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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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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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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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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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Governor Cuomo’s Cancer Research Initiative Disappointing. No ACES included.

Peter Chiavetta ·
I attended the presentation of Governor Cuomo's Cancer Research Initiative at the Buffalo Science Museum October 22, 2019. Brad Hutton Deputy Health Commissioner State of NY presented. Erie County Health Commissioners in attendance. It had all the data on the 4 major cancers in the East Side of Buffalo, NY. https://www.health.ny.gov/diseases/cancer/cancer_research_initiative/docs/erie_presentation.pdf I'm all excited. Prepared with 2 dozen ACE handouts. Sat quietly for the 45 minute power...
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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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Doctor Goes Viral for Explaining How Biases Affect the Healthcare Black Patients Receive (Distractify)

Karen Clemmer ·
By Robin Zlotnick, June 9, 2020, Distractify. If you want concrete evidence of deeply ingrained racism, look no further than our doctors and healthcare workers. Dr. Jennifer Lincoln is going viral on TikTok for explaining just how rampant implicit bias is in hospitals and doctors' offices. She highlights a 2016 study , which found that about half of white medical students and residents subscribed to the false narrative that Black people feel less pain than white people and were more likely...
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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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Resilience for Children & Families: Being Brave When Things are Hard

Building Resilience with Children During Racial Discrimination & Violence: This attached Resilience Brief for Children has been the hardest one I have written yet. I have been an active advocate for the equal treatment of people from all backgrounds, religions, ethnic heritages, orientations, and families my entire life. It is hard to see the pain present today, not only due to COVID19 but also due to the harm and anger we see daily in the news. I want to share a story about the person...
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Reimagining Healthcare as a Community Investment

Jennifer A Walsh ·
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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Do safe, stable, and nurturing relationships work? New research has important findings for responding to ACEs

Alyssa Koziarski ·
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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Donald Trump is the product of abuse and neglect. His story is common, even for the powerful and wealthy.

Jane Stevens ·
“In order to cope,” writes Mary Trump, “Donald began to develop powerful but primitive defenses, marked by an increasing hostility to others and a seeming indifference to his mother’s absence and father’s neglect….In place of [his emotional needs] grew a kind of grievance and behaviors—including bullying, disrespect, and aggressiveness—that served their purpose in the moment but became more problematic over time. With appropriate care and attention, they might have been overcome.”
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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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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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Implementing the Neurosequential Model of Therapeutics in Tennessee: Parent and Clinician Perspectives (Child Wefare)

Karen Clemmer ·
Child Welfare publication, Child Trends, September 25, 2020. The QIC-AG is a five-year project working with eight sites that implemented evidence-based interventions or developed and tested promising practices which, if proven effective, can be replicated or adapted in other child welfare jurisdictions. Effective interventions are expected to achieve long-term, stable permanence in adoptive and guardianship homes for waiting children as well as children and families after adoption or...
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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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Make “Giving Tuesday” your day to support the work of ACEs Connection. Help us meet our matching grant goal of $50K, and your gift will be matched, dollar-for-dollar!

Carey Sipp ·
"This Giving Tuesday, and every day, we thank you for your support," said members of the ACEs Connection staff on a recent "all staff Zoom." L-R (top row) Laurie Udesky, Carey Sipp, Gail Kennedy, Lara Kain (second row) Cissy White, Rafael Maravilla, Donielle Prince, Jenna Quinn (third row) Ingrid Cockhren, (off camera) Alison Cebulla, Jane Stevens. Out that day, and grateful all the same, were Karen Clemmer, Dana Brown, Elizabeth Prewitt, Marianne Avari, and Samantha Sangenito Called “the...
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Opportunity to sign on to “A Trauma-Informed Agenda for the First 100 Days of the Biden-Harris Administration”—Deadline Dec. 8th

The Campaign for Trauma-Informed Policy and Practice ( CTIPP ) is inviting individuals and organizations to express their support for a set of executive actions for the Biden-Harris Administration to take “to address trauma and build resilience throughout the country.” Most of these actions could be taken early in the Administration and would not require congressional action with the exception of some recommendations that could be included in a new stimulus package. The recommendations are...
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Whole People Watch Weekend on ACEs Connection (Dec. 11th - 13th)

