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PACEs in Pediatrics

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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...
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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...
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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 Bird registration ends Feb 2 for the AAP Trauma Informed Pediatric Provider Course

Tammy Piazza Hurley ·
Early bird registration ends soon for the 2019 AAP Trauma Informed Pediatric Provider (TIPP) Course scheduled March 2-5, 2019 in San Antonio, TX. Learn from other pediatric healthcare providers about the recent science, evidence base and treatments of adversity, resiliency and toxic stress. AAP Past-President, Dr. Colleen Kraft, will deliver the keynote presentation Pediatricians as Leaders in Addressing Toxic Stress and Trauma in Children . For more information, a schedule of speakers and...
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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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Governor Newsom announces Nadine Burke Harris to be CA's first-ever surgeon general

Jane Stevens ·
Governor Gavin Newsom today announced the appointment of Dr. Nadine Burke Harris, a national leader in pediatric medicine, to serve as California’s first-ever Surgeon General. There is overwhelming consensus in the scientific community around early warning signs and childhood determinants of serious health outcomes. As California's Surgeon General, Dr. Burke Harris will urge policymakers at every level of government and leaders across the state to consider the social determinants of health,...
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Hearing in House Education and Labor Early Childhood Subcommittee addresses intersection of trauma and education

Dr. Nadine Burke Harris (l) and Karina Chicote, Churchill Fellow from western Australia meet after congressional hearing After watching the hearing on a monitor in the overflow room, Karina Chicote, a Churchill Fellow from western Australia, and I hustled to the hearing room in hopes of speaking to the lead witness, Nadine Burke Harris, MD, the first Surgeon General of the State of California. She was deep in conversation with others, including a young woman who wanted to tell her how...
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Hillary Clinton’s Comprehensive Agenda on Mental Health [The Briefing—Fact Sheets]

The first bullet under Early Diagnosis and Intervention of today’s release of Hillary Clinton’s mental health agenda is titled “ Increase public awareness and take action to address maternal depression, infant mental health, and trauma and stress in the lives of young children.” It states “We also know that infant mental health depends on children forming close and secure relationships with the adults in their lives, and that too many children are growing up in environments that cause them...
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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 Does Trauma Affect a Person’s Interaction with Their Child? (www.nicabm.com) & Commentary

Christine Cissy White ·
Has anyone seen this video posted on the National Institute for the Clinical Application of Behavioral Medicine (NICAMB) blog? "According to Dr. Ruth Lanius, a parent's experience of trauma can impact their ability to form a close, intimate relationship with their child." Ruth Buczynski, PhD Those of us Parenting with ACEs sure know that's the truth. Developmental trauma impacts our ability to form close and intimate relationships with ourselves, other adults and our children. The video was...
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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 Kids Were Restrained to Chairs With Bags Over Their Heads at a Juvenile Hall in Virginia [motherjones.com]

By Samantha Michaels, Mother Jones, January 22, 2020 Antonio was tired of people calling him names. Staff members at the Virginia juvenile hall where he was held would call him pendejo and “onion head,” he said. After fleeing violence in Mexico at age 15 and arriving alone at the US border, he’d been sent to Shenandoah Valley Juvenile Center in 2016 and held alongside American teens while he awaited immigration proceedings. Shenandoah is one of two juvenile halls nationally that the Office...
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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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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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8 Myths About Screening For Adverse Childhood Experiences

Laura Shamblin ·
I’d like to take this opportunity to address some of the objections to screening for ACEs that I have come across. It is true that some areas of research are still emerging, such as protocols, but in other ways we are twenty years behind using the information we have to make a positive difference in our patients lives and in training new physicians to be more comfortable addressing social and experiential determinants of health.
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A community-based approach to supporting substance exposed newborns and their families

Alex Risley Schroeder ·
This information brief highlights a community-based approach to supporting families and newborns affected by substance use. MA EfC developed this brief to address the profound intersection between the Massachusetts opioid crisis, Federal mandates for the development of Plans of Safe Care for substance exposed newborns, and, the MA EfC focus on increasing social connectedness as a means to reduce child maltreatment.
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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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A National Agenda to Address Adverse Childhood Experiences

Christina Bethell ·
What are ACEs and Why Do They Matter? In 2016 1 , nearly half of U.S. children – 34 million kids – had at least one Adverse Childhood Experience (ACE) and more than 20 percent experienced two or more. The new brain sciences and science of human development explain how ACEs can have devastating, long-lasting effects on children’s health and wellbeing. These events resonate well beyond the individual child to have far-reaching consequences for families, neighborhoods, and communities. ACEs...
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A Pandemic Benefit: The Expansion of Telemedicine [nytimes.com]

