Child Health 2

Question 1

Which UK public health intervention may prevent dental carries developing in children

Answer 1

in UK public health policy, fluoride is added to water EG. in Wales not added so more susceptible to dental carried

Question 2

adverse childhood experiences

Answer 2

• negative effect on later health - negative health behaviours

Question 3

social determinants and lifestyle behaviours of Archie

Answer 3

• neglect teeth brushing - diet - disrupted sleep = behavioural problems - missed school = affects school readiness (social development and well-being) - late immunisations - child in need plan - previous domestic violence - family setting

Question 4

Which skate-holders are responsible for child health

Answer 4

parent family child in need health care professional local community school

Question 5

impact of ACEs and examples in order of risk

Answer 5

Question 6

2 main ways ACEs impact health

Answer 6

toxic stress and epigenetic changes

Question 7

What is toxic stress

Answer 7

impact of ACE

Excessive chronic activation of the stress response ⇒

System dysregulation:

Child’s developing brain, immune system, metabolic regulatory systems, and cardiovascular system

Question 8

How do ACEs play a role in epigenetics

Answer 8

Childhood experience (positive and negative)

affects the ‘epigenome’ and gene expression.

Temporarily or permanently depending on how easily the gene is turned on or off.

Brain is developing most rapidly in early years so epigenetic expression shapes health and behaviour from this early stage.

Question 9

3 evidenced based ways to reduce impact of ACEs

Answer 9

We can reduce the impact of ACEs and intervention can prevent and counteract lasting harm. Early intervention is preferable.

Reducing stress, building responsive relationships and strengthening life and coping skills prevent the long-term effects of ACEs

Question 10

things to include in a child lifestyle prescription

Answer 10

• diet = health vouchers and healthy eating promotion charities
• physical activity = group activity (social) - something child enjoys
• counselling
• positive parenting practises

Be aware of financial status of patient

• contact child in need plan (involve social service support)
• signposting

Question 11

Proccess to create lifestyle medicine prescription

Answer 11

symptom web ⇒ 4 pillars ⇒ how/what/when⇒lifestyle prescription

Question 12

8 factors in symptom web

Answer 12

1. Exercise
2. Sunlight
3. Environment
4. Genetics
5. Stress
6. Diet
7. Infections
8. Sleep

think about factors playing a role in symptoms and how it can be reduced

Question 13

4 pillars to consider when creating lifestyle medicine prescription

Answer 13

eat

sleep

move

relax

• lots to do with environment
• patient centred approach

how, what and when for

Question 14

What questions do we ask patients/carers when making a lifestyle medicine prescription

Answer 14

Ask how, what and when for each: eat, sleep, move, relax (4 pillars)

• lots to do with environment
• patient centred approach
• practical easy steps for patient
• LEAP Criteria (local, enjoyable and practical)

note this down ⇒ lifestyle medicine prescription

Question 15

Why is Henry a good example of an early intervention

Answer 15

• early intervention
• for parents and children
• strengthening family relationships
• positive health outcomes immediately and long term

Evidence-based early interventions to achieve a healthy start working with parents, supporting them to provide a healthy start in life for their children.

Question 16

key ponts

Answer 16

a. Adverse childhood experiences (ACEs) increase the risk of various health outcomesthrough their effect on the stress response and epigenetic expression.
b. The symptom web, four pillars, LEAP criteria and “how, what, when?” are core components of a personalised lifestyle medicine prescription.
c. Early intervention (e.g., HENRY) to reduce stress, build responsive relationships and strengthen life and coping skills can prevent the long-term effects of ACEs and promote a healthy start to life.