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PACEs in Nursing

Tagged With "forgiving others"

Blog Post

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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COVID-19 and Healthcare worker's families: behind the scenes of frontline response [thelancet.com]

By Amine Souadka, Hajar Essangri, Amine Benkabbou, et al., EClinical Medicine, May 17, 2020 During the COVID-19 outbreak, healthcare professionals are exposed to a high-risk of infection and mental health problems, but also fear of contagion and spreading the virus to their families. In fact, considering them as individuals implies looking beyond their function as frontline responders and taking into account their societal role as parents, spouses and offspring. While work-family balance is...
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Cultivating Deliberate Resilience During the Coronavirus Disease 2019 Pandemic (JAMA Network)

Karen Clemmer ·
JAMA Pediatr. Published online April 14, 2020. doi:10.1001/jamapediatrics.2020.1436 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...
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Del Mar (CA) nurse launches virtual support group for healthcare providers (KUSI News)

Karen Clemmer ·
By KUSI Newsroom staff, April 27, 2020. SAN DIEGO (KUSI) – Del Mar nurse Pantea Vahidi has launched the ‘ Caring for Those Who Care’ virtual support group for nurses, and other healthcare providers, with the intention of supporting those bravely fighting on the front lines of the novel Coronavirus all around the world. The groups are held daily ; interested nurses, and healthcare professionals, can register via www.PanteaVahidi.com. “ COVID -19 has humbled us to recognize that regardless of...
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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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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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Overview of the Community Resiliency Model, used worldwide to help trauma survivors re-regulate their central nervous system, offered in two, free 90-minute webinars.

Carey Sipp ·
Elaine Miller Karas , key creator of the Community Resiliency Model (CRM), will be joined by CRM trainers from Wilmington, NC, Allison Wine , behavioral specialist, and Kelly Purcell , instructional coach and multi-tiered support specialist for this free, two-part training. Register now for two, FREE 90-minute sessions May 7 from 11 a.m. - 12:30 p.m. EST and May 14 from 11 a.m. - 12:30 p.m. EST (The complete overview requires attendance at both sessions. Registration link below registers you...
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Study: Tough childhoods are tough on adult hearts (MedicalXpress)

Karen Clemmer ·
Posted on May 7, 2020, MedicalXpress. Adults who had rough childhoods have higher odds for heart disease. That's the conclusion from a look at more than 3,600 people who were followed from the mid-1980s through 2018. Researchers found that those who experienced the most trauma, abuse, neglect and family dysfunction in childhood were 50% more likely to have had a heart attack, stroke or other heart problem in their 50s and 60s. The Northwestern University study, published recently in the...
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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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Mental Health Awareness: When Suffering Is Not an Illness

Lori Chelius ·
When I was an adolescent and young adult, I struggled with depression. As I reflect back on that time, so much of what I was experiencing was deeply tied to coming to terms with my sexuality. Growing up in the 1980’s in a relatively conservative town, I was closeted (even to myself) until I was a young adult. The pain and fear of being different, of not belonging, of being judged or rejected for who I was more than my adolescent brain could wrap its conscious head around.
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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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"Addiction begins with solving a problem, the problem of human pain, emotional pain"

Laurie Udesky ·
In his groundbreaking book , In the Realm of Hungry Ghosts: Close Encounters with Addiction , trauma and addiction expert Dr. Gabor Maté writes, “There are almost as many addictions as there are people.” ACEs Connection founder and publisher Jane Stevens read that quote as a springboard to asking Maté to define addiction and explain whether or not it is always rooted in adverse childhood experiences. Maté, along with filmmaker Michelle Esrick and Saturday Night Live star Darrell Hammond,...
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How nurses are coping with the stress from the coronavirus — it isn’t easy (Miami Herald)

Karen Clemmer ·
By Ana Veciana-Suarez, April 28, 2020, Miami Herald. Each has a compelling story about what inspired them to become a nurse. Now each of them has a gripping worry about contracting COVID-19. As these frontline healthcare workers mark another Nurses Week in May, it’s never been more stressful to help sick people get healthy — yet that hasn’t stopped nurses from going to work. “Typically,” says Barbara Bruce, a 42-year RN veteran who works for Memorial Healthcare System in Broward, “you don’t...
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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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ACEs Connection Anti-Racism Resources

Morgan Vien ·
Hi everyone! We'd like to introduce our new ACEs Connection Anti-Racism Resources List c ulled from resources shared by Learn4Life, Prevention Institute., Rise Magazine , V A TICN , Vital Village , 10% Happier . and our own ACEs Connection members and staff . You can access them from this widget on the top right side of our home page or by clicking here. The list has the following categories of resources: Racial Trauma, Historical Trauma, & Healing Police Brutality & Reform...
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A Better Normal Tuesday, June 30th at Noon PDT: Reinterpreting American Identity, a Community Discussion

