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FALL-WINTER2018SEMI-ANNUALREPORT

THENisaneducationalprogramoftheHektoenInstitutewww.hektoen.org

WeareexcitedtosharethatTHENisontracktomeet3ofits5goalsinonlyourfirstyearofoperation!

-ExpandedWebsite-Freeeducationformedicine-healthcareFacultyandStudents-Beginningdevelopmentofgraduate-levelCurriculumonTrauma,HeathEquity&Neurobiology

ThisSemi-AnnualReporthighlightsCenteraccomplishments–aswellasthemanycontributionsofouresteemedAdvisoryPanel.Wewelcomesuggestionsandfeedback–andlookforwardtocontinuedgrowthin2019.

Co-founders:MardgeCohen,PatRush,AudreyStillerman,andKathleenWeber

THENWebsiteUpdates:asthesciencesofneurobiology,traumaandhealthequitycontinuetoevolve,wehaveexpandedourWebsitewww.thencenter.org.Weinviteyoutoexploretwonewfeatures:

• CORECONCEPTS:usingasystem-basedapproach,wehaveorganizedkeyconceptsintosixbranchingclusterswithlinkstovideos,explanatorygraphics,peer-reviewedpublications,andotherkeywebsites.

o Preface:TheImpactofTraumaonScientistsandHealthcareProviderswithaGuidetoSelf-Careo ScienceofComplexSystemso SystemScienceandHumanHealtho Brain-BodyRegulationo PathwaytoIllness:RoleofAdversityandtheRootsofHealthDisparityo PreventionandTreatment

• RETHINKINGOFDISEASEMODELS:OurTHENteamisdevelopinganew,integratedapproachtore-evaluatemodelsofhealthanddisease–startingwithastatementofConventionalMedicalThinking,versusaSystemsBiologyperspective,pluslookingatdiseasethroughaTrauma-HealthEquity-Neurobiologylens[T-HE-N]Forexample,pleasevisitournewWebpages: [comingsoon>RethinkingChronicPain]

o Disease>Hypertension:RethinkingHypertensionasonephaseofInflammatoryVascularDiseaseo Disease>Obesity:RethinkingObesityasacomplexneuro-endocrine-inflammatoryBrainDisease

FreeEducationforMedicine-HealthcareFacultyandStudentsWeprovided1FacultyWorkshopand2StudentWorkshopsduringFall2018–plusmanypresentationsthroughoutChicagoandtheMidwest(detailedbelow).1) THENFacultyWorkshopOctober3:THENhostedaFacultyWorkshoponNeurobiologyatRushMedicalUniversity.38Facultyrepresentingmedicine,nursing,psychology,socialworkandpublichealthattendedfromRush,UniversityofIllinoisChicago,CookCountyHospital,Loyola,andUniversityofChicago.OurguestspeakerwasWayneGiles,MDMS,Dean

THENSemi-AnnualReportFall-Winter2018

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oftheUICSchoolofPublicHealthandseniorinvestigatorofmanypublicationsoftheAdverseChildhoodExperiencesresearch.Evaluationswereverypositive,"Workshopmetmyexpectations"rated4.94(outof5).ThankstoTHENAdvisorsJoseNinoforhelpingleadReflectivediscussionandLorenWilliamsforjoiningus.2)THENStudentWorkshops:ThestudentresponsetotheTHENWorkshoponNeurobiologyandHealthEquitywasoverwhelming!Ticketssoldoutin24hours.OnOctober3wehostedaninterdisciplinaryaudienceof42studentsfromRush,UIC,Northwestern,andLoyolarepresentingmedicine,nursing,socialwork,publichealth,pharmacy,neuroscience,speech-language,andcommunityhealth.StudentswereenthusiasticandratedtheWorkshop4.64(outofmaximum5).ThankstoTHENAdvisorOrrinWilliamsandDavidFreedmanfortheirsupportinleadingtheCaseDiscussion.Wehostedarepeatofthisworkshopto23studentsfromdiversebackgroundsincludingdentalschoolonNovember8.3)UICMedicalColloquium/UrbanHealth:Neurobiology,Trauma&HealthEquity2018-19.AudreyandPattaughtfourelectiveandspecialtrackcoursestoover200firstandsecondyearstudents.Topics:-IntroductiontotheNeurobiologyofTraumaandChronicDisease;NeuroRegulation;HealthEquity;ControversiesaroundTraumaScreeninginHealthCare.THENDevelopmentofGraduateLevelCurriculumECHO-Chicago(ExtensionforCommunityHealthcareOutcomes)providesonlinetrainingforcommunity-basedprimarycareproviderstoimproveproviderknowledgeandself-efficacyaswellaspatienthealthoutcomes.InFall2018,Audrey,pediatricandclinicalpsychologycolleaguesdevelopedandco-taughta12sessioncourse,“ChildhoodAdversityandTrauma:StrategiesforPromotingHealth”topracticingclinicians.

