Submitted by Jeanie Holt, Former Policy Committee Co-Chair

NHPHA’s Public Policy Committee is in the midst of some transitions. First, we expect to soon have a new Co-Chair. As we have previously mentioned, Jeanie Holt takes on new APHA leadership responsibilities in November so we have needed someone to work with JJ Smith in leading the Public Policy Committee. Donna Asbury has volunteered to take on organizing the committee work and leading the meetings while JJ Smith continues to use her expertise in legislative processes to lead our work with the NH House and Senate.

Second, the election will happen soon! Once that is over, the work pace will pick up—double time. Currently 126 Legislative Services Requests (LSRs—the first step in proposing a bill) have been filed. Any of those submitted by legislators who are re-elected will move forward while new legislators will quickly begin to file LSRs as well. Over the next two months, the Public Policy Committee will be assessing the results of the elections, and reading LSR titles and eventually bills. From this we will draft a list of legislation to follow as we prepare for January and the opening of the 2017 Session.

In preparation for 2017, we have been recruiting topic leads for our priority issues: Access to Quality Care, Alcohol and Other Drugs, Child Health and Safety, Climate Change and Health, Mental Health, Public Health Infrastructure, and Social Justice and Health. We also hope to add someone with budget expertise to help us evaluate biennial budget proposals and advocate for critical public health resources. These leads along with Committee and NHPHA leadership will hold a short weekly phone meeting during the session to look ahead a week or two and plan any needed NHPHA actions.

Meanwhile we are working to finish up policy statement writing and revising started during the summer. By the opening of the 2017 Session we hope to have new position statements on Child Health and Safety, Tobacco, Infectious Diseases, and Sexual and Reproductive Health. We also must finish up work on selecting and honoring Public Health Champions from the 2016 Session.

Never a dull moment! Want to join the fun? Send an email to info@nhpha.org

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An article from the October 2016 issue of the NHPHA e-Newsletter
Submitted by Jessica Morton, Health Promotion Advisor and Health Officer Liaison
Healthy Homes and Environments Section, DPHS, NH DHHS and the NH State Fire Marshalls's Office

Two very important Safety Campaigns take place every fall.  The fall of 2016 is no exception.   New Hampshire State Fire Marshal, J. William "Bill" Degnan, has requested that Governor Maggie Hassan sign two  proclamations.  One is to declare October as Fire Prevention Month. This year's theme for Fire Prevention is Don't Wait - Check the Date! Replace Smoke Alarms Every 10 Years.  “Time and again, I’ve seen the life-saving impact smoke alarms can have in a home fire, but I’ve also seen the tragedy that can result when smoke alarms aren’t working properly,” says Marshal Degnan.  “That’s why we’re making a concerted effort to educate the residents of New Hampshire about the overall importance of smoke alarms, and that they do have a life limit.”  The second is to declare November as Carbon Monoxide Awareness Month.  Often called the Invisible Killer because carbon monoxide (CO) is an odorless, colorless poisonous gas that you cannot see or smell.   It is created when fuels -gasoline, wood, charcoal, natural gas, propane, oil and methane - burn incompletely. The Carbon Monoxide Alliance, a New Hampshire/Vermont collaborative effort was formed to educate the public on the preventable causes of CO incidents and to help them understand how to take action to remedy them. 

Learn more about the NH Department of Safety, Divison of Fire Safety here
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Submitted by Debbie Manus Love, Two Months and Counting, Breast Cancer Survivor

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I was diagnosed with breast cancer on April 20th of this year. Nothing can prepare you for those three words, “YOU HAVE CANCER”. It’s a moment that reprioritizes your life in an instant. There is no history of breast cancer in my family. I didn’t have a lump or experience any pain leading up to my scheduled mammogram. I had a routine screening and was called back for a biopsy less than a week later to confirm what the doctor suspected was probably only “calcification”.


concordstrides2016In hindsight I realize that having been asked at every doctor’s visit, “Does breast cancer or uterine cancer run in my family?” and repeatedly answering “no” lead me to feel a false sense of security that I was not at risk for this disease. I should know better than to think I would be immune – but I had no family history of breast cancer. This diagnosis blindsided me. What bits of the conversation I did retain that fateful day was that I wouldn’t need a mastectomy.  My breast cancer was Stage 1. I didn’t even know what that meant other than assuming a higher stage meant the survival rate diminishes. The only thing I did know was my diligence of screening annually was the reason I caught my breast cancer early enough to beat it.  So, surgery was scheduled and then the “wait” began.