Marianne Avari ·
By Jane Brody, The NY Times, May 11, 2020. Even if no other good for health care emerges from the coronavirus crisis, one development — the incorporation of telemedicine into routine medical care — promises to be transformative. Using technology that already exists and devices that most people have in their homes, medical practice over the internet can result in faster diagnoses and treatments, increase the efficiency of care and reduce patient stress. Without having to travel to a doctor’s...
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A plethora of journal articles on ACEs science

Laurie Udesky ·
As the community manager of ACEs in Pediatrics, I comb the web looking for pertinent studies and information that may be of interest to ACEs in Pediatric members. In the last several days the journals Pediatrics, the North Carolina Medical Journal, Child Abuse & Neglect and the Journal of Women's Health have published a number of articles on ACEs science. Here is a list of some of the articles and commentary featured in each journal: ACEs and Pregnancy: Time to Support All Expectant...
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AAP President Publishes Letter in The New York Times on Childhood Poverty

Former Member ·
Today, AAP President Sandra G. Hassink published a  letter to the editor  in The New York Times in response to an  op-ed  that ran in the paper earlier this week on childhood pover ty, referencing a new report from the...
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AAP Statement in Response to Tear Gas Being Used Against Children at the U.S. Southern Border [aap.org]

Alicia Doktor ·
“Images and news reports of tear gas being used on children and families seeking asylum at our border have stunned and shaken pediatricians just as they have so many others across the country. Our objection to this type of treatment of children and their parents is grounded in our own policy: “The American Academy of Pediatrics recommends that all immigrant children and families seeking safe haven are treated with dignity and respect to protect their health and well-being. Children who are...
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ACE Fact Sheets to Give Your Doctors, Patients & Beyond (free downloads)

Veronique Mead ·
I was first inspired to create a fact sheet summarizing the effects of adverse childhood experiences (ACEs) after reading a comment in “Got Your ACE score?” A reader wished she had a form to give her doctor that documented the vast body of evidence explaining how early trauma increases risk for chronic physical and mental health conditions and much more. I could relate.
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ACEs Research Corner — February 2020

Harise Stein ·
Editor's note: Dr. Harise Stein at Stanford University edits a web site — abuseresearch.info — that focuses on the health effects of abuse, and includes research articles on ACEs. Every month, she's posting the summaries of the abstracts and links to research articles that address only ACEs science. Thank you, Harise!! -- Jane Stevens] Kambeitz C, Klug MG, Greenmyer J, Popova S, Burd L. Association of adverse childhood experiences and neurodevelopmental disorders in people with fetal alcohol...
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ACEs Research Corner — January 2020

Harise Stein ·
Research papers this month include links between ACEs and bullying, dropping out of high school, adult disability, and the effects of countering ACEs.
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ACEs Research Corner — March 2020

Harise Stein ·
Editor's note: Dr. Harise Stein at Stanford University edits a web site — abuseresearch.info — that focuses on the health effects of abuse, and includes research articles on ACEs. Every month, she's posting the summaries of the abstracts and links to research articles that address only ACEs science. Thank you, Harise!! -- Jane Stevens] Brown SM, Bender K, Orsi R, McCrae JS, Phillips JD, Rienks S. Adverse childhood experiences and their relationship to complex health profiles among child...
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ACEs Research Corner — November 2019

Harise Stein ·
[Editor's note: Dr. Harise Stein at Stanford University edits a web site -- abuseresearch.info -- that focuses on the health effects of abuse, and includes research articles on ACEs. Every month, she's posting the summaries of the abstracts and links to research articles that address only ACEs. Thank you, Harise!! -- Jane Stevens] Jackson DB, Chilton M, Johnson KR, Vaughn MG. Adverse Childhood Experiences and Household Food Insecurity. Am J Prev Med. 2019 Nov;57(5):667-674. PMID: 31522923...
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ACEs screening in CA — a Q and A with Dr. Dayna Long

