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PACEs in Pediatrics

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Parental Disengagement in Childhood and Adolescent Male Gun Carrying [pediatrics.aappublications.org]

Alicia Doktor ·
OBJECTIVES: To examine the association between parental disengagement in childhood and adolescent gun carrying and determine whether this association is accounted for by externalizing problems and affiliation with delinquent peers during early adolescence. METHODS: The sample included 503 boys (55.7% African American, 40.6% white, 3.7% other) recruited from first-grade classrooms in Pittsburgh public schools. Multi-informant assessments were conducted regularly (semiannually then annually)...
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Re: Kenneth Ginsburg, M.D., M.S. Ed on “Using Trauma Informed Care and a Strength Based Approach to Reach Teenagers and Build Resilient Kids and Communities,” Tuesday October 28th 6-8 PM

Former Member ·
He is great and he has a book called " Building Resilience in Children and Teens: Giving Kids Roots and Wings" In fact I was going to post something from Healthychildren.org on resilience. I will just post it here. Building Resilience in Children ​The world can be a frightening place. As a parent, I am constantly aware of choices that I make to minimize my perception of fear and uncertainty. Death, illness, divorce, crime, war, child abductions, tsunamis, and terrorism — both here and abroad...
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Re: Conversation-starting Resilience Project posters

Former Member ·
These posters are awesome. They look like the three weeks it took me to copy, cut and past on scrap booking materials --- info for my office doors which the kids liked.... So to all you pedis out there when you go to that much work keep extras for the bottom of the door cause the kids are going to peel the pictures off!!!!!!! I love all these posters. My only suggestion to the AAP and Dr. Block would be this: "Where is the teen photo?" They get left out so often as if teens (and middle...
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Re: 12 Things I Wish My Doctor Understood About Childhood Trauma

Martina Jelley ·
Thank you, Anna. Patients' stories are so helpful to all of us clinicians. My colleagues and I are teaching students and residents about ACEs and how to talk to adults about ACEs. We are also working on a set of competencies that we hope will be adopted into medical school curricula all over the country. Physicians are starting to learn - but there is a long way to go!
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Re: 12 Things I Wish My Doctor Understood About Childhood Trauma

Anna Runkle ·
Re: 12 Things I Wish My Doctor Understood About Childhood Trauma
Blog Post

Doctor-patient role-playing featured in ACEs Connection webinar

Laurie Udesky ·
On an ACEs Connection webinar on Monday, Dr. Andrew Seaman, an assistant professor at Oregon Health & Science University, showed how he navigates his students through the science of adverse childhood experiences (ACEs). And, in an unusual twist for a webinar, Seaman and O’Nesha Cochran, a peer mentor with the Mental Health Association of Oregon, role-played doctor-patient interactions to show how to develop the skills to communicate with patients with high ACE scores. About 90 people...
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Doctor-patient role-playing featured in ACEs Connection webinar

Laurie Udesky ·
On an ACEs Connection webinar on Monday, Dr. Andrew Seaman, an assistant professor at Oregon Health & Science University, showed how he navigates his students through the science of adverse childhood experiences (ACEs). And, in an unusual twist for a webinar, Seaman and O’Nesha Cochran, a peer mentor with the Mental Health Association of Oregon, role-played doctor-patient interactions to show how to develop the skills to communicate with patients with high ACE scores. About 90 people...
Blog Post

Doctors and teachers could team up to reduce stress in schools [reuters.com]

Alicia Doktor ·
(Reuters Health) - - Partnerships between teachers and doctors could help students and school staffers better deal with “toxic stress,” suggests a former teacher turned doctor. Pediatricians can help build resilience in both children and teachers to counter the effects of traumatic childhood experiences, poverty and violence, Dr. Kavitha Selvaraj of the Ann and Robert H. Lurie Children’s Hospital in Chicago writes in the journal Pediatrics. “Before I was a pediatrician, I was a teacher, and...
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Doctors are burning out and trite ‘wellness’ measures aren’t helping [CenterForHealthJournalism.org]

