (2016, April). Ransomware scare: Will hospitals pay for protection. Modern    

        Healthcare, 46(15), 8-8.

Damrongsak, M., & Brown, K.C. (2008). Data security in occupational health. AAOHN

        Journal, 56(10), 417-421. Retrieved from http://search.proquest.com.resources.njstatelib.

        org/docview/219399232?accountid=63787.

Elliot, M. (2005, September). Securing the healthcare border. Health Management Technology,

        26(9), 32-35.

Klein, T. (2014, September). How to protect medical devices against malware.

        Operating Theatre Journal, 14-14.

Rhea, S. (2010, December). Cyberbattle: Providers work to protect devices, patients. Modern

        Healthcare, 40(50), 33-34.

Taitsman, J. K., Grimm, C. M., Agrawal, S. (2013, March). Protecting

        Patient privacy and data security. The New England Journal of Medicine, 368, 977-979.

        doi: 10.1056/NEJMp1215258. Retrieved from http://www.NEJM.org.

Dawn Pisturino
Nursing 340, Thomas Edison State University, New Jersey
Copyright 2016 Dawn Pisturino. All Rights Reserved.
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2016 Best of Kingman - Healthcare Award

I'm pleased to announce that COSMIC HEALTH BLOG has received the 2016 Best of Kingman - Healthcare Award. This is the second year in a row. We're so happy!

Thank you!

Dawn Pisturino, RN

Copyright 2016 Dawn Pisturino. All Rights Reserved.

Buddhist Metta Prayer

 

 

 

 

May all beings be peaceful.

 

May all beings be happy.

 

May all beings be safe.

 

May all beings awaken to the light of their true nature.

 

May all beings be free.

National Drug and Alcohol Facts Week 2016

 

 

January 26 -31, 2016 is National Drug and Alcohol Facts Week.  This event, which is co-sponsored by the National Institute on Drug Abuse (NIDA) and the National Institute on Alcohol Abuse and Alcoholism (NIAAA), teaches teens the effects of drug use on the brain and body through local events and online chats. The information provided has been thoroughly researched by National Institute of Health (NIH) scientists.

Chat Day is January 26th.  On this day, high school students and scientists from the National Institute on Drug Abuse hook up online to discuss the dangers of drug use. Students can get answers to all of their questions from actual scientific researchers.

This is an important event because researchers have found that teens who use drugs on a regular basis are at high risk for developing cognitive disorders and learning disabilities since the teenage brain is still maturing. And some drugs are so dangerous, they can cause permanent psychiatric disorders.

For more information, check out these websites:

http://teens.drugabuse.gov    (NIDA for Teens)

http://www.niaaa.nih.gov      (NIAAA)

http://www.drugabuse.gov   (National Institute on Drug Abuse)


Thanks!

Dawn Pisturino, RN

Copyright 2016 Dawn Pisturino. All Rights Reserved.

Live for Today

 

 

 

 

Today is the first day of the rest of your life. And, no matter what happened yesterday, the past is over. No matter what will happen in the future, that day has not yet arrived.

 

LIVE FOR TODAY.

 

Moment by moment, hour by hour, day by day, month by month, season by season, year by year, decade by decade . . .

 

Life is happening right now -- this second -- and there it goes, it's gone! So precious, so fleeting, so finite.

 

I am writing this essay right now, word by word. Once I sign my name at the end, this small block of time is forever gone. But, look what I accomplished in that small block!

 

Make every second, minute, day, month, year count to its fullest. Start right now.

 

Dawn Pisturino, RN

 

Copyright 2016 Dawn Pisturino. All Rights Reserved.