Sandra is the Founder, Lead Legal Nurse Consultant, and Coordinator of Krug Consulting, a Legal Nurse Consulting firm. She is a Certified Registered Nurse Anesthetist (CRNA), Advanced Practice Registered Nurse (APRN), and Registered Respiratory Therapist (RRT). She has over 12 years of college ...
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This Is The 2019 National Crime Victims’ Rights Week
By Sandra Krug
National Crime Victims’ Rights Week (NCVRW) will be commemorated April 7–13, 2019. This year’s theme—Honoring Our Past. Creating Hope for the Future.—celebrates the progress made by those before us as we look to a future of crime victim services that is even more inclusive, accessible, and trauma-informed.
Since 1981, National Crime Victims’ Rights Week (NCVRW) has challenged the nation to confront and remove barriers to full justice for all victims of crime. Each year, communities across the country revisit the history of the victims’ rights movement, celebrate the progress made, and recommit to further advancements in the crime victims field.
Director of OVC, Darlene Hutchinson stated, “We commemorate, honor, and respect the advocates, allied professionals, and selfless volunteers who courageously work to give victims a voice in the criminal justice system and provide much-needed services to survivors in need. Their legacy of commitment, passion, and hope propels us toward a future where meaningful crime victims’ rights and justice are a reality.”
Executive Director of the National Center for Victims of Crime, Mai Fernandez stated, “As we approach NCVRW this year, we take a moment to reflect and show gratitude to those individuals and organizations that were so instrumental in building the foundations of today’s initiatives. We applaud the current work of the victim services field, which has adapted to and embraced new technologies as tools to engage communities and reach victims who may have been previously overlooked. The future holds new projects and programs, made possible by greater funding, to provide specialized services to victims. Together, we can ensure that those services help victims who need them most.”
Collaboration is an integral part of the crime victims’ rights movement. Strong partnerships among victim service providers and criminal justice and allied professionals provide rich opportunities for raising awareness and educating communities.
Training, Technical Assistance and Other Services for Victim Service Providers
Child Welfare Information Gateway
www.childwelfare.gov
800-394-3366
online chat
National Adult Protective Services Association
www.napsa-now.org
202-370-6292
National Childrens Alliance
www.nationalchildrensalliance.org
202-548-0090
National Clearinghouse on Abuse in LAter Life
www.ncall.us
608-255-0539×213
TTY 608-255-3560
National Council of Juvenile and Family Court Judges
www.ncjfcj.org
775-507-4777
National Crime Prevention Council
www.ncpc.org
443-292-4565
National Criminal Justice Reference Service
www.ncjrs.gov
800-851-3420
TTY 302-240-6310
online chat
National Organization for Victim Assistance
www.trynova.org
800-TRY-NOVA
National Resource Center on Domestic Violence
www.nrcdv.org
800-537-2238
TTY 800-553-2508
National Sexual Violence Resource Center
www.nsvrc.org
877-739-3895
TTY 717-909-0715
OVC TTAC
www.ovcttac.gov
866-OVC-TTAC
TTY 866-682-8880
Resource Center on Domestic Violence: Child Protection and Custody
www.rcdvcpc.org
800-527-3223
In the midst of winter, I found there was, within me, an invincible summer.
– ALBERT CAMUS (1913 – 1960)
Autism – it looks like a unique world
By Sandra Krug
World Autism Awareness Day is April 2, 2019. Autism spectrum disorder (ASD) is a developmental disability that may lead to considerable social, communication and behavioral challenges.
There is often nothing about how someone with ASD looks that sets them apart from others, however people with ASD may communicate, interact, behave, and learn in ways that are different from most other people.
The learning, thinking, and problem-solving aptitude of those with ASD can vary from gifted to severely challenged. Many with ASD need a lot of help in their daily lives, while others need less.
A diagnosis of ASD now includes several conditions that used to be diagnosed separately: autistic disorder, pervasive developmental disorder not otherwise specified (PDD-NOS), and Asperger syndrome.
Signs and Symptoms
People with ASD might repeat certain behaviors and might not want to change their daily activities. Many also have different ways of learning, paying attention, or reacting to things. Signs of ASD begin during early childhood and typically last throughout a person’s life.
