Child Health

Question 1

contextualise child health in relation to lifestyle

Answer 1

SLIDE 54

Question 2

contextualise child health in relation to behaviour

Answer 2

SLIDE 54

Question 3

contextualise child health in relation to social

Answer 3

SLIDE 54

Question 4

contextualise child health in relation to environmental

Answer 4

SLIDE 54

Question 5

what does ACE stand for?

Answer 5

adverse childhood experience

Question 6

ACEs include?

Answer 6

experiencing abuse or witnessing domestic abuse, having a close family member or caregiver misuses drugs or alcohol, with mental health problems, has served time in prison, experiencing parental separation or divorce on account of relationship breakdown

Question 7

evidence behind impact of ACEs

Answer 7

strong associations w/ sexual risk taking, mental ill health, problematic alcohol use, strongest w/ problematic drug use, violence, excessive chronic activation of stress response > system dysregulation, affects epigenome and gene expression

Question 8

effective lifestyle medicine with children and families normally focuses on?

Answer 8

nutrition

physical activity

Question 9

techniques for lifestyle medicine consultation with children

Answer 9

opportunistic, sensitive, non-judgemental, strengths based approach, focus on barriers important to the child, relate to other children, engage parents, specific short term goals, daily routine, LEAP criteria activities

Question 10

what does LEAP stand for?

Answer 10

local, enjoyable and practical

Question 11

national child measurement programme

Answer 11

measures height and weight in reception (age 4 + 5) and year 6 (age 10 +11)

Question 12

tier 1 BMI centile criteria

Answer 12

none

Question 13

tier 1 offer

Answer 13

universal prevention
consultation w/ health professional
public health approaches

Question 14

tier 2 BMI centile criteria

Answer 14

> 91st centile

Question 15

tier 2 offer

Answer 15

intensive + community based
time-specific
public health approaches

Question 16

tier 3 BMI centile criteria

Answer 16

> 99.6th centile or > 91st centile + co-morbidities/complex needs

Question 17

tier 3 offer

Answer 17

specialist MDT
weight management clinics
longer term follow up

Question 18

tier 4 BMI centile criteria

Answer 18

not available in children

Question 19

tier 4 offer

Answer 19

surgical options

Question 20

what is orexin?

Answer 20

neuropeptide that regulates arousal, wakefulness, and appetite

Question 21

there are higher levels of orexin in those who?

Answer 21

don’t need much sleep

Question 22

effects of orexin

Answer 22

arousal state (cerebral cortex activation + LC neurons)
autonomic fx
food intake
hormonal changes
glucose control
energy expenditure + metabolic rate

Question 23

effect of age on sleep

Answer 23

sleep time decreases
becomes more fragmented
changes in type
from 2 months = circadian, infants = ultraradian
circadian rhythm delays in adolescents 
slowed melatonin
sleep disorders e.g OSA, insomnia
in adolescence, sleep walking, night terrors, sleep paralysis, nocturnal enuresis