Nothing prepares you for the “waiting”. I had to wait a month for surgery with cancer in my body. I had to wait two weeks after surgery to hear if the cancer had spread to my lymph nodes. I had to wait another month to start radiation to kill any possible cancer cells that may have (as the doctor explained) “escaped” during surgery.  It’s probably one of the biggest mental challenges you face as a cancer patient – waiting to get better, waiting for your body to heal from the paces you put it through so you can proceed to the next attack on your body while juggling the many doctor visits in between. And while that is going on – you are suddenly more attuned to others battling the disease, finding comfort with the patients you sit with while you wait your turn for radiation and hearing of those who lost their battle while trying to keep life as normal as possible for you and your family.

This is truly when the reprioritization of your life begins – starting with constantly reminding yourself “you will be okay” before you start each day. Deciding you’ll do whatever it takes to survive, take whatever medicine is necessary for as long as necessary, and willingly expose your body for months to daily radiation in a room, separating you from the medical staff viewing your treatment,  by a foot-thick steel door. Then managing the side effects that come with the exposure to that treatment and pushing through your day reminding yourself this is helping you live so you can watch your children grow up.

When I rang the bell at the Payson Center signifying the completion of my radiation treatment this past August, a ten-year survivor approached me and gave me a hug, handed me flowers and said to remember on this day that I conquered this disease, but I will always have cancer. I understood as only a cancer patient could. The cancer may be out of my body – but my fear that every ache or pain I experience from this day forward could be my cancer returning -- is a part of my life now.  I can live with that, because even though my story may have started with three words, it’s ending with one, “SURVIVOR”.

Debbie Manus Love
Two months and counting Breast Cancer Survivor
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An article in the October issue of the NHPHA e-Newsletter

The NH Oral Health Coalition is pleased to announce the keynote speakers for the 2016 NH Oral Health Fall Forum scheduled for November 11 at the Concord Holiday Inn.  Registration is now open at:  www.nhoralhealth.org.   The time of the event is 8:00 am to 4:30 pm.   This annual event is geared for physicians, nurses, dentists, hygienists, program managers, policy makers, and others interested in oral health, its role in systemic health, and the availability of community-based services for children and adults.  Speakers, Drs. Caswell Evans and Jane Grover will present keynote addresses and moderate local panels.

Dr Evens OHCCaswell Evans, DDS, MPH, coordinator for the 2002 Surgeon General’s Report on the Silent Epidemic and the 2003 “Call to Action,” was an active member of the original Coalition for NH’s Oral Health work team that developed and published the New Hampshire Oral Health Plan: A Framework for Action.  He will provide the morning’s keynote address and facilitate a conversational retrospective that includes many of the state’s oral health leaders from 2000 through 2016 addressing public-private partnership, public health oral health initiatives, medical-dental integration, and the evolution of community-based prevention. 

Dr. Evans is the Associate Dean for Prevention and Public Health Sciences at the University of Illinois, Chicago College of Dentistry; he is also a faculty member in the UIC School of Public Health.   Previously he served as the Executive Editor and Project Director for Oral Health in America: A Report of the U.S. Surgeon General.  For twelve years, Dr. Evans was Director of Public Health Programs and Services, for the Los Angeles County Department of Health Services.  He is a member of the National Academy of Medicine, National Academy of Sciences.  He is a past president of the American Public Health Association, the American Association of Public Health Dentistry, and the American Board of Dental Public Health.  Dr. Evans is Chairman of DentaQuest Foundation Board.  He also serves on the Chicago Board of Health and the boards of the Institute of Medicine of Chicago, Oral Health America and the Children’s Dental Health Project.  

Dr. Grover for OHCJane Grover, DDS, MPH, has supported NH’s Federally-Qualified Health Centers and dental community by providing expertise and consultation to help build strong community-based oral health programs.  She will be the afternoon’s keynote speaker and will moderate a future-looking prospective of innovative programs and strategies that are moving our state into the future including oral health care in the right place at the right time, new community access points, emerging financing models, community-based oral health disease management and Interprofessional education. 