Children or adults with ASD might not:
point at objects to show interest (for example, not point at an airplane flying over)
look at objects when another person points at them
have an interest in other people at all
want to be held or cuddled, or might cuddle only when they want to
make eye contact and want to be alone
be aware when people talk to them but respond to other sounds
play “pretend” games (for example, not pretend to “feed” a doll)
Children or adults with ASD might have trouble:
relating to others
understanding other people’s feelings
talking about their own feelings
expressing their needs using typical words or motions
adapting when a routine changes
Children or adults with ASD might repeat:
words or phrases said to them
words or phrases in place of normal language
actions over and over again
Children or adults with ASD may also:
be very interested in people, but not know how to talk, play, or relate to them
have unusual reactions to the way things smell, taste, look, feel, or sound
lose skills they once had (for example, stop saying words they were using)
Treatment
Early intervention services help children from birth to 3 years old learn important skills. Services include therapy to help the child talk, walk, and interact with others.
It is important to talk to your child’s doctor as soon as possible if you think your child has ASD or other developmental problems.
Even if your child has not been diagnosed with an ASD, he or she may be eligible for early intervention treatment services.
The Individuals with Disabilities Education Act (IDEA) says that children under the age of 3 years who are at risk of having developmental delays may be eligible for services.
These services are provided through an early intervention system in your state. Through this system, you can ask for an evaluation.
In addition, treatment for particular symptoms, such as speech therapy for language delays, often does not need to wait for a formal ASD diagnosis.
Who is Affected
ASD occurs in all racial, ethnic, and socioeconomic groups, but is about 4 times more common among boys than among girls.
For over a decade, Centers for Disease Control and Prevention (CDC’s) Autism and Developmental Disabilities Monitoring (ADDM) Network has been estimating the number of children with ASD in the United States.
They have learned a lot about how many U. S. children have ASD. It will be important to use the same methods to track how the number of children with ASD is changing over time in order to learn more about the disorder.
If You’re Concerned
If you think your child might have ASD or you think there could be a problem with the way your child plays, learns, speaks, or acts, contact your child’s doctor, and share your concerns.
If you or the doctor is still concerned, ask for a referral to a specialist who can do an in-depth evaluation of your child.
Specialists who can do a more in-depth evaluation and make a diagnosis include:
Developmental Pediatricians (doctors with special training in child development and children with special needs)
Child Neurologists (doctors who work on the brain, spine, and nerves)
Child Psychologists or Psychiatrists (doctors who know about the human mind)
At the same time, call your state’s public early childhood system to request a free evaluation to find out if your child qualifies for intervention services. This is sometimes called a Child Find evaluation.
You do not need to wait for a doctor’s referral or a medical diagnosis to make this call.
Where to call for a free evaluation from the state depends on your child’s age:
If your child is not yet 3 years old, contact your local early intervention system.
You can find the right contact information for your state by calling the Early Childhood Technical Assistance Center (ECTA) at 919-962-2001.
Or visit the ECTA website
If your child is 3 years old or older, contact your local public school system.
Even if your child is not yet old enough for kindergarten or enrolled in a public school, call your local elementary school or board of education and ask to speak with someone who can help you have your child evaluated.
In order to make sure your child reaches his or her full potential, it is very important to get help for an ASD as soon as possible.
Additional Resources:
100 Days Kit, Autism Speaks
This kit provides information to help families get through the first steps of an autism diagnosis.
Caring for Children With Autism Spectrum Disorders: A Resource Toolkit for Clinicians
A clinical resource to assist in the recognition, evaluation, and ongoing management of autism spectrum disorders throughout the patient’s lifespan from the American Academy of Pediatrics (AAP).
Developmental and Behavioral Pediatrics Online
Developmental and Behavioral Pediatrics Online is for professionals interested in child development and behavior in a medical setting. The website focuses on primary care development and behavior, including early intervention and screening, and provides articles, handouts, and materials about developmental disabilities developed for professionals and parents. It also offers a practice section with information to support primary and specialty health care practice.
Exposed to asbestos in the last 15-40 years?
By Sandra Krug
Mesothelioma incidence rates may be relatively low, but the extreme harm this disease can cause is high.
Mesothelioma: Your Health In Jeopardy, Even After Many Years
Mesothelioma is often misdiagnosed until the later stages of the disease.
Are you at risk of Mesothelioma?
If you are above 40 and have ever been exposed to asbestos continuously for more than 2 months in the last 15-40 years, then you are at risk of Mesothelioma.
It is a rare but deadly cancer of membrane cells, which covers some vital parts of our body like lungs, abdominal cavity, and heart, called mesothelium.
