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PACEs in Medical Schools

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One state. One year. (Partial) Cost of ACEs = $5.2 billion.

Jane Stevens ·
In looking at the impact of childhood trauma, you can’t get much clearer than this: In 2017, ACEs among Tennessee adults led to an estimated $5.2 billion in direct medical costs and lost productivity from employees missing work. That’s just one year, according to the new report, “ The Economic Cost of ACEs in Tennessee ," released on Feb. 1, 2019 by The Sycamore Institute in Nashville, Tenn. And to provide some perspective, $5.2 billion is one-seventh of the state’s annual budget . This $5.2...
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Op-Ed: I'm a doctor fighting COVID-19. Outside of the hospital, I've never felt more alone [latimes.com]

By Samuel Yamshon, Los Angeles Times, May 15, 2020 As I make my way into my building’s elevator after a long hospital shift, a neighbor throws his arm out to stop me. “Sorry,” he says, “only one person per elevator.” Seeing my confusion, our doorman kindly but firmly corrects him. “Two per elevator is fine.” I take a step toward the open doors, but the passenger again holds up his palm. “Please,” he pleads, his eyes glancing frantically at my scrubs. “Please, just take a different one.”...
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Preventable trauma in childhood costs north America and Europe US$ 1.3 trillion a year [WHO]

Karen Clemmer ·
By World Health Organization (photo by WHO/Malin Bring) The findings of a new study on the life-course health consequences and associated annual costs of adverse childhood experiences (ACEs) show that preventable trauma in childhood costs north America and the European Region US$ 1.3 trillion a year. The article, published in the Lancet and co-authored by Dinesh Sethi and Jonathon Passmore, Programme Manager, Violence and Injury Prevention, WHO/Europe, looks at the legacy of ACEs and their...
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Sheltering in Place: ACEs-Informed Tips for Self-Care During a Pandemic

Jim Hickman ·
Millions of lives have been affected in unprecedented ways by the Coronavirus (COVID-19). We are all grappling with uncertainty—our daily routines interrupted, not knowing what is to come. For those of us who have Adverse Childhood Experiences (ACEs), these times can be particularly distressing. At the Center for Youth Wellness (CYW), we know that childhood trauma can have a significant impact on an individual’s health and well-being – both physiologically and psychologically. Since the...
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Study finds meditation and aerobic exercise relieves stress in medical school students (EurekAlert)

Karen Clemmer ·
Rutgers, Released May 4, 2020, Journal of Alternative and Complementary Medicine. Rutgers professor and medical school student collaborating on research touched by pandemic. Rutgers Robert Wood Johnson Medical School student Paul Lavadera expected his career would put him on the front lines of dealing with medical emergencies. But he never could have imagined he'd be graduating during the biggest global pandemic in a century when he joined forces two years ago with Tracey Shors,...
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The Challenges and Blessings of My Dissociative Disorder: A new Journal article for Medical Practitioners

Bonnie Armstrong ·
A remarkable coping mechanism helped me survive the ACE parts of my childhood, and I find I need to give a heads-up about it to anyone who treats me in a medical setting. While chatting at last year’s ACEs Conference in San Francisco, Dr. Vince Felitti asked me to write an article for The Permanente Journal about my experiences with the medical community, as a person with a childhood-trauma-related, but mostly invisible, mental health disorder. And, of course, who can say “No” to Dr.
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The Relentless School Nurse: ACEs Impact Nurses More Than We Realized!

Robin M Cogan ·
I ran across this message on www.acesconnection.com and not only did it catch my attention, but it also made me want to dig deeper. Could it be true that nurses have a higher ACEs score than other healthcare professionals? It seemed true in this small survey, but was this a representation of a trend? If it was, the implications in nursing practice could be tremendous and concerning. What I found was that there is a grand canyon gap in research. The minimal studies that do exist confirm that...
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The Relentless School Nurse: When the Health Office Pass Includes Emotions

Robin M Cogan ·
The collaboration between school counselors and school nurses creates safe spaces for students at school. Building a coalition between school counselors and school nurses creates a safety net for our most complex and challenging students while benefiting the whole school community. Promoting connections through intentional relationship building, and ensuring a school environment that is physically, emotionally and psychologically safe changes the culture and climate. Read about an amazing...
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Tools and how to use them is focus of second webinar on Community Resiliency Model, May 14, 2020