Samantha Sangenito ·
“I'm already beat. The trick is to not let the caring get to you.” These were the words recently uttered by one of my physician colleagues, referring to the stresses of caring for patients in the world of modern health care. The weariness was clear over the phone. Without missing a step, I responded, “I know. Of course.” It took me weeks to realize that it might be concerning that I immediately empathized with her sense of being submerged and overpowered by an uncaring health care system.
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Documentary Broken Places uses archival footage to tell stories of ACEs and resilience over time

Laurie Udesky ·
Why do children exposed to the same level of adversity in childhood have different outcomes? Why do some thrive and others become completely damaged? These were the kinds of burning questions that prompted filmmaker Roger Weisberg to produce the documentary Broken Places , which was shown in a private screening at the 2018 National ACEs Conference in San Francisco. The film delves into the adverse childhood experiences (ACEs) that each of the adults profiled in it endured first as children.
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Documentary on Connection Between Foster Care, Homelessness and Human Trafficking [chronicleofsocialchange.org]

Alicia Doktor ·
A new foster care documentary , Breaking the Cycle , explores exactly how intertwined the foster care system is with homelessness and human trafficking. Filmmaker Arzo Yusuf captured multiple perspectives from people with close connections to the pipeline of living in foster care to becoming homeless or being sexually exploited, including a former foster youth and professionals who work with young people in foster care. Personal accounts from former foster youth speak to the circumstances...
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Donna Jackson Nakazawa Chats Live with Jane Stevens & You: Nov. 14th

Christine Cissy White ·
Featured Guest: @Donna Jackson Nakazawa Topic: Well-Being, Self-Care & ACEs Date: November 14th, 2017 Time: 10 AM PST / 1 PM EST Where: Here / Chats Donna Jackson Nakazawa is an winning researcher, writer and public speaker on health and family issues. She explores the intersection between neuroscience, immunology, and the deepest inner workings of the human heart. Her most recent book, Childhood Disrupted: How Your Biography Becomes Your Biology, and How You Can Heal , examines...
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Dozens of Kaiser Permanente pediatricians in Northern California screen three-year-olds for ACEs

Laurie Udesky ·
Since August 2016, more than 300 three-year-olds who visited Kaiser Permanente’s pediatric clinics in Hayward and San Leandro have been screened for adverse childhood experiences (ACEs), such as living with a family member who is an alcoholic or losing a parent to separation or divorce. But when the idea to screen toddlers and their families for ACEs was first broached at the Kaiser Permanente Hayward Medical Center, the staff were, in a word, “angsty,” says Dr. Paul Espinas, who led the...
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Dozens of stakeholders representing thousands of practitioners send public comments on Calif. ACEs-screening plan

Laurie Udesky ·
Update: We posted this story on Tuesday evening and received a response from the Department of Health Care Services Wednesday that clarifies additional information. DHCS information Officer Katharine Weir said that subject to budget approval by the legislature and the governor: The reimbursement rate will be $29. Federally Qualified Health Centers will also be reimbursed for screening pediatric patients for trauma through Prop 56 funds and federal matching funds. In response to a question...
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Dr. Claudia Gold: Empathy & Listening as ACE-Informed Practice

Christine Cissy White ·
"You are absolutely not doomed from having ACEs."
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Early childhood adversities linked to health problems in tweens, teens [medicalxpress.com]

Alicia Doktor ·
Adverse experiences in childhood—such as the death of a parent, growing up in poverty, physical or sexual abuse, or having a parent with a psychiatric illness—have been associated with physical and mental health problems later in life. But new research at Washington University School of Medicine in St. Louis has shown that multiple adverse experiences in early childhood are linked to depression and physical health problems in kids as young as 9 to 15. Further, the researchers have identified...
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Evidence-based therapies can ameliorate behavior problems in maltreated children [AAPPublications.org]

