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Did you know certain medications can interact with everyday food and drink? We asked Pharmacy Manager Adam Porath how to take these important medications safely. One in five Americans between the ages of 40 and 75 are currently taking a statin drug to reduce their cholesterol level or to prevent atherosclerosis (hardening of the arteries). Many others also take anticoagulants (blood thinners) to prevent blood clots from forming, which can increase the risk of stroke. Adam Porath, pharmacy manager with the Renown Institute for Heart and Vascular Health’s Anticoagulation Program, explains how to safely take these medications. What is a statin? A statin is a drug that can lower cholesterol by helping your body absorb cholesterol or by blocking a substance your body needs to make it. The American Heart Association cites a global study reporting the benefit of statins to help reduce heart attacks and strokes. Common statins include atorvastatin (Lipitor), pravastatin (Pravachol), rosuvastatin (Crestor) and simvastatin (Zocor). Which foods or drinks should be avoided while taking statin drugs? Grapefruit juice is the only food or drink that has a direct interaction with statins. Statins do not directly interact with any food but people taking statins should moderate their intake of saturated fats to help lower their LDL cholesterol and overall risk of cardiovascular disease. What is a blood thinning drug? Blood thinning drugs, such as warfarin, rivaroxaban (Xarelto), apixiban (Eliquis), dabigatran (Pradaxa) and edoxaban (Savaysa), are used to prevent stroke. Which foods or drugs should be avoided while taking blood thinning drugs? If taking warfarin, alcohol and cranberries (including juice) should be avoided. Patients taking warfarin should be aware of foods that contain Vitamin K (green leafy vegetables) and try to maintain a consistent diet of these foods. Warfarin interacts with many over the counter and prescription medications. Patients should consult a pharmacist when starting, stopping, or changing doses of any medication when taking warfarin. Also, patients taking any blood thinning medication should avoid over-the-counter pain relievers (i.e. aspirin, ibuprofen, etc.) How do I know whether to take my medication with food or not? Consulting with a pharmacist is the best resource to determine if a medication should be taken with or without food. In general, all statins and blood thinners can be taken with or without food. The only exception is Xarelto (rivaroxaban), which should be taken with the largest meal of the day If you are a Renown patient you can also review your prescriptions online, request a refill or ask a question via MyChart. With MyChart, you can access all your healthcare information securely 24/7.

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Clinical research provides agency for our patients navigating a scary diagnosis, and the field has never been stronger in northern Nevada. This strength is thanks in part to the Affiliate Clinical Research Office (ACRO) formed by the 2021 affiliation between Renown Health and the University of Nevada, Reno School of Medicine. Since its creation, the ACRO team has been busy ensuring that community members have access to the latest care options and exceptional experiences as participants in both research and their healthcare. Here are just a few things that set this office apart from the rest. 1. A focus on engagement In 2022, the ARCO team focused on promoting a research culture with patients, clinicians, residents and students by intentionally engaging with healthcare providers, department administrators, internal research team members and leadership. They educated the community with learning materials that emphasized the importance of doing research. This team also worked with front-line staff to raise awareness and excitement about the clinical research options available for Renown Health patients. 2. Meaningful partnerships The most impactful partnership to date is between Renown Health and UNR Med. By identifying opportunities and leveraging resources across institutions, we have maximized our impact and built a solid and sustainable foundation. This gives the people of northern Nevada greater access to new interventions or novel treatments. This team is also investing in the community and national partnerships to provide training opportunities for our research staff and learning opportunities for our medical students. 3. Novel treatments across many disease areas Our research study offerings must reflect the healthcare needs of our community and the expertise of practicing clinicians. The department has over 80 active studies in neurology, pulmonology, oncology, cardiology, pediatrics and disease prevention. The ARCRO team strives to expand care opportunities to allow our community members to stay close to home when seeking care. This year, they will continue exploring our community's unmet healthcare needs by bringing new treatment options to the greater Reno area.

