Tagged With "Black patients"
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Penn Nursing Conference Stresses Need for Mental Health Awareness in Health Care [thedp.com]
By Anya Tullman, The Daily Pennsylvanian, October 21, 2019 A student-run conference in the School of Nursing Saturday drew nearly 200 students and community members to talk about incorporating mental health awareness into health care. The "Reimagining Mental Health" conference featured speakers from across the Philadelphia and Penn communities who discussed harm reductionist and trauma-informed approaches to health care. "Harm reduction" refers to the practice of medical professionals...
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The Black Community, COVID-19 & Trauma [sdvoice.com]
By Latanya West, San Diego Voice, May 15, 2020 In January 2019, Governor Gavin Newsom appointed Dr. Nadine Burke Harris as California’s first-ever Surgeon General. An award-winning physician, researcher and advocate, Dr. Burke Harris’ career has been dedicated to serving vulnerable communities and combating the root causes of health disparities. Her work is equally dedicated to changing the way our society responds to one of the most serious, expensive and widespread public health crises of...
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The Center for Youth Wellness Launches Childhood Adversity Screening Program with Leading North Carolina Health Systems [PR Newswire]
Charlotte pilot program with Atrium Health and Novant Health supports state's goal to address social, economic and environmental health to improve child and family health outcomes The Center for Youth Wellness (CYW) announced it is partnering with two leading U.S. health systems in the Southeast to launch a screening program on childhood adversity. CYW's National Pediatric Practice Community (NPPC) has done on-site training at the headquarters of Atrium Health and Novant Health in Charlotte,...
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The mother of invention (The Harvard Gazette)
By M. R. F. Buckley, May 15, 2020, The Harvard Gazette. COVID-19 pandemic spurs creation of new, remote teaching methods at HMS When the COVID-19 pandemic prompted Harvard Medical School (HMS) to move learning online in March, faculty moved swiftly, developing new curriculum approaches, sometimes within hours, allowing educators to continue to teach classes and ensure that students are achieving learning objectives remotely. But, among Harvard Schools, they had some unique challenges. Part...
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The Relentless School Nurse: ACEs Impact Nurses More Than We Realized!
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
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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Trauma-Informed Care as a Universal Precaution: Beyond the Adverse Childhood Experiences Questionnaire [jamanetwork.com]
By Nicole Racine, Teresa Killam, and Sheri Madigan, JAMA Pediatrics, November 4, 2019 Experiences of childhood adversity are common, with more than 50% of adults reporting having experienced at least 1 adversity as children and more than 6% exposed to 4 or more adverse childhood experiences (ACEs). There is currently a controversial debate in the medical field as to whether the ACEs questionnaire, which asks about abuse, neglect, and household dysfunction before age 18 years, should be...
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Trauma-Informed Care May Ease Patient Fear, Clinician Burnout [jamanetwork.com]
By Bridget M. Kuehn, JAMA Network, January 29, 2020 For many sexual assault survivors whom Anita Ravi, MD, MPH, sees as a New York City–based family physician, the prospect of even basic medical care can be frightening. Some have put off Papanicolaou tests and mammograms for years or even decades. To help them, Ravi has adopted a trauma-informed approach that works to restore patients’ trust and give them a greater sense of control over their visit. This may include asking permission before...
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Why Is the Pandemic Killing So Many Black Americans [podcasts.apple.com]
By The Daily, The New York Times, May 20, 2020 Some have called the pandemic “the great equalizer.” But the coronavirus is killing black Americans at staggeringly higher rates than white Americans. Today, we explore why. Guest: Linda Villarosa, a writer for The New York Times Magazine covering racial health disparities, who spoke to Nicole Charles in New Orleans, La. about the death of her husband, Cornell Charles, known as Dickey. He was 51. For more information on today’s episode, visit...
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12 Things I Wish My Doctor Understood About Childhood Trauma
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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ACEs & African Americans Community on ACEs Connection
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 Research Corner — November 2019
[Editor's note: Dr. Harise Stein at Stanford University edits a web site -- abuseresearch.info -- that focuses on the health effects of abuse, and includes research articles on ACEs. Every month, she's posting the summaries of the abstracts and links to research articles that address only ACEs. Thank you, Harise!! -- Jane Stevens] Jackson DB, Chilton M, Johnson KR, Vaughn MG. Adverse Childhood Experiences and Household Food Insecurity. Am J Prev Med. 2019 Nov;57(5):667-674. PMID: 31522923...
