Tagged With "primary care"
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Healthy Spaces December 2019 Webinars
Healthy Spaces: Promoting Healthy and Resilient Communities December 2019 Webinars Funding provided by the New Jersey Department of Children and Families The New Jersey Chapter, American Academy of Pediatrics (NJAAP) believes that all children deserve to feel safe and secure in their home, at school, and while at play. The Healthy Spaces program aims to address adverse childhood experiences (ACEs) through partnerships with pediatric/family healthcare teams, schools and communities.
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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 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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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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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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Med school free rides and loan repayments — California tries to boost its dwindling doctor supply (calmatters.org)
Primary care doctors are a hot commodity across California. Students are being lured by full-ride scholarships to medical schools. New grads are specifically recruited for training residencies. And full-fledged doctors are being offered loan repayment programs to serve low-income residents or work in underserved areas. These efforts are intended to ease or stave off the physician shortage expected to peak within the next decade in California. By 2030, the state will be short some 4,000...
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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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Moving Upstream to Address Contributors to Toxic Stress in Pediatric Primary Care [chapinhall.org]
By Angeline Spain, Angela Sander, and Amanda Brown, Chapin Hall at The University of Chicago, October 2019 Healthcare in the U.S. is increasingly moving “upstream” to address the risk of social determinants of health. One common strategy is the early screening of needs and connection to services. Chapin Hall, in collaboration with national and local partners, is conducting an evaluation of innovations designed to promote screening for contributors to toxic stress during pediatric well-child...
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New Study Reveals Annual Cost of Childhood Adversity in California Is Approximately $113 Billion [prnewswire.com]
SAN FRANCISCO , Jan. 28, 2020 /PRNewswire/ The Center for Youth Wellness announces the release of an in-depth study on the health-related cost of adverse childhood experiences (ACEs) in the state of California . A number of studies have investigated the cost of child maltreatment, but the current study, entitled " Adult health burden and costs in California during 2013 associated with prior adverse childhood experiences ," is the first to examine the cost associated with adult health...
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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.
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Nurturing relationships in childhood boost adult mental health, relationships
We're proud to announce major research that suggests that positive childhood experiences — such as supportive family interactions, caring relationships with friends, and connections in the community — are associated with reductions in chances of adult depression and poor mental health, and increases in the chances of having healthy relationships in adulthood. This association was true even among those with a history of adverse childhood experiences.
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Re: Becoming Trauma Informed (Millstein JGIM 2020)
As a family doc with 40 years of practice under my belt I heard the phrase "Trauma Informed Care." for the first time in 2019. This not so benign neglect is complimented by adult medicine's obliviousness to the pervasive morbidities caused by the fact that about 20% of our adult patients were abused as children. This affects both mental and physical health. Training in adult medicine is void of attention to both child abuse and TIC, much to the detriment of our patients.
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Prioritizing Physician Mental Health as COVID-19 Marches On [jamanetwork.com]
By Jennifer Abbasi, JAMA Network, May 20, 2020 I n the spring of 2013, Eileen Barrett, MD, MPH, lost a colleague to suicide. The two worked at the Indian Health Service’s Gallup Indian Medical Center in New Mexico, where Barrett was the deputy chief of medicine. Even before the tragic event, she saw workers struggle under administrative burdens and hold themselves personally responsible for problems outside of their control. With her coworker’s death it became painfully clear that clinician...
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ACEs Research Corner — May 2020
[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] Williams AB, Smith ER, Trujillo MA, et. al. Common health problems in safety-net primary care: Modeling the roles of trauma history and mental health. J Clin...
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Forsyth County Trauma Informed Care Network
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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Experience of emergency department use among persons with a history of adverse childhood experiences [bmchealthservres.biomedcentral.com]
By Eva Purkey, Colleen Davison, Meredith MacKenzie, et al., BMC Health Services Research, May 24, 2020 Background Adverse childhood experiences (ACEs) are associated with increased morbidity and mortality, lower levels of distress tolerance, and greater emotional dysregulation, as well as with increased healthcare utilization. All these factors may lead to an increased use of emergency department (ED) services. Understanding the experience of ED utilization among a group of ED users with...
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Commentary: Why so many black Americans are dying from COVID-19 and how to make health care equitable (sandiegouniontribune.com)
Evidence suggests that during the early phase of the coronavirus pandemic, blacks are suffering the greatest death rates compared to all other ethnic groups. Why? I can assure you that the coronavirus does not discriminate based upon skin color or ethnicity. Instead, it has a predilection for populations with the highest rates of chronic diseases, poor access to health care and too little information from trusted sources. For decades, the National Medical Association — which represents more...
