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Alberta Family Wellness Initiative: BRAIN STORY CERTIFICATION (FREE)

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WHAT YOU’LL LEARN

Lifelong health is determined by more than just our genes: experiences at sensitive periods of development change the brain in ways that increase or decrease risk for later physical and mental illness, including addiction. That finding is the premise of the Brain Story, which puts scientific concepts into a narrative that is salient to both expert and non-expert audiences. The Brain Story synthesizes decades of research and reflects a body of knowledge that experts agree is useful for policy-makers and citizens to understand.

The Alberta Family Wellness Initiative (AFWI) has developed an online course to make Brain Story science available to professionals and the public. Brain Story Certification is designed for those seeking a deeper understanding of brain development and its consequences for lifelong health. The course is also designed for professionals seeking certification in a wide range of fields.

Click to download course content: BRST101-CourseOutline

To register or for more information please visit: https://www.albertafamilywellness.org/training

 

Global Prevalence of Fetal Alcohol Spectrum Disorder Among Children and Youth A Systematic Review and Meta-analysis

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JAMA Pediatr. 2017;171(10):948-956. doi:10.1001/jamapediatrics.2017.1919

Key Points

Question  What is the prevalence of fetal alcohol spectrum disorder among children and youth in the general population?

Findings  In this meta-analysis of 24 unique studies and 1416 unique children and youth with fetal alcohol spectrum disorder, approximately 8 of 1000 in the general population had fetal alcohol spectrum disorder, and 1 of every 13 pregnant women who consumed alcohol during pregnancy delivered a child with fetal alcohol spectrum disorder. The prevalence of fetal alcohol spectrum disorder was found to be notably higher among special populations.

Meaning  The prevalence of fetal alcohol spectrum disorder among children and youth in the general population exceeds 1% in 76 countries, which underscores the need for universal prevention initiatives targeting maternal alcohol consumption, screening protocols, and improved access to diagnostic services, especially in special populations.

Abstract

Importance  Prevalence estimates are essential to effectively prioritize, plan, and deliver health care to high-needs populations such as children and youth with fetal alcohol spectrum disorder (FASD). However, most countries do not have population-level prevalence data for FASD.

Objective  To obtain prevalence estimates of FASD among children and youth in the general population by country, by World Health Organization (WHO) region, and globally.

Data Sources  MEDLINE, MEDLINE in process, EMBASE, Education Resource Information Center, Cumulative Index to Nursing and Allied Health Literature, Web of Science, PsychINFO, and Scopus were systematically searched for studies published from November 1, 1973, through June 30, 2015, without geographic or language restrictions.

Study Selection  Original quantitative studies that reported the prevalence of FASD among children and youth in the general population, used active case ascertainment or clinic-based methods, and specified the diagnostic guideline or case definition used were included.

Data Extraction and Synthesis  Individual study characteristics and prevalence of FASD were extracted. Country-specific random-effects meta-analyses were conducted. For countries with 1 or no empirical study on the prevalence of FASD, this indicator was estimated based on the proportion of women who consumed alcohol during pregnancy per 1 case of FASD. Finally, WHO regional and global mean prevalence of FASD weighted by the number of live births in each country was estimated.

Main Outcomes and Measures  Prevalence of FASD.

Results  A total of 24 unique studies including 1416 unique children and youth diagnosed with FASD (age range, 0-16.4 years) were retained for data extraction. The global prevalence of FASD among children and youth in the general population was estimated to be 7.7 per 1000 population (95% CI, 4.9-11.7 per 1000 population). The WHO European Region had the highest prevalence (19.8 per 1000 population; 95% CI, 14.1-28.0 per 1000 population), and the WHO Eastern Mediterranean Region had the lowest (0.1 per 1000 population; 95% CI, 0.1-0.5 per 1000 population). Of 187 countries, South Africa was estimated to have the highest prevalence of FASD at 111.1 per 1000 population (95% CI, 71.1-158.4 per 1000 population), followed by Croatia at 53.3 per 1000 population (95% CI, 30.9-81.2 per 1000 population) and Ireland at 47.5 per 1000 population (95% CI, 28.0-73.6 per 1000 population).

Conclusions and Relevance  Globally, FASD is a prevalent alcohol-related developmental disability that is largely preventable. The findings highlight the need to establish a universal public health message about the potential harm of prenatal alcohol exposure and a routine screening protocol. Brief interventions should be provided, where appropriate.

