Child Health Flashcards
What is a life-course approach to health?
In looking at health from a life course perspective, rather than a ‘disease-focussed’ approach, we approach health more holistically and can take a more proactive role in promoting and restoring health and wellbeing at different stages of an individuals life and in turn prevent ill health in the future. Takes into account the wider determinants of health.
What are dental caries?
Dental caries occur when oral bacteria metabolise sugar and produce acid that demineralises enamel and dentin from the hard coating of the tooth. Severe caries can cause pain and infection and can even lead to sepsis and death.
Describe epidemiological importance of dental caries
They are major public health problem and the most common non-communicable disease globally. Children and adolescents are most at risk of developing dental caries.
How are dental caries managed and what places someone at risk?
Management may need to involve tooth extraction – which is both extremely expensive, time consuming and widely unavailable in low income countries. Social deprivation is associated with excessive intake of sugar. Unsurprisingly dental caries and obesity often occur together, disproportionally affecting disadvantaged populations.
How can dental caries be prevented on a population level?
Prevention of dental caries can be achieved with sugar reduction in the diet and maintaining good oral hygiene. Reducing free sugar intake to less than 10% of energy intake can minimise the risk of developing dental caries throughout the life course. Population-wide approaches can include water fluoridation, fluoride varnish programmes and sugar-reduction programmes.
What is an Adverse Childhood Experience?
ACES are stressful events that occur in childhood. They include, but are not limited to:
- Experiencing abuse: Physical, sexual, psychological or neglect.
- Witnessing domestic abuse
- Having a close family member or caregiver who misused drugs or alcohol
- Having a close family member or caregiver with mental health problems
- Having a close family member or caregiver who served time in prison
- Experiencing parental separation or divorce on account of relationship breakdown.
What is the association between adverse childhood experiences and various health behaviours?
Weak or modest for: physical inactivity, overweight or obesity, and diabetes (ORs of less than two)
Moderate for: smoking, heavy alcohol use, poor self-rated health, cancer, heart disease, and respiratory disease (ORs of two to three)
Strong for: sexual risk taking, mental ill health, and problematic alcohol use (ORs of more than three to six) Strongest for: problematic drug use and interpersonal and self-directed violence (ORs of more than seven)
What are recommended techniques to use when consulting about lifestyle and behaviour change with children and families?
- Be opportunistic
- Be sensitive
- Non-judgemental approach
- Strengths-based approach
- Focus on barriers of particular importance to the child
- Relate to other children
- Engage parents and families
- Specific, short term goals
- Work behaviour change into daily routine
What is the LEAP criteria?
Local, Enjoyable and Practical. Boosts participation in activities, ensuring behaviour change.
What is the National Child Measurement programme?
Measures height and weight of children in reception, aged 4-5 and then again in Year 6, ages 10-11. Defining children as overweight or obese is challenging as children of different ages and sex grow and develop differently. Therefore, BMI categorised differently than in adults.
What services are offered to children in BMI centile 1 and 2?
1 is none - not overweight/obese. Universal prevention measures used with public health approach and consultation with frontline healthcare professionals.
2 is >91 or =91 centile - intense and community based team interventions. Are time-specific with courses of a finite duration targetting lifestyle changes using public health approaches.
What services are offered to children in BMI centile 3 and 4?
3 is for those above 99.6th centile or 91 and above but with comorbidities/complex needs - longer-term clinics offered with specialist MDT in a weight management clinic with longer term follow-up.
4 is not offered to children - involves surgical intervention like bariatric surgery.
What are the effects of orexin?
- Cerebral cortex activation and involvement of LC neurons: arousal state
- Autonomic function
- Food intake
- Energy expenditure and metabolic rate
- Glucose control
- Hormonal changes: insulin, glucagon, ACTH, GH, etc
What sleep rhythm exists at birth?
Ultradian rhythm: repetition of sleep cycles within a 24 hour period. Circadian system only develops at around 2 months of age and breastmilk may aid the development of this rhythm.
What is sleep like during adolescence?
More delayed circadian rhythm chronotypes - more pronounced in males. Sleep homeostat builds sleep pressure more slowly in adolescents which means they experience less pronounced impact of prolonged wakefulness.