Alison Cebulla ·
"I think that all of us, regardless of our racial or ethnic background, feel relieved that we no longer have to deal with the racism and the sexism associated with the system of slavery. But we treat the history of enslavement like we treat the genocidal colonization of indigenous people in North America, as if it was not that important, or worse, as if it never happened." —Angela Davis, "The Meaning of Freedom" Please join us for the ongoing community discussion of A Better Normal, our...
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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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UCSF study shows health workers grappling with pandemic anxiety: 'It's exhausting' [sfchronicle.com]

By Mallory Moench, San Francisco Chronicle, July 21, 2020 Dr. Robert Rodriguez’s anxiety rises and falls with the number of coronavirus cases and deaths. Fear that he could get infected at his San Francisco General Hospital job, or bring the virus home, affects his sleep. He doesn’t hug his 16-year-old son as much. Other worried family members avoid interacting with him. The stress isn’t sustainable, he said. “If day after day, you’re waking up and dealing with patients that are extremely...
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ACEs and Gynecological Problems - A Conversation Starter

Dianne Couts ·
Gynecological problems as a result of ACEs, and particularly of Childhood Sexual Abuse (CSA), are rarely discussed in books and articles about the ACEs. The author would like to see that issue become part of the ACEs conversation.
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How a Pandemic Could Advance the Science of Early Adversity [jamanetwork.com]

By Danielle Roubinov, Nicole R. Bush, and W. Thomas Boyce, JAMA Pediatrics, July 27, 2020 The reach of the coronavirus disease 2019 (COVID-19) pandemic is global, a health crisis with a ubiquity never before experienced. While the physical health consequences of COVID-19 appear to affect proportionally fewer children compared with adults, its psychosocial consequences may be magnified within families who consistently weather a landscape of severe stressors or adverse childhood experiences...
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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.”
Blog Post

Confessions of a California Covid Nurse (Bloomberg)

Karen Clemmer ·
By Michael Lewis, July 30, 2020, Bloomberg. Notes From A Pandemic: A California county’s efforts to stop the spread has also become a battle with the public’s denial. Erica Dykehouse will wait for minds to change. The Humboldt County Public Health department in California is inside what used to be a juvenile jail. The offices are former prison cells. A few of the doors still have the small windows with the sliding panels that allowed guards to observe prisoners. The basement is a dungeon,...
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Dear Nursing Education, If We Can’t Even Acknowledge the Institutional Racism Apparent in Our Policies…How Will We Do the Harder Work? (Medium)

Karen Clemmer ·
By Rachel K. Walker, July 23, 2020, Medium. In recent weeks, professional nursing organizations such as ANA, AACN, Sigma Nursing, ONS, AAN, APHA and NLN released statements of solidarity voicing an “[end] hatred, discrimination, and racism in every form.” Some of these organizational statements were more direct than others. Practically none but the Nursology Theory Collective provided a description of specific resource investments or other steps being taken towards greater accountability to...
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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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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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Back-to-School in a Pandemic? Questions, Concerns, and Discussion with School Nurse, Robin Cogan

Christine Cissy White ·
Robin is a brilliant, passionate, and vocal school nurse with almost two decades of experience as a New Jersey school nurse in the Camden City School District. She is the Legislative Co-Chair for the New Jersey State School Nurses Association and she joined us last week for A Better Normal community discussion about back-to-school (or not) plans families are facing this school year. Robin serves as faculty in the School Nurse Certificate Program at Rutgers University-Camden School of Nursing...
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Trajectories of childhood adversity and mortality in early adulthood: a population-based cohort study (The Lancet)

Karen Clemmer ·
Prof Naja H Rod, PhD , Jessica Bengtsson, MS , Esben Budtz-Jørgensen, PhD , Clara Clipet-Jensen, MS , Prof David Taylor-Robinson, PhD , Prof Anne-Marie Nybo Andersen, PhD , et al. Published: August 15, 2020 DOI : https://doi.org/10.1016/S0140-6736(20)30621-8 Background Childhood is a sensitive period with rapid brain development and physiological growth, and adverse events in childhood might interfere with these processes and have long-lasting effects on health. In this study, we aimed to...
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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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New ACEs initiatives learn about strategic plan development from from New Hanover (NC) Resiliency Task Force executive director Mebane Boyd