Laurie Udesky ·
Last year, the California Department of Health Care Services rolled out its plans for universal screening for trauma among its pediatric and adult Medicaid population. Beginning January 1, 2020, California physicians were able to receive an incentive payment of $29 for each pediatric patient screened for ACEs using the PEARLs ( Pediatrics Adverse Childhood and Resilience Study) tool. Dr. Dayna Long talked with ACEs Connection staff reporter Laurie Udesky about ACEs science, what led to the...
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Adverse Childhood Experiences (ACE) Study: Beyond Screening in Pediatrics

Claudia Gold ·
The evidence is clear. When bad things happen to us as young children, we are at significantly increased risk for not only mental health problems, but also a wide range of physical health problems including asthma, heart disease, and even early death. These "bad things" all involve disruptions in caregiving relationships. A national movement directed at screening for ACEs in pediatric practices has emerged from this work. My suggestion that the implication of the Adverse Childhood...
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After 5-year journey to integrate ACEs science, Santa Rosa, CA, pediatric clinic is trauma-informed, from head to toe

Jane Stevens ·
Dr. Meredith Kieschnick was among the first physicians in the U.S. to hear the term, "adverse childhood experiences". That was in 1998, early on in her career as a pediatrician, when the CDC-Kaiser Permanente Adverse Childhood Experiences Study (ACE Study) published its initial findings in the American Journal of Preventive Medicine . “I attended a conference at which (Dr. Vincent) Felitti spoke,” she recalls. Felitti, at that time director of the Health Appraisal Center at Kaiser Permanente...
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All hands on deck (from a distance): remote care for traumatized moms and babies

Jonathan Joseph Goldfinger ·
Dear colleague, Coronavirus is forcing providers and allied professionals serving mothers and babies to make unprecedented decisions. Should pregnant women needing care go through our hospital quarantine entrance? Should moms deliver without partners, family or doulas present? Be sent home early before key screenings or jaundice treatment are completed? To make matters worse, our systems aren't ready for basic remote care of mothers and infants now "socially distanced". Prenatal, post-partum...
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As California Moves to Screen Children for Childhood Trauma, Poverty Has To Be Part of the Equation

Jim Hickman ·
In California, we are coming full circle in recognizing the connection between poverty and health.
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Shasta Health Center Screening Parents for ACEs

Karen Clemmer ·
Shasta Community Health Center The trust that many families feel for their child's doctor makes the primary care setting an essential place to screen for ACEs and begin the conversation with caregivers about potential risks to their child's health and well-being. Their experience has shown that when risk is identified and assessed early on, there is a better chance of offering interventions that prevent long-term health and behavioral problems. Screening for ACEs is also an opportunity to...
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Sitler: Managing Depression and Anxiety in Children [newarkadvocate.com]

By Penny Sitler, Newark Advocate, March 1, 2020 There’s much conversation about mental health in children and youth these days. At Welsh Hills School, local pediatrician Dr. William Knobelach recently spoke about depression and anxiety in school aged children to a standing room only crowd at a parent education event. The Adverse Childhood Experiences Study (ACES), which looks at the impact of childhood trauma on health and well-being later in life, frequently comes up in talks about mental...
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Solano County's (CA) ACEs initiative, a robust community effort, makes room for input from all

Laurie Udesky ·
In a house called “Johanna’s House” on a tree-lined side street in Vallejo, Calif., four women are filling out the adverse childhood experiences (ACE) survey given to them by Maria Guevara, the founder of Vallejo Together, an organization that serves homeless residents in Vallejo. The house was named for Johanna Dilag, a homeless woman who was found dead along with her dog.
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Some 350 Florida Leaders Expected to Attend Think Tank with Dr. Vincent Felitti, Co-Principal Investigator of the ACE Study; Expert on ACEs Science

Carey Sipp ·
Leaders from across the Sunshine State will take part in a “Think Tank” in Naples, FL, on Monday, August 6, to help create a more trauma-informed Florida. The estimated 350 attendees will include policy makers and community teams made up of school superintendents, law enforcement officers, judges, hospital administrators, mayors, PTA presidents, child welfare experts, mental health and substance abuse treatment providers, philanthropists, university researchers, state agency heads, and...
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Stopping Generational Trauma in Communities of Color [sundial.csun.edu]

By Michaella Huck, The Sundial, February 3, 2020 Over the past decade, clinicians and scholars have intensely studied and treated the effects of intergenerational trauma suffered by communities of color (i.e. one generation to the next — be it individual or collective) that is passed onto future generations. Intergenerational trauma is defined as the transmission of historical oppression and its negative consequences across generations. There is significant evidence of the impact of...
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Strengths-based Approaches to Screening Families for Health-Related Social Needs in the Healthcare Setting [Center for the Study of Social Policy]