Carey Sipp ·
The second of two free Community Resiliency (CRM) webinars with Elaine Miller-Karas , key creator of the CRM, will be held Thursday, May 14, from 11 a.m. - 12:30 p.m. ET, (10 a.m. CT; 9 a.m. MT, and 8 a.m. PT) and will include the practical application of tools of the model. CRM is an ACEs science-based biological model for helping individuals become emotionally regulated during natural disasters and other dysregulating times. Miller-Karas will be joined by CRM trainers from Wilmington, NC:...
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University of Florida Graduate Public Health Course: Trauma-Informed Approaches for Individuals, Communities, and Public Health: Student Project Summaries

Lindsey King ·
The University of Florida College of Public Health and Health Professions partnered with Peace4Tarpon under the Robert Wood Johnson Mobilizing Action for Resilient Communities (MARC) grant. Together they created 2 online graduate courses that focus on addressing ACEs and creating trauma-informed and resilience-based programs from a public health approach. Peace4Gainesville and Peace4 TheBigBend have also contributed to these courses. This post is intended to showcase some of the work of the...
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Webinar: The Human Impact of Climate Change

Alison Cebulla ·
The Community Resiliency Model Disaster Relief Program Climate change emergencies are real and the human toll during and in the aftermath impact children, teens and adults. This webinar will hear from Kelly Doty, a survivor, who lost her home in Paradise and is working in a community-based program to help the children and their parents in the aftermath. Elaine Miller-Karas, the key developer of the Community Resiliency Model Disaster Relief Program, will explain the program and how it helps...
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What a Pediatrician Can Do for a Child Seeking Asylum-And What She Can't [newyorker.com]

By Rachel Pearson, The New Yorker, October 8, 2019 On a cool spring afternoon, in a clinic that serves refugee and immigrant families, I sit across from a teen-age girl. She is otherwise known as an unaccompanied alien child, or U.A.C. She left her home in Central America, crossed the southern border, and was detained for a week—in Texas, she thinks—in a facility where breakfast was a cold bean burrito, lunch was a cup of microwavable noodle soup, and dinner was a cold bean burrito. She says...
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When Hidden Grief Gets Triggered During COVID-19 Confinement

Tian Dayton ·
first published by The Meadows 4/15/20 Our sense of loss during the current COVID-19 crisis can trigger hidden emotions from when we experienced a sense of loss before. Whatever early losses you have had in your life — whether they be your own divorce, your parents, or both, or the abandonment of one parent, a childhood or parental illness or death, financial upheaval, constant moving around, or growing up with parental addiction or adverse childhood experiences (ACEs) — they are likely to...
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Why Emotional Eating Can Be a Consequence of Trauma

Rachel Eddins ·
Research suggests that trauma can be a cause of emotional eating, or the drive to consume “comfort foods,” to manage the negative emotions directly related to past negative events.
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12 Things I Wish My Doctor Understood About Childhood Trauma

Anna Runkle ·
It doesn’t happen that often anymore, but one place where I almost always get triggered with my Childhood PTSD symptoms is when I visit the doctor. I could never even put this into words before. But now that I’m mostly healed from my Childhood PTSD symptoms, I want to express what I wish my doctors – all the doctors of my life – had understood about the effects of Childhood trauma, about me. Note: This is one of my most personal posts ever. Unless you’re someone who really prefers text, I...
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5 Tips for Supporting College Age Students' Mental Health [blogs.psychcentral.com]

By Andrea Schneider, PsychCentral, February 7, 2020 Did you know that the second leading cause of death in people ages 15-22 is suicide (ACHA, 2020)? Those are some sobering statistics. After a recent move from S CA to N Ca, I am currently serving in a new role in which I am the Lead Counselor on a college campus for this age range. Unfortunately, those statistics don’t lie. I am deeply involved in creating new programs, strategies, and direct clinical support for the students my campus...
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7 Ways to Help a Child Deal with Traumatic Stress

Hilary Jacobs Hendel ·
Traumatic stress feels awful. Thankfully, there are small things we can all do to help relax a hyperaroused nervous system.
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A Nurse Survivor Shares Her Story and Concerns