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Announcing Trauma and Resilience Competencies for Nursing Education
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
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)
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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California unveils ACEs Aware initiative to screen for trauma
Will screening for adverse childhood experiences (ACEs) in California be mandatory? No, but it’s recommended. Will there be training for physicians and staff on how to screen? Yes. Who will be reimbursed for screening patients in California? Physicians who serve patients in the state’s Medi-Cal program — for now. For more answers to these and other questions that surfaced during a Dec. 4 webinar introducing Californians to a new statewide initiative, read on. Come January 1, California will...
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Cancer as a survivor
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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CenteringParenting Recognized as Innovative Pediatric Intervention in New Report from The Center for the Study of Social Policy [globenewswire.com]
By Vandana Devgan, Centering Healthcare Institute, November 15, 2019 Centering Healthcare Institute (CHI) is honored to share that its pediatric group care model CenteringParenting®, has been recognized by The Center for the Study of Social Policy (CSSP) as an innovative pediatric intervention in its latest study. "Fostering Social and Emotional Health: Common Threads to Transform Everyday Practice and System" , released as part of the Pediatrics Supporting Parents (PSP) initiative, shares...
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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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Dissecting Racial Bias in an Algorithm Used to Manage the Health of Populations [science.sciencemag.org]
By Ziad Obermeyer, Brian Powers, Christine Vogeli, and Sendhil Mullainathan, Science, October 25, 2019 Racial bias in health algorithms The U.S. health care system uses commercial algorithms to guide health decisions. Obermeyer et al. find evidence of racial bias in one widely used algorithm, such that Black patients assigned the same level of risk by the algorithm are sicker than White patients (see the Perspective by Benjamin). The authors estimated that this racial bias reduces the number...
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Efforts to Reduce Black Maternal Mortality Complicated by COVID-19 [chcf.org]
By Xenia Shih Bion, California Health Care Foundation, April 20, 2020 Latoyha Young had a birth plan. She was going to have the baby in Sacramento with community doula Joy Dean by her side. Dean was funded by the county’s Black Child Legacy Campaign , which works to reduce the disproportional number of Black infant and child deaths in Sacramento. But in mid-March, when Young went into labor just as Governor Gavin Newsom ordered Californians to stay at home to avoid spreading the novel...
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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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Home Gun Safety Queries in Well-Child Visits [jamanetwork.com]
By Carole H. Stipelman, Greg Stoddard, Kyle Bata, et al., JAMA Pediatrics, October 28, 2019 Firearms are a leading cause of death in US children, and the rate of suicide by firearms in people aged 10 to 19 years has increased since 2008.1 In the United States, 4.6 million children (approximately 7%) live in households with at least 1 gun that is stored loaded and unlocked.2 Safe storage of guns and ammunition may decrease the occurrence of self-inflicted or unintentional firearm injury to...
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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.
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
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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`I'm never going to be the same': Medics grapple with mental trauma on COVID-19 front line (msn.com)
Anne Messman, a veteran emergency room physician in Detroit, knew something was wrong when she developed insomnia and became unusually irritated with people she loved. Messman and thousands of other healthcare workers across the United States are grappling with psychological traumas that mental health professionals say are more commonly associated with soldiers returning home from far-flung battlefields. The unrelenting horror of COVID-19 has exacted a toll on healthcare workers who have...
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Jones: Day 2: Soda, cigarettes and trauma: How Adverse Childhood Experiences alter brain chemistry, cultivate unhealthy habits and prompt premature death
Patients would carry soda into Dr. Gerard Clancy’s office, with cigarettes tucked away for after therapy. Often victims of abuse or violent crime, they would seek soothing but risky behaviors to cope. Overweight. Chronic pain. Chronic obstructive pulmonary disease. Type II diabetes. His former patients will die younger than they should, he said. Clancy conducted therapy sessions until he became president of the University of Tulsa in 2016. At his psychiatry clinic, he saw firsthand how a...
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Mount Sinai Announces Center for Stress, Resilience and Personal Growth [newswise.com]
Newswise — (New York, NY – April 30, 2020 ) -- Mount Sinai Health System (MSHS), one of New York’s largest integrated health systems, announced today the launch of the Mount Sinai Center for Stress, Resilience and Personal Growth, a first-of-its-kind initiative in North America that is designed to address the psychosocial impact of COVID-19 on the mental health and lives of frontline health care providers at Mount Sinai and will serve as a model for institutions and communities around the...
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NPPC shares lessons learned and results from ACEs screening pilot sites
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.
Comment
Re: ACEs & African Americans Community on ACEs Connection
The more solid scientific evidence, the better the chances of convincing the medical community that we will not make a dent in the numbers of chronic diseases/ mental health and substance issues, until we provide treatment for ACEs, generational trauma .... as readily as we prescribe a pill. Thank you for the work you are doing!