Christine Cissy White ·
The Transform Trauma with ACEs Sciences FREE Film Festival continues this weekend. Please join us to watch parts 1, 2, and 3 of the PBS Whole People series at your convenience, on ACEs Connection, by clicking play on the videos below: Whole People | 101 | Childhood Trauma | Episode 1 (27 min) Preview: Whole People | 102 | Healing Communities | Preview | Episode 2 Whole People | 102 |Healing Communities Episode 2 (27 min) Whole People | 103 |A New Response | Episode 3 (27 min) This is one of...
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Whole People Watch Weekend on ACEs Connection (Dec. 11th - 13th)

Christine Cissy White ·
The Transform Trauma with ACEs Sciences FREE Film Festival continues this weekend. Please join us to watch parts 1, 2, and 3 of the PBS Whole People series at your convenience, on ACEs Connection, by clicking play on the videos below: Whole People | 101 | Childhood Trauma | Episode 1 (27 min) Preview: Whole People | 102 | Healing Communities | Preview | Episode 2 Whole People | 102 |Healing Communities Episode 2 (27 min) Whole People | 103 |A New Response | Episode 3 (27 min) This is one of...
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Whole People Film Discussion on Tuesday, December 15th at 7p.m. EST

Christine Cissy White ·
ACEs Connection, the Campaign for Trauma-Informed Policy & Practice ( CTIPP), and the Relentless School Nurse will be hosting a Zoom discussion on Tuesday, Dec, 15th at 7p.m. EST about parts 1, 2, and 3 of Whole People. We hope you can join us: Pre-Registration Link Quotes from Childhood Trauma (Part 1 of Whole People): If you have yet to watch the Whole People series, you can still do so by visiting the PBS website. There is no cost to watch. 101 | Childhood Trauma | 102 | Healing...
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Black Doctor Dies of Covid-19 After Complaining of Racist Treatment [nytimes.com]

Jane Stevens ·
Dr. Moore with her 19-year-old son, Henry Muhammed (photo by Henry Muhammed). By John Eligon Lying in a hospital bed with an oxygen tube hugging her nostrils, the Black patient gazed into her smartphone and, with a strained voice, complained of an experience all too common among Black people in America. Susan Moore, the patient, said the white doctor at the hospital in suburban Indianapolis where she was being treated for Covid-19 had downplayed her complaints of pain. He told her that he...
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8 Categories of Adversity To Help Medicine Better Understand, Prevent and Treat Chronic Illness: ACEs, ABEs, Discrimination and More

Veronique Mead ·
I was a family doctor when the first symptoms of what would turn out to become a disabling chronic illness first began to arise. I didn't know about ACEs back then and even if I had, I would have thought my score was zero and that ACEs didn't apply to me. What I've learned in the 20 years since then is that my ACE score is actually a two, which increases the chances of ever being hospitalized for an autoimmune disease by 70%.
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Join Special Guest Father Paul Abernathy for a Zoom Discussion on March 16th, at 7p.m. EST to discuss the Whole People Documentary Series and Trauma-Informed Community Development

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

Ariane Marie-Mitchell ·
Sharing our recent publication of data on ACEs and immune cell gene expression
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To solve the Black maternal mortality crisis, start with upending racist practices

Laurie Udesky ·
It’s been all over the news for months: Black women in the United States are dying from complications during their pregnancies or in childbirth at alarming rates, and those deaths are preventable. Less well explored is how systemic racism and historical trauma have been at the core of what’s driven up these rates over several decades. A March 20 conference entitled The Impact of ACEs on Black Maternal Health took an in-depth look into why Black maternal mortality and complications during...
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Historical Trauma in the American Midwest Event Recap

Alison Cebulla ·
On September 16, 2021, PACEs Connection hosted our second event in our Historical Trauma in America series . This event was led by Ingrid Cockhren, the director of the PACEs Connection Cooperative of Communities; and Porter Jennings-McGarity, our community facilitator of the Midwest Region. It featured guest speaker Agnes Woodward who is Plains Cree from Kawacatoose First Nation, Saskatchewan, Canada. To download the slide deck from this presentation, click here. Then click "download file".
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[The Grand Finale] All new Talks on Trauma featuring 33+ amazing experts, celebrities & healers [wisdomoftrauma.com]

Carey Sipp ·
We are just a few days away from broadcasting our all-new 7-day event October 4‒10 , which includes the Talks on Trauma Series Part 2 , a showing of the Wisdom of Trauma Movie, daily meditations, integration sessions, and artistic performances. Dr. Gabor Maté will be in conversation with 33+ trauma experts, physicians, authors, visionaries and artists. The talks will be exploring how trauma relates to parenting, chronic pain, the medical paradigm, the climate crisis, politics, spirituality,...
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A Trauma-Informed Approach to Vaccine Hesitancy (Sign On Letter Attached In First Line)