Dr. Grover is the Director, Council on Access, Prevention and Interprofessional Relations (CAPIR) in the division of Government/Public Affairs at the American Dental Association (ADA).  Dr. Grover served as the dental director for the Center for Family Health, a federally qualified health center in Jackson, Michigan.  She is an adjunct faculty member of the University of Michigan School of Dentistry and Lutheran Medical Center of New York.  She has been active in organized dentistry, first as a trustee of the Michigan Dental Association, and also on the ADA Strategic Planning Committee in the 1990s. She completed five years on the ADA Political Action Committee, serving 2003-2005 as chair. She served as vice-president of the ADA from October 2006 until October 2008.  Dr. Grover received her D.D.S. degree from the University of Michigan School of Dentistry and her M.P.H. degree from the University of Michigan School of Public Health.

For more information:  www.nhoralhealth.org or email info@nhoralhealth.org

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An article in the October 2016 issue of the NHPHA e-Newsletter

NHPHA has contracted with Morel Communications to provide communication training to the NH Nutrition Incentive Network (NHNIN) regional leads and market managers to support increased participation in the Granite State Market Match program, as well as general farmer market use.  The learning series kicked off on October 11 during three-hour in-person session, and is part of the project funded by the NH Beverage Association.

Brendan Cornwell, NHNIN Coordinator says "There was a palpable excitement at the end of the meeting on where this process is going and the communication tools that network is going to learn and utilize. Everyone is looking forward to the next meeting in the process."

Michele Morel of Morel Communications said, "It was wonderful to work with a group of people so dedicated to increasing participation in farmers markets and the Granite State Market Match. We shared ideas about what was working in each of the regions and discussed opportunities to reach more community members and SNAP recipients using different messages and communications channels." She continues, "I am hoping to share skills and tools that they can use to make their communications efforts more impactful over the coming years."

The group will meet again in early December to develop a communications plan to help guide marketing efforts for the upcoming year.

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An article in the October 2016 issue of the NHPHA e-Newsletter

Affordable Child Care Roundtables Photo
Members of the New Hampshire Public Health Association (NHPHA) were in attendance at the recent roundtables held in the state by the Campaign for a Family Friendly Economy (CFFE).  CFFE held the roundtables in hopes of raising the issue of child care costs with the local candidates who are running for office. CFFE hosted roundtables across the state for candidates to learn costs of raising a family in New Hampshire, priorities for families, impacts on workforce and childhood education, and need of more affordable resources and better pay in order to retain qualified childcare employees.  NHPHA members Jeanie Holt, Dennis Holt, and Neil Twitchell came to speak and educate around  the disproportionate burden on low-wage workers who often have less formal education and face significant struggles to “keep body and soul” together. Speakers highlighted the stress of these daily, year-round struggles on NH families: the stress of accepting low-quality child care in order to pay the rent and feed their families, the stress of deciding between losing a day’s wages to take the child to a doctor versus waiting another day or two to see if a child’s health improves. They emphasized that these stresses are toxic to individuals, families and communities and highlighted how the impacts translate to short term and long term health and economic losses for NH families and the NH economy. NHPHA has also been looking at the research on Adverse Childhood Experiences or “ACEs”. Common ACEs are Abuse and neglect, exposure to crime and violence, living in a home with substance abuse or mental health issues, including depression, and divorce, separation or loss of a close family member/parent. Speakers highlighted data specific to the adverse effects of ACEs on children, including that in NH’s most vulnerable communities, 52% of the households with children are headed by a single parent. NHPHA made the point that research has identified factors which can counteract the adverse experiences. Two of the important factors are information and support for parents, and a child’s consistent connection to a caring adult. Both of these needs can be at least partially met by quality child care.

For more information on ACEs visit https://www.cdc.gov/violenceprevention/acestudy/ and http://www.samhsa.gov/capt/practicing-effective-prevention/prevention-behavioral-health/adverse-childhood-experiences .

For more information aboutCampaign for a Family Friendly Economy visit http://www.familyfriendlyeconomy.org/.


