Pediatrics

Question 1

Definition of community pediatrics

Answer 1

the practice of promoting and integrating the positive social, cultural, and environmental influences on children’s health as well as addressing potential negative effects that deter optimal child health and development within a community

Question 2

Goals of the routine well child visit

Answer 2

• Provide surveillance of growth and development
• Conduct age-appropriate evidence based screening
• Administer immunizations
• Provide anticipatory guidance
• Address parental concerns.

Question 3

What are the factors that influence health outcomes, and how is the percentage distribution ?

Answer 3

Social , environmental and behavioral influence 50-60% of health outcomes

Genetic factors influence 30%

Health care system only 10%

Question 4

What is the definition of SDH? What are these?

Answer 4

conditions in which people are born, grow, live, work and age

Economic stability
Neighborhood and physical environment
Education 
Food
Community and social context
Healthcare system

Question 5

Adverse childhood experiences types

Answer 5

3 types:

1. Abuse( physical, emotional, sexual)
2. Neglecct ( physical and emotional)
3. Household dysfunction
   
   1. Mental illness
   2. Incarcerated relative
   3. Mother treated violently
   4. Substance abuse
   5. Divorce

Question 6

CDC-Kaiser permanent ACE study

Answer 6

largest investigations of childhood abuse and neglect and household challenges and later-life health and well-being.

Found that increased ACEs would lead to:
Increased morbidity and mortality
negative outcomes: alcoholism, illicit drug use, COPD, depression, fetal death, ischemic heart disease, liver disease

Question 7

ACE Pyramid

Answer 7

Bottom to top:

• ACE
• Disrupted Neurodevelopment
• Social, emotional, cognitive impairment
• Adoption of health risk behaviors
• Disease, disability and social problems
• Early death

Question 8

What do you consider when choosing a tool for screening SDH

Answer 8

The goals of screening in your setting( referral sources, identifying needs, social’s context)
Format used ( paper, electronic, self administered)
Who will respond to positive results