Retrieved from: https://jamanetwork.com/journals/jamapediatrics/article-abstract/2649225?utm_source=twitter&utm_campaign=content-shareicons&utm_content=article_engagement&utm_medium=social&utm_term=101717#.Web6R23_fvc.twitter

Judge blasts treatment of chronically-addicted patients at Royal Alex

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CBC News Posted: Oct 18, 2017 1:34 PM MT

The culture at the Royal Alexandra Hospital, where the city’s most vulnerable people are treated as nuisances, must change if deaths like that of a homeless woman who died tied to a wheelchair in an ambulance bay while drunk on hand sanitizer are to be prevented, says an Edmonton judge.

“They are banned, issued tickets for trespassing and public intoxication and escorted off the premises to go home, even if they are homeless,” provincial court Judge Janet Dixon wrote in a fatality report released Wednesday.

“Vulnerable individuals suffering from addictions and other mental health issues should be assumed to have a health purpose in coming to the RAH and not be treated as nuisances and trespassers.”

On Dec. 28, 2009, Sharon Lewis was tied to a wheelchair by hospital security staff because she could not sit or stand after drinking Microsan, a hospital hand cleaner containing 70 per cent alcohol.

Lewis, 35, was homeless, a chronic alcoholic and a frequent visitor to the hospital. She was placed in the ambulance bay until she could sober up, when security intended to charge her with trespassing and remove her from the hospital.

When Lewis was later found unresponsive, she was taken into emergency where she died a few minutes later, the report said.

Eight recommendations

Following the fatality inquiry held last summer, Dixon’s report issued eight recommendations to prevent similar deaths.

The recommendations involve changes to policy and standards in dealing with intoxicated people, better tracking of hand sanitizer misuse, improve education around addictions, and reviewing a patchwork of discharge procedures.

But even if all the recommendations were put in place, Dixon warned they may not be enough to prevent similar deaths.

“Underlying all of the evidence heard in this inquiry was a fragmentation of policies and procedures designed to meet various issues that have arisen over time, without considering the collateral impact on the individual involved,” she wrote.

Much of the evidence at the inquiry described the challenges faced by staff at the inner-city hospital who deal with the demands of those coming to emergency while intoxicated, to panhandle, or for food, warmth or to consume hand sanitizer, she said.

“The culture of the RAH in 2009 and at the time of this inquiry is generally to regard these individuals as nuisances,” she wrote.

“There appears to be little recognition that the deliberate design of the security operations of the RAH builds an invisible wall around the emergency department.”

That wall must come down, Dixon said.

“It is critical to ensuring the success of any programs being offered from or through the RAH.”

AHS responds to criticism

Alberta Health Services said its hospital staff prevented Lewis from leaving on that cold winter day.

“They did this out of compassion for Ms. Lewis,” AHS said in a news release Wednesday. “They were concerned she would have nowhere safe and warm to go to sober up, and decided that keeping her in the ambulance bay was the safest option.”

There are now many more options for hospital staff trying to provide care and support to patients like Lewis, AHS said.

This February, the hospital renovated space in the emergency department, adding four designated detox beds and 10 stretcher spaces administered by a team of addiction and mental health specialists aided by consulting psychiatrists.

An additional six complex medical detox beds will open in November 2017, AHS said.

The hospital also implemented a program to address root social causes for patients struggling with mental health issues, drug use, poverty and homelessness, AHS said.

 

Retrieved from: http://www.cbc.ca/news/canada/edmonton/sharon-lewis-fatality-inquiry-royal-alexandra-hospital-1.4360758

GENDER TRANSFORMATIVE HEALTH PROMOTION: HOW HEALTH PROMOTION CAN IMPROVE GENDER EQUITY

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Click to download info sheet: Info-Sheet-Health-Promotion-and-Gender-Equity

Retrieved from: https://promotinghealthinwomen.ca/wordpress/wp-content/uploads/2015/02/Info-Sheet-Health-Promotion-and-Gender-Equity.pdf

 

Introduction to Women’s Health Indicators

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Having a comprehensive picture of the health of a population is critical to guiding health research, policy and programs. Such a picture is created by collecting data on a range of health measures – health indicators – that can be pooled together and analyzed to describe, compare and monitor patterns of mortality (deaths), morbidity (illness, disease), wellness, and health-affecting factors (personal behaviours, resources such as housing and systemic influences such as the availability of care). To understand women’s health, this information must be available and should be analyzed by sex and by gender. Sex- and gender-based analysis (SGBA) is recognized internationally and by the Canadian government as a critical component of sound health planning. According to Government of Canada policy, SGBA is used “to ensure that the initiatives and activities of the Health Portfolio lead to sound science, ensure gender equality and are effective and efficient”.