Upcoming Affordable Childcare Roundtables in October

Wolfeboro
**Please note the date of this event has changed, please contact mike@civixstrategygroup.com at the Campaign for A Family Friendly Economy for more information**

What:              Wolfeboro Affordable Childcare Roundtable
When:              **Thursday, October 20th
                       6:00 pm - 7:30 pm (doors open at 5:45 pm)
Where:            The Children's Center, 180 South Main Street, Wolfeboro

RSVP HERE! 


Antrim
What:              Antrim Affordable Childcare Roundtable
When:             Thursday, October 27th
                      6:00 pm - 7:30 pm (doors open at 5:45 pm)
Where:            Grapevine Family & Community Resource Center, 4 Aiken Street, Antrim


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Submitted by Shasta Jorgensen, Affiliate Representative to the Affiliate Governing Council

Today is APHA’s Get Ready Day!
Get Ready Day is part of National Preparedness Month, which urges all Americans to prepare, plan and stay informed each September. Get involved by sharing APHA’s preparedness fact sheets, infographics and e-cards and download their new Pepper the Prepper Cat Coloring Book. Click here for more information and materials. Don’t miss APHA’s new music video, "One Chance (To Get Ready)." Inspired by Drake’s “One Chance,” the video has preparedness-themed lyrics and tips for packing your stockpile, taking shelter and more.APHA Affliate logo rgb

Lights, camera,  APHA  action!
Check out APHA’s new videos!  They have posted short clips on some great topics such as advancing your career, using APHA to bolster your professional network, getting the most out of the Annual Meeting, earning CE credits and navigating APHA.org. They also feature a recording of the Sept. 6 live APHA Town Hall with Executive Director Georges Benjamin and Associate Executive Director Susan Polan, who offer a look inside APHA. Check them out! 

Highlights from The Nation’s Health
I have found this newsletter to be very informative. Want to stay up with what’s happening in public health? Sign up for Highlights from The Nation’s Health, the monthly e-newsletter from APHA’s newspaper. This free newsletter shares stories from The Nation’s Health as they’re published — and you don’t need to be a member to receive it. Sign up now!

APHA Annual Meeting – Who’s Going?
Hey, NHPHA Members! Who’s going to the APHA Annual Meeting in Denver this year? Are you presenting a poster, on a panel, and/or attending? Please email me at Shasta.jorgensen@gmail.com and let me know if you are going. I will plan an informal night for NHPHA members to get together, have dinner and share stories from the conference.
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Submitted by Lisa Vasquez, MS, CPS 
Substance Misuse Prevention Coordinator
Greater Nashua Public Health Network; Beyond Influence
City of Nashua, Division of Public Health & Community Services

What is Public Health Photo 1What is Public Health Prevention and where can you see it in your community? If you don’t know ask any of the children who participated in Nashua’s Photovoice Project! Armed with cameras, 20 participating kiddos went out into the Nashua community and created a story with pictures of Public Health within the community. They all saw Public Health prevention in different places whether at the crosswalk or in the public pools they realize Public Health prevention is all around us and makes our lives healthier and safer. Out of the 20 participants, 13 projects were completed.  The Nashua Division of Public Health and Community Services hosted a Gallery of the children’s artwork.  The participating youth were proud of the work and eager to talk to attendees about their projects. One of the attendees Nashua Mayor Jim Donchess was very impressed by the quality of the pictures and the enthusiasm and knowledge of the participants regarding Public Health.

As the region’s Prevention Coordinator I look forward to another Photovoice Project with more participants. It was great seeing the participants develop their stories and the pride in their faces with their finished projects. All participants received a certificate for their outstanding work and one of the participants was interviewed by the Nashua Telegraph regarding his project.  The Project received great community support and the artwork will be available for viewing at more community venues like the Public Library, dates to be announced soon. 