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In February, we think about hearts not just in honor of Valentine’s Day but because it is American Heart Association Month. This is a great reminder to focus on our personal cardiovascular health. Renown Health helps patients think about their heart health with our world-class providers and cutting-edge treatments through our Cardiovascular Clinical Trials. “Research serves a vital role in the future care of cardiovascular diseases. Being involved in research will help our medical community to further discover new treatment plans in our quest for life preservation and extension,” Dr. Thomas To, Cardiologist and Researcher at Renown Health. For example, let’s talk about atherosclerosis. When our hearts are healthy, they are a strong muscle that pumps our oxygen-rich blood through our coronary arteries. Over time, cholesterol and fats can build up in our arteries. This is a condition known as atherosclerosis. This type of plaque buildup in the arteries can lead to a heart attack or stroke if not properly managed. If you are experiencing chest pain or discomfort, shortness of breath or pain in areas of the upper body, these can be the warning signs of a heart attack, and you should call 911. One contributing factor to atherosclerosis is elevated lipoprotein(a) levels and the accumulation of cholesterol in the arteries, which increases the likelihood of a heart attack or stroke. Lipoprotein(a) is tested separately from the standard panel that is completed for cholesterol management, and while your total cholesterol levels may be in a healthy range, lipoprotein(a) levels can still be elevated. "Increasingly we are realizing that lipoprotein(a) levels can be used as an important assessment in more carefully delineating an individual's risk of future cardiovascular events and treatment targets" said Dr. Michael Bloch, Lipid Specialist and Researcher at Renown Institute for Heart and Vascular Health. While it is clear that elevated lipoprotein(a) contributes to atherosclerosis, there are currently no approved medications for reducing cardiovascular disease risk through reducing lipoprotein(a) levels. This is why Renown Health’s Research Office is proud to offer a phase III clinical trial, called the OCEAN(a) study, to our patients with elevated lipoprotein(a) levels as a care option for management of their heart disease risk. Our teams of expert providers and researchers are here to support you on your healthcare journey. “I am thrilled to be able to be part of this study and bring opportunities like this to our patients. The highlight of my day is getting to hear life stories from my patients during our study visits,” Lisa Preciado, Primary Clinical Research Coordinator for the OCEAN(a) study said. Join us in raising awareness around American Heart Month by talking to your provider about lipoprotein(a) at your next appointment. At Renown Health, our goal is to make it easy for patients to access clinical research as a care opportunity where patients can access a variety of standard care treatment options for their health condition or choose to participate in a clinical trial. For more information about clinical trial opportunities available to you or to ask any questions, contact the Renown Research Office at Renown-CRD@renown.org or 775-982-3646.

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While there used to be three basic treatment options for cancer -- surgery, radiation and chemotherapy, or a combination of the three -- there's a fourth option: clinical trials. Here, a Renown patient shares her successful battle with ovarian cancer, aided by a clinical trial. Shari Flamm's battle with ovarian cancer began in 2011. She was experiencing prolonged bleeding, irregular thyroid levels and anemia and was scheduled to undergo a hysterectomy. Before the surgery, her gynecologist ran routine tests to check for cancer as a precautionary measure. All tests were negative for cancer, expect her CA 125 test. A CA 125 test measures the amount of the protein CA 125 (cancer antigen 125) in the blood. In some cases, a CA 125 test may be used to look for early signs of ovarian cancer in women with a very high risk of the disease. In most laboratories, the normal level is 0 to 35 units/ml. Flamm's CA 125 level was 121. As Flamm can attest, early diagnosis played a key role in her battle with ovarian cancer. September is Gynecologic Cancer and Ovarian Cancer Awareness Month – an important time to learn the signs, symptoms and risk factors of this type of cancer so your doctor can diagnosis the disease as early as possible. Ovarian Cancer: Round One Despite the elevated CA 125 results, her doctor recommended