Laneita Williamson ·
Yesterday was another trauma informed care training to nurses. I'm still very amazed at the biases that occur around sex, drugs, abortion, alcoholism, mental health or other challenges. As typical I received a follow up email from a survivor with their thoughts, not about the training but about the response of other humans around human behaviors and actions. The nurse survivor that emailed me felt so empowered to make a change that she has requested that I share her story with others in the...
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A View From the Sharp End of New Zealand's Suicide Problem [thespinoff.co.nz]

By Gawen Carr, The Spinoff, October 21, 2019 Last week, as I left yet another 3am crisis interview in ED as a psychiatric doctor for a suicidal teenager, I felt drained and weary. This was partly due to the time, but mostly something else: although I felt I had helped keep the young person safe in the imminent future, I was frustrated that I was unable to meaningfully address the reasons why they felt that way. I thought I’d look through the recently released Ministry of Health authored...
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ACEs & African Americans Community on ACEs Connection

Ingrid Cockhren ·
ACEs Connection envisions a resilient world where ALL people thrive. We are an anti-racist organization committed to the pursuit of social justice. In our work to promote resilience and prevent and mitigate ACEs, we intentionally embrace and uplift people who have historically not had a seat at the table. ACEs Connection celebrates the voices and tells the stories of people who have been barred from decision-making and who have shouldered the burden of systemic and economic oppression as the...
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ACEs Community Spotlight Series: Dr. Richard Honigman, Central Nassau Pediatrics

Margaret Wayne ·
For our second community spotlight interview, I spoke with Dr. Richard Honigman, a pediatrician at Central Nassau Pediatrics in Levittown and infant mental health advocate. We discussed the importance of addressing childhood adversity and the relevant work he is doing both inside and outside his practice. Please note that responses have been adjusted for length and clarity. Dr. Honigman is also the first recipient of the 2019 Ed Tronick Award for Distinguished Contribution to Infant-Parent...
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Action needed today by trauma advocates to urge Congress to address mental health and trauma in current COVID-19 legislation

The follow is a message from Dan Press, Legal Advisor to the Campaign for Trauma-Informed Policy and Practice ), about the need to contact Congress regarding a COVID 19 funding bill being considered this weekend. He is urging ACEs science/trauma advocates and leaders to send emails to their U.S. Senators and Representatives immediately to address the mental health and trauma implications of this pandemic. All – I hate to bother you on a Sunday, but we urgently need you to contact Congress to...
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Announcing Trauma and Resilience Competencies for Nursing Education

Kathleen Wheeler ·
The authors are pleased to announce the Trauma and Resilience Competencies for Nursing Education. These competencies serve as a guideline of minimal expectations and reflect essential knowledge, skills and behaviors for three levels of nursing education: 1) undergraduate, 2) graduate, and 3) psychiatric nurse practitioner programs. The Trauma and Resilience Competencies, developed in 2018 at the Egan School of Nursing and Health Studies at Fairfield University in Connecticut by an Expert...
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At the scene of a house fire, ACEs cast long shadows

Peter Chiavetta ·
I am on the scene of a house fire in a town near where I live in Brant, NY. As part of my duties as EMT with my fire company ambulance (I'm first assistant chief firefighter), I make sure firefighters who are working a fire stay healthy while they’re fighting it, especially firefighters with ACEs.
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Becoming Trauma Informed (Millstein JGIM 2020)

Megan Gerber MD MPH ·
When I look at Victoria through a clearer lens, there are many clues—her anxiety, troubled marriage and family life, avoidance of physically intrusive examina- tions. I realize that I hardly know her at all. I focus on her health issues, and despite many stumbles, we have a nice rapport. I accept whatever she is willing to share about her tumultuous home life, but I do not ask how it all came to be so. Now I float with her in a reservoir of pain and shame.
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Cancer as a survivor

Christine Cissy White ·
Many people use the phrase CPTSD to stand for PTSD from complex trauma. To me, C-PTSD means cancer and PTSD. I have cancer and I’m a trauma survivor. I’m a survivor with cancer but not yet a cancer survivor. Will I be a survivor squared?
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Child Abuse Doc: We Often Wish for a Different Explanation [medpagetoday.com]