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Submitted by Lisa Vasquez, MS, CPS 
Substance Misuse Prevention Coordinator
Greater Nashua Public Health Network; Beyond Influence
City of Nashua, Division of Public Health & Community Services
Recovery Month Article Photo 1
We celebrate recovery from Substance Use Disorder and Mental Illness. Why have an entire month dedicated to celebrating recovery you may ask? Recovery Month reminds everyone that Substance Use Disorder and Mental Illness can happen to anyone but it also reminds us that recovery is possible. Let’s take a minute to think about it in a different way. Have you ever broken a bone, had surgery or even had a common cold? You had to somehow recover from those ailments. It was not easy; it took time to feel better.  Everyone recovers differently, some may take medications, and some may use a more natural approach.  In the same way, recovery from Mental Health Illness and Substance Use Disorder has many different routes. For example some people may need residential treatment while someone else may be able to use medication assisted treatment along with outpatient treatment to work towards recovery of Substance Use Disorder. In the case of Mental Illness depending on the diagnosis someone may require medication while others might work with a Mental Health Counselor to increase behavioral tools to manage their mental health symptoms. The goal of recovery is to increase the quality of life of a person. There are many recovery stories both of Mental Illness and Substance Use Disorder. There are currently over 23 million people in long-term recovery from a Substance Use Disorder in the United States alone. The main message of recovery month is a hopeful and simple one “Recovery is Possible” 

Recovery is possible! It happened for me. My name is Ed McDonough, I am in long term recovery. My story began in Greater Boston, coming from a middle class family with a nurse as a mother and police officer as a father. I had a private school education with a childhood that consisted of sports; especially hockey, boy scouts and a good family, but also included other things fears, doubts and insecurities. Alcohol was the first substance I ever used, Recovery Month Article Photo 2it made me feel at ease and able to socialize without thinking about those fears doubts and insecurities. After realizing that I liked the feeling that alcohol gave me all I wanted was to have that feeling more and more often. During this time I started middle school, still played hockey but a perfect storm of circumstances changed this story from alcohol and marijuana to prescription drugs and later heroin. A hockey injury occurred around the same time my grandfather moved in with my family due to his cancer diagnosis. I was prescribed a small amount of opiates for my hockey injury. I discovered I liked the feeling of not having pain both physical and emotional. When my own prescription ran out I didn’t have to go far to access more. My grandfather was in the same home with a large supply of unsupervised opiates. As my grandfather’s cancer progressed and the opiates prescribed became a stronger dose so progressed my opiate use. I could use alcohol but my parents, teachers or coaches could detect the smell of alcohol.  Opiates for me through middle and high school were easily accessible, free, had no detectable smell, I could sit right next to my police officer father after taking opiates and no one would be able to tell.  There were some beliefs that also played a part in this story. I believed I was treating my hockey injury, I believed prescription opiates were safer than other substances after all it was prescribed by a doctor and it was not heroin, I believed I didn’t have a problem. I soon found myself not being able to function without opiates. Withdrawal was awful I needed to continue to use just not to feel sick. When the supply of opiates was no longer available at home I began to purchase it from friends, I saw several doctors for pain and was prescribed opiates but it wasn’t enough. I soon was unable to afford my prescription drug use. The beliefs of right and wrong were replaced by the necessity to not feel sick from withdrawal. I didn’t see any alternatives. Heroin became easily accessible and was cheaper than prescription opiates. When I was charged with armed robbery I realized something had to change.  I went to Detox, tried Medication Assisted Treatment but in retrospect realize that I wasn’t addressing the reason I used, those fears, doubts and insecurities. At the time nothing seemed to work, I couldn’t relate to clinicians. It wasn’t until I found a place that offered me structure and therapy that I was able to have those real and hard conversations with myself. I needed to be shown how to be sober one day at a time by people who were also going through the same struggles I was. That’s when I was able to find recovery. I finally felt that someone was able to relate to how I thought and felt. I knew I wanted to stay sober but now I was working on the “now what”.  My belief changed from “It can’t be me I’m a great kid to it is me”. I realized I didn’t have to do it alone and that I no longer ran the show the substance did and that needed to change. 

