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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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Opinion: All Doctors Should Practice Trauma-Informed Care [calhealthreport.org]

By Bob Erlenbusch and Drew Factor, California Health Report, November 20, 2019 “Adverse childhood experiences are the single greatest unaddressed public health threat facing our nation today,” Dr. Robert Block, former president of the American Academy of Pediatrics, has been widely quoted as saying. According to the Adverse Childhood Experiences Study, conducted in the 1990’s by the Centers for Disease Control & Prevention and Kaiser Permanente, adverse childhood experiences are common,...
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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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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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Primary Care & Telehealth Strategies for Addressing the Secondary Health Impacts of COVID-19

From ACEs Aware, May 13, 2020 This webinar will focus on building understanding and identifying primary care and telehealth strategies and tools to address the secondary health effects of the COVID-19 emergency. Widespread stress and anxiety regarding COVID-19, compounded by the economic distress due to lost wages, employment and financial assets; mass school closures; and necessary physical distancing measures can result in an increase of stress-related health conditions. These secondary...
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Screening for ACEs in Pediatric Practice [American Academy of Pediatrics - CA Chapter 2]

By Ariane Marie-Mitchell, American Academy of Pediatrics, October 2019 In the August newsletter, we provided an overview of the definition and impact of adverse childhood experiences (ACEs) (http://aapca2.org/aces). In this article, we will explore the argument in favor of screening for ACEs in pediatric practice, and describe the process and results of a California state advisory group on screening for trauma. The American Academy of Pediatrics (AAP) recommended screening for toxic stress...
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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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Suicides among nurses are on the rise. Here's why one of America's fastest-growing jobs is facing a major crisis. (businessinsider.com)

Researchers from the University of California at San Diego recently conducted what they said is the first nationwide investigation into nurse suicides in more than 20 years. They found that both male and female nurses had higher rates of suicide than men and women in the US . The findings are consistent with the increasing rates of suicide across the country. The US suicide rate has risen in recent years, increasing by 28% in the past two decades , to the highest it's been since World War II...
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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 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 missing link of emotional intelligence [indianapolisrecorder.com]

By James W. Dix III, Indianapolis Recorder, May 16, 2020 The entire world has been introduced to an invisible monster that has crippled our existence. The reported, unprecedented death tolls have been staggering with no foundational resolve near. In the midst of chaos, health care professionals continued to serve patience and uphold their professional creed. However, as the staggering number of deaths arise, in the shadows are emotionally wounded and traumatized health care professionals.
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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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TIC: News and Notes for November 2019

Scott A Webb ·
ACEs, Adversity's Impact Podcast: Dr. Nadine Burke Harris Vital Signs: Estimated proportion of adult health problems attributable to adverse childhood experiences and implications for prevention - 25 states, 2015-2017 Animal study shows how stress and mother's abuse affects infant brain LGBTQ, traumatized homeless youth more vulnerable to being trafficked: Report How do these pediatricians do ACEs screening?Early adopters tell all When family relationships become toxic: The trauma of...
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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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Understanding and Addressing Sources of Anxiety Among Health Care Professionals During the COVID-19 Pandemic [jamanetwork.com]

By Tait Shanafelt, Jonathan Ripp, Mickey Trockel, JAMA, April 7, 2020 The coronavirus disease 2019 (COVID-19) pandemic has become one of the central health crises of a generation. The pandemic has affected people of all nations, continents, races, and socioeconomic groups. The responses required, such as quarantining of entire communities, closing of schools, social isolation, and shelter-in-place orders, have abruptly changed daily life. Health care professionals of all types are caring for...
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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: Cultivating Our Best Selves in Response to COVID-19 | Tuesday, March 17 at Noon PDT