Samantha Sangenito ·
A father brings his 10-year-old to your office because the boy is having a hard time paying attention at school, gets in fights with classmates and is oppositional with his teacher. As you take the psychosocial history, it’s important to ask whether the child has been exposed to any abuse, neglect, abandonment or other traumas, according to the updated AAP clinical report Clinical Considerations Related to the Behavioral Manifestations of Child Maltreatment. [For more of this story, written...
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Families Are Still Being Separated at the Border, Months After “Zero Tolerance” Was Reversed [propublica.org]

Alicia Doktor ·
The Trump administration has quietly resumed separating immigrant families at the border, in some cases using vague or unsubstantiated allegations of wrongdoing or minor violations against the parents, including charges of illegally re-entering the country, as justification. Over the last three months, lawyers at Catholic Charities, which provides legal services to immigrant children in government custody in New York, have discovered at least 16 new separation cases. They say they have come...
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Family Border Separation Policy Has Long-Term Effects on Child Health [medicalbag.com]

Alicia Doktor ·
Despite a reversal of the Trump administration family separation policy, as of July 2018, more than 2000 children remain separated from their parents or legal guardians. 1 In an article published in JAMA, Howard A. Zucker, MD, JD, and Danielle Greene, DrPH, of the New York State Department of Health, suggest that child-parent separation during an already tumultuous and emotionally strenuous event may exert greater long-term physical and mental health effects on children than is currently...
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Fathers & ACEs with Trauma Dad & Father's Uplift CEO: Tuesday, September 12th

Christine Cissy White ·
What supports exist to "uplift" fathers who have survived abandonment, abuse or torture as children? Where can men go to discuss the joys, struggles and issues of being a father with ACEs? Where are the men who face hard, heavy and complicated realities to make life easier and lighter for all who come after? We found two of them and they will be the featured guests in the next Parenting with ACEs chat . Meet Charles Clayton Daniels, Jr. of Father's Uplift and "Trauma Dad" Byron Hamel. Both...
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Fathers' postnatal hormone levels predict later caregiving, study shows [medicalxpress.com]

Alicia Doktor ·
Much has been written about what happens to mothers hormonally during pregnancy and after, but what about fathers? In a first-of-its-kind study, University of Notre Dame Assistant Professor of Anthropology Lee Gettler and lead author Patty Kuo, visiting assistant professor of psychology, focused on how dads' biology around the birth of their children relates to their parenting down the road. They partnered with Notre Dame psychologists and Memorial Hospital of South Bend to analyze...
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Fighting Compassion Fatigue with CONNECTION

Crystal Morris ·
As one of the Trauma Informed Care trainers for my region, I work with community based organizations daily and see first hand the extent of compassion fatigue and how it manifests itself through burn out and secondary trauma. How do we fight this silent, gradual killer? We build connections. Whether it's in our schools or agencies, the barriers to forming relationships are present. Time, communication skills, authenticity,etc- there are several barriers than can block developing organization...
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First health-related cost of ACEs study shows $113 billion price tag for California; just one ACE costs $28 billion

Laurie Udesky ·
Researchers who have been looking for a way to quantify the health toll of ACEs in dollar terms, now have an example in a newly-released study of California. ACEs exacted a toll costing an estimated $113 billion annually, according to the study in the journal PLOS One that was commissioned by the Center for Youth Wellness. ACEs-associated cardiovascular disease was the condition that lead author Ted Miller dubbed “the giant in the room.” It accounted for $29.6 billion in spending, more than...
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Five Numbers to Remember about Early Childhood Development [DevelopingChild.Harvard.edu]

Samantha Sangenito ·
The early years matter because, in the first few years of life, more than 1 million new neural connections are formed every second. * Neural connections are formed through the interaction of genes and a baby’s environment and experiences, especially “ serve and return ” interaction with adults, or what developmental researchers call contingent reciprocity. These are the connections that build brain architecture – the foundation upon which all later learning, behavior, and health depend. [For...
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For a pediatrician and former teacher ACEs awareness came from a punch in the face