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What Do We Do? What Do We Do Now?
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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Could Community Health Workers and Promotores de Salud Help California Respond to COVID-19? (CHCF Blog)
By Rob Waters, June 4, 2020, California Health Care Foundation. Aida Meza has been working as a promotora de salud, a community health worker, since she moved across the border from Tijuana, Mexico, to the San Diego area 23 years ago. She came to Chula Vista with her husband, an American citizen, so they could send their kids to better schools. “At first I cried every day because I wanted to go back to my home,” she said. Then the principal at her children’s school, Vista Square Elementary,...
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NEW Trauma-informed Care Podcast (CME provided)
Join us as we delve into the paradigm-shifting ethos of trauma-informed care with renowned expert Dr. Megan Gerber. Dr. Gerber is an Associate Professor of Medicine at Boston University School of Medicine and serves as Medical Director of Women’s Health for VA Boston where she directs the Women’s Health Fellowship. Dr. Gerber edited the textbook, “Trauma-informed Health Care Approaches: A Guide for Primary Care.” We discuss the framework for trauma-informed universal precautions, as well as bas
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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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Inside Boston Hospitals, A Reckoning With Racism (WBUR)
By Martha Bebinger, June 19, 2020, WBUR As calls for racial justice continue on Boston streets, conversations have shifted to what’s next. That’s true inside hospitals as well, where the life-long effects of racism play out every day. “You could almost take any chronic disease in America, diabetes, hyper-tension, and there will be higher rates and worse outcomes in Black Americans,” says Dr. Rose Olson, a resident physician at Brigham and Women’s Hospital. “That’s not due to biology or...
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Patients in a pandemic (Oregon Coast Today)
By Rachel Baird & Krista Melone, June 16, 2020, TODAY. I n the middle of a pandemic, a discussion about “everyday health” and the medical community tends to take a backseat to the more pressing questions surrounding the spread of a new virus. However, as many of us are realizing, the impact COVID-19 has had on medical practice nationwide is far-reaching. From elective surgeries that have been postponed, to blood drives being canceled and increased concern about routine visits; the...
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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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Linda Grabbe: Helping her communities develop resilience through the Community Resilience Model
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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HHS Awards $107.2 Million to Grow and Train the Health Workforce (HHS.gov)
Sharing - if funding is in your area, consider seeking opportunities to infuse ACEs science! June 18, 2020, Press Release: Today, the U.S. Department of Health and Human Services (HHS), through the Health Resources and Services Administration (HRSA), is announcing awards totaling $107.2 million to 310 recipients to increase the health workforce in rural and underserved communities . Recipients across 45 states and U.S. territories received funding to improve the quality, distribution and...
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CMS: NEW – Waivers & flexibilities for health care providers 6.25.20
Click here for the CMS Corona Virus Waivers & Flexibilities. Coronavirus Waivers & Flexibilities In certain circumstances, the Secretary of the Department of Health and Human Services (HHS) using section 1135 of the Social Security Act (SSA) can temporarily modify or waive certain Medicare, Medicaid, CHIP, or HIPAA requirements, called 1135 waivers. There are different kinds of 1135 waivers, including Medicare blanket waivers. When there's an emergency, sections 1135 or 1812(f) of...
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A Medical School Is Using Art to Combat Bias, Training Students to Diagnose Famous Paintings (and Identify Their Assumptions in the Process) (ArtNet News)
By ArtNet News, June 29, 2020. As conversations about bias in health care reach new heights amid the COVID-19 pandemic, a new course at the University of Alabama at Birmingham School of Medicine is hoping to combat the scourge with an unlikely tool: famous artworks. The school has launched a new course in collaboration with the university’s Abroms-Engel Institute for Visual Arts and the Birmingham Civil Rights Institute that tasks junior- and senior-level med students with analyzing works of...
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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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Reimagining Healthcare as a Community Investment
At this point, COVID-19 has been a part of our lives for nearly six months now. While the most recent current events are not unfamiliar social problems, this pandemic has provided us with a stronger lens with which to see many of the underlying inequities within our communities. This article, “The Moral Determinants of Health,” explores these inequities by illustrating the systemic imbalances within the field of medicine and the amount of resources we allocate to solving problems as opposed...