Like in other cancers, in mesothelioma the membrane cells divide ruthlessly causing abnormal growth, which ultimately damages the lining of vital organs such as lungs and abdomen.
Causes of Mesothelioma
Asbestos a mineral, used in different processes including building, shipyard, and manufacturing in the years of World War II and for a few more decades, is the main cause of Mesothelioma.
Researches have proven that those who have worked in asbestos-related industries are most at risk of Mesothelioma.
The minute asbestos particles go into the human body through nose or mouth during inhalation, talking, or any other reason. They reach the lungs or abdomen and damages the lining, causing Mesothelioma.
Even years after exposure?
Unfortunaly, Yes
Due to its long latency period, mesothelioma can attack you even 15 – 40 years after the inhalation of asbestos particles.
Even the family members of the person working in asbestos-related industries could be vulnerable to mesothelioma.
Symptoms of Mesothelioma
Sometimes cancer causes fluid to collect in the chest or in the abdomen. Signs and symptoms may be caused by fluid, malignant mesothelioma, or other conditions.
Check with your doctor if you have any of the following:
• Trouble breathing
• Cough
• Pain under the rib cage
• Pain or swelling in the abdomen
• Lumps in the abdomen
• Constipation
• Problems with blood clots (clots form when they should not)
• Weight loss for no known reason
• Fatigue (feeling very tired)
Treatments for Mesothelioma
Some treatment options for mesothelioma cancers are surgical removal of the affected tissues; chemotherapy and radiotherapy.
However, the prognosis of later stage mesothelioma patients is bleak and the average survival time after diagnosis is 12-24 months.
Mesothelioma Compensations
Many owners of Asbestos-related industries were quite aware of the health hazards of asbestos. However, they persisted with its use without issuing any warnings or taking steps for avoiding health hazards.
This is the reason why U.S. courts have awarded huge sums as compensation to the Mesothelioma patients/families by the companies/persons responsible for causing asbestos exposure.
If there is evidence a defendant (company) actively concealed the dangers of asbestos exposure from the plaintiff (victim), the defendant’s potential financial liability could be high.
A lawsuit could take years?
Unfortunaly, Yes
A lawsuit takes time. There are many processes involved – research, preparation, filing, response, discovery, trial, appeal. It can go on for some time.
However in most cases, mesothelioma lawsuits are settled out of court. This process can be faster.
If you find this article helpful, please share it with friends and colleages. And, send them to our website.
This is World Down Syndrome Day
By Sandra Krug
World Down Syndrome Day is 3/21/2019
In recent years, Down syndrome has become more common, and these children are living longer.
This is a lifelong condition. Services early in life will often help babies and children to improve their physical and intellectual abilities. Most of these services focus on helping children with Down syndrome develop to their full potential.
What is Down Syndrome?
Down syndrome is a medical condition in which a person has an extra chromosome.
Chromosomes are small packages of genes within the body. They determine how a baby’s body forms during pregnancy and how the baby’s body functions as the baby grows in the womb and after birth.
Typically, a baby is born with 46 chromosomes. Babies with Down syndrome have an extra copy of one of these chromosomes, chromosome 21.
A medical term for having an extra copy of a chromosome is trisomy.
Down syndrome is also referred to as Trisomy 21. This extra copy changes how the baby’s body and brain develop, which can cause both mental and physical challenges for the baby.
What is the occurance?
Down syndrome remains the most common chromosomal condition diagnosed in the United States.
Each year, about 6,000 babies born in the United States have Down syndrome. This means about 1 out of every 700 babies.1
Types of Down Syndrome
There are three types.
Trisomy 21:
About 95% have Trisomy 21.2 With this type of Down syndrome, each cell in the body has 3 separate copies of chromosome 21 instead of the usual 2 copies.
Translocation Down syndrome:
This type accounts for a small percentage (about 3%).2 This occurs when an extra part or a whole extra chromosome 21 is present, but it is attached or “trans-located” to a different chromosome rather than being a separate chromosome 21.
Mosaic Down syndrome:
This type affects about 2%.2 Mosaic means mixture or combination. For children with mosaic type, some of their cells have 3 copies of chromosome 21, but other cells have the typical two copies of chromosome 21. Children with mosaic type may have the same features as other children with Down syndrome. However, they may have fewer features of the condition due to the presence of some (or many) cells with a typical number of chromosomes.