they move forward with the hysterectomy. But when surgery began, doctors discovered a mass. She had stage 4 cancer. The procedure was halted, the mass was biopsied and she was immediately seen by Dr. Peter Lim of the The Center of Hope. Following diagnosis, Flamm underwent surgery with Dr. Lim to remove the cancer, which had spread to part of diaphragm, spleen, colon and other organs. Three months after surgery, Flamm had recovered enough to start six rounds of chemotherapy in her hometown of Carson City. She continued working at a doctor's office during her treatment, and was grateful for Dr. Lim’s ability to co-manage her care so she could stay close to work and family. “To me, chemo was the scariest part because I didn’t like feeling sick,” Flamm says. Thankfully, her body responded well to the treatments and she was back to the things she loved. “I stated working out at the gym, even if it was only for 10 minutes,” she says. She also stayed positive by spending time with her grandchildren, attending a San Jose Sharks hockey game, going for walks and enjoying concerts. Ovarian Cancer: Round Two In November 2014, Flamm had a cancer check-up. That’s when doctors discovered three cancerous tumors. For this round, Flamm choose another treatment option -- clinical trials at Renown Institute for Cancer. Clinical trials are the studies that test whether drugs work, and inform doctors' decisions about how to treat their patients. Flamm participated in a clinical trial that featured oral-targeted therapy stronger than IV chemotherapy. The hope was for the drug to shrink her tumors, however the result was stabilization -- meaning the lumps weren’t growing or spreading. The best part of the clinical trial, Flamm says, was the constant monitoring. Between the CT scans every six weeks, a heart scan every three months and monthly doctor visits, she was confident that if the cancer started growing or spreading, her healthcare team would catch it right away. For Flamm, the benefits of the clinical trial included less hair loss, less fatigue and more time to focus on what’s important in her life -- her family. “I decided I wasn’t going to be that sick grandma on the couch with cancer,” Flamm says. After taking the oral medication for one year, Flamm developed a rash and discontinued treatment due to discomfort. Clinical Trials, Setbacks and Survival In June 2016, two of the three tumors began to grow and had to be surgically removed. Despite the setback, Flamm was determined to maintain a positive outlook. "You have to stay positive because cancer feeds off anger, depression and stress," Flamm says. Flamm was released to go home with clear margins, meaning the tumors were removed and are surrounded by a rim of normal tissue that does not have cancerous cells. Flamm says her outlook on life has changed drastically since her first cancer diagnosis. “Your whole mentality changes when cancer disturbs your life," Flann says. "The things that weren’t important, are now ever so important. I’m a lot calmer now,” Flamm says.

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Young children under 4 and adults over 65 are especially vulnerable to heat exhaustion. Avoid heat exhaustion this summer with some expert tips. Northern Nevada summers can be downright hot, and although the balmy temperatures can feel great, they may cause heat-related illness, also known as heat exhaustion. Infants and children under 4 and adults over 65 are particularly vulnerable to heat exhaustion because their bodies adjust to heat more slowly. Without proper intervention, heat exhaustion can progress to heat stroke, which can damage the brain and other vital organs and even cause death. The Warning Signs of Heat Exhaustion Heavy sweating Elevation of body temperature Paleness Muscle cramps Tiredness, weakness, dizziness Headache Fainting Nausea or vomiting Cool and moist skin Fast and weak pulse Fast and shallow breathing Heat stroke happens when the body’s temperature rises rapidly and the body loses its ability to sweat. The Symptoms of Heat Stroke Body temperatures rising to 106 degrees or higher within 10 to 15 minutes Red, hot and dry skin (no sweating) Rapid, strong pulse Throbbing headache Dizziness or nausea Prevention and Treatment Make sure your air conditioner works Stay indoors and drink plenty of fluids Limit strenuous outdoor activities to mornings and evenings Drink plenty of water throughout the day Avoid caffeine and alcohol Do outdoor activities in the shade and wear light, loose clothing Take plenty of breaks and drape a wet bandanna around your shoulders to cool down If you suspect you or someone else is headed toward heat exhaustion or heat stroke, call 911 immediately.

