Adverse Childhood Experiences: Perceptions, Practices, and Possibilities.

BACKGROUND: Adverse childhood experiences are negative life events occurring in childhood that can have long-term health effects. Many health professionals do not receive formal education surrounding childhood trauma, and few providers screen for adverse childhood experiences. OBJECTIVE: This scoping review examines how current literature describes the perceptions, attitudes, and practices of health professionals and trainees regarding childhood trauma, identifies educational opportunities aiming to increase awareness for child trauma, and discusses screening for adverse childhood experiences. METHODS: PubMed, PsycInfo, and Google Scholar were used to find articles. Key search terms included "adverse childhood experiences" or "ACEs," combined with terms such as "screening implementation," "Education, Professional" (Medical Subject Headings [MeSH]), "Education, Medical, Graduate" (MeSH), "Curriculum" (MeSH), "Health Knowledge, Attitudes, and Practices" (MeSH), and "Attitude" (MeSH). RESULTS: A large proportion of providers and trainees are unaware of the effects of adverse childhood experiences. Training opportunities can increase knowledge about adverse childhood experiences and promote trauma-informed care practices. However, the long-term effects of these trainings remain largely unexplored. Barriers such as a lack of time, resources, comfort, or consensus regarding how to ethically screen impede broader efforts to implement systematic screenings for adverse childhood experiences. CONCLUSIONS: Adverse childhood experiences are a public health concern. However, health professionals and trainees are undereducated about their pervasive effects. Further research is needed on how to better educate health professionals about adverse childhood experiences and trauma-informed care. Adverse childhood experiences screenings could promote the early identification of childhood trauma, yet the ethics and effectiveness of screening must be further studied.

Management of Information in Radiation Oncology: An Integrated System for Scheduling, Treatment, Billing, and Verification.

An effective information system is an essential prerequisite to delivering quality patient care at competitive costs. From scheduling and billing to complex treatment machine control and verification, the quality of the information system strongly affects the efficiency and accuracy with which patient care is delivered. The standard paper-based information system used in many clinics suffers form inefficiencies and incompleteness in scheduling and billing, no centralized database and the inability to generate routine reports and communicate with other information systems. Many of these problems are resolved by the introduction of an electronic information system. The implementation, gains, and limitations of two electronic information systems are discussed. While limitations such as the lack of complete seamless integration of all information still exist, major improvements have been made in efficiency, accuracy, data integrity, and reporting and billing completeness.