Jesse Maxwell Kohler ·
Please sign onto and share this memo supporting using a trauma-informed approach to decreasing vaccine hesitancy! Many of the challenges we are facing with vaccine hesitancy can be better understood by looking at the issue through a trauma-informed lens. The following memo has been developed with input from many of the clinical and academic thought leaders from the trauma healing field to offer supportive guidance to the Administration. To successfully address this challenge, we need to...
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Re: A Trauma-Informed Approach to Vaccine Hesitancy (Sign On Letter Attached In First Line)

Jeoffry Gordon ·
It is really challenging to understand the vociferous rejection of powerful, effective, well proven medical therapies like vaccines even when your children are thus made vulnerable and even when people around you are getting ill and even dying. This obviously not a logical, rational process. Medicine and public health are to be faulted for trying to motivate a change in these attitudes by just repeating established clinical data. This post has a cogent and interesting analysis which adds to...
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A Trauma Informed Approach to Vaccine Fear

Jesse Maxwell Kohler ·
PLEASE SIGN ON TO THIS MEMO TO SUPPORT OUTREACH ALONG THESE LINES TO THE ADMINISTRATION! If the goal is to impact meaningful change, it might prove helpful to view vaccine fear through a trauma informed-lens. There is an intentional shift from the use of the word “hesitancy” and instead using the more specific and appropriate term “fear”. We are more likely to change that which we better define and understand. The following memo has been developed with input from an interdisciplinary team of...
Comment

Re: A Trauma-Informed Approach to Vaccine Hesitancy (Sign On Letter Attached In First Line)

Jeoffry Gordon ·
It is really challenging to understand the vociferous rejection of powerful, effective, well proven medical therapies like vaccines even when your children are thus made vulnerable and even when people around you are getting ill and even dying. This obviously not a logical, rational process. Medicine and public health are to be faulted for trying to motivate a change in these attitudes by just repeating established clinical data. This post has a cogent and interesting analysis which adds to...
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Nourishing a Brain Wounded by Childhood Adversity

Dr. Glenn Schiraldi ·
The right mix of nutrients revitalizes the brain that's been wounded by ACEs. Good nutrition can quickly improve mood and functioning in the present, while improving the potential to rewire disturbing memories imprinted in childhood.
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Join us to talk with the nation’s first known 'minister of gun violence prevention,' this Thursday for our podcast 'History. Culture.Trauma.'

Carey Sipp ·
Ingrid Cockhren, PACEs Connection CEO, welcomes Rev. Deanna Hollas , the nation’s first known “minister of gun violence prevention,” for this week’s episode of "History. Culture. Trauma." on Thursday, June 2, at 1 p.m. PT; 4 p.m. ET. They will discuss the more than 60 mass shootings in the United States during the month of May 2022 — including the shooting of 10 Black adults and one White adult in Buffalo, New York, and last week’s killing of 19 students and two teachers in Uvalde, Texas.
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How to Decolonize Mental Health Treatment for BIPOC (yesmagazine.org)

Illustration by GOOD STUDIO / ADOBE STOCK Author Gabe Torres / Yes Magazine / 7.28.22 How to Decolonize Mental Health Treatment for BIPOC Note: Whenever you read the terms BIPOC (Black, Indigenous, and people of color), racialized people, and racially marginalized, I mean them synonymously while understanding the distinctiveness of experiences and respective identities of racially oppressed peoples. Whenever I refer to BIPOC, I refer to us as “we,” because I, the writer, identify as a person...
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Moving Forward After Adverse Childhood Experiences: How to Move from Suffering to Flourishing

Dr. Glenn Schiraldi ·
Once the suffering resulting from adverse childhood experiences is managed, we can turn toward creating a more satisfying life. Pursuing the honorable life leads to self-respect and inner peace. Compassion for mistakes, understanding their reasons, and applying integrity skills starts us on the path to flourishing.
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Why Are So Many Women Suddenly Being Diagnosed With ADHD? (refinery29.com)

PHOTOGRAPHED BY LISSYELLE LARICCHIA Author: Dr. Sanah Ahsan's article, please click here. Are you struggling to focus? Finding it hard to concentrate on one thing or read for more than 30 seconds without picking up your phone? Do you feel like you don’t fit in, like you can’t do bills, taxes or keep up with the pace of society? Are ADHD memes circling online resonating with you? You’re not alone. Hundreds of thousands more women are being assessed for ADHD than ever before, especially Black...
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An autistic teen needed mental health help. He spent weeks in an ER instead. (centerforhealthjournalism.org)