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Participating in a clinical trial is voluntary and a personal choice. Clinical trials are research studies that involve people and are an important part of patient care. What is a clinical trial?  Clinical trials are research studies that involve people, and they are an important part of patient care. There are several different types of clinical trials; some are designed to understand trends in a disease or identify better ways to diagnose a condition, while others determine if a new treatment is safe and works when treating, improving or preventing a health condition. There are over 400,000 clinical trials currently being conducted in the United States, and even more across the world. This includes health conditions such as heart failure, cancer, Parkinson’s Disease, respiratory conditions like COPD, common infections, cystic fibrosis, and many more. Clinical trials lead the healthcare industry to new discoveries that contribute to reliable and exact care, improving healthcare quality and saving lives. Clinical trials are conducted by a team of researchers, including doctors, pharmacists and clinical research coordinators. These research teams are highly skilled in their specialty areas, often providing traditional patient care and seeing research patients in the same day. These teams are responsible for making sure the clinical trial is completed correctly, and their patients are their top priority. Why should I consider participating in a clinical trial? Participating in a clinical trial is voluntary and a personal choice. There are many reasons why patients decide to get involved in clinical research. While many clinical trials are designed for patients who have a certain health condition, many studies also ask healthy volunteers to contribute in order to compare health outcomes. Clinical trials are also for patients at all different stages of their diagnosis. Depending on the specific study, the patient may receive access to a new cutting-edge treatment before it is widely available. When patients join a clinical trial, the research team becomes a health partner dedicated to their health and well-being. When patients join a clinical trial, they make an informed decision in their healthcare by weighing all available options in addition to routine treatments. Research participants know that they are contributing meaningfully and helping other patients like them. Where can I find more information about clinical trials at Renown Health? Renown Health’s mission is to make a genuine difference in the health and well-being of the communities we serve. Renown’s clinical trial portfolio offers leading care options to patients in northern Nevada, close to home, in a variety of specialties. Contact the Renown Clinical Research Office for more information on clinical trials available to you!

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The University of Nevada, Reno School of Medicine (UNR Med) and Renown Health affiliated in June of 2021. First Integrated Health System The University of Nevada, Reno School of Medicine (UNR Med) and Renown Health affiliated in June of 2021. This agreement established Nevada’s first integrated health system with missions in education, patient care, and clinical research. While there was extensive media coverage regarding the historic partnership in general, there is less information regarding the important impact to the community. In terms of clinical research, the potential benefits are endless. The School of Medicine has a very successful program in molecular bio sciences. That means they have a plethora of brilliant minds working on the smallest components of life related to body systems and disease. With the affiliation, there is a distinct opportunity to bridge some of these important findings happening on campus and translate them into care protocols for the patients seen in the community. Making connections between the cellular basics to the physical manifestations of conditions is a key opportunity of the affiliation. Additionally, cooperative funding models for projects that fit in the translational research bucket are available to these researchers. Renown and UNR Med are poised to provide potentially cutting-edge treatments with bench to bedside research. Expanding Clinical Trials Perhaps the most important outcome of the affiliation is access to novel treatments via clinical trials. In the coming years, Renown and UNR Med will work to expand their clinical trial portfolio in an effort to provide a clinical trial option for many diseases in addition to standard of care. This endeavor will allow patients to make an informed choice about their healthcare. With novel treatments available right here in Reno, people won’t have to travel to other research institutions for similar care. This eases a tremendous potential burden on patients and families alike navigating complex illnesses like cancer. The affiliation is exciting and provides many opportunities for clinicians (present and future) and the community. Renown's Clinical Research Office is thrilled to be a part of this historic time and are enthusiastic to communicate our successes and opportunities to the community. We sincerely look forward to contributing to the vision of “a healthy Nevada.”