Carey Sipp ·
The desire to see other ACEs initiatives grow and flourish was evident at a recent meeting of the Resilient Columbus County (North Carolina) ACEs initiative when Mebane Boyd, executive director of the New Hanover Resiliency Task Force (also in North Carolina), shared with the Columbus County and neighboring Pender County groups how New Hanover created and works on its strategic plan. In the spirit of sharing, Boyd agreed to let ACEs Connection post the strategic plan and the video of the...
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Introducing the Transform Trauma with ACEs Science Film Festival & Follow-Up Discussions

Christine Cissy White ·
Transform Trauma with ACEs Sciences Film Festival & Follow-Up Discussions The following weekend watch parties and follow-up discussions are co-hosted by ACEs Connection, The Relentless School Nurse , and The Campaign for Trauma-Informed Policy & Practice (CTIPP) . We appreciated the filmmakers for making these films free to watch for our members and for the public programming of PBS. The films we’ll feature are as follows: Portraits of Professional Caregivers Whole People Part 1...
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Strong relationships in adulthood won't 'fix' effects of early childhood adversity (Science Daily)

Karen Clemmer ·
Materials provided by University of Notre Dame . Original written by Jessica Sieff. Note: Content may be edited for style and length. August 3, 2020, University of Notre Dame. Summary: Harsh conditions in early life are a fundamental cause of adult stress, and according to new research on wild baboons, this effect is not explained by a lack of social support in adulthood. [ Please click here to read more. ]
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ACEs Aware Seeking Applicants to Support Clinical Work [acesaware.org]

ACEs Aware Seeking Applicants to Support Clinical Work Apply by September 15, 2020 ACEs Aware , led by the Office of the California Surgeon General (CA-OSG) and the California Department of Health Care Services (DHCS), is hiring for three new positions to further the mission of supporting Medi-Cal providers across California with training, clinical protocols, and payment for screening children and adults for Adverse Childhood Experiences (ACEs). Aurrera Health Group is the project management...
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CALIFORNIA ACES ACADEMY: Parental ACEs and Pediatrics: Transforming Well Care [avahealth.org]

CALIFORNIA ACES ACADEMY (CAA) , funded by ACEs Aware, is providing free online training to Medi-Cal providers and others featuring: Practical strategies for integrating trauma-informed health care into your team’s practice that improves patients’ well being and the productivity of your practice. Meet colleagues with experience and success providing trauma-informed health care in their practices. Learn from national and local experts. Talk to other professionals from your region in small...
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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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RSVP now! FREE Learning opportunity for CA healthcare providers: Oct 1, 2020 at noon PST

Karen Clemmer ·
RSVP now for a presentation by Susie Wiet, MD who is an integrative developmental psychiatrist with expertise in holistic treatment of trauma-addiction, dual diagnosis, and complex psychiatric disorders. Target Audience T his activity is intended for CALIFORNIA physicians, physician assistants, registered nurses, nurse practitioners, psychologists and social workers engaged in the care of patients who have experienced violence or trauma. Educational Objectives After completing these...
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Improving Discharge Care for Children with Special Health Care Needs through a Nurse-led Learning Collaborative (Lucile Packard Foundation)

Karen Clemmer ·
September 22, 2020 *Wondering if there is a connection between ACEs and children with special healthcare needs - there is a connection, click HERE to read a Child Trends report. Please see below to learn what nurses are doing to address the unique needs of children with special healthcare needs and their families. Source Being discharged from the hospital is a vulnerable time for families and caregivers of children with special health care needs (CSHCN). Appropriate resources and support are...
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Wabanaki Public Health Serves Native People, Community, and Culture During COVID-19 Crisis (RHIhub)

Karen Clemmer ·
By Kathryn Rutz, September 30, 2020, Rural Health Hub. “One great thing about being a service-based organization: when people need us more, we’re there.” Lisa Sockabasin works for Wabanaki Public Health based in Bangor, Maine. Their organization is one of the recipients of the Rural Tribal COVID Response (RTCR) grant, created by the Federal Office of Rural Health Policy to help rural tribal communities during the COVID-19 global pandemic. Indigenous communities are one of the demographics...
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Food Insecurity and the Risk of Obesity, Depression, and Self-Rated Health in Women (Women’s Health Report)

Karen Clemmer ·
By Sydney K. Willis,1,* Sara E. Simonsen,2 Rachael B. Hemmert,2 Jami Baayd,2 Kathleen B. Digre,3 and Cathleen D. Zick4. Women’s Health Reports Volume 1.1, 2020 DOI: 10.1089/whr.2020.0049 Accepted May 21, 2020. Abstract Background/Introduction/Objective: Recent studies have shown that food insecurity is associated with obe- sity, depression, and other adverse health outcomes although little research has been focused on these relation- ships in underrepresented cultural and social groups. In...
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'A Better Normal:' Can universal ACEs screening be equitable? -- Concerns and solutions