Medspiration—Patwasinvitedtoprovidea10sessiontutorialonTrauma-NeurobiologyandSystemsSciencetothephysicianfoundersofMedspiration,anot-for-profitofferingfreeonlineeducationandhealthpromotionresourceswiththegoalof“advancinghumanpotentialandpromotingbetterphysical,mentalandspiritualhealthforourhumanfamily.”www.medspired.org.MedspirationhasavibrantsocialmediapresenceonFacebook,YouTube,Instagramwithover305Kfollowersandupto5millioncontactspermonth.

LivePresentations/Symposia2018

Grantmaker’sinHealthAnnualNationalmeeting(Chicago,June2018)—AudreyStillerman,PatRush,andTHENAdvisorsMargieSchapsandOrrinWilliamsparticipatedin3sessions-inpartnershipwiththeSweetwaterFoundationhttps://www.sweetwaterfoundation.com,ChicagoFoundationforWomen,https://www.cfw.org,andIllinoisACEResponseCollaborative,http://www.hmprg.org/programs/illinois-aces-response-collaborative/.THENAdvisorLarryTurnerledyogasessionsforConferencewellnessbreaks.MidwestACERegionalMeeting,HealingTrauma,HealthyCommunities(Milwaukee,September2018)featuredTHENAdvisorBrucePerryaskeynotespeakeraswellassessionsbyTHENAdvisorsPaulAlt,MargieSchaps,andMarlitaWhiteaswellasPatRushandAudreyStillerman

THENAdvisorGeneGriffinpresentedattheThirdInternationalNeurosequentialModelSymposiuminBanff(Alberta,Canada)hostedandorganizedbyBrucePerryandtheChildTraumaAcademy(www.childtrauma.org).THENAdvisorBrucePerryofferedmulti-daytrainingworkshopsontheNeurosequentialModelofTherapeutics(NMT)intheUnitedStates,CanadaandEurope.NMTisanevidence-based,developmentally-informed,biologically-respectfulapproachtoworkingwithat-riskchildren.TheNMTapproachhasbeenexpandedtoEducation(teachers),Sport(athletesandcoaches),andsoontoCaregivers.

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THENAdvisorStanSonudeliveredthe17thannualDonaldShaffnerlectureatEmoryUniversity(Atlanta),presentationsatStroger-RushInternalMedicineGrandRounds,NorthPark’scommunityevent“We’reAllinthisTogether”(Chicago),andTheAnnualGeorgiaGrantmakersAssociation.THENFoundersandAdvisorsreached5000audiencemembers(conservativeestimate)—talkingabouttrauma,healthequityandneurobiologytocommunitymembers,undergraduates,healthprofessionaltrainees,faculty,practicingcliniciansandphilanthropist-funders.

Multimedia

THENAdvisorPaulAlt-InterviewedonWORTMadisonWisconsin“ProvidingVeteransWithSpacesForHealing”https://www.wortfm.org/providing-veterans-with-spaces-for-healing/andpresentedthewebinar:“Transformation:DepartmentofVeteransAffairsHealingEnvironmentDesignGuidelines”http://hmprg.org/events/transformation-the-department-of-veteran-affairs-healing-environment-design-guideline/

PatRushwaspartofateamofpublicinterestlawyers,policyanalystsandcommunityactivistswhodevelopedaClassActionSuitonbehalfofIllinoischildrenaffectedbygunviolence.Therewasexcellentpresscoverage[atleast8print&videostories]andthestorywaspickedupbytheAP.HerearelinkstoarticlesfromtheChicagoTribune(fullhalf-page)andTheTrace.http://www.chicagotribune.com/news/local/breaking/ct-met-gun-violence-lazwsuit-20181003-story.htmlhttps://www.thetrace.org/2018/10/chicago-gun-violence-children-ptsd-lawsuit/

THENAdvisorsStanSonuandMarlitaWhitepartneredwithGRIPOutreachforYouthtoproducethisvideo:https://www.youtube.com/watch?reload=9&v=uDGFHtpNTJAAudreyStillermanwasinterviewedforHarvardCenterforPrimaryCare’s“ReviewofSystems”podcast,https://primarycare.hms.harvard.edu/rospod/4203-2/andhttps://primarycare.hms.harvard.edu/rospod/ros-understanding-the-importance-of-adverse-childhood-events-on-health-w-audrey-stillerman-part-2/andbyChicagoHealthmagazine,https://chicagohealthonline.com/healing-the-hurt/

