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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 $5.2...
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Preventable trauma in childhood costs north America and Europe US$ 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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The Center for Youth Wellness Launches Childhood Adversity Screening Program with Leading North Carolina Health Systems [PR Newswire]

Jim Hickman ·
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 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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TIC: News and Notes for the Week of October 21, 2019 [dhs.wisconsin.gov]

Scott A Webb ·
ACEs, Adversity's Impact There is only one boat: The myth of normalcy by Dr. Gabor Mate Understanding historical trauma to strengthen community Childhood trauma linked to early, premarital childbirth and poor health for women Early life racial discrimination linked to depression, accelerated aging When mothers are killed by their partners, children often become 'forgotten' victims. It's time they were given a voice Children's language skills may be harmed by social hardship Does racism...
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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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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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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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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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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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California unveils ACEs Aware initiative to screen for trauma

Laurie Udesky ·
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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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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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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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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Intimate Partner Violence Screening and Intervention: The American College of Preventive Medicine Position Statement (Abstract) [sciencedirect.com]

By Tanya M. Phares, Kevin Sherin, Suzanne Leonard Harrison, et al., American Journal of Preventive Medicine, December 2019 The purpose of this paper is to produce a position statement on intimate partner violence (IPV), a major sociomedical problem with recently updated evidence, systematic reviews, and U.S. Preventive Services Task Force guidelines. This position statement is a nonsystematic, rapid literature review on IPV incidence and prevalence, health consequences, diagnosis and...
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What Do We Do? What Do We Do Now?

Jane Stevens ·
People’s response to the great chasms of structural inequities glaringly laid bare by the COVID-19 pandemic have been further inflamed by the murder of George Floyd and deaths of other African Americans in recent weeks. The acute emergency of the pandemic has eased, but the violence inflicted on racial minorities and now those who are protesting the inequities in our society has compounded the outrage. Right after the pandemic began running riot across the US, I often heard people ask: When...
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2020 Health Equity Call for Research (AAMC)

Karen Clemmer ·
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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Hidden in Plain Sight — Reconsidering the Use of Race Correction in Clinical Algorithms (NEJM)

Karen Clemmer ·
By Darshali A. Vyas, M.D., Leo G. Eisenstein, M.D., and David S. Jones, M.D., Ph.D., June 17, 2020, NEJM. Physicians still lack consensus on the meaning of race. When the Journal took up the topic in 2003 with a debate about the role of race in medicine, one side argued that racial and ethnic categories reflected underlying population genetics and could be clinically useful. 1 Others held that any small benefit was outweighed by potential harms that arose from the long, rotten history of...
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ACEs screening is about building relationships, says early adopter

R.J. Gillespie ·
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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Linda Grabbe: Helping her communities develop resilience through the Community Resilience Model

Sylvia Paull ·
Grabbe searched for models that would help her homeless and addicted patients. “There are good body-based models for psychotherapy, which may be the most effective approach for trauma,” she says, “but hardly any of my patients were receiving any kind of therapy. There are thousands of people in our communities who have high ACE scores who will never get the years of psychotherapy they deserve. CRM is a self-mental wellness care tool and is exquisitely trauma-sensitive—so it can help enormously.”
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Help Navigating the Road to Community Resiliency

Becky Haas ·
The first time I ever heard the words trauma-informed care and the Adverse Childhood Experiences (ACEs) study was in the summer of 2014. At the time, I was working for the local Police Department as the Director of a grant-funded Crime Reduction Project aimed at reducing drug-related and violent crime. Of the many program goals, one was to develop a rehabilitative corrections program for felony offenders with addictions in order to reduce recidivism. Though I’ve lived in this region for...
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Donald Trump is the product of abuse and neglect. His story is common, even for the powerful and wealthy.

Jane Stevens ·
“In order to cope,” writes Mary Trump, “Donald began to develop powerful but primitive defenses, marked by an increasing hostility to others and a seeming indifference to his mother’s absence and father’s neglect….In place of [his emotional needs] grew a kind of grievance and behaviors—including bullying, disrespect, and aggressiveness—that served their purpose in the moment but became more problematic over time. With appropriate care and attention, they might have been overcome.”
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Baby courts: A proven approach to stop the multigenerational transmission of ACES in child welfare; new efforts to establish courts nationwide

Carey Sipp ·
The organization Zero To Three estimates that in the U.S., a child is taken into the child welfare system every six seconds. “Many of society’s most intractable problems can be traced back to childhood adversity. Being in the child welfare system increases the likelihood of more adversity and criminality. Baby court is a proven approach to healing the trauma of both child and parent, and breaking the cycle of maltreatment,” says Mimi Graham, Ed.D ., director of the Florida State University...
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Trauma informed pain treatment

bennet davis ·
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 VP Candidate Kamala Harris know about ACEs?  You bet!