By Antoinette Laskey, MedPage Today, December 1, 2019 I always knew I wanted to be a doctor. I also always knew working with children is what brought me the most joy. Finding the subspecialty of child abuse pediatrics was not something I had anticipated. In medical school, I had the opportunity to work with a child abuse pediatrician when a child was brought in for medical care after being sexually assaulted. We examined the child, calmed the obviously distressed parent, and talked with the...
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CPTSD and Social Awkwardness: Another Source of Isolation

Anna Runkle ·
For those of us who grew up with abuse and neglect at home, it can be hard to know how to ACT in social situations. Here's an example.... Have you ever been to a hotel where there is a person who is there to carry your bags, and even though you didn’t ask, they carry your bags to the room and it’s totally awkward, and you think “I’m supposed to give them a tip, right? I’ve, like seen this on TV. But you don’t have cash, and they’re just standing there ," and you think, "What do I do? What do...
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Cultivating Deliberate Resilience During the Coronavirus Disease 2019 Pandemic [jamanetwork.com]

By Abby R. Rosenberg, JAMA Pediatrics, April 14, 2020 Coronavirus disease 2019 (COVID-19) is affecting our health care community in unprecedented ways. As a pediatric oncologist who studies resilience in the context of illness, I started thinking about what this pandemic means for our professional resilience a few weeks ago, when the first US patient with fatal COVID-19 died in my home city of Seattle, Washington. Promoting resilience among health care workers and organizations starts with...
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Despite Gains, the Emotional Lives of Children Often Forgotten by Our Medical System [centerforhealthjournalism.org]

By A.K. Whitney, Center for Health Journalism, November 11, 2019 I don’t remember the date, or even the time of year, though the medical records tell me it was 1977. I was 6. But I will always remember that day: the gloomy, wood-paneled exam room at Karolinska Institutet in Stockholm, the hard, high table I sat on, the doctor looming above me as he muttered about swan necks and hammers, though there were no birds or tools in sight. He didn’t bother making eye contact with me. I’m not sure he...
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Donna Jackson Nakazawa on bringing down the stress-threat response

Christine Cissy White ·
Cissy's note: Donna Jackson Nakazawa has graciously allowed me to cross-post some of her current and future Facebook page posts here in the Practicing Resilience for Self-Care and Healing community on ACEs Connection . Hello Friends. As a SciComm journalist with 30 years of reporting and 6 books under my belt, which focus on how our stress response governs our immune health, I’ve been thinking about what I have learned, and how I might help you quiet your body and mind during this # pandemic...
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Doulas & Covid-19: A toolkit for doulas (DONA International)

Karen Clemmer ·
Please the attached toolkit for more information. From the toolkit: Best practices when working with clients Given how new this virus is, we currently have very little data on how it might affect pregnant people and newborns. Guidelines from the CDC outline recommendations for how to support pregnant and laboring people with Coronavirus. (3) There is currently no evidence that the virus is spread from mother to baby in utero, or that it is transmitted in human milk. (4)
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During COVID-19: The need for your skills. Self-care resources. Share your TI responses? Thank you!

Mimi graham ·
Dear Trauma F riends and C olleagues: The COVID 19 pandemic offers a critical opportunity to share your unique skills in coping with stress and trauma. Many of us and the families we serve may be shifting through the stages of change and grief----denial, anger, bargaining, acceptance---about this pandemic. You may be adjusting to telehealth and virtual visits but know that our families need your reassurance and help in regulating and coping. Hope you’re all practicing self-care while you...
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Fed Up With Deaths, Native Americans Want to Run Their Own Health Care [nytimes.com]

By Mark Walker, The New York Times, October 15, 2019 When 6-month-old James Ladeaux got his second upper respiratory infection in a month, the doctor at the Sioux San Indian Health Service Hospital reassured his mother, Robyn Black Lance, that it was only a cold. But 12 hours later James was struggling to breathe. Ms. Black Lance rushed her son back to the hospital in western South Dakota, where the doctors said they did not have the capacity to treat him and transferred him to a private...
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For Community Health Centers, a Hands-On Guide to Building Partnerships [chcf.org]