Laurie Udesky ·
Can universal ACEs screening be equitable? A conversation about concerns and solutions. When: Tuesday, Oct. 13, 2-3:30 pm PDT/5-6:30 pm EDT This webinar explores what it takes to ensure that equity is built into the process of screening and providing support for families who have experienced trauma and want help. REGISTER HERE Background At the beginning of this year, California, through the ACEs Aware initiative began rolling out universal screening for adverse childhood experiences (ACEs),...
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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]

Tasneem Ismailji ·
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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Hope and Progress, No Matter What! — an ACEs Connection/Cambia Health Foundation “Better Normal”, Oct. 22, 2020

Jane Stevens ·
The election is upon us. In two short weeks, we voters in this country decide who will lead us for the next four years. We have the opportunity to embrace — as a national priority — the tenets of understanding, nurturing and healing that underlie the science of adverse childhood experiences and move in a direction that embraces cultural and racial equity and anti-racism. Or not. What is clear is that no matter what, the ACEs movement will continue.
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Combined $1M awarded to Duquesne, Penn State for program supporting sex-assault survivors (Pittsburgh Post-Gazette)

Karen Clemmer ·
By Lauren Lee, October 22, 2020, Pittsburgh Post-Gazette. Both Duquesne and Penn State are among eight universities across the country awarded a combined $1 million in grants to establish and nurture a U.S. Department of Justice program designed to offer medical forensic care, advocacy and other victim services to sexual assault survivors on campuses of higher education. The department’s Office for Victims of Crime awarded around $4 million to various universities across the country to...
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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: Suicide Awareness and Community Cafes

Karen Clemmer ·
Join us on Friday November 6, 2020 from noon to 1:00 PST as we come together and join Satya Chandragiri MD, Bonnie O’Hern RN, Denise PNP, & Michael Polacek RN for a discussion around the tender issue of suicide. Together we will discuss ways people and providers can support each other and encourage communities to take action to support one another around suicide prevention, crisis intervention, and the layers of culture and structural barriers to care. A special emphasis will be on...
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Adverse Childhood Experiences as Predictors of Perceived Health: Assessing the ACE Pyramid Model Using Multiple-Mediation [scholarlycommons.hcahealthcare.com]

By Phillip Hughes and Tabitha L. Ostrout, HCA Healthcare Journal of Medicine, November 1, 2020 Background: Adverse Childhood Experiences (ACEs) have been shown to contribute to a litany of mental and physical health problems, including several chronic diseases and death, via a model known as the ACE pyramid. Many of the results of ACEs in the ACE pyramid are known contributors to poor perceived health, which has significant health implications. Despite these results, a possible link between...
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"A Better Normal" Community Discussion: Suicide Awareness and Community Cafes

Karen Clemmer ·
Join us on Friday November 6, 2020 from noon to 1:00 PST as we come together and join Satya Chandragiri MD, Bonnie O’Hern RN, Denise Proudfoot RN, & Michael Polacek RN for a discussion around the tender issue of suicide. Together we will discuss ways people and providers can support each other and encourage communities to take action to support one another around suicide prevention, crisis intervention, and the layers of culture and structural barriers to care. A special emphasis will be...
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A New Hippocratic Oath Asks Doctors To Fight Racial Injustice And Misinformation [NPR]

Jennifer A Walsh ·
First-year medical student Sean Sweat "didn't want to tiptoe around" issues of race when she sat down with 11 of her classmates to write a new version of the medical profession's venerable Hippocratic oath. "We start our medical journey amidst the COVID-19 pandemic, and a national civil rights movement reinvigorated by the killings of Breonna Taylor, George Floyd and Ahmaud Arbery," begins the alternate version of the oath, rewritten for the class of 2024 at the University of Pittsburgh...
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A Better Normal- Education Upended 11/19, with special guest Robin Cogan, The Relentless School Nurse!

Lara Kain ·
Hi Everyone! Welcome back. I am SO very excited to announce our special guest for this Thursday 11/19 12-1 PST. Please join us as we discuss everything school health and school nursing with rock star school nurse Robin Cogan. Along with all her amazing achievements in her bio below she has recently been featured on CNN, USA Today, Newsweek, and the NYT commenting on school health and the invaluable role of school nurses during a pandemic. Robin Cogan, MEd, RN, NCSN is a Nationally Certified...
 
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