CivicEngagementandSystemsWorkMardgeCohencontinuesherleadershipworkwithHIVinRwanda-WE-ACTxforHope(WFH).WFHledKigaliwith93%completeviralloadsuppression(comparedto86%intheUSA)withnomaternal-childtransmissioninbabiesbornlastyear.THENAdvisorKimManncontinuestodirectTheIllinoisEarlyChildhoodCourtTeamprogramIDCFSEarlyChildhoodCourtTeam(ECCT),currentlyserving55childrenyoungerthan4involvedinchildwelfare,aswellasTheIllinoisBirth-3[IB3]projectIDCFS:IllinoisBirththroughThree(IB3)Waiver–ChildandFamilyIntervention,providingparentingprogramsto2500childrensince2013toaddressconsequencesofchildmaltreatmentandsupportsecureattachment.Recentoutcomedatademonstratesthatchildrenreceivingtheseserviceshavea53%higherchanceofreunificationandlegalguardianship.AdvisorGeneGriffinchairsIllinoisChildren’sMentalPartnershipcommittedtomentalhealthsupportforchildren&families.AdvisorMargieSchapsisco-facilitatingtrauma-informedsystemschangeeffortsforIllinoisHealthDepartments,Chicagoareahospitals,andlocalfunders.AdvisorMarlitaWhiteisleadingthetrauma-informedcitywork,partofHealthyChicago2.0thecity’shealthplannowcompletingits2ndof5years,whichbeganwithorganizationaltransformationworkintheChicagoDepartmentofPublicHealth.PatRush,MargieSchapsandAudreyStillermanhavebeenregularparticipantsandsupporters.AdvisorOrrinWilliamsco-organizedahealingceremonyfortheearthwithSweetwaterFoundation(Chicago).

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AcademicLeadership

UICDepartmentofFamilyMedicinenamedTHENAdvisorMemoonaHasnainasInterimDepartmentHead.

THENAdvisorStanSonuwasnamedAssociateProgramDirectorfortheJ.WillisHurstInternalMedicineResidencyaswellastheEmoryPreventiveMedicineResidency.

ScholarshipTHENfoundersandadvisorshadalmosttoomany2018publicationstocount!ThereweremultiplecollaborationsamongAdvisors.PapersparticularlyrelevanttoTHENworkinclude:THENAdvisorHelenBurgess(7publications).https://www.ncbi.nlm.nih.gov/pubmed/?term=Helen+Burgess+2018Socialsupport,socialunderminingandacuteclinicalpaininwomen.https://www.ncbi.nlm.nih.gov/pubmed/30146929THENCoFoundersMardgeCohenandKathleenWeber.(total21publications)ImpactofchronicsexualabuseanddepressiononinflammationandwoundhealinginthefemalereproductivetractofHIV-uninfectedandHIV-infectedwomen.https://www.ncbi.nlm.nih.gov/pubmed/29894487andCohen.TheeffectofunstablehousingonHIVtreatmentbiomarkers…https://www.ncbi.nlm.nih.gov/pubmed/30153546MardgeCohen--https://www.ncbi.nlm.nih.gov/pubmed/?term=Mardge+Cohen+2018KathleenWeber--https://www.ncbi.nlm.nih.gov/pubmed/?term=kathleen+weber+2018MardgeandKathleenarekeyleadersinWIHS(Women’sInteragencyHIVStudy)–thenation’slargestandlongestrunningHIVstudyinwomen.CurrentcollaborationsincludeTHENAdvisorsHelenBurgess,AlanLanday,EileenMartin,andPamelaVergara-Rodriguez.Researchtopicsincludesleep,exercise,depression,epigeneticchangesrelatedtostress.THENAdvisorMemoonaHasnain-(2publications)-https://www.ncbi.nlm.nih.gov/pubmed/?term=memoona+hasnain+2018THENAdvisorAlanLanday(16publications)-https://www.ncbi.nlm.nih.gov/pubmed/?term=alan+landay+2018THENAdvisorEileenMartin(7publications)-https://www.ncbi.nlm.nih.gov/pubmed/?term=Eileen+Martin+2018THENAdvisorBrucePerry.(2publications)BeyondtheACEScore:Examiningrelationshipsbetweentimingofdevelopmentaladversity,relationalhealth,anddevelopmentaloutcomesinchildren.https://www.researchgate.net/publication/328833363_Beyond_the_ACE_score_Examining_relationships_between_timing_of_developmental_adversity_relational_health_and_developmental_outcomes_in_childrenTHENAdvisorStanSonuandAudreyStillerman.ScreeningforToxicStressRiskFactorshttps://www.ncbi.nlm.nih.gov/pubmed/30297291AudreyStillermanarticleChildhoodAdversityandLifelongHealthwaschosenasthecoverarticlefortheJournalofFamilyPractice(November2018)https://www.ncbi.nlm.nih.gov/pubmed/30481245

• Recognition that the prevalence and diversity of adversity and trauma affecting development and health are much greater than the current medical model anticipates

• Evidence-based clinical practice recommendations • Description of current neuroscience research supporting the pathway from adversity,

through inflammation, to chronic illness • Full-page summary comparing risk factors versus protective factors • Glossary with tools for trauma-informed clinical care, emphasizing neuroregulation

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