Laurie Udesky ·
Dr. Kavitha Selvaraj did not learn about adverse childhood experiences (ACEs) from a class in medical school. Her first awareness of ACEs came after a student slugged her in the face when she was a new teacher in a school in Los Angeles. She had heard a chorus in the hallway urging her students she refers to as “J” and “N” to “Fight! Fight! Fight,” she writes in an essay in a recent issue of the journal Pediatrics . The two were trading punches. When she stepped in the middle to break it up...
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Graduations, non-linear paths, & the importance of getting started

Lori Chelius ·
With graduation season upon us, I have been thinking a lot about one of my favorite graduation speeches. It’s the speech that Shonda Rhimes, creator of Grey’s Anatomy, gave in 2014 at Dartmouth College. She references the typical expected advice from a graduation speech: “Follow your dreams. Listen to your spirit. Change the world. Make your mark. Find your inner voice and make it sing. Embrace failure. Dream. Dream and dream big..." And then she says, “I think that’s crap.”
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Greener Childhood Associated With Happier Adulthood [npr.org]

Alicia Doktor ·
The experience of natural spaces, brimming with greenish light, the smells of soil and the quiet fluttering of leaves in the breeze can calm our frenetic modern lives. It's as though our very cells can exhale when surrounded by nature, relaxing our bodies and minds. Some people seek to maximize the purported therapeutic effects of contact with the unbuilt environment by embarking on sessions of forest bathing , slowing down and becoming mindfully immersed in nature. But in a rapidly...
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Harvard Center on the Developing Child April Issue (Resilience)

Former Member ·
  Below is the link to April's Issues with Videos and A Brief on Resilience   I didn't put the information here individually because you can go to the link and see the videos and the Brief. ...
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Helping New Parents Make Room for Uncertainty

Claudia Gold ·
A new program for parents and infants, thanks to generous support from Mill Town Capital , is coming to Pittsfield, Massachusetts. The Hello It’s Me Project shines a spotlight on these tender new relationships, investing resources around the birth of a baby with the long-term goal of building a healthy community from the bottom up. When world-renowned child development researcher Dr. Ed Tronick spoke in the spring of 2018 for an audience of a wide variety of practitioners in Berkshire County...
Blog Post

Helping New Parents Make Room for Uncertainty

Claudia Gold ·
A new program for parents and infants, thanks to generous support from Mill Town Capital , is coming to Pittsfield, Massachusetts. The Hello It’s Me Project shines a spotlight on these tender new relationships, investing resources around the birth of a baby with the long-term goal of building a healthy community from the bottom up. When world-renowned child development researcher Dr. Ed Tronick spoke in the spring of 2018 for an audience of a wide variety of practitioners in Berkshire County...
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Heroin children, removed: Children of the opioid epidemic face neglect, trauma [Cincinnati Enquirer]

Laurie Udesky ·
"The infants often cry and cry. Some of the toddlers go limp when caregivers pick them up. Others hug every adult in sight. Some older children with younger brothers and sisters act as if they are little parents. “They’re very protective, and they struggle with being separated from their siblings,” says Tiffany McDonald, a Cincinnati Children’s Hospital Medical Center social worker. “It’s a survivor skill,” says Mary Greiner, a Cincinnati Children’s physician and expert in child abuse and...
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Home Visits Help Parents Overcome Tough Histories, Raise Healthy Children [NPR.org]

Samantha Sangenito ·
Seated at a kitchen table in a cramped apartment, Rosendo Gil asks the parents sitting across from him what they should do if their daughter catches a cold. Blas Lopez, 29, and his fiancée, Lluvia Padilla, 28, are quick with the answer: Check her temperature and call the doctor if she has a fever they can't control. "I'm very proud of both of you knowing what to do," Gil says, as 3-year-old Leilanie Lopez plays with a pretend kitchen nearby. Padilla says that's not a question they could have...
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HOPE, Engagement, and COVID19

Bob Sege ·
As children grow and develop, engaging with the larger community around them provides a sense of “mattering” — a sense that their participation in the community really does matter. The emergency conditions now in effect provide numerous opportunities to children and teens to pitch in. Here are a few ideas . . .
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How can we help people understand that asking for help is a strength?

