Increasing Staff Knowledge and Screening Practices for Adverse Childhood Experiences in Primary Care

Adverse childhood experiences (ACE) are important to future health outcomes. Many health care providers lack the knowledge or training to assess for ACE. Purpose. The purpose of this quality improvement project is to increase the identification of ACE among adult clients in a primary care clinic in Saint John New Brunswick Canada, through the delivery of an education session for the health care team members and patient screening for ACE. Methods. Staff at one clinic attended an educational program about ACE. Staff completed a pre and post education survey questionnaire (N = 8). Additionally, clinic patients (N= 32) were screened for childhood trauma using the ACE questionnaire. Post-screening surveys were completed by the clinicians who screened for ACE. Results. Most staff (85.7%) reported inadequate training/knowledge of ACE pre-education session; improvement in knowledge/understanding of ACE post session; and better prepared to discuss/screen patients for ACE. Nearly all of the 32 clinic patients reported a positive ACE score, and 62.7% had a score of four or more. Time to screen was not reported as a barrier by clinicians, and 10.0% of patients who screened positive were referred for counselling or booked a follow-up appointment. Conclusion. Health care providers lack education/training on ACE and patients are not regularly screened for ACE. To do this effectively, a trauma informed care approach must be used. A history of ACE in the patient sample was found to be high, yet previously unknown to the clinicians. This information has implications for primary care practice, community programming and policy development

Gradings by Groups on Graded Cartan Type Lie Algebras

In this paper we describe all gradings by abelian groups without elements of order p, where p > 2 is the characteristic of the base field, on the simple graded Cartan type Lie algebras

Legal Solutions in Health Reform: Privacy and Health Information Technology

Identifies gaps in the federal health privacy standard and proposes options for strengthening the legal framework for privacy protections in order to build public trust in health information technology. Presents arguments for and against each option

Spiritual Responses to the Regulation of Birth (A Historical Comparison)

Over 30 years ago the founders of the Christian Family Movement (CFM), a worldwide Catholic family action group, conducted a survey to investigate the marital effects of practicing “rhythm.” Their final report indicated that many participants felt that periodic abstinence was harmful to their marriage and caused spiritual and religious distress. The CFM survey results were thought to have been influential in convincing the 1966 Papal Birth Control Commission to recommend a change in church teaching. The purpose of this paper is to report a re-analysis of the 1966 archived data (in the light of the Papal Encyclical Humane Vitae–On the Regulation of Birth) and to compare that study with responses from married couples using modern methods of NFP, i.e., methods that purport to be more effective and to have fewer days of periodic abstinence. This paper will provide an examination of the original study within its historical context and report on the responses relating to spirituality from the 1966 couples in comparison with couples currently practicing periodic abstinence through the Billings Ovulation Method

Economic Contribution of the Agricultural Sector to the Arkansas Economy in 2009

This report is the sixth in a series of reports examining agriculture’s economic contribution on the Arkansas economy. Utilizing data from the United States Bureau of Economic Analysis (BEA), USDA Economic Research Service (ERS), USDA National Agricultural Statistics Service (NASS), and Minnesota IMPLAN Group, Inc. (MIG), the economic contribution of agriculture on the Arkansas economy was estimated for the most recent year available, 2009. Gross Domestic Product (GDP) by State information for Arkansas in 2009 was compared with those of other states in the southeast U.S. to give a measure of the relative importance of agriculture in Arkansas.2 The total economic contribution of agriculture (direct, indirect, and induced effects) on value added, employment, and labor income was estimated by employing the Impact Analysis for Planning System (IMPLAN). The economic contributions of agricultural production and processing were estimated for agriculture as a whole and also separately for the Crops Sector, the Animal Agriculture Sector, and the Forestry Sector

Privacy and Health Information Technology

The increased use of health information technology (health IT) is a common element of nearly every health reform proposal because it has the potential to decrease costs, improve health outcomes, coordinate care, and improve public health. However, it raises concerns about security and privacy of medical information. This paper examines some of the “gaps” in privacy protections that arise out of the current federal health privacy standard, the Health Insurance Portability and Accountability (HIPAA) Privacy Rule, the main federal law which governs the use and disclosure of health information. Additionally, it puts forth a range of possible solutions, accompanied by arguments for and against each. The solutions provide some options for strengthening the current legal framework of privacy protections in order to build public trust in health IT and facilitate its use for health reform. The American Recovery and Reinvestment Act (ARRA) enacted in February 2009 includes a number of changes to HIPAA and its regulations, and those changes are clearly noted among the list of solutions (and ARRA is indicated in the Executive Summary and paper where the Act has a relevant provision)

Collaborative Learning

Professors and students learn together in the lab, at the fire station, behind a camera. A look at six projects that combine faculty and student learning in creative and challenging ways