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Halloween is around the corner. So while you're prepping pumpkins for carving, putting together creative costumes and coordinating trick-or-treating plans, safety is one more detail to remember.   Masks, haunted houses, witches, ghosts and ghouls — it all spells Halloween, and what could be more frighteningly fun, right? For children, however, Halloween can indeed be frightening and not so fun.  According to Dr. Kristina Deeter, Physician-in-Chief of Renown Children’s Hospital and Chair of Pediatrics for the University of Nevada, Reno School of Medicine, it is common for younger children to express Halloween fears — being afraid of monsters, the dark or really anything out of the norm. “It's normal for children to struggle with separating reality from fantasy,” she explains.   For children who fall into this category, the month of October can be traumatizing. Halloween may not come until the end of the month. Still, in the weeks building up to the spookiest night of the year, little ones are bombarded on all sides with decorations — mummies, skeletons, coffins, vampires, you name it. For a child with a blossoming imagination who, as Dr. Deeter said, is still learning to differentiate real from pretend, this can cause additional fears and anxieties. In commemoration of Halloween Safety Month, Dr. Deeter shares safety tips for the spooky holiday from the American Academy of Pediatrics:  Dressing Up & Heading Out  Plan costumes that are bright and reflective. Ensure shoes fit well and that costumes are short enough to prevent tripping, tangling or coming into contact with flames.   Consider adding reflective tape or striping to costumes and trick-or-treat bags and baskets for greater visibility.  Masks can limit or block eyesight. Instead, consider non-toxic makeup and hats, which should fit properly to prevent them from sliding over the eyes. Test makeup ahead of time on a small patch of skin to test for allergies before full application.  When shopping for costumes, wigs and accessories, look for and purchase those with a label clearly indicating they are flame resistant.  If a sword, cane or stick is a part of your child's costume, make sure it is not sharp or long. A child may be easily hurt by these accessories if he stumbles or trips.  Do not use decorative contact lenses without an eye examination and a prescription from an eye care professional. While the packaging on decorative lenses will often make claims such as "one size fits all," or "no need to see an eye specialist," obtaining decorative contact lenses without a prescription is both dangerous and illegal. This can cause pain, inflammation, serious eye disorders and infections, which may lead to permanent vision loss.  Review with children how to call 9-1-1 (or their local emergency number) if they ever have an emergency or become lost.  Carving Pumpkins  Leave the carving to the grownups. Have children draw the pumpkin design with markers, but keep knives away.  Consider using a flashlight or glow stick instead of a candle to light your pumpkin. If you do use a candle, a votive candle is safest.  Candlelit pumpkins should be placed on a sturdy table, away from curtains and other flammable objects, and not on a porch or any path where visitors may pass close by. They should never be left unattended.  Prepping Your Home  Keep your entryway safe for trick-or-treaters by removing all items from the porch or front yard that a child could trip over, like garden hoses, toys, bikes and lawn decorations.  To ensure visibility, check outdoor lights and replace burned-out bulbs.  Sweep leaves (or snow) from sidewalks and steps.  If there are dogs in the home, take steps to ensure they don't jump on trick-or-treaters. Hunting for Treats  Young children should always be accompanied by a parent or responsible adult.   Give each child and adult a flashlight (with fresh batteries).  If older children are heading out to trick-or-treat alone, plan and review a route you can agree on, as well as a specific time they are supposed to return home.   Only visit homes with a lit porch light. Never enter a home or a car for a treat.  Notify law enforcement authorities of any suspicious or unlawful activity immediately.  Since pedestrian injuries are the most common injuries to children on Halloween, remind youngsters to take crosswalk safety precautions.  For more key tips regarding Halloween safety for your young trick-or-treaters, visit our partners at Safe Kids Worldwide for a variety of spooky safety resources.

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October is Domestic Violence Awareness Month in the United States. We spoke with Renown Health experts and local domestic violence prevention organizations who gave us a deeper look into understanding the warning signs of abuse and the many proactive and reactive resources in our community that you can reach out to today.  Domestic violence, also referred to as domestic abuse, is an everyone issue. Whether you identify as male or female, an adult or a child, single or partnered – domestic violence can affect anyone. In fact, it may be closer to home than you might think.   According to the Nevada Quality Parenting Initiative, in Nevada, 43.8% of women and 32.8% of men experience domestic violence in their lifetime, and the risk of that figure rising is imminent. This year alone, the Domestic Violence Resource Center (DVRC) in Reno experienced a 55% increase in overnight emergency stays, according to the Reno Gazette-Journal.   This problem also, unfortunately, extends to children. More than 5,000 children in Nevada were reportedly primary or secondary victims of domestic abuse in 2021, as stated by the Nevada Coalition to End Domestic and Sexual Violence.  “Domestic violence can manifest in many different ways,” said Kami Price, Supervisor of Social Services for Renown Health. “Abuse isn’t always strictly physical. It can also be emotional, verbal, sexual and even digital. Understanding those differences can help you prepare accordingly and respond safely if you or a loved one are experiencing domestic violence.”   