● Fever. ● Rash.
There is no typical presentation of FDIA. Almost every disease category has been implicated in FDIA, and there is a broad range of manifestations (Roesler & Jenny, 2018). Here are general features of FDIA (Roesler & Jenny, 2018): ● The history the parent gives is different than what is observed or does not make sense (e.g., the parent describes serious symptoms in a normal appearing child). ● Histories from different observers vary significantly, suggesting the perpetrator’s history is distorted. ● The illness is recurrent, unexplained, unusual, or prolonged and does not respond to treatment. ● Family history may indicate that the child’s siblings died or have had similar illnesses. ● The child is subject to repeated office visits, multiple diagnostic tests, and medical interventions as well as management by many specialists without improvement of the illnesses. ● Signs or symptoms begin only in the presence of the caregiver. Clinical improvement occurs when the child is separated from the caregiver. Signs of FDIA The following are the most common signs and symptoms for FDIA (Unal et al., 2017): ● Apnea. ● Anorexia or feeding problems. ● Bleeding, including blood in urine, vomit, or stool.
FDIA includes not only fabrication of physical conditions but also fabrication of emotional and behavioral conditions, including (Roesler & Jenny, 2018): ● Attention-deficit/hyperactivity disorder (ADHD). ● Bipolar disorder. ● Anorexia. ● Allegations of sexual abuse. Healthcare consideration: Many attempts have been made to develop a profile of a typical FDIA perpetrator. The profile includes the following characteristics: Having extensive medical knowledge, exhibiting calm during otherwise stressful medical events, being a medical provider, and becoming angry at medical providers who do not agree with them (Roesler & Jenny, 2018). Although these may be helpful in raising one’s suspicion, they have little predictive value; thus, the nurse should remain focused on the experience of the child rather than the personality of the caregiver (Roesler & Jenny, 2018). Self-Assessment Quiz Question #6 Which of the following is not a common sign or symptom of possible FDIA in a child?
a. Seizures. b. Vomiting. c. Kidney stones. d. ADHD.
● Diarrhea. ● Vomiting. ● Seizures.
HUMAN TRAFFICKING
○ Peonage: paying off debt through work. ○ Debt Bondage: debt slavery, bonded labor, or services for a debt or other obligation. ○ Slavery: a condition compared to that of a slave in respect of exhausting labor or restricted freedom. As of December 2020, the National Human Trafficking Hotline (NHTH) had received a total of 328,255 contacts, with a total of 51,667 in 2020 alone (National Human Trafficking Hotline, 2020). Between 2007 and 2020, the NHTH received 6,588 contacts (calls, texts, online chats, webforms, emails; NHTH, 2020). Of those, 1,705 contacts were reported cases of human trafficking (Human Trafficking Hotline, 2020). In 2020 alone, there were 909 total contacts from Pennsylvania, of which 221 human trafficking cases were reported (Human Trafficking Hotline, 2020). In 2014, Pennsylvania passed Act 105, Pennsylvania’s anti– human trafficking law, which defined human trafficking to include both sex trafficking and labor trafficking (PCAR, 2018a). The Pennsylvania Legislature then enacted Act 115 of 2016, which amended Title 23 (Domestic Relations) and 42 (Judiciary and Judicial Procedure) of the Pennsylvania Consolidated Statutes to include human trafficking (PCAR, 2018a). Labor trafficking is labor obtained by use of threat of serious harm, physical restraint, or abuse of legal process. Examples of labor trafficking include: ● Being forced to work for little or no pay (frequently in factories and farms). ● Domestic servitude: providing services within a household for 10-16 hours per day, such as, but not limited to: childcare, cooking, cleaning, yard work, gardening, etc.
Human trafficking, at its most basic level, is defined by the Trafficking Victims Protection Act of 2000 as (a) the recruitment, harboring, transporting, supplying, or obtaining a person for labor or services through the use of force, fraud, or coercion for the purpose of involuntary servitude or slavery or (b) sex trafficking in which a commercial sex act is induced by force, fraud, or coercion or in which the person induced to perform sex acts is under 18 years of age. The key elements of the Trafficking Victims Protection Act (TVPA) indicate it is illegal to use force, fraud, or coercion to exploit a person for profit or for personal services. The use of coercion can be direct and physically violent, or it can be through psychological means. Although most news accounts of human trafficking focus on the violence endured by the victims of human trafficking, the powerful effects of psychological coercion play a key role in entrapment and continued enslavement (Logan et al., 2009). Severe forms of trafficking in persons: ● Sex trafficking in which a commercial sex act is induced by force, fraud, or coercion or in which the person induced to perform such act has not attained 18 years of age; or ○ Sex trafficking: the recruitment, harboring, transportation, provision, obtaining, patronizing, or soliciting of a person for the purpose of a commercial sex act. ○ Commercial sex act: Any sex act on account of which anything of value is given to or received by any person. ● The recruitment, harboring, transportation, provision, or obtaining of a person for labor or services, through the use of force, fraud, or coercion, for the purpose of subjection to involuntary servitude, peonage, debt bondage, or slavery.
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Book Code: FPA0625
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