Nadine Burke Harris, California’s Surgeon General, has a lot in common with the vice presidential candidate Kamala Harris—Jamaican heritage, surname, home state—and a commitment to addressing ACEs and toxic stress. As reported in the New Yorker article by Paul Tough, “The Poverty Clinic,” Dr. Harris told Kamala Harris, then San Francisco district attorney, about ACEs in 2008 and in response, she offered to help. District Attorney Harris then introduced her to professor of child and...
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Free 2020 Virtual Trauma-Informed Care Conference

Bharat Sanders ·
Each year, STAR hosts a Trauma-Informed Care Conference to help educate the next generation of leaders and build a strong network of Trauma-Informed professionals in the state of Georgia. The conference will be held on Saturday, October 3rd from 10:00am- 1:00pm EST and Sunday, October 4th , 2020 from 2:00pm-5:00pm EST conducted virtually via Zoom.
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Implementing the Neurosequential Model of Therapeutics in Tennessee: Parent and Clinician Perspectives (Child Wefare)

Karen Clemmer ·
Child Welfare publication, Child Trends, September 25, 2020. The QIC-AG is a five-year project working with eight sites that implemented evidence-based interventions or developed and tested promising practices which, if proven effective, can be replicated or adapted in other child welfare jurisdictions. Effective interventions are expected to achieve long-term, stable permanence in adoptive and guardianship homes for waiting children as well as children and families after adoption or...
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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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A Better Normal Community Discussion - Reimagining Health Care

Gail Kennedy ·
In a conversational style, join physician Drew Factor who will speak with Dr. Tracy Gaudet, Liza Guroff and An é Watts in a discussion entitled "Reimagining Health Care". Dr. Gaudet will speak about her experience engaging in transformational change at the Veterans Administration and how this has shaped the development of her own Functional Medicine Institute, while Ms. Guroff and Ms. Watts will speak about their knowledge of a Trauma-Informed Approach both at a systems (National Council for...
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The Intersection of Systematic Racism, the Pandemic, and SDoMH: Reality Mandates Change

Ellen Fink-Samnick ·
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.
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"A Better Normal" Community Discussion Series- Our Reckoning with Race and Equity at ACEs Connection

Donielle Prince ·
Register for A Better Normal- Our reckoning with race and equity at ACEs Connection
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Top 5 Social Determinants of Health Domains for Payers to Address (Health Payer Intelligence)

Karen Clemmer ·
By Kelsey Waddill, October 23, 2020, Health Payer Intelligence. To employ a comprehensive social determinants of health approach, payers can devise innovative solutions that tackle each of the five social determinants of health domains. October 23, 2020 - There are five social determinants of health domains, according to the Office of Disease Prevention and Health Promotion (ODPHP) Healthy People 2030 website . While certain domains will at times require more urgent attention than others, a...
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Tools to Mitigate Work Stress and Prevent Burnout: For Health Care Providers during COVID and Beyond  

Laurie Udesky ·
Whether you work in a hospital, a safety net clinic, or in another health care setting, no health care provider working during the COVID-19 pandemic needs to read the flurry of news stories that highlight the extreme stress experienced by people in this line of work – you already know it firsthand. This webinar will introduce health care providers to the Community Resiliency Model ( CRM ), an evidence-based method of managing traumatic stress, preventing burnout and building resiliency. This...
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Opportunity to sign on to “A Trauma-Informed Agenda for the First 100 Days of the Biden-Harris Administration”—Deadline Dec. 8th

The Campaign for Trauma-Informed Policy and Practice ( CTIPP ) is inviting individuals and organizations to express their support for a set of executive actions for the Biden-Harris Administration to take “to address trauma and build resilience throughout the country.” Most of these actions could be taken early in the Administration and would not require congressional action with the exception of some recommendations that could be included in a new stimulus package. The recommendations are...
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ACEs Connection/CTIPP Southeastern Leaders’ call: State updates, funding information, and “mind-blowing” information about helping people out of poverty