Laurie Udesky ·
How do you screen families to determine whether they have enough to eat or if they feel safe in their homes or communities without alienating them? In this new brief, authors Dr. Renee Boynton-Jarrett and JoHannah Flacks describe strength-based approaches to screening for health related social needs.
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Stress is hurting kids’ health. California’s new surgeon general has a plan to help [qz.com]

Alicia Doktor ·
The US medical system isn’t particularly good at preventing illness . Once someone is sick, doctors hopefully know how to treat them. But historically, there’s been far less focus on preventing people from needing treatment in the first place. That’s finally starting to change, thanks to a growing movement in the health-care community that looks to address the environmental and behavioral causes of many common diseases. Prevention, experts say, will save money (though it’s unclear how much )...
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Survey: Healthcare providers, community organizations weigh in on California's ACEs screening program

Laurie Udesky ·
In January, California took a historic leap forward to promote universal ACEs screening of the state’s 13 million adults and children in the Medi-Cal program. The eventual goal is to promote ACEs screening for all patients, but this is a first step in dealing with a major issue that ACEs science has identified: that many children will develop serious health problems later in life because the healthcare system is not currently set up to detect the roots of those problems. The term ACEs, which...
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The Academy of Pediatrics Calls to End Spanking, and APSAC agrees!

Janet Rosenzweig ·
The American Academy of Pediatrics (AAP) advises parents against the use of spanking as a disciplinary tool, citing multiple potential hards. APSAC agrees and offers alternatives for parents
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The Relentless School Nurse: What Happened at School Today?

Robin M Cogan ·
Welcome to a new feature on the Relentless School Nurse website: "What Happened at School Today?" The idea for this view from different health offices is the result of discussions with school nurses across the country who wanted to share their practice settings. Last year, Abby Pelletier and I shared pictures taken from our perspective health offices. I am in an urban NJ school and she is in rural NH, so the differences were quite distinct. "What Happened at School Today?" will feature...
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The Relentless School Nurse: When the Health Office Pass Includes Emotions

Robin M Cogan ·
The collaboration between school counselors and school nurses creates safe spaces for students at school. Building a coalition between school counselors and school nurses creates a safety net for our most complex and challenging students while benefiting the whole school community. Promoting connections through intentional relationship building, and ensuring a school environment that is physically, emotionally and psychologically safe changes the culture and climate. Read about an amazing...
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TIC: News and Notes for the Week of March 18 2019

Scott A Webb ·
ACEs, Adversity's Impact Screening for adverse child experiences in primary care Linked: Adverse childhood experiences, health + addiction Adults with childhood traumas 11 times more likely to be involved in drugs and violence, report says Warning of overload in childhood trauma data Mental health issues increased significantly in young adults over last decade New student group to give hope to those with traumatic childhoods How anxiety leads to disruptive behavior Brain and Biology...
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Top Organizations Encourage Appeals Court to Rule Against Trump Administration, End Detention of Migrant Children [Psychiatry.org

Jim Hickman ·
Contact: Nathan Carlile , Head of Firmwide Communications, Arent Fox LLP On behalf of a coalition of the nation’s leading organizations dedicated to the care, health, education, well-being, and welfare of children and families, Arent Fox LLP filed an amicus brief in the U.S. Court of Appeals for the Ninth Circuit in support of the Plaintiff in Jenny Lisette Flores, et al., v. William Barr, Attorney General of the United States, et al. Nearly thirty organizations steadfastly oppose the Trump...
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Trauma education and mindfulness help youth living amid gun violence

Laurie Udesky ·
Armon Hurst, 2nd from left, first row, Teens on Target, courtesy of YouthAlive! Eighteen-year-old Armon Hurst serves as vice president of the student body at Castlemont High School in Oakland, Calif. He has a 4.0 grade point average, is an avid baseball player, and is slated to go to college next year. But until a few years ago, Hurst would find himself waking from nightmares in the middle of the night. It was difficult to concentrate at school, and he wasn’t eating well. Armon Hurst “There...
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U.S. Hospitals May Often Miss Signs of Child Abuse (consumer.healthday.com)

Former Member ·
Less than half follow up on suspicious fractures among at-risk kids, study finds   MONDAY, July 13, 2015 (HealthDay News) -- Many U.S. hospitals may miss an opportunity to detect physical abuse in babies and toddlers, a new study reveals.  ...
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