To understand women’s health, this information must be available and should be analyzed by sex and by gender. Sex- and gender-based analysis (SGBA) is recognized internationally and by the Canadian government as a critical component of sound health planning. According to Government of Canada policy, SGBA is used “to ensure that the initiatives and activities of the Health Portfolio lead to sound science, ensure gender equality and are effective and efficient”.

Canadian Women’s Health Indicators: An Introduction, Environmental Scan, and Framework Examination has been developed to introduce the concepts and context of work done in the area of women’s health indicators in Canada. This introduction includes an overview of what is meant by women’s health indicators and the rationale behind their use. This material is followed by a brief introduction to indicator frameworks, which are explained more fully in the following pages.

Click to download document: Womenshealthindicators_review_final

Three Principles to Improve Outcomes for Children and Families

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Core Principles of Development Can Help Us Redesign Policy and Practice

Recent advances in the science of brain development offer us an unprecedented opportunity to solve some of society’s most challenging problems, from widening disparities in school achievement and economic productivity to costly health problems across the lifespan. Understanding how the experiences children have starting at birth, even prenatally, affect lifelong outcomes—combined with new knowledge about the core capabilities adults need to thrive as parents and in the workplace—provides a strong foundation upon which policymakers and civic leaders can design a shared and more effective agenda.

The science of child development and the core capabilities of adults point to a set of “design principles” that policymakers and practitioners in many different sectors can use to improve outcomes for children and families. That is, to be maximally effective, policies and services should:

  1. Support responsive relationships for children and adults.
  2. Strengthen core life skills.
  3. Reduce sources of stress in the lives of children and families.

The three principles point to a set of key questions: What are policies, systems, or practices doing to address each principle? What could be done to address them better? What barriers prevent addressing them more effectively?

These three principles can guide decision-makers as they choose among policy alternatives, design new approaches, and shift existing practice in ways that will best support building healthy brains and bodies. They point to a set of key questions: What are current policies, systems, or practices doing to address each principle? What could be done to address them better? What barriers prevent addressing them more effectively?

Moreover, these design principles, grounded in science, can lead policymakers to think at all levels about the forces that could lead to better outcomes for children. At the individual level, policies can focus on skill-building for both kids and adults; at the human services level, they might focus on the critical place of relationships in promoting healthy development, supportive parenting, and economic productivity; and at the systemic or societal level, policies can emphasize reducing sources of stress that create lifelong challenges for children and make it extraordinarily difficult for adults to thrive as parents and breadwinners.

The Science Behind the Principles

Scientists have discovered that the experiences children have early in life—and the environments in which they have them—not only shape their brain architecture, but also affect whether, how, and when the developmental instructions carried in their genes are expressed. This is how the environment of relationships young children experience with adult caregivers, as well as early nutrition and the physical, chemical, and built environments, all get “under the skin” and influence lifelong learning, behavior, and both physical and mental health—for better or for worse. Starting at birth and continuing throughout life, our ability to thrive is affected by our ongoing relationships and experiences and the degree to which they are healthy, supportive, and responsive or not.

The biology of stress activation also explains why significant hardship or threat (e.g., from abuse, neglect, or extreme poverty) can lead to physiological and behavioral disruptions that can have lasting impact. Not all stress is bad—for example, children need to experience manageable amounts of stress in the presence of supportive adults to develop a healthy stress response system. But frequent or extreme experiences that cause excessive stress can be toxic to the architecture of children’s developing brains and can overload adults’ capacity to engage productively in work, families, and communities. Fortunately, most of us have powerful stress-protection shields in the form of supportive caregivers, families, and friends. Stable and responsive relationships in the earliest years of life help protect children from the potential harm that excessive stress can cause, and in adulthood they provide the buffering and hope that are necessary for resilience.

Experiencing significant adversity early in life can set up our body’s systems to be more susceptible to stress throughout life, with long-term negative consequences for physical and emotional health, educational achievement, economic success, social relationships, and overall well-being. For adults who have experienced a pile-up of adversity since childhood, the additional weight of current adversity, such as prolonged poverty, may overload their ability to provide the stable, responsive relationships children need and consistently meet the demands of the modern workplace. Therefore, these scientific findings are relevant to policy choices in a wide variety of areas—from traditional “children’s” areas such as pediatrics, early care and education, and child nutrition to “adult” domains such as income support, employment training, foster parent training, health care, and housing.

To download the full document please click: HCDC_3PrinciplesPolicyPractice

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