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Diagnosing and Treating Systemic Racism (NEJM)
June 10, 2020. Michele K. Evans, M.D., Lisa Rosenbaum, M.D., Debra Malina, Ph.D., Stephen Morrissey, h.D., and Eric J. Rubin, M.D., Ph.D. For the New England Journal of Medicine. For physicians, the words “I can’t breathe” are a primal cry for help. As many physicians have left their comfort zones to care for patients with Covid-19–associated respiratory failure, the role of the medical profession in addressing this life-defining need has rarely been clearer. But as George Floyd’s repeated...
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2020 Health Equity Call for Research (AAMC)
2020 Health Equity Call for Research: AAMC Consumer Survey of Health Care Access Introduction In recognition of the importance of research and the dissemination of evidence-based solutions to achieve health equity, the AAMC (Association of American Medical Colleges) founded the Collaborative for Health Equity: Act, Research, Generate Evidence (CHARGE), a forum for investigators, clinicians, and community partners to collaborate and improve upon research that aims to minimize disparities in...
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Racism's Effect on Health, and the Heartbreak of Being a Black Parent Right Now: California's Surgeon General Speaks [kqed.org]
By KQED Science, KQED, June 14, 2020 The coronavirus pandemic and the recent killing of George Floyd have brought longstanding racial inequities into sharp focus. One of those disparities concerns the high rate of coronavirus transmission among people of color. To talk about the intersection of race and health, KQED's Brian Watt spoke last week with California Surgeon General Dr. Nadine Burke Harris, who is known for her pioneering work on the role that childhood stress and trauma play on...
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Humana: ‘Unhealthy Days’ For Medicare Population Fall As Social Determinants Screened (Forbes)
By Bruce Japsen, June 18, 2020, Forbes. A project by Humana to improve the health of seniors in private Medicare plans through better management of patient populations continues to show improvement five years into the effort, the health insurer said in a new report. Humana’s “Bold Goal” initiative, which began in 2015, uses measures established by the Centers for Disease Control and Prevention to track an individual’s physical and mental “unhealthy days” over a 30-day period. The social...
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ACEs screening is about building relationships, says early adopter
Whether or not to screen for ACEs in primary care is an important debate—and I hear and respect the passion from both sides of the argument. I fall in the “pro-ACE assessments” camp, but with some important caveats. I think that assessments for ACEs are dramatically different from screening for autism or developmental delays. In my opinion, assessments for ACEs in primary care should be primarily about building relationships.
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Stolen Breaths [njem.org]
By Rachel R. Hardeman, Eduardo M. Medina, and Rhea W. Boyd, New England Journal of Medicine, June 10, 2020 In Minnesota, where black Americans account for 6% of the population but 14% of Covid-19 cases and 33% of Covid-19 deaths, George Floyd died at the hands of police. “Please — I can’t breathe.” He was a black man detained on suspicion of forgery, an alleged offense that was never litigated or even charged, but for which he received an extrajudicial death sentence. “Please — I can’t...
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Physician Burnout, Interrupted (NEJM)
By Pamela Hartzband, M.D., a nd Jerome Groopman, M.D. June, 25, 2020, N Engl J Med 2020; 382:2485-2487 DOI: 10.1056/NEJMp2003149. Before the onset of the Covid-19 pandemic, each day seemed to bring another headline about the crisis of physician burnout. The issue had been simmering for years and was brought to a boil by mounting changes in the health care system, most prominently the widespread implementation of the electronic health record (EHR) and performance metrics. 1 Initially, the...
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Resilience for Children & Families: Being Brave When Things are Hard
Building Resilience with Children During Racial Discrimination & Violence: This attached Resilience Brief for Children has been the hardest one I have written yet. I have been an active advocate for the equal treatment of people from all backgrounds, religions, ethnic heritages, orientations, and families my entire life. It is hard to see the pain present today, not only due to COVID19 but also due to the harm and anger we see daily in the news. I want to share a story about the person...
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Incidence of Stress Cardiomyopathy During the Coronavirus Disease 2019 Pandemic (JAMA)
By : Ahmad Jabri, MD ; Ankur Kalra, MD ; Ashish Kumar, MBBS ; et al, July 9, 2020, JAMA. Question Is psychological, social, and economic stress associated with coronavirus disease 2019 (COVID-19) associated with the incidence of stress cardiomyopathy? See attached pdf - or [ Please click here to read more. ]
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Trauma informed pain treatment
A patient-centered approach to opioid tapers must account for the reality that many people who are given a prescription for an opioid to treat pain have significant mental health conditions—for which opioids act as a psychotropic agent. An opioid taper must therefore address psychological trauma, in particular.
