Tagged With "complex health needs"
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Building trust is now a critical part of health care
In a video clip , a hospital patient turns away in protest as a physician enters the room. “Why do you all keep coming in my room!” she asks in frustration. The physician moves a chair out of the way and sits down at eye level with the patient. “You’ve had to see so many people,” he acknowledges. “And I’m tired of it!” she yells. “I already know I have to get both of my legs cut off. That’s what they keep saying. I don’t have a choice!” “You don’t feel like you have a choice,” he repeats...
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‘Bureaucratic Ninjas’ Slice Red-Tape To Battle Health Disparities [KHN.org]
When a receptionist hands out a form to fill out at a doctor’s office, the questions are usually about medical issues: What’s the visit for? Are you allergic to anything? Up to date on vaccines? But some health organizations are now asking much more general questions: Do you have trouble paying your bills? Do you feel safe at home? Do you have enough to eat? Research shows these factors can be as important to health as exercise habits or whether you get enough sleep. Research has begun to...
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CA announces robust perinatal depression prevention for Medi-Cal recipients
Melinda Coates experienced a tumultuous pregnancy. “I was really mentally upset literally from day one (of the pregnancy),” she says. (Melinda Coates is a pseudonym. To protect her and her children’s privacy and safety, we are not using her real name.) Coates had hoped to get counseling last October, when she was seven months pregnant. That’s when she enrolled in the state’s Medi-Cal program, shortly after she and her abusive husband moved to California, “but nobody was able to get me in...
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CA announces robust perinatal depression prevention for Medi-Cal recipients
Melinda Coates experienced a tumultuous pregnancy. “I was really mentally upset literally from day one (of the pregnancy),” she says. (Melinda Coates is a pseudonym. To protect her and her children’s privacy and safety, we are not using her real name.) Coates had hoped to get counseling last October, when she was seven months pregnant. That’s when she enrolled in the state’s Medi-Cal program, shortly after she and her abusive husband moved to California, “but nobody was able to get me in...
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CA pediatrician develops, tests, gets state OK for whole-child assessment tool that includes ACEs
Over the last dozen years or so, many pediatricians, astounded by the ramifications of the science of adverse childhood experiences (ACEs) on the children they care for, began integrating this science into their practices. The most common approach has been to ask parents about ACEs using a questionnaire, and to use this information to counsel parents and identify resources for the family. Different practices have been using different questionnaires: Some ask parents for their ACE scores...
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CA pediatrician develops, tests, gets state OK for whole-child assessment tool that includes ACEs
[Editor's note: This blog was first posted in April 2017. Dr. Marie-Mitchell updated the assessment by modifying a few of the questions, so we are republishing with the new assessment, one in Spanish and one in English.] Over the last dozen years or so, many pediatricians, astounded by the ramifications of the science of adverse childhood experiences (ACEs) on the children they care for, began integrating this science into their practices. The most common approach has been to ask parents...
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CA Surgeon General and DHCS Launch ACEs Aware Initiative and Website
Join a live webinar with California Surgeon General Dr. Nadine Burke Harris and Dr. Karen Mark Medical Director, Department of Health Care Services for a Medi-Cal provider introduction to the new ACEs Aware Initiative and the www.ACEsAware.org website. The Office of the California Surgeon General and the Department of Health Care Services (DHCS), in the first public unveiling of the initiative, will host a live webinar to share details of the new ACEs Aware Initiative for Medi-Cal providers...
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CA to reimburse for only one of three ACEs screeners
California health care providers will soon begin to learn how many of the 13.2 million California children and adults in the state’s MediCal program have been exposed to adverse childhood experiences (ACEs). But the state’s proposed decision to reimburse only one of three recommended options for screening children has drawn mixed reactions from pediatricians. “If we have mandated legislation that only looks at one screening tool, it really limits the opportunity to improve that screening...