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Help Navigating the Road to Community Resiliency
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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Do safe, stable, and nurturing relationships work? New research has important findings for responding to ACEs
While we know that adverse childhood experiences (ACEs) can cause risk behaviors, research has told us that the presence of protective factors can help mitigate the effects of ACEs. Common risk behaviors such as smoking tobacco and alcohol misuse can be a result from the trauma of childhood disadvantage. In responding to ACEs, public health research proposes that protective factors such as safe, stable, nurturing relationships (SSNRs) with a caring adult can mitigate the long-term effects of...
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Health Disparity, Racial Weathering, and Social Determinants: How Do We Create Antiracist Healthcare? [saragottfriedmd.co]
By Sara Gottfried, Dr. Sara Gottfried MD, July 13, 2020 I take respectful care of my patients regardless of skin color, but in the past few years, I’ve realized that is not enough. There are many sources of information that have influenced me. Conversations, particularly a recent interview with integrative physician Andrea Pennington MD. Books, mentioned in this article, including How to Be an Antiracist by Boston University Professor Ibram X. Kendi and founder of the Antiracism Center for...
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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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Donald Trump is the product of abuse and neglect. His story is common, even for the powerful and wealthy.
“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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Structural Racism, Social Risk Factors, and Covid-19 — A Dangerous Convergence for Black Americans (NEJM)
Perspective by Leonard E. Egede, M.D., and Rebekah J. Walker, Ph.D. July 22, 2020, DOI: 10.1056/NEJMp2023616 . *Author Affiliations: From the Division of General Internal Medicine, Department of Medicine, and the Center for Advancing Population Science, Medical College of Wisconsin, Milwaukee. Current protests throughout the United States are highlighting the history of marginalization of and discrimination against Black Americans, including 250 years of slavery, 100 years of Jim Crow laws,...
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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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‘Death by structural poverty’: US south struggles against Covid-19 [theguardian.com]
Monica McCasklill, left, and her daughter Kena Johnson, at their home in Greenwood, Missisppi. They respectively lost their grandmother and great grandmother, Ethel Huntley, to Covid-19. Huntley lived in a nearby nursing home and the family allege failings in her primary care. Photograph: Rory Doyle/The Guardian. By Oliver Laughland, The Guardian, August 5, 2020 Poor access to healthcare, failed political leadership and the endurance of segregation and racism have contributed to a surge in...
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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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Psychological Trauma Is the Next Crisis for Coronavirus Health Workers [Scientific American]
After his roughest days in a New York City emergency room, physician Matthew Bai feels his whole body relax when he sees his wife and 17-month-old daughter. “My light at the end of the tunnel is going home to family,” Bai says. When Manhattan’s Mount Sinai Hospital started to overflow with COVID-19 patients in late March, however, Bai and his wife decided she should take their toddler and stay with her parents in New Jersey. The risk of spreading the virus to his family was too great. Now...
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New ACEs initiatives learn about strategic plan development from from New Hanover (NC) Resiliency Task Force executive director Mebane Boyd
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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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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Trauma-Informed Healthcare Approaches: A Guide for Primary Care
https://www.springer.com/us/book/9783030043414
On sale through 9/30/2020.
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Introducing ACEs (Adverse Childhood Experiences) and Resilience to First-Year Medical Students [mededportal.org]
By Edore Onigu-Otite, Sindhu Idicula, MedEdPORTAL, September 15, 2020 Abstract Introduction: Adverse childhood experiences (ACEs) are associated with negative mental and physical health outcomes and predictive of higher sociodemographic risk. Introducing ACEs into undergraduate medical education is key to prevention, early recognition, and intervention. Methods: In a 1-hour lecture, held live and viewed online, we delivered a condensed introduction to ACEs to first-year medical students.
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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
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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Addressing Childhood Poverty in Pediatric Clinical Settings [jamanetwork.com]
By Margaret G. Parker, Arvin Garg, Margaret A. McConnell, JAMA Pediatrics, September 14, 2020 Two in 5 children are poor or nearly poor, and childhood poverty is a key social determinant of heath that is associated with negative health and developmental outcomes across the life course. In 2016, the American Academy of Pediatrics published a policy statement on child poverty and health, emphasizing the importance of addressing poverty-related risk factors in the delivery of pediatric care.1...
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Free 2020 Virtual Trauma-Informed Care Conference
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.