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Does racism make us sick? Amid a national reckoning, the question gains new importance [sfchronicle.com]
By Tatiana Sanchez, San Francisco Chronicle, August 24, 2020 Elaine Shelly has lived with multiple sclerosis for 30 years. But she said she still panics whenever she has to see a new neurologist because of racial discrimination she’s experienced in the past. Even getting a proper diagnosis for her illness was a battle. “I’d go to these neurologists who would tell me that Black people don’t get M.S. and that I must be mentally ill,” said Shelly, 63, of San Leandro. A former print journalist,...
Comment
Re: What’s behind burnout in trainee physicians (Contemporary Pediatrics)
YES, BUT! Even to use the term "burnout" is to buy into the oppressive perspective of an immoral, exploitative medical system. The real issue is "moral anguish" of clinicians who must work in an industrial environment where productivity and efficiency and an oppressive constraining electronic medical record trump attention, caring and compassion. Traditionally in medicine trainees (residents) learn best by being pushed, stressed, and dominated by the learned superiors (Germanic model). Now,...
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Addiction Born Out of ACEs and The Return of Hope [avahealth.org]
The downstream effect of childhood trauma has been well documented regarding the biological and psychosocial impacts. This presentation will highlight the neurobiological changes associated with ACEs that function as a "primer" for the onset of addiction and related behaviors. It will conclude with principles for influencing these same pathways that assist with restoration of the mind and health downstream effect of childhood trauma has been well documented regarding the biological and...
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Medicine and medical science: Black lives must matter more The Lancet
The following quote appeared in an editorial in The Lancet on June 13, 2020: "What can medical journals do? Our task is to educate ourselves and others about racism. We must support Black and minority ethnic health workers. And we must use evidence and our values to speak out for Black and minority ethnic communities. The Lancet is a journal with a deep colonial history: the journal has published work that supported the health of settler colonialists and that prioritised their health over...
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Just in TIME: Trauma-Informed Medical Education [link.springer.com]
By Aneesah McClinton & Cato T Laurencin, Journal of Racial and Ethnic Health Disparities, October 1, 2020 Abstract Numerous organizations implement a trauma-informed approach. This model assists institutions in providing care and education that delivers support to members who have undergone traumatic experiences, and many institutions apply the principles as a universal precaution. Student and trainee experiences in medical education reveal a hidden curriculum that may deliver...
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The importance of care coordination [medcitynews.com]
By Brooke Sabia, MedCity News, September 30, 2020 Some may ask the question, “What does a care coordinator do for my personal well-being?” There is no short answer as to what a patient can benefit from by receiving assistance from a care coordinator. Their job is to connect with high-risk individuals to uncover and identify needs in a patient-centered manner and in a way that takes into account whether the patient has endured any trauma. When people think of care coordination, they typically...
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NOW AVAILABLE ON DEMAND: The Repressed Role of Adverse Childhood Experiences in Adult Well-Being, Disease and Social Functioning: Turning Gold into Lead (Dr. Vincent J. Felitti) [avahealth.org]
The ACE Study reveals how typically unrecognized adverse childhood experiences are not only common, but causally underlie a number of the most common causes of adult social malfunction, biomedical disease, and premature death. Moreover, it enables one to see that the Public Health Problem is often an individual’s attempted Solution to childhood experiences about which we keep ourselves unaware. A renowned physician and researcher, Dr. Vincent J. Felitti is one of the world’s foremost experts...
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An exploration of medical student attitudes towards disclosure of mental illness (Medical Education Online)
By Ian Fletcher , Michael Castle , Aaron Scarpa , Orrin Myers , and Elizabeth Lawrence , Published online 2020 Feb 13. doi: 10.1080/10872981.2020.1727713 . ABSTRACT Background : Medical students are reluctant to access mental health services, despite having high rates of anxiety and depression. This reluctance persists through residency and into practice. Physicians and trainees who are unwell deliver lower quality patient care, behave less professionally, communicate less effectively and...
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The Intersection of Systematic Racism, the Pandemic, and SDoMH: Reality Mandates Change
Systematic racism is at the core of mental health disparities and social determinants of mental health (SDoMH).Upstream factors obstruct patient access to needed and appropriate assessment, timely intervention, with treatment for these populations often reflecting poorer quality, and ending prior to completion of treatment. COVID-19 and the recent pandemic have only amplified meso and micro-level gaps in care. considered, provided, and reimbursed.