By Carlina Hansen, California Health Care Foundation, October 15, 2019 Before joining CHCF, I spent almost 20 years as executive director of the Women’s Community Clinic in San Francisco. In my time there, we forged some valuable partnerships to serve our clients and community, including our merger with another community health center, HealthRIGHT 360. It was during the merger process that I learned first-hand one of the biggest challenges to forging such partnerships — and it wasn’t what I...
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From Trauma-Informed to Asset-Informed Care in Early Childhood [brookings.edu]

By Ellen Galinsky, Brookings Institute, October 23, 2019 The focus on “toxic stress,” ACEs (Adverse Childhood Experiences), and trauma-informed care have been game-changers in the field of early childhood development. They have helped us recognize the symptoms of trauma, provide appropriate assistance to children, and understand that prolonged adversity in the absence of nurturing relationships can derail a child’s healthy development. Just look at the media’s and the public’s reaction to...
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GABOR MATÉ JOINS EP. 3 on May 21 with Darrell Hammond and Filmmaker Michelle Esrick. [crackedupmovie.com]

CRACKED UP THE EVOLVING CONVERSATION TRAUMA AS THE ROOT CAUSE OF ADDICTION With DARRELL HAMMOND DIRECTOR MICHELLE ESRICK and RENOWNED TRAUMA AND ADDICTION EXPERT GABOR MATÉ, M.D. author of In the Realm of Hungry Ghosts: Close Encounters With Addiction MODERATED BY JANE STEVENS, FOUNDER OF ACES CONNECTION Hosted by ACES Connection Thursday May 21st at 2pm PDT / 3p MT / 4p CT / 5pm EDT FREE FOR ALL WHO REGISTER! IF YOU REGISTER, BUT CAN NOT ATTEND, YOU WILL RECEIVE A RECORDING WITHIN ONE WEEK.
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Got time for a little brainstorming with ACEsConnection?

Jane Stevens ·
On Friday, March 20, 2020, you're invited to join me to talk about how we, as a community, can continue to guide and educate ourselves about to deal with the effects of the spread of Covid-19, and how to continue those efforts with people who don't yet know about ACEs science. And, given this last week, how we can provide more support to stay in the front of our brains instead of feeding our amygdala.
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Governor Cuomo’s Cancer Research Initiative Disappointing. No ACES included.

Peter Chiavetta ·
I attended the presentation of Governor Cuomo's Cancer Research Initiative at the Buffalo Science Museum October 22, 2019. Brad Hutton Deputy Health Commissioner State of NY presented. Erie County Health Commissioners in attendance. It had all the data on the 4 major cancers in the East Side of Buffalo, NY. https://www.health.ny.gov/diseases/cancer/cancer_research_initiative/docs/erie_presentation.pdf I'm all excited. Prepared with 2 dozen ACE handouts. Sat quietly for the 45 minute power...
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How Can a Doctor Stop from Burning Out in the Pandemic? (greatergood.berkeley.edu)

Over the din of the negative pressure machine, I shouted goodbye to my patient. I zipped my way out of one of the little plastic enclosures in our emergency department (ED). With disgust and a bit of fear, I carefully shed my gloves, gown, and face shield. Only my precious mask remained on my face. I thought, This is a whole new world, and I hate it . The problem is that I’m losing that deep feeling of connection with patients, which is such an important part of this work. A few weeks ago,...
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How do these pediatricians do ACEs screening? Early adopters tell all.

Laurie Udesky ·
Last week, three pediatricians — with a combined experience of 15 years integrating ACEs science into their practices — reflected on the urgency they felt several years ago that prompted them to begin screening patients for childhood adversity and resilience when there was practically no guidance at all. Along their journey , they accumulated a list of lessons learned for other pediatricians and family clinics to use. The three pediatricians participated in the ACEs Connection webinar,...
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How trauma-informed care promotes healing: Patient Narrative