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CAC Directors’ Guide to Mental Health Services for Abused Children
From the NCTSN, comprehensive resource for CAC's. http://nctsn.org/nctsn_assets/pdfs/CAC_Directors_Guide_Final.pdf
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California ACES Learning & Quality Improvement Collaborative (CALQIC) - Opportunity to be a part of the Learning Collaborative!
Apply to be a part of ACEs Aware's California ACES Learning & Quality Improvement Collaborative (CALQIC) In partnership with the UCSF Center to Advance Trauma-Informed Healthcare and other key partners, we'll select 15 organizations across California to participate in this 18-month learning collaborative to support clinics in screening for and responding to adverse childhood experiences (ACEs) in children and adults. This is a challenging time, and we know that many of our health care...
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California considers investing $100 million in-home visits for new moms and their babies [SCPR.org]
A bill working its way through the state legislature would create a state-funded program to help new mothers in the first few months and years after the birth of their children. The CalWORKs Baby Wellness and Family Support Home Visiting Program would spend $100 million to offer home visits from nurses or social workers to new mothers who are living in poverty. Support for home visiting programs is grounded in research that has found regular postpartum home visits can improve the health of...
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California gets its first ever surgeon general (ktvu.com)
California's first-ever Surgeon General has launched a listening tour that will take her around the state to hear about people's hopes for the new position and the state's new commitment to improving Californians' health. Dr. Nadine Burke Harris is a pediatrician with degrees from U.C. Berkeley, U.C. Davis Medical School, and Harvard University. She says, as the daughter of a biochemist and a nurse, she knew what her dream job was at an early age. "My immediate priorities as Surgeon General...
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California has Begun Screening for Early Childhood Trauma, But Critics Urge Caution [sciencemag.org]
By Emily Underwood, Science, January 29, 2020 On 1 January, California became the first U.S. state to screen for adverse childhood experiences (ACEs)—early life hardships such as abuse, neglect, and poverty, which can have devastating health consequences in later life. The project is not just a public health initiative, but a vast experiment. State officials aim to cut the health impacts of early life adversity by as much as half within a generation. But critics say the health benefits of...
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California healthcare providers adapt ACEs screening from in-person to virtual environment
Dr. Amy Shekarchi, a pediatrician based in Los Angeles, CA, was helping to lead the rollout of ACEs screening among 50 health care providers at six clinics affiliated with the L.A. County Department of Health Services when the COVID-19 pandemic hit—days before she was set to launch the effort. “We had trained everybody in doing face-to-face [ACEs screening], and when COVID-19 happened we thought, let’s not throw the screening out. Everybody was ready,” says Shekarchi, who is the pediatric...
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California Is Giving Doctors Incentives To Ask Patients About Childhood Trauma [capradio.org]
By Sammy Caiola, Capital Public Radio, December 9, 2019 California health officials want children and adults on Medi-Cal to get screened for traumatic childhood events that can cause negative health effects down the line. Now the state has started giving doctors and nurses tools to do the screenings. People who experience adversity early in life have much higher chances of substance abuse, depression, or chronic diseases than their peers, according to national research. Gov. Gavin Newsom’s...
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California unveils ACEs Aware initiative to screen for trauma
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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Call For Workshop and Poster Submissions: Third Philadelphia Trauma Training Conference
The 3rd Annual Philadelphia Trauma Training Conference: Promoting Equitable Access to High Quality Services for Vulnerable Children and Families , will be held on Thomas Jefferson University's East Falls Philadelphia Campus July 29 th -August 1st, 2019 . This unique training conference will provide an intensive, collaborative, and engaging experience to providers, educators, and leaders across health, education, and social service disciplines, as well as to community members invested in...
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Calling all People Interested in ACEs in Pediatrics
Image: courtesy of wikimedia Dear Aces in Pediatrics members: I want to let you all know that I have the honor of managing the ACEs in Pediatrics site. I began working with ACEs Connection in October. I came here with more than 25 years of experience as a health journalist, and a commitment to reporting on the remarkable shifts occurring in medicine and other sectors to promote trauma-informed and resiliency-building practices based on ACEs science . ACEs in Pediatrics is a forum for...