Knowing what to look out for is crucial in protecting yourself and others against the effects of domestic abuse and taking action when warning signs appear. The National Domestic Violence Hotline shares the common signs of an abusive partner, no matter how old they are or what gender they identify as:  Telling you that you never do anything right.  Showing extreme jealousy of your friends or time spent away from them.  Preventing or discouraging you from spending time with friends, family members or peers.  Insulting, demeaning or shaming you, especially in front of other people.  Preventing you from making your own decisions, including about working or attending school.  Controlling finances, including taking your money or withholding money for needed expenses.  Pressuring you to perform sexual acts you’re not comfortable with.  Pressuring you to use drugs or alcohol.  Intimidating you through threatening looks or actions.  Threatening to harm or take away your children or pets.  Intimidating you with weapons.  Destroying your belongings or your home.  "People experiencing domestic violence may feel as though they are trapped,” said Kami Price. “The reality is – this often couldn’t be further from the truth, especially with the resources we have at our disposal in northern Nevada.”  Respected Resources Ending the Silence on Domestic Violence  While these facts and figures might be staggering, those experiencing domestic violence at any age are not alone. There is hope at the end of the tunnel, especially here locally.  Devoted to meeting the growing needs of the communities we serve, Renown Health proudly supports and sponsors several organizations in our community that are committed to educating children and adults on the signs and symptoms of domestic violence, along with what each child and family member can do today to prevent abuse in the household. These essential organizations are on the frontlines of shifting attitudes from “I don’t want to get involved” to “How can I help?”  Serving children across northern Nevada, the Child Assault Prevention (CAP) Project offers “education and prevention programs designed to increase children’s safety from bullying, abuse and assault” and break the cycle of domestic abuse. During 2021 and the first half of 2022, CAP led about 500 different workshops, teaching 10,000 second-grade and fourth-grade children in Washoe, Storey, Lyon and Churchill Counties how to keep themselves safe from domestic violence.   “As domestic violence is on the rise, open communication, early intervention and education are key to protecting children from the effects of domestic violence," said Rebecca LeBeau, Executive Director of the CAP Project. “That’s why I begin speaking about child assault prevention and stranger danger to kids as young as six years old. It's important to explain the true reality of domestic violence to both children and adults, tailoring language specifically to whatever age they are, and allowing them to process it. Kids of all ages will learn how to deal with extremely dangerous situations this way.”  According to Rebecca, common symptoms of abuse to be on the lookout for at school include grades dropping, a lack of focus and feelings of not wanting to return home after the school day ends. If someone in a child’s home is being hurt or abused, children are always encouraged to speak with a trusted adult or school counselor. From there, organizations like the CAP Project develop a safety plan moving forward.  Adults and family units aren’t alone either. The DVRC provides a wide variety of services to Washoe County residents experiencing domestic abuse. To date, the DVRC has helped more than 100,000 victims of domestic violence, and with the recent launch of their crisis text line, they are poised to serve many more. Like the CAP Project, the DVRC also believes that education is one of the first lines of defense against domestic violence.  “Education on what domestic violence looks like is so much more than talking about physical violence,” said Aria Overli, Volunteer Coordinator at the DVRC. “Educating the community, and particularly youth, about what healthy relationships look like is a major factor in preventing abuse. Understanding the intersection of how other issues – such as race, mental illness and immigration status – affect domestic violence risk factors is key to addressing those issues.”   The list doesn’t stop there. Renown Health Foundation has provided financial support for many more organizations that are dedicated to ending the silence on domestic violence, sexual violence and family abuse, including:  The Children’s Cabinet – A child-focused organization offering many support services for youths and families, including Safe Place, a program that partners with local businesses to offer safe locations for children to seek help if they feel threatened at school or at home. The organization also provides free family counseling, providing a pathway to better communication for families experiencing a myriad of issues ranging from domestic violence to substance abuse.  Awaken – A nonprofit committed to increasing awareness and education regarding sex trafficking and providing housing and healing to all survivors.  Safe Embrace – The largest and most inclusive safe house in Reno-Sparks for survivors of domestic and sexual violence, offering a wide range of resources including counseling, emergency transportation, court support and more.  Eddy House – A safe space for at-risk individuals aged 18-24 recovering from the effects of domestic abuse, unsafe housing conditions, homelessness and more.  Being an advocate starts with us – if you see something, say something. Keeping a transparent line of communication is key to preventing, noticing and combating domestic violence.   “The more you reach out and talk about the issues, the better,” closed Kami Price. “No one has to go through their struggles alone.”

Read More About Take a Stand Against Domestic Violence