Recovery brought me my family back. It has brought me the opportunity to help others, independence from a substance that ruled my life and personal independence. Recovery has lifted a burden from my shoulders, it has brought me relief; no more guilt, shame or remorse. I no longer have to look over my shoulder. But most importantly it has brought me contentment, being ok with myself and knowing that everything will be okay because I have worked on those fears doubts and insecurities but it’s also an ongoing process and I will continue to work on my recovery.
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Submitted by Jeanie Holt, Public Policy Committee Co-Chair

As the Public Policy Committee works to update our Child Health and Safety Policy Statement, we have been talking about the public health impacts of Adverse Childhood Experiences. Karen Welford (Children's Trust and member of NHPHA's Public Policy Committee) and Dr. Kelley White wrote the following article to help us better understand the research on this important topic.



Adverse Childhood Experiences: A Public Health Perspective
Submitted By Karen Welford, BSN MSPA and Kelley White, MD

The whole-life perspective taken by the Adverse Childhood Experiences (ACE) study uncovers the effect of childhood stressors on a person’s health and social well-being throughout life beyond childhood. The study, an ongoing collaboration between the Centers for Disease Control (CDC) and Kaiser Permanente, measures a variety of adverse childhood experiences and their effect on the public health.

Begun in 1994, the study included over 17,000 adults surveyed by the Kaiser HMO in San Diego, California. The survey asked questions on 10 adverse childhood experiences: physical, psychological, and sexual abuse; emotional Publication1and physical neglect; alcoholism or drug use in the home; loss of a biological parent when under 18 years of age; depression or mental illness in the home; seeing a mother treated violently; and having an imprisoned household member. People who had these experiences as children were defined as having had “adverse childhood experiences” (ACEs)

Three important findings are revealed by this research. First, adverse childhood experiences are very common and often remain unrecognized. Second, they are powerful predictors of adult social function, well-being, health risks, disease and premature death. And third, the combination of these first two findings make adverse childhood experiences “the leading determinant of the health, social well-being, and economy of the nation". (1)

The prevalence of traumatic life experiences in childhood and adolescence is far higher than had been previously conceived. Only 33% of the survey participants had an ACE score of 0, while one in six adults acknowledged 4 or more adverse childhood experiences, having an ACE score of 4 or more.

The broad public-health perspective of the ACE study led to the recognition of a wide array of impacts on health behavior, disease-risk factors, and health outcomes such as obesity, inactivity, smoking, alcoholism, use of illicit drugs, depression, autoimmune disease, liver disease and premature death. The ACE score captures the cumulative negative impact on social, emotional, and cognitive development; and other impairments in the function of brain and body systems. As the number of adverse childhood experiences increases, the risk of developing significant health problems increases in a strong and graded fashion. More adverse childhood experiences mean more risk of negative outcomes. Dr. Robert Anda concludes that understanding this causal connection will help us make progress in preventing and recovering from these problems. (2)

The American Public Health Association Child Health Policy for the United States acknowledges: “Access to medical services is necessary but not sufficient to support children’s health and healthy development; attention also must be paid to the larger context of families’ lives and to the intergenerational effects of health status and economic resources. (3)

Evidence presented by the ACE Study indicates that adverse childhood experiences are major risk factors for illness, disability, death, and poor quality of life. This has important implications for those addressing public health in New Hampshire. Early-childhood and family support and strengthening programs, such as Family Resource Centers, continue to learn more about the long and short-term outcomes of adverse childhood experiences and to develop policies and programs addressing the prevention of these traumatic experiences for the children of our state. New Hampshire is beginning to understand that PREVENTION MATTERS.
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[1] Anda, R, Felitti,V. “The Lifelong Effects of Adverse Childhood Experiences” Chadwick’s Child Maltreatment Encyclopedic Volume 2, STM Learning Inc.

[2] Anda, R. “The Adverse Childhood Experiences Study: Child Abuse and Public Health,”  Prevent Child Abuse America, http://preventchildabuse.org/resource/adverse-childhood-experiences-robert-anda/

[3] American Public Health Association Child Health Policy for the United States https://www.apha.org/policies-and-advocacy/public-health-policy-statements/policy-database

Additonal Resources

www.ACEsConnection.com
www.cdc.gov/nccdphp/ACES/index.htm
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Submitted by Bobbie D. Bagley, RN, MS, MPH, CPH
Director, City of Nashua DPHCS