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Can people be saved from a terrible childhood? [theguardian.com]
When Sabrina Bugget-Kellum walked into a neighbourhood clinic in New York for a routine appointment in in 2016, she was desperate. Her son was in prison. She was trying to look after his two young children, who were aged one and two. Their mother was emotionally unstable. Bugget-Kellum did not want the chaos of the adults’ lives passed down to another generation. “We didn’t know if they would be safe with their mother,” she recalled recently. “I began to pray, please God, I need some help.
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Can We Harness Pediatrician T. Berry Brazelton's Message of Hope?
Photo courtesy of Brazelton Touchpoints Center As our nation mourns the passing of renowned pediatrician T. Berry Brazelton, hearing his voice through the outpouring of articles, video clips, and conversations on social media feels like a balm for the soul. In these trying times, his simple shift from learning "what's wrong" to listening for "what's right" in a child and family seems very much needed. In his 50 years practicing pediatrics, he saw up close the ways parents can struggle. With...
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Care Provider Facilities Described Challenges Addressing Mental Health Needs of Children in HHS Custody [cmhnetwork.com]
By Joanne M. Chiedi, Department of Health and Human Services, September 18, 2019 Care Provider Facilities Described Challenges Addressing Mental Health Needs of Children in HHS Custody. Facilities that care for children in the Office of Refugee Resettlement’s (ORR’s) custody face the difficult task of addressing the mental health needs of all the children in their care, including children who have experienced intense trauma. According to those who treat them, many children enter the...
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CDC announces Adverse Childhood Experiences (ACEs) Research & Evaluation Fellowship opportunity
The Centers for Disease Control and Prevention (CDC) in Atlanta has announced an Adverse Childhood Experiences (ACEs) Research & Evaluation Fellowship opportunity that resides in the National Center for Injury Prevention and Control (NCIPC) at CDC. The new fellowship position reflects a growing ACEs capacity within the CDC. The announcement states “The selected candidate will assist with research related to evaluating comprehensive community-based prevention strategies for primary...
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CDC releases first US data on COVID-19 cases in children [Ars Technica]
Photo by Eric Froehling on Unsplash In all of the grim statistics of COVID-19’s devastation, one seemingly bright spot has been that children seem to be largely unaffected. They consistently make up small percentages of confirmed cases and nearly all have a mild form of the disease. But as more data accumulates, we’re getting a clearer picture of what COVID-19 looks like in children—and when its youngest victims are not spared from the worst. On Monday, April 6, public health researchers at...
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CDC's 'Connecting the Dots' Tool
Great new Resource from CDC shared with me from Dr. Kevin Sherin, Health Officer & Director of Florida Department of Health in Orange County, Florida. Welcome to the Connections Selector! This tool makes it easier for you to connect the dots and explore the relationships between multiple types of violence and the risk and protective factors they share at each level of the social-ecological model (SEM). A clear understanding of these connections can help you plan strategies to prevent...
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Change Package is Now Available!
Click here for the Change Package : Fostering Resilience and Recovery: A Change Package for Advancing Trauma – Informed Primary Care Earlier this year, to help primary care address the impacts of trauma, the National Council for Behavioral Health, with the support of Kaiser Permanente, launched a three-year initiative, Trauma-Informed Primary Care: Fostering Resilience and Recovery . “Trauma work is not new to the National Council. With effects across the lifespan, we’ve spent the last...
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Chat Event TODAY! Menopause, Parenting & ACEs with Carey Sipp
How to Attend Chat Event on August 8th @ 10 AM PST / 1 PM EST : If You are a Member of the Parenting with ACEs Group Go to Parenting with ACEs Group on August 8th. Find Featured Chat at top. If You're Not a Member of the Parenting with ACEs Group Go to Groups, All Groups, find Parenting with ACEs Group , Join This Group. Find Featured Chat at top of page. More about the Chat: Carey Sipp is a health writer, parenting educator and trauma-informed communities advocate. She is the author of The...
