VLE and SocPop Flashcards
1
Q
What is every child matters?
A
Organise services and resources around children to ensure safety, proper development and improve well-being
2
Q
What is the Local safeguarding children board?
A
Statutory multi agency body
Coordinate and lead child protection activities in an area
Audit and review safeguarding and welfare promoting strategies
3
Q
What did Lord Laming say about doctors involved in the care of a child?
A
All doctors involved in care of a child about whom there are concerns about deliberate harm must provide children’s social care with a written statement of the nature and extent of concerns
Responsibility of doctor to ensure concerns are properly understood
4
Q
What does Good Medical Practice (2006) say on Relationships with patients: Children and young people?
A
Be aware of needs and welfare of children and young people when you see patients who are parents or carers and patients who may represent a danger to children or young people
Safeguard and protect health and well-being of children and young people
Offer assistance to children and young people if you have reason to think that their rights have been abused or denied
5
Q
When communicating with a child or young person you must:
A
Treat them with respect and listen to their views
Answer their questions to the best of your ability
Provide information in a way they can understand
6
Q
What do you do if you suspect a child is at risk of abuse?
A
Sufficient to justify a referral
Consult with experienced colleague (Designated Nurse or Doctor for Child Protection) or line manager if in any doubt
Referral to Children’s Social Services
7
Q
Who are named professionals involved in child protection in hospitals and what is their role?
A
Each Trust has a Named doctor, nurse and midwife to take lead on child protection matters
Responsibilities include education, support and supervision
Appropriate person to contact with any child protection matter
8
Q
Who is responsible for identifying abuse and how might you do this?
A
All those who work with children need to be able to identify signs of abuse or neglect and know what actions to take to safeguard the child’s welfare
Knowing when a child is not developing as would be expected for their age
9
Q
What effect does early intervention have on child protection?
A
Early intervention is vital in ensuring fewer children grow up in abusive or neglectful homes, but also to help as many children as possible reach their full potential
10
Q
What is the common assessment framework?
A
Tool designed to aid assessment of a child’s needs where more than one practitioner is involved in meeting needs
Designed for early intervention end of spectrum of need rather than for children who are at risk of significant harm
11
Q
When is a child in need of protection?
A
Suffering or likely to suffer significant harm which is attributable to not receiving standard of care which it would be reasonable to expect a parent to give them
12
Q
What are factors likely to affect parenting capacity?
A
Substance misuse, domestic abuse and parental mental health concerns can greatly increase the risk of an infant being neglected
13
Q
What signs can indicate neglect?
A
Observing interactions between mother and child and baby’s behaviour in general
A mother who does not engage with her child and a baby who is unnaturally passive
14
Q
What type of attachment is most likely in children that are abused?
A
Disorganised attachment in 80% child abuse cases
15
Q
What does significant harm indicate?
A
Threshold that justifies compulsory intervention in family life in best interests of children
Local authority is under a duty to make enquiries (s47)
A care order or supervision order can be made by the court
16
Q
What is Section 47 (Children Act 1989)?
A
Enquiry initiated by local authority if a child is:
Under an Emergency Protection Order or Police Protection Order
Has or is likely to suffer significant harm
Has contravened a court order
Enables a Child protection plan to be made
Professionals/other agencies have a legal duty to cooperate and provide/share information requested regarding the child and other involved adults
17
Q
What is the aim of the child protection plan?
A
Ensure child is safe & prevent child suffering further harm
Promote child’s health & development
Support family to safeguard the child & promote their welfare
18
Q
What are child protection registers?
A
Contain confidential details of children who are at continuing risk of physical, emotional, sexual abuse or neglect, and for whom there is a child protection plan
19
Q
What is the purpose of Serious Case Reviews?
A
Identify lessons about how professionals and agencies work together to safeguard and promote the welfare of children
Ensure inter-agency working is improved as a result
20
Q
What is a serious case review?
A
Following death or serious injury where child abuse is confirmed/suspected
Child protection issues of major public concern arise
Identify system failures
Identify areas for improvement
21
Q
What did the Munro Review (2011)call for?
A
Called for more effective inter agency working and empowering social workers with skills and confidence to act in best interests of the child
22
Q
What is the most common reason for someone to contact the NSPCC, for a child to be put on the child protection register or to be made subject to a child protection plan?
A
Neglect
23
Q
What does the United Nations convention say on rights of the child?
A
Taking all appropriate measures to protect the child from all forms of
physical or mental violence, injury or abuse, neglect or negligent treatment, maltreatment or exploitation, including sexual abuse, while in the care of parents, legal guardians or any other person who has care of the child
24
Q
What did the NSPCC study on maltreatment show?
A
1/10 young adults experienced serious neglect during their childhood
25
What is neglect?
Persistent failure to meet a child's basic physical and/or psychological needs, likely to result in serious impairment of child's health or development
26
How can neglect occur in pregnancy?
Maternal substance abuse
27
What can neglect involve?