Megan Gerber MD MPH ·
So pleased that KevinMD published this patient narrative. I was encouraged to share it here as well! https://www.kevinmd.com/blog/2...romotes-healing.html By MEGAN R. GERBER, MD | CONDITIONS | JULY 26, 2019 As physicians, we face the formidable task of working with patients who appear angry, never content with care or “made better” by anything we do. They may be known as “difficult,” unpleasant, or demanding. These patients are the most challenging and often the least rewarding to care for.
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Hundreds of Miles From Home, Nurses Fight Coronavirus on New York's Front Lines [nytimes.com]

By Jenny Gross, The New York Times, April 28, 2020 Each night at dusk, in an otherwise desolate Times Square, hundreds of nurses in blue scrubs gather to board buses that take them to hospitals across New York City. Of the thousands of nurses who have come from other states to shore up New York’s hospitals, more than 4,000 are staying in Midtown Manhattan. During the day, many rest at their hotels, amid darkened Broadway marquees, quiet streets and boarded up shops. At night, they face...
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Moving Upstream to Address Contributors to Toxic Stress in Pediatric Primary Care [chapinhall.org]

By Angeline Spain, Angela Sander, and Amanda Brown, Chapin Hall at The University of Chicago, October 2019 Healthcare in the U.S. is increasingly moving “upstream” to address the risk of social determinants of health. One common strategy is the early screening of needs and connection to services. Chapin Hall, in collaboration with national and local partners, is conducting an evaluation of innovations designed to promote screening for contributors to toxic stress during pediatric well-child...
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My son was hospitalized and now he has PTSD

Stephanie Kennelly ·
“Grant, do you remember when you were in the hospital?” “Yes… they came to take the blood and I turned into a werewolf.” Original Post It happened quickly. A year ago my three year old had a collarbone fracture, it became infected and within 24 hours the situation was emergent. A week long hospital stay, one month with a PICC line and two months on oral antibiotics. Finally, the labs finally came back normal. The X-Ray was clean. Gillette Children’s Hospital closed our case. But the healing...
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NPPC shares lessons learned and results from ACEs screening pilot sites

Laurie Udesky ·
For Dr. Mercie Digangi, a pediatrician at Kaiser Southern California in Downey, CA, ACEs screening provided a crystal clear before-and-after in how she changed treatment plans for her pediatric patients, she explained to attendees of a December 2 webinar organized by the National Pediatric Practice Community on ACEs (NPPC) and cosponsored by ACEs Connection. Dr. Mercie Digangi One case that turned ACEs screening into a never-go-back moment for her was a three-year-old who was speech-delayed.
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Nurturing relationships in childhood boost adult mental health, relationships

Christina Bethell ·
We're proud to announce major research that suggests that positive childhood experiences — such as supportive family interactions, caring relationships with friends, and connections in the community — are associated with reductions in chances of adult depression and poor mental health, and increases in the chances of having healthy relationships in adulthood. This association was true even among those with a history of adverse childhood experiences.
Comment

Re: Becoming Trauma Informed (Millstein JGIM 2020)

Jeoffry Gordon ·
As a family doc with 40 years of practice under my belt I heard the phrase "Trauma Informed Care." for the first time in 2019. This not so benign neglect is complimented by adult medicine's obliviousness to the pervasive morbidities caused by the fact that about 20% of our adult patients were abused as children. This affects both mental and physical health. Training in adult medicine is void of attention to both child abuse and TIC, much to the detriment of our patients.
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Re: A Nurse Survivor Shares Her Story and Concerns

Lisa Eason ·
Thank you Laneita. We all need a strong reminder that we never know what another has gone through. And we also need to consider making a commitment to ourselves to try to never leave someone worse off than how we found them. In your case you were left worse off, by the judgmental words. I am sad that you had to experience that, especially from we nurses. I sincerely hope that nursing and physician programs teach ACES content, as well as have their students evaluate their own ACE scores and...
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Prioritizing Physician Mental Health as COVID-19 Marches On [jamanetwork.com]

By Jennifer Abbasi, JAMA Network, May 20, 2020 I n the spring of 2013, Eileen Barrett, MD, MPH, lost a colleague to suicide. The two worked at the Indian Health Service’s Gallup Indian Medical Center in New Mexico, where Barrett was the deputy chief of medicine. Even before the tragic event, she saw workers struggle under administrative burdens and hold themselves personally responsible for problems outside of their control. With her coworker’s death it became painfully clear that clinician...
 
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