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Chat Live with Sebern Fisher on ACEs Connection
"Evidence with neurofeedback suggests that trauma-informed treatment should also be brain-informed treatment- and not just to know that the brain is an issue, but to work with it directly.” Sebern Fisher, Neuofeedback in the Treatment of Developmental Trauma: Calming the Fear-Driven Brain. Neurofeedback for ACEs: Chat with Sebern Fisher Oct. 10th (10 AM PST / 1 PM EST) Chats are live, online discussions - not webinars. We gather and connect, via chat messaging to share stories, resources,...
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CHCS brief outlines foundational steps toward implementing trauma-informed care
A newly-released brief by the Center for Health Care Strategies details some practical strategies and recommendations for health care organizations seeking to implement trauma informed practices. “It draws from the experiences of pilot sites in Advancing Trauma-Inform ed Care , a CHCS-led national initiative made possible through support from the Robert Wood Johnson Foundation.” Here is a related video CHCS-organized webinar entitled Implementing Trauma-Informed Care in Pediatric and Adult...
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Chicago healthcare providers start center for ACEs science education; aim to reach all medical, health students by 2025
In 2017, Dr. Audrey Stillerman and three other women from the Chicago healthcare community founded the THEN Center . Its goal is lofty: By 2025, it wants every graduating student in medical and health sciences across the United States to apply core concepts of childhood adversity, neurobiology, resilience and health equity into their work. Dr. Audrey Stillerman Today, the THEN Center (The Collaborative Study of Trauma, Health Equity and Neurobiology) is well on its way. Its founders are...
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Child abuse could leave 'molecular scars' on its victims [medicalxpress.com]
Children who are abused might carry the imprint of that trauma in their cells—a biochemical marking that is detectable years later, according to new research from the University of British Columbia and Harvard University. The findings, based on a comparison of chemical tags on the DNA of 34 adult men, still need confirmation from larger studies, and researchers don't know if this tagging—known as methylation—affects the victims' health. But the difference in methylation between those who had...
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Child and youth advocacy centres: A change in practice that can change a lifetime [Journal of Paediatrics & Child Health]
"While often a silent and invisible issue, childhood trauma is pervasive, and has profound individual, societal and economic impacts. Many forms of childhood trauma exist, including child physical and sexual abuse. Given the prevalence, impact and availability of prevention and intervention approaches, child abuse deserves the same level of awareness, policy priority and investment as is directed to other issues of significant public health importance. The complex issue of child abuse...
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Child’s behavior may be linked to parent’s adverse childhood experiences [contemporarypediatrics.com]
Parents who have experienced adverse childhood experiences (ACEs), such as abuse, neglect, or household dysfunction, are more likely than parents without these experiences to have children with behavioral health problems, according to an analysis of data from several large, nationally representative surveys of US households that addressed ACEs and children’s behavioral problems and diagnoses. Of the more than 2500 children for whom researchers had data, one-fifth had a parent who reported...
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Childhood Stress and Adversity is Associated with Late-Life Dementia in Aboriginal Australians
This was just sent by the RACP “Paediatric Pot-Pourri”. It continues the developing and worrying themes presented at the recent NBPSA and CCCH satellites days before the RACP Congress. I cannot see any reason to imagine that these same outcomes do not also apply to those children living anywhere in the world where ACE’s are flooding into their lives. John Goldsmith “All paediatricians, particularly those with an interest in child development, are aware of the Adverse Childhood Experiences...