Co-Chair NHPHA Nurse's Section

Whether its putting together the program for their first - to be annual - health conference for practitioners or tracking down contacts to a complex infectious disease case, the public health nurses in Nashua have had their work cut out for them this summer.  Theresa Calope, RN, Nurses Photo 1PHN, had an idea “Why don’t we put together a conference for health providers?” and just like that the planning efforts began. Working with state and local partners, the public health nurses of the Division of Public Health and Community Services planned their first Pediatric Health Conference. There were over a hundred attendees representing nurses from community health, school, primary care and public health practice in the audience as well as physicians, advance nurse practitioners, behavioral health providers and others. The premier focus of the agenda was on immunization updates and lead poisoning prevention. The planning committee was able to get local providers, Wendy Wright, ARNP, Dr. Charles Cappetta and Dr. Storo as speakers. 

After coming down from a very successful educational venue, the team was then up and running to respond to increased outreach activities, infectious disease case investigations and coordinating efforts to support community partners in screening for tuberculosis infection. At the time not realizing they would soon be faced with an investigation that would exemplify the importance of the role of the public health nurse in coordinating case investigation with collaborating partners in primary care and community services. The team relied on outreach and rapport established within the community to successfully identify high-risk and vulnerable contacts in a transient population. The local nurses sought technical support from NH DHHS Bureau of Infection Control who responded by coming to Nashua to review the progress of this ongoing case investigation.  Nurses Photo 2

This lean team of nurses that has not cut any slack on their own prevailing efforts of health promotion and disease prevention, also made time to recognize the efforts of others. The PHNs in Nashua made two nominations this year for “TB Heroes” which have been recognized by National TB Programs.  Darlene Morse, RN, MSN, MED, CHES and Dr. Elizabeth Talbot of Dartmouth and DHHS Deputy State Epidemiologist were both recipients of national honors as a result of the nominations!

As members of the NHPHA Nurses Section these nurses are in the field making a difference! If you have not yet joined, take the opportunity to become a member of those dedicated to protecting, preserving and promoting health and mental wellbeing in our communities.

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An estimated 200,000-400,000 people in the United States contract Lyme disease each year, although only ~35,000 are reported. Incidence has been increasing in both the United States and New Hampshire and New Hampshire has the second highest incidence rate of Lyme TIck Free NHdisease in the country (CDC).

TicksThe Community Health Institute (CHI) is working with a range of state and community partners throughout New Hampshire to identify, prioritize, and fund Lyme disease prevention efforts around the state.

Prevent: Wearing tick-repellent clothing, tucking long pants into socks, having long sleeves, using insect repellent, and staying to the center of paths, is the best way for people to prevent tick bites when they venture outdoors.

Inspect: Do a tick check on yourself, your children, and pets after being outside, every time.

Remove: If you find a tick on your body, your children, or your pets it is important to remove it immediately. To properly remove an attached tick using a plain set of fine-tipped tweezers or a tick removal spoon – learn more at TickFreeNH.org!

The project is funded by a private donor through the NH Charitable Foundation; an advisory committee helped to prioritize the prevention activities and determine the best partners to carry out implementation. CHI is working with stakeholders who are on the front line of tick encounter prevention, such as: summer camps, childcare facilities, schools, and parks, and focusing prevention messaging on parents of children aged 2 to 13 and recreational outdoors enthusiasts. CHI will also implement a grassroots education campaign to inform and protect the New Hampshire public about Lyme disease prevention.

Help share the message of Lyme disease prevention and help New Hampshire be #TickFreeNH

https://www.facebook.com/TickFreeNewHampshire/

https://www.youtube.com/channel/UC_ngD4NW5Sogx0ukQCy3-iw

https://www.instagram.com/tickfreenh/



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Submitted by Shasta Jorgensen, Affiliate Representative to the Affiliate Governing Council

NIH Launches Moms’ Mental Health Matters

The Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), part of the National Institutes of Health (NIH), has launched Moms’ Mental Health Matters, a new initiative to raise awareness among pregnant and postpartum mothers, their families, and health care providers about depression and anxiety during pregnancy and after the baby is born. Free health education materials are available in English and Spanish. The posters describe the signs of depression and anxiety during and after pregnancy and address the misconception that for all women, pregnancy and new motherhood can only be "the happiest time of your life." In addition, the action plan helps moms identify when and where to seek help, and the conversation starter postcard, specifically designed for a mom's support system, offers suggestions for communicating with a loved one about this issue. For more information, click here.