John Trayser ·
I keep thinking the best way to change our current problems with ACE issues is to make a national MANDATORY use of the ACE Survey at all pediatric practices. Yet, someone today said..."Is there any follow-up to the Portland pediatric story?" Are parents following through on getting counseling, etc. after sharing their ACE results? " Does anyone have that information? Because I was getting push back today from the CEO of a big, respected Corporate Wellness coaching firm. He found the ACEs...
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How chapters are addressing pediatric mental health crisis [aappublications.org]

Alicia Doktor ·
Approximately one in five youths ages 13-18 experiences a severe mental disorder at some point during their life, according to the National Alliance on Mental Illness. For children ages 8-15, the number is 13%. The AAP Arizona, California 3, Florida, New Jersey and Virginia chapters received Healthy People 2020 grants to develop programs to empower families, the media and/or communities to address the mental health crisis in children and youths. Following is an overview of each chapter’s...
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How collaboration helps clinic in San Mateo County, CA, tackle ACEs in children

Laurie Udesky ·
Dr. Elizabeth Grady is a pediatrician at the South San Francisco Clinic, a community clinic of San Mateo Medical Center. She and Susana Flores , a senior public health nurse with San Mateo County Health, spoke with me about how the clinic and other health agencies in San Mateo have been able to craft ways to work together to prevent and heal toxic stress in children. Grady also talked about how she and Flores have been working with the Resilient Beginnings Collaborative (RBC), a group of...
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How do these pediatricians do ACEs screening? Early adopters tell all.

Laurie Udesky ·
Last week, three pediatricians — with a combined experience of 15 years integrating ACEs science into their practices — reflected on the urgency they felt several years ago that prompted them to begin screening patients for childhood adversity and resilience when there was practically no guidance at all. Along their journey , they accumulated a list of lessons learned for other pediatricians and family clinics to use. The three pediatricians participated in the ACEs Connection webinar,...
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How "Sesame Street" is helping kids learn to cope with trauma [abcnews.go.com]

Laura Pinhey ·
Big Bird and his " Sesame Street " buddies are taking on a new mission: helping kids learn to cope with stress and trauma. Sesame Workshop, the nonprofit offshoot of the long-running children's program "Sesame Street," launched the powerful new initiative, which was designed with the help of psychologists, the same week that the nation was rocked by the deadliest mass shooting in modern U.S. history. The initiative includes materials for parents, caregivers and social workers, as well as...
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How to Be More Resilient [nytimes.com]

Alicia Doktor ·
As a psychiatrist, I’ve long wondered why some people get ill in the face of stress and adversity — either mentally or physically — while others rarely succumb. We know, for example, that not everyone gets PTSD after exposure to extreme trauma, while some people get disabling depression with minimal or no stress. Likewise, we know that chronic stress can contribute to physical conditions like heart disease and stroke in some people, while others emerge unscathed. What makes people resilient,...
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Hugs, Not Drugs, May Help Ease Kids' Pain in the ED [MedPageToday.com]

Samantha Sangenito ·
[Photo by Juhan Sonin ] Non-pharmacologic strategies and tactics to ease a child's pain may help expedite treatment and improve care in this challenging population, clinicians said here. With both increased pressure to decrease waiting times in the ED and minimize the use of pharmacologic therapies due to the opioid abuse crisis, providers have been forced to get creative, according to presenters at the annual Pain Week conference. This may mean turning to certain behavioral and...
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Immigrant teens, parents explore ACEs, resilience in 5-week course with family doc

Laurie Udesky ·
Dr. Angela Bymaster, a family doctor in San Jose, Calif., was determined to find a way to teach ACEs science to her patients. Teens would come to the Washington Neighborhood Clinic clearly depressed by a range of problems at home that were contributing to risky sexual behavior and marijuana use, as well as preventable health problems like extreme obesity.
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Immigration Rules Change Could Mean More Kids Separated From Parents [chronicleofsocialchange.org]