A photo of Zachary Chafos dressed as one of his favorite Pixar characters, Mr. Incredible, at his home in Clarksville, Md. (Matt McClain/The Washington Post) Author: To read William Wan's article, please click here. By his fourth week waiting for help in the emergency room, Zachary Chafos’s skin had turned pale white from lack of sun. His mother, Cheryl Chafos, bathed her autistic teenage son daily in the ER’s shower, trying to scrub the sickly pallor off him. His father, Tim Chafos, held...
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Highly-honored school nurse and nurse educator Robin Cogan calls PACEs Connection her ‘north star’; urges each member’s support!

Carey Sipp ·
Note: PACEs Connection is in dire financial straits. We are asking for support, from you, our 57,505 members, to help cover the loss of foundation funding that was promised and did not come through. Pay and hours have been cut for our staff—most of us will be laid off for the month of December. Another grant will pick up in January. Since sounding the alarm this summer, we’ve raised about $24,000 . To get a sense of who your fellow members are, who is donating and why, please enjoy and share...
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Finding Joy After Adverse Childhood Experiences

Dr. Glenn Schiraldi ·
Adverse childhood experiences understandably can numb feelings, including feelings of joy, happiness, and pleasure. Making time to be joyful rewires the wounded brain. Once healing has progressed, the capacity for joy can usually be expanded through the repeated application of proven joy strategies.
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How much would the NAS poverty reduction packages reduce referrals to CPS and foster care placements? Would they reduce racial disproportionality in child welfare? (nasonline.org).

Carey Sipp ·
Because of a collaboration with Columbia University and UW-Madison, we have answers to these questions. By Peter Peter Pecora, Casey Family Programs, March 17, 2023 - Overview The National Academy of Sciences (NAS) recently released a “ roadmap ” to reduce child poverty by as much as half through the implementation of a series of social policy packages. The aim of this study was to simulate the reductions in Child Protective Services (CPS) involvement and foster care placements that are...
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PACEs Research Corner — May 2023, Part 2

Harise Stein ·
[Editor's note: Dr. Harise Stein at Stanford University edits a web site — abuseresearch.info — that focuses on the effects of abuse, and includes research articles on PACEs. Every month, she posts the summaries of the abstracts and links to research articles that address only ACEs, PCEs and PACEs. Thank you, Harise!! — Rafael Maravilla] Domestic Violence – Effects on Children Makris G, Eleftheriades A, Pervanidou P. Early Life Stress, Hormones, and Neurodevelopmental Disorders. Horm Res...
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Better therapy for Asian Americans (knowablemagazine.org)

Psychologists hope that making psychotherapy more relevant for Asian Americans will help to increase their use of mental health services and promote psychological well-being. CREDIT: THUMY PHAN To read more of Diana Kwan's article, please click here . Early in her practice as a clinical psychologist, Janie Hong noticed a troubling trend. With her patients’ permission, Hong had been tracking their progress in therapy — and saw a clear pattern. Compared to her white American patients, her...
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‘Falling through the cracks’: Why ADHD is under-diagnosed among Asian Americans (statnews.com)

At 23, after navigating school and college in a nearly perpetual state of panic, Emily Chen was diagnosed with ADHD. VANESSA LEROY FOR STAT To read more of Olivia Goldhills' article, please click here. Behind a veneer of accomplishment, underneath good grades and musical talents, Emily Chen was in disarray. She never knew what she was missing, perpetually cycling through potential mistakes in her mind in a desperate attempt not to slip up. “I was using anxiety to motivate and power myself.
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Health Equity and the Social Determinants of Health Are NOT Synonyms

Ellen Fink-Samnick ·
Successful health equity strategies must be inclusive, and focus on all marginalized and minoritized persons and their communities. Any lesser view will continue to yield a faulty health equity equation.
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Chronic Illness, Adverse Pre-Onset Experiences (APOEs) and A Splinter Metaphor

Veronique Mead ·
This splinter story is an APOE metaphor, a term I have coined as "adverse pre-onset experiences" aka APOEs. This builds on the term for our knowledge that ACEs (adverse childhood experiences) influence risk for chronic illness. This is about how chronic illness starts for many of us within weeks or months of a stressful or traumatic event. And how we think, very normally, that this particular event is the cause...
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