Enter APHA’s 2016 Get Ready Photo Contest
DEADLINE EXTENDED: Enter by Monday, Aug. 22!
APHA is holding a fun photo contest for their Get Ready Campaign. Winning photos will be used for APHA’s 2017 Get Ready Calendar. From APHA website, “Everyone loves baby animals. They are just so gosh-darn cuddly and cute! We love them so much, in fact, that we made them the focus of this year's Get Ready Photo Contest. The contest is using baby animals — of any kind — to promote emergency preparedness. We'll add witty captions to the photos and use them to share messages about emergency preparedness with the world. Need some inspiration? Take a look at photos from past rounds of the Get Ready Photo Contest, featuring cats, dogs, babies and other animals. Read our FAQs  and official rules and regulations  for complete info. Contest entries are being accepted July 11 through Aug. 22, so get snapping!”

Get Ready Day, September 20, 2016
Not in the mood to enter the Get Ready Photo Contest but want more information regarding APHA’s Get Ready Campaign? Click here

APHA Annual Meeting and Expo: "Creating the Healthiest Nation: Ensuring the Right to Health", October 29th - November 2nd – Advance Registration Deadline is September 15th
APHA's 2016 Annual Meeting and Expo brings together more than 12,000 of your peers from across the U.S. and around the world to network, educate and share experiences. This year the focus will be on health equity and ensuring the right to health

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Zika virus disease is a mosquito-borne infection that is related to dengue, yellow fever, and West Nile virus. First discovered in Uganda in 1947, Zika virus disease did not begin spreading to South and Central America until 2015. The outbreak in Brazil led to reports of Guillain-Barré syndrome and pregnant women giving birth to babies with microcephaly (small head size), as well as other birth defects.  

zika photoThere have been cases of Zika virus disease in the United States in people who traveled to countries or territories where the virus is being transmitted and in individuals whose sex partner traveled to a Zika-affected area.  To date, there have been a total of 8 confirmed cases of Zika virus infection amongst New Hampshire residents who were infected during travel to a Zika affected area.  It is important to note that Zika virus is not present in mosquitoes in NH and there is no evidence of sustained populations of the Zika virus mosquito vectors, Aedes  aegypti and Aedes albopictus, in NH.  The NH Division of Public Health Services (DPHS) has plans to expand mosquito surveillance, however, local transmission of Zika virus by mosquitoes should be considered extremely unlikely at this time.

Approximately 80% of people who are infected with the Zika virus do not develop symptoms. In those who do become ill, the disease is usually mild and lasts from several days to a week. The symptoms of Zika virus infection include fever, rash, joint pain, and conjunctivitis (red eyes). Severe disease requiring hospitalization is uncommon.

In January 2016, the U.S. Centers for Disease Control and Prevention issued a travel advisory for people planning to visit countries where Zika virus is being transmitted by mosquitoes.  There are currently 52 countries and territories reporting local transmission of Zika virus infection. The NH DPHS recommends that pregnant women consider postponing travel to any affected areas, and women and their partners who are planning to become pregnant should take steps to prevent mosquito bites while in Zika affected areas, including the use of insect repellents.  It is unknown how long the virus persists in semen; studies to assess this are ongoing.  Therefore, it is recommended that men who have lived in or traveled to regions where Zika virus is being transmitted by mosquitoes and who have a pregnant sex partner should abstain from sex or consistently and correctly use condoms during the partner’s pregnancy. Anyone planning to travel should talk to their healthcare provider or visit a travel medicine clinic prior to any travel.

Additional resources:

1.) NH DPHS Zika Virus Webpage: http://www.dhhs.nh.gov/dphs/cdcs/zika/index.htm

2.) NH DPHS Zika Virus Fact Sheet: http://www.dhhs.nh.gov/dphs/cdcs/zika/documents/zika-virus-fact-sheet.pdf

3.) CDC Zika Virus Webpage: http://www.cdc.gov/zika/index.html

4.) CDC Zika Virus Prevention Webpage: http://www.cdc.gov/zika/prevention/index.html  
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