Elaine Miller Karas ·
How to use the skills of the Community Resiliency Model (CRM) for self and others to be the calm in the storm as we face the unknown. Free Webinar Tuesday, March 17 at Noon PDT Speakers: Elaine Miller-Karas, LCSW Linda Grabbe, PhD, FNP-BC, PMHNP-BC Zoom Webinar Registration Link: https://zoom.us/j/715837300 Additional ways to join are listed at the bottom of this post. About the webinar leaders: Elaine Miller-Karas is the Executive Director and co-founder of the Trauma Resource Institute and...
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Webinar Oct. 17 — Integrating ACEs science in pediatrics: Early adopters share lessons from the field

Laurie Udesky ·
An ACEs Connection webinar co-sponsored with 4 CA In 2017, California became the first state in the country to pass a law supporting universal screening for adverse childhood experiences (ACEs) in the 5.3 million children in the state’s Medicaid program. As clinicians around California await the state’s announcement of what this new policy will entail, many are wondering what it takes to integrate ACEs science in a pediatric practice. Meet Drs. Deirdre Bernard-Pearl, R.J. Gillespie and...
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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 Is the Pandemic Killing So Many Black Americans [podcasts.apple.com]

Carey Sipp ·
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

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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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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AAP Policy Statement Stresses Pediatrician's Role in Mental Health [healio.com]

By Healio, October 21, 2019 An updated policy statement and a technical report issued by the AAP highlighted the need for increased involvement among pediatricians in their patients’ mental health care and increased mental health care training in medical education programs. “Pediatricians — whether in primary care or subspecialty practice — typically have longitudinal, trusting relationships with their patients and families and, as a result, unique opportunities to promote social-emotional...
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ACEs Research Corner — November 2019

Harise Stein ·
[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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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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Aligning Systems for Health: 2019 Call for Proposals [rwjf.org]

By Robert Wood Johnson Foundation, November 1, 2019 Required Components Aligning Systems for Health will explore the degree to which health equity is impacted or results from current models of collaboration incorporating health care, public health, and social services. Gaps in health are large, persistent and increasing, and RWJF is committed to a system that meets people’s goals and needs and addresses these gaps that many populations face. Studies should include a focus on health equity by...
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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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Association of Exposure to Civil Conflict With Maternal Resilience and Maternal and Child Health and Health System Performance in Afghanistan [jamanetwork.com]

By Nadia Akseer, Arjumand Rizvi, Zaid Bhatti, et al., JAMA Network Open, November 8, 2019 Key Points Question: Is conflict severity associated with the performance of health systems and population health outcomes in Afghanistan during the 2003 to 2018 reconstruction period? Findings: In this survey study of 64 815 women in Afghanistan, notable health and health system improvements were made despite increasing conflict after 2010. However, regions with greater conflict had lower gains in...
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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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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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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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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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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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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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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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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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Emergency Department Admissions for Child Sexual Abuse in the United States from 2010 to 2016 [jamanetwork.com]

By Jesse J. Helton, Jason T. Carbone, et al., JAMA Pediatrics, November 4, 2019 For children who have been sexually abused, emergency department (ED) professionals provide immediate medical care, including testing and treatment for sexually transmitted infections, prophylaxis for potential HIV exposure, and emergency contraception. In some cases, ED clinicians conduct forensic examinations to assist with child protection and criminal investigations. Physicians and nurses in EDs are among the...
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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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Forsyth County Trauma Informed Care Network

Laneita Williamson ·
The Forsyth County Trauma Informed Network is taking great strides into recognizing and addressing community post Covid-19 impacts. PowerPoint attached.
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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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Healing Hurt People: Helping Victims of Violence Heal from Their Trauma and Become Community Peer Health Workers [citywidestories.com]

By Michael Butler, City Wide Stories, November 1, 2019 Healing Hurt People started in 2008 as an initiative to help victims of violence heal and deal with the trauma of their injuries; more than a decade later the organization has created a sustainable model for hospitals across the city of Philadelphia. Young men that have dealt with violence are encouraged to go through training, become community peer health workers, and help those who have gone through similar experiences. We spoke with...
 
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