Alicia Doktor ·
Anti-poverty and children’s advocates are bracing for the fallout of proposed federal policy changes that would slash access to the social safety net for immigrant families, which could result in more children entering foster care. “Any proposal that undermines the economic stability of families — which is exactly what this does — puts families at increased risk of involvement with the child welfare system,” said Wendy Cervantes, a senior policy analyst at The Center for Law and Social...
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Immune Biomarkers of Early-Life Adversity and Exposure to Stress and Violence - Searching Outside the Streetlight [jamanetwork.com]

By Nicole R. Bush and Kirstin Aschbacher, JAMA Pediatrics, November 4, 2019 Evidence of an association between early-life adversity and heightened risk of chronic disease in adulthood has been found, but the optimal biomarkers for identifying vulnerable or resilient individuals remain unclear. Global trends, including widening socioeconomic disparities, the refugee crises, and climate change, increasingly sculpt trauma exposure and call for scalable early-risk identification and treatment...
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Researchers share learned lessons from screening for adverse childhood experiences in pediatric clinics

Laurie Udesky ·
What are the reasons that parents or caregivers do not fully disclose their own or their young children’s ACEs when asked to fill out an ACE screening form in their child’s pediatrician’s office? That was one of the many questions raised in a recent webinar entitled Screening for Adverse Childhood Experiences in the Pediatric Primary Care Setting: Practical Considerations and Lessons Learned . Dr. Kavitha Selvaraj, an attending physician at the Ann & Robert H. Lurie Children’s hospital...
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In ACEs Connection webinar, physicians talk trauma, offer tips for helping pediatric immigrant patients

Laurie Udesky ·
Dr. Raul Gutierrez, a pediatrician in the San Francisco Bay Area, said he and his fellow clinicians see constant fear and its health consequences every single day among the largely immigrant and Latino population they serve. It’s all the result of anti-immigrant policies and the news cycle that feeds the fear. Dr. Raul Gutierrez “It is almost inescapable with the repercussions of immigration policy on the radio, television, social media and from friends and family,” Gutierrez told the 69...
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In El Paso, Border Patrol Keeps Families Under a Bridge (In Photos) [psmag.com]

Alicia Doktor ·
In El Paso on Wednesday, Kevin McAleenan, the commissioner of Customs and Border Protection, stood in front of the steel bollards that line the border between the United States and Mexico and warned that the border had hit a " breaking point ." As McAleenan addressed reporters at the border, elsewhere in the city, hundreds of asylum-seeking families were being held in a razor wire-surrounded enclosure under a bridge. Photos showed children and families standing behind chain link and...
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Interim report of the President’s opioid commission says its final report will address early intervention strategies for children with ACEs

On August 8, President Trump spoke to the opioid crisis in this country and declined to declare a national emergency as recommended by the “President’s Commission on Combating Drug Addiction and the Opioid Crisis.” Instead, the President emphasized the law and order aspects of the problem and the importance of preventing drug use in the first place since addiction is so hard to overcome. The Commission will make a final report in the fall. The recently released interim report makes eight...
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4 years after integrating ACEs science, Pueblo, CO clinic improves services for families; cuts ER costs, doctor stress

Laurie Udesky ·
Four years ago, Dr. Leslie Dempsey would never have talked about ACEs — adverse childhood experiences — with her patients. Now ACEs is a common topic. “Just as I don’t feel awkward asking someone if they smoke or do intravenous drugs, I don’t really feel awkward talking about their childhood traumas in a way that it relates to their health. It’s just integrated into obtaining background and social history,” she says. Dr. Leslie Dempsey Dempsey is a physician in obstetrics who oversees a team...
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A Conversation with Nadine Burke Harris: How Should Pediatricians Address Childhood Adversity?

Claudia Gold ·
Pediatrician Nadine Burke Harris is a masterful storyteller. I learned in a conversation with her at Wheelock College before her presentation for the Brookline, MA organization Steps to Success , that before she decided to become doctor, Dr. Burke Harris wanted to be an author. Only after the smashing success of her TED talk: How childhood trauma affects health across a lifetime , when she was approached by a literary agent, did she find her way to writing. Her newly released book The...
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