Carey Sipp ·
Southeastern ACEs Connection and national CTIPP leaders on the quarterly leader call welcomed guest speaker Rebecca Lewis-Pankratz (top left) for their quarterly call. Also among those present were (top row l-r) Carey Sipp, Jesse Kohler, Jesse Hardin, (second row, l-r) Patti Tiberi, Mebane Boyd, Jen Drake-Croft, Dan Press, (third row, l-r) Mimi Graham, Christopher Freeze, Margaret Stagmeier, (fourth row, l-r) Emily Marsh, Liz Peterson, Alyssa Koziarski and Janet Pozmantier. Also present was...
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A Comprehensive Policy Framework to Understand and Address Disparities and Discrimination in Health and Health Care: A Policy Paper From the American College of Physicians [acpjournal.org]

By Josh Serchen, Robert Doherty, and Omar Atiq, Annals of Internal Medicine, January 12, 2021 Abstract Racial and ethnic minority populations in the United States experience disparities in their health and health care that arise from a combination of interacting factors, including racism and discrimination, social drivers of health, health care access and quality, individual behavior, and biology. To ameliorate these disparities, the American College of Physicians (ACP) proposes a...
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Prematurity: Transdisciplinary Approach to Understanding Early Trauma in Babies

Kate White ·
Nearly one in 10 people born in the United States is premature (birth before 37 weeks of pregnancy), and its complications are the number one cause of death in babies. Those who survive premature birth often have long-term health issues. Surprisingly, the United States has one of the worst premature birth rates among high-resource nations (Source: March of Dimes ). Research has also shown that the countries with the highest prematurity rates also have high rates of depression and alcoholism...
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Join Special Guest Father Paul Abernathy for a Zoom Discussion on March 16th, at 7p.m. EST to discuss the Whole People Documentary Series and Trauma-Informed Community Development

Christine Cissy White ·
On behalf of ACEs Connection , the CTIPP (The Campaign for Trauma -Informed Policy & Practice), and the Relentless School Nurse , we want to invite you to the streaming of parts 4 and 5 of the Whole People documentary series on the weekend o f M arch 12th through March 14th, 2021. We will stream both parts on ACEs Connection in the Transforming Trauma with ACEs Sciences Film Festival community. The documentary viewing will be followed by a discussion with special guest, Father Paul...
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We’ve changed our name to PACEs Connection! 

Jane Stevens ·
We have some very exciting news! As of today, ACEs Connection is now PACEs Connection. PACEs stands for Positive and Adverse Childhood Experiences.
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Research from San Bernardino pediatric population

Ariane Marie-Mitchell ·
Sharing our recent publication of data on ACEs and immune cell gene expression
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Nicki Prevou

Nicki Prevou
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Drew Factor

Drew Factor
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Criticizing ACEs in Peer Reviewed Professional Journals Impairs Child Abuse Treatment

Jeoffry Gordon ·
Criticizing ACEs in Peer Reviewed Professional Journals Impairs Child Abuse Treatment Jeoffry B. Gordon, MD, MPH May 23, 2021 As a family doc practicing in San Diego I was privileged to hear Dr. Vincent Felitti talk about his inspired development of the ACEs questionnaire and its association with many adult mental and physical diseases directly from him only a few years after his original insight. Yet, although I had a lively clinic and learned how to manage a vast array of medical...
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2011-2021—A decade of steady growth in ACEs and TI laws and resolutions in the states

In 2019 and 2020, dozens of states enacted nearly 60 laws and resolutions that reference adverse childhood experiences or trauma. In this post, there's an interactive map that shows them all.
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Trauma-Informed Early Childhood Initiatives [CTIPP]

Kelsey Visser ·
CTIPP CAN Call - Trauma-Informed Early Childhood Initiatives - September 15th, 2-3:30pm ET/11am-12:30pm PT - Join Zoom Meeting: https://us02web.zoom.us/j/742183645 Meeting ID: 742 183 645 One tap mobile +19292056099,,742183645# US (New York) Please join us for next week's CTIPP CAN Call, which will focus on building mental well-being for infants, toddlers and preschoolers and the adults who care for them. This month's presentation will feature Drs. Kaitlin Mulcahy and Gerry Costa, and Kelly...
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** NCTSN September 2021 Spotlight ** [mednet.ucla.edu]

Natalie Audage ·
While natural disasters can strike at any time with very little warning, families and communities can take steps to prepare in the event that a disaster does occur. With the devastation caused by ongoing events (hurricanes, flooding, wildfires, COVID-19) across the nation, this reaffirms the need for disaster preparedness. Our thoughts are with the families, children, and communities who have been affected by these disasters. The National Child Traumatic Stress Network (NCTSN) has resources...
 
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