Other Health Problems
Some people with Down syndrome might have one or more major birth defects or other medical problems. Some of the more common health problems are listed below.3
Hearing loss
Obstructive sleep apnea, which is a condition where the person’s breathing temporarily stops while asleep
Ear infections
Eye diseases
Heart defects present at birth
Health care providers routinely monitor for these conditions.
Early treatment programs can help improve skills. They may include speech, physical, occupational, and/or educational therapy.
With support and treatment, many people with Down syndrome live happy, productive lives.
Therapies encourage strengths
There is no single, standard treatment.
Treatments are based on each individual’s physical and intellectual needs as well as his or her personal strengths and limitations.1 People can receive proper care while living at home and in the community.
Physical therapy includes activities and exercises that help build motor skills, increase muscle strength, and improve posture and balance.
Physical therapy is important, especially early in a child’s life, because physical abilities lay the foundation for other skills. The ability to turn over, crawl, and reach helps infants learn about the world around them and how to interact with it.
A physical therapist also can help a child compensate for physical challenges, such as low muscle tone, in ways that avoid long-term problems. For example, a physical therapist might help a child establish an efficient walking pattern, rather than one that might lead to foot pain.5
Speech-language therapy can help children improve their communication skills and use language more effectively.
Children with Down syndrome often learn to speak later than their peers. A speech-language therapist can help them develop the early skills necessary for communication, such as imitating sounds. The therapist also may help an infant breastfeed because breastfeeding can strengthen muscles that are used for speech.6
In many cases, children understand language and want to communicate before they can speak. A speech-language therapist can help a child use alternate means of communication, such as sign language and pictures, until he or she learns to speak.7
Learning to communicate is an ongoing process, so a person may benefit from speech and language therapy in school as well as later in life. The therapist may help with conversation skills, pronunciation skills, understanding what is read (called comprehension), and learning and remembering words.
Occupational therapy helps find ways to adjust everyday tasks and conditions to match a person’s needs and abilities.
This type of therapy teaches self-care skills6 such as eating, getting dressed, writing, and using a computer.
An occupational therapist might offer special tools that can help improve everyday functioning, such as a pencil that is easier to grip.
At the high school level, an occupational therapist could help teenagers identify jobs, careers, or skills that match their interests and strengths.
Emotional and behavioral therapies work to find useful responses to both desirable and undesirable behaviors.
Children may become frustrated because of difficulty communicating, may develop compulsive behaviors, and may have Attention Deficit Hyperactivity Disorder and other mental health issues.
These types of therapists try to understand why a child is acting out, create ways and strategies for avoiding or preventing these situations from occurring, and teach better or more positive ways to respond to situations.
A psychologist, counselor, or other mental health professional can help a child deal with emotions and build coping and interpersonal skills.
The changes in hormone levels that adolescents experience during puberty can cause them to become more aggressive. Behavioral therapists can help teenagers recognize their intense emotions and teach them healthy ways to reach a feeling of calmness.
Parents may also benefit from guidance on how to help a child with Down syndrome manage day-to-day challenges and reach his or her full potential.8
Resources:
Down Syndrome Research Foundation (DSRF)
DSRF initiates research studies to better understand the learning styles of those with Down syndrome.
Global Down Syndrome Foundation
This foundation is dedicated to significantly improving the lives of people with Down syndrome through research, medical care, education and advocacy.
National Association for Down Syndrome
The National Association for Down Syndrome supports all persons with Down syndrome in achieving their full potential. They seek to help families, educate the public, address social issues and challenges, and facilitate active participation.
National Down Syndrome Society (NDSS)
NDSS seeks to increase awareness and acceptance of those with Down syndrome.
References
1. Parker SE, Mai CT, Canfield MA, et al. Updated national birth prevalence estimates for selected birth defects in the United States, 2004-2006. Birth Defects Res A Clin Mol Teratol. 2010;88:1008-16.