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Childhood trauma and Its lifelong health effects more prevalent among minorities [NPR Health Shots]
Photo: Woodleywonderworks/ CC 2.0 "When researchers first discovered a link in the late 1990s between childhood adversity and chronic health problems later in life, the real revelation was how common those experiences were across all socioeconomic groups. But the first major study to focus on adverse childhood experiences (ACEs) was limited to a single healthcare system in San Diego. Now a new study — the largest nationally representative study to date on ACEs — confirms that these...
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Children and US Federal Policy on Health and Health Care Seen but Not Heard
Children account for 73.5 million Americans (24%), but 8% of federal expenditures. Data on health and health care indicate that child well-being in the United States has been in decline since the most recent recession. Childhood poverty has...
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Children of Color Face Higher Barriers to Success, New Casey Report Says [jjie.org]
The children of immigrants make up less than one-fourth of the nation’s youth population yet account for 30 percent of children living in poverty, a new report finds. More than that, young black and brown Americans were worse off compared to white and Asian-American children, the Annie E. Casey Foundation said. The foundation analyzed youth welfare along several axes, including education, health and economic indicators, to come up with an index of how well young people in various racial and...
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Chronic Stress Exposure Among Young African American Children with Asthma: Racism is a Factor [annallergy.org]
By Bridgette L. Jones, Vincent Staggs, and Brianna Woods-Jaeger, Annals of Allergy, Asthma & Immunology, September 17, 2019 African American and Hispanic children are more likely to have a diagnosis of asthma and significantly higher disease related morbidity in comparison to non-Hispanic white children. Mortality rates are likewise higher as African American children are 8 times more likely than non-Hispanic white children to die from asthma 1. The cause of this striking health...
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'Clear Link' Between Childhood Trauma and Substance Abuse, Addiction Doctor Says [johnsoncitypress.com]
By Jonathan Roberts, Johnson City Press, September 2, 2019 Almost half of all American children have experienced at least some form of childhood trauma. Many of these adverse childhood experiences, or ACEs, can be tied back to drug and substance abuse, but their impact may be more widespread than many perceive. In Tennessee, an estimated 49% of children have at least one adverse childhood experience, and 24.1% have at least two. Nationally, those numbers sit at 45% and 20.5%, respectively.
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Colorado Launches Two Generation Approach to Family Services [chronicleofsocialchange.org]
Colorado is testing a new approach to providing services to struggling families in an effort to address the intergenerational cycle of poverty, incarceration and foster care. Two Generation (2Gen) is a new initiative by the state recognizing that children and their parents are best served by recognizing the needs of the entire family unit. “CDHS embedded the 2Gen approach into all of our services, recognizing that our clients only succeed when their providers or children also get the support...
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Come Chat with Dr. Claudia M. Gold: An ACE-Informed Pediatrician
Date: July 11th Time: 10 AM PST / 1 PM EST Location: Parenting with ACEs Group , Online Flyer: Attached below. Please share. Dr. Claudia M. Gold has practiced general and behavioral pediatrics for 25 years and specializes in early childhood mental health. She is on the faculty of the University of Massachusetts, Boston Infant-Parent Mental Health program, William James College, and the Austen Riggs Center where she is a Human Development consultant. Dr. Gold is author of the following...
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Commentary: Pediatricians called to address racism, intolerance to achieve health equity [AAPPublications.org]
As pediatricians, we champion the need to address social determinants of health, such as poverty and food insecurity, in an effort to achieve health equity. We emphasize screening for toxic stress. In our conversations about equity, we include data about racial and ethnic disparities. Because of our commitment to work for the health and well-being of all children, pediatricians are uniquely positioned to consider and address the needs and concerns of the at-risk communities for whom we care.
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Connecting with Families During Quarantine: Virtual Support and Telehealth
The New Jersey Chapter, American Academy of Pediatrics Healthy Spaces program offers this webinar to provide strategies for health care providers to provide trauma-informed care during virtual patient encounters. Drs. Nicole Leopardi and Ruth Gubernick will share guidance on outreach messaging, stress management, and positive discipline. Participants will also engage in thoughtful reflection on how to implement small tests of change to adapt patient care and support connections with families...
