Screening and Injury

Question 1

Principles of screening

Answer 1

It is not a diagnostic test. It is a sieve to detect asymptomatic individuals who have a high risk of developing a particular disease/ condition.

Can produce false positives and false negatives

Question 2

Screening Criteria

What makes a condition/ disease a candidate for screening?

Answer 2

Wilson:

1) should be important to health
2) The natural history of the condition should be understood
3) A delectable latent period or early symptomatic stage
4) There should be a test that is easy to perform and interpret
5) The test should be accurate, acceptable, reliable, sensitive and specific
6) There should be an effective treatment
7) Treatment should be more effective if treated early
8) There should be a policy on who should be treated
9) Diagnosis and treatment should be cost- effective
10) Case- finding should be a continuous process

Question 3

Examples

Answer 3

• Abnormal aortic aneurysm
• Cancer- including bowel, breast and cervical
• Sickle cell disease
• Feotal abnormalities

Question 4

Routine screening (0-5)
Healthy Child Programme

Answer 4

Includes:

• Health promotion
• Assessment of development
• Screening
• Immunization
• Keeping children safe
• Assessment of child and family needs

Question 5

Routine Screening (0-5)
Newborn and Infant Physical Examination (NIPE)

Answer 5

Within 72 hours and again at 6-8 weeks:

• Examination of the heart, eyes, hips and testes
• General examination and discussion of concerns
• Allows for referral for further assessment

At 5-8 days- heel prick test:

• Hypothyroidism
• Cystic Fibrosis
• Sickle Cell Disease
• Inherited metabolic disorders, including PKU

At birth (or within 2 weeks for a home birth):
Diagnosis of profound or moderate hearing loss. Early diagnosis allows parents to form an effective way off communicating with their child so attachment and development isn't inhibited

Question 6

Universal Proportionalism

Answer 6

A screening programme that is universal but targeted at those most at risk.
eg. Breast Cancer- women aged 50- 70 are invited for a screening

Additional services available for those with specific needs or are more vulnerable group

Question 7

Childhood Injury Statistics

Answer 7

• Estimates that over 630, 000 children under 15 were killed by an injury (WHO)
• 8% of all home-related deaths are caused by an injury
• For every child killed by an injury, several thousand are left with life-long disabilities

Question 8

Injuries vs Accidents

Answer 8

Unlike accidents they do not happen in predictable patterns. Predictable patterns allow for prevention

Question 9

Vulnerability to Injury

Answer 9

• Height
• Sensory ability
• Cognitive skills
• Play
• Risk-taking behaviour
• No political voice
• Environment designed for adults

Question 10

Reducing Injury

Answer 10

Primary- Stopping the injury from happening

Secondary- Reducing the impact of the injury

Tertiary- Reducing disability that results from injury

If injury can be avoided it will significantly reduced the amount of child deaths because it is one of the largest killers, and will also save the government a lot of money that can be invested else where