2. Shin M, Siffel C, Correa A. Survival of children with mosaic Down syndrome. Am J Med Genet A. 2010;152A:800-1.
3. Bull MJ, the Committee on Genetics. Health supervision for children with Down syndrome. Pediatrics. 2011;128:393-406.
4. National Human Genome Research Institute. (2010). Learning about Down syndrome. Retrieved June 11, 2012, from http://www.genome.gov/19517824
5. Winders, P. C. (n.d.). Gross motor development and Down syndrome. Retrieved June 11, 2012, from the NDSS website: http://www.ndss.org/en/Education-Development–Community-Life/Therapies–Development/Physical–Occupational-Therapy/#gross
6. NDSS. (n.d.). Elementary & secondary education. Retrieved June 11, 2012, from http://www.ndss.org/en/Education-Development–Community-Life/Elementary–Secondary-Education
7. Kumin, L. (n.d.). Speech & language skills in infants, toddlers & young children with Down syndrome. Retrieved June 11, 2012, from the NDSS website: http://www.ndss.org/resources/speech-language-therapy/
8. NDSS. (n.d.). Managing behavior. Retrieved June 14, 2012, from http://www.ndss.org/Resources/Wellness/Managing-Behavior/
How to Make National Protein Day Energizing
By Sandra Krug
2/27/2019 is National Protein Day
Did you know that your protein needs can easily be met by eating a variety of plant foods? All foods made from beans and peas, processed soy products (such as tofu, tempeh), nuts, nut butters and seeds are considered part of the Protein Foods Group.
Because of their high nutrient content, consuming beans and peas is recommended for everyone, vegetarians and non-vegetarians alike.
Enjoy some vegetarian chili, three bean salad, or split pea soup. Make a hummus filled pita sandwich. Choose unsalted nuts as a snack and use them in salads or main dishes. Add almonds, walnuts, or pecans to a green salad.
Choose beans, peas, or soy products as a main dish or part of a meal often.
Some choices are:
Chili with kidney or pinto beans
Stir-fried tofu
Split pea, lentil, minestrone, or white bean soups
Baked beans
Black bean enchiladas
Garbanzo or kidney beans on a chef’s salad
Rice and beans
Veggie burgers
Hummus (chickpeas spread) on pita bread
Choose unsalted nuts as a snack, on salads, or in main dishes.
Some choices are:
Use pine nuts in pesto sauce for pasta.
Add slivered almonds to steamed vegetables.
Add toasted peanuts or cashews to a vegetable stir fry instead of meat.
Sprinkle a few nuts on top of low-fat ice cream or frozen yogurt.
Add walnuts or pecans to a green salad instead of cheese or meat.
The amount of food from the Protein Foods Group you need to eat depends on age, sex, and level of physical activity. Most Americans eat enough food from this group, but need to make leaner and more varied selections of these foods.
Recommended daily amounts are shown in the table below.
Daily Recommendation*
Children
2-3 years old
4-8 years old
2 ounce equivalents
4 ounce equivalents
Girls
9-13 years old
14-18 years old
5 ounce equivalents
5 ounce equivalents
Boys
9-13 years old
14-18 years old
5 ounce equivalents
6½ ounce equivalents
Women
19-30 years old
31-50 years old
51+ years old
5½ ounce equivalents
5 ounce equivalents
5 ounce equivalents
Men
19-30 years old
31-50 years old
51+ years old
6½ ounce equivalents
6 ounce equivalents
5½ ounce equivalents
*These amounts are appropriate for individuals who get less than 30 minutes per day of moderate physical activity, beyond normal daily activities. Those who are more physically active may be able to consume more while staying within calorie needs.
In general, ¼ cup cooked beans, 1 tablespoon of peanut butter, or ½ ounce of nuts or seeds can be considered as 1 ounce-equivalent from the Protein Foods Group.
The table below lists specific amounts that count as 1 ounce-equivalent in the Protein Foods Group towards your daily recommended intake.
Nuts and seeds
½ ounce of nuts (12 almonds, 24 pistachios, 7 walnut halves)
½ ounce of seeds (pumpkin, sunflower, or squash seeds, hulled, roasted)
1 Tablespoon of peanut butter or almond butter
1 ounce of nuts or seeds = 2 oz-equiv
Beans and peas
¼ cup of cooked beans (such as black, kidney, pinto, or white beans)
¼ cup of cooked peas (such as chickpeas, cowpeas, lentils, or split peas)
¼ cup of baked beans, refried beans
¼ cup (about 2 ounces) of tofu
1 oz. tempeh, cooked
¼ cup roasted soybeans
1 falafel patty (2 ¼”, 4 oz)
2 Tablespoons hummus
1 cup split pea soup = 2 oz-equiv
1 cup lentil soup = 2 oz-equiv
1 cup bean soup = 2 oz-equiv
1 soy or bean burger patty = 2 oz-equiv
Get tips, ideas, and a personalized plan to meet your food group targets. Find what works for you and your family within your food preferences, health goals, and budget. Choose My Plate
This blog is for informational purposes only. Your doctor or dietician should be consulted for any diet plan or diet change.
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