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Conversations about Emotional Health AAP
The AAP developed 2 promotional ads — Mom! Dad! Ask the doctor about my emotional development, too! — to promote the importance of mental health as part of a health supervision visit. - See more at: ...
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Course credit for "Childhood Adversity and Toxic Stress in Medical Care: Promoting Health and Healing Throughout the Lifespan"
Dr. Beth Grady, a pediatrician at South San Francisco Clinic, developed a course called: "Childhood Adversity and Toxic Stress in Medical Care: Promoting Health and Healing throughout the Lifespan". She did the presentation on June 15, 2016, and the webinar was posted on June 22, 2016. The termination date for the webinar is June 22, 2019. Instructions for earning 1 AMA PRA Category 1 Credit TM for this enduring material: Watch the video of the presentation, which can be accessed via this...
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Cover Story November Issue of Journal of Family Practice: Childhood Adversity and Lifelong Health
I was honored to have my review article, “Childhood Adversity and Lifelong Health: from research to action”, chosen as the November 2018 cover story of the Journal of Family Practice . Here is a link to the article. Access is free after registration with the journal and retrievable directly by anyone who has Medline PubMed access. https://www.mdedge.com/jfponline/article/178388/pediatrics/childhood-adversity-lifelong-health-research-action Highlights from the article include: - recognition...
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COVID-19 and our dialogue with death
[Editor's note: Dr. Cristian Zanartu, an internist and palliative medicine specialist, is currently volunteering at Bellevue Hospital during the pandemic.] I was angry. So angry. How come the smartest country in the world is acting like the dumbest? Why aren’t health authorities giving us clear guidelines now, before this starts? Like: how to quarantine, how to quarantine from a symptomatic loved one in the same household (we knew by late February from Chinese data that most spread happened...
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COVID-19 Response: Using Telehealth for Maternal & Infant Healthcare - Mahmee 03-20-2020
For those of you unable to join the 'COVID-19 Response: Using Telehealth for Maternal & Infant Healthcare' webinar today (Friday, March 20, 2020), here is a link to the webinar recording. Hosted by Mahmee , a maternal-infant health care coordination platform committed to equity, discussed how to make adjustments to clinical workflows and triage prenatal and postpartum concerns. Best practices were offered for identifying patients who should continue receiving in-clinic and in-home...
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COVID-19's profound effects on children are on the horizon [dailymemphian.com]
By Bindiya Bagga and Jason Yaun, Daily Memphian, May 8, 2020 While the toll of the COVID-19 pandemic accelerates as the case and death totals continue to climb, children have fortunately been spared from the worst of the direct ravages of this virus. But as the pandemic continues and the effects on the health and financial well-being of caregivers mount, children are being impacted in a myriad of harmful ways that could have long-lasting consequences if not addressed. As parents and...
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COVID-19: The Trauma of Witnessing So Much Illness and Death Will Have Lasting Effects [medicinenet.com]
From MedicineNet, May 3, 2020 The tragic death by suicide this week of an emergency department physician who had been caring for COVID-19 patients in New York City underscores the huge psychological impact of the pandemic -- which will linger long after the virus is gone, experts say. "For frontline responders, the trauma of witnessing so much illness and death will have lasting effects for many," Bruce Schwartz, MD, president of the American Psychiatric Association (APA), said during the...
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COVID-19: What’s equity got to do with it? [George Washington University Milken Institute School of Public Health]
Editor’s note: This illustration is a new COVID specific Pair of ACEs tree shown along with the original tree. The post is by Wendy Ellis, DrPH, MPH the Director of the Building Community Resilience Collaborative and Networks at the George Washington University Milken Institute School of Public Health. It took less than two months for a virus undetectable to the naked eye to lay bare what lies in plain sight — exposing long-standing inequities, driven by social policies that have created...