Parent or carer failing to provide adequate food, clothing and shelter Failing to protect from physical and emotional harm
Failing to ensure adequate supervision (including use of inadequate care-givers)
Failing to ensure access to appropriate medical care
Neglect of, or unresponsiveness to basic emotional needs
28
Why is neglect hard to define?
Effects are cumulative, can be difficult for professionals to identify point at which to make referral
Co-exists with other forms of child maltreatment. Boundaries between abuse and neglect can become blurred
29
Which groups of children are vulnerable and particularly at risk of neglect?
```
Children born prematurely
Children with disabilities
Infants
Adolescents
Children in care
Runaways
Asylum-seeking children
```
30
What are factors linked to neglect?
Depression
Domestic violence
Substance use
Poverty
31
Why are children under 1 particularly vulnerable to neglect?
Older children who are not fed properly may be able to find food from other sources but for infants, a lack of nourishment can soon become life threatening
32
What sort of approach is essential in dealing with neglect cases?
Effective inter agency approach
33
What did the NSPCC study on maltreatment show?
1/10 young adults experienced serious neglect during their childhood
34
What is neglect?
Persistent failure to meet a child's basic physical and/or psychological needs, likely to result in serious impairment of child's health or development
35
How can neglect occur in pregnancy?
Maternal substance abuse
36
What can neglect involve?
Parent or carer failing to provide adequate food, clothing and shelter Failing to protect from physical and emotional harm
Failing to ensure adequate supervision (including use of inadequate care-givers)
Failing to ensure access to appropriate medical care
Neglect of, or unresponsiveness to basic emotional needs
37
Why is neglect hard to define?
Effects are cumulative, can be difficult for professionals to identify point at which to make referral
Co-exists with other forms of child maltreatment. Boundaries between abuse and neglect can become blurred
38
Which groups of children are vulnerable and particularly at risk of neglect?
```
Children born prematurely
Children with disabilities
Infants
Adolescents
Children in care
Runaways
Asylum-seeking children
```
39
What are factors linked to neglect?
Depression
Domestic violence
Substance use
Poverty
40
Why are children under 1 particularly vulnerable to neglect?
Older children who are not fed properly may be able to find food from other sources but for infants, a lack of nourishment can soon become life threatening
41
What sort of approach is essential in dealing with neglect cases?
Effective inter agency approach
42
What are key elements of the Human Fertilisation andEmbryology Act 2008?
Unlawful to store or use embryos or gametes except with a license granted by HFE Authority
Requirement for appropriate counselling (includes donated gametes)
Requirement to consider welfare of child born as a result of treatment, and of any other child who may be affected by the birth
Specification of who is legally recognised as mother and father of a child created by IVF
Prohibition of preferential use of gametes or embryos that carry a gene, chromosome or mitochondrial abnormality (or of a particular sex associated with an abnormality) involving significant risk that this child would have or develop a serious physical or mental disability, serious illness, or any other serious medical condition
43
What does the Human Fertilisation and Embryology Act 2008 Permit embryo testing for?
Does embryo have abnormality that will reduce risk of live birth
Risk that embryo will have an abnormality that will result in a serious disability or illness
Risk of gender related abnormalities that will result in a serious disability or illness, sex selection is permitted
Is embryo tissue compatible with a sibling who has a serious medical condition which could be treated with umbilical cord blood, bone marrow or other tissue of resulting child (specifically excludes whole organs under definition of tissue)
44
What ethical principles and values must be considered in IVF treatment with respect to autonomy?
Right to procreate?
Right to choose future child?
Right to make choices to benefit other children?
45
What ethical principles and values must be considered in IVF treatment with respect to duty of care?
Minimising harm
Balancing benefits and burdens
Harm/benefit to who? Future child, parents, existing children
What counts as a harm? physical harm, psychological harm
46
What ethical principles and values must be considered in IVF treatment with respect to societal values?
Fair use of resources (principle of justice): Impact on IVF and PIGD funding (setting limits/criteria)
Limits on individual autonomy: Harm to other individuals (selection for abnormal genes), Discrimination (effect on societal attitudes to specific groups, perception of disability), Respect for persons/human life
47
What is PIGD?
Pre implantation genetic diagnosis
48
What values do people hold with regard to technology and reproduction?
Complex and multi-faceted
Informed by personal circumstances and experiences
Broader cultural and social ideas
49
What is Spinal Muscular Atrophy?
After CF, SMA is most common potentially fatal autosomal recessive inherited condition in UK population
Neuromuscular condition affecting anterior horn cells in spinal cord
Leads to generalised and severe muscle atrophy
Divided into three clinical ‘types’ (Types I-III) each with different prognoses and ages of onset
Carrier frequency between 1 in 40 and 1 in 60 in general population
Two carrier parents have a 25% chance of having a child with SMA, a 50% chance of a child who is an asymptomatic carrier and a 25% chance of a child who is neither affected nor a carrier
50
What Genetic Testing is Available for SMA?
Adult Carrier Status Testing (over 18s)
Prenatal Genetic Testing (for families known to be at risk)
Pre-Implantation Genetic Diagnosis (for families known to be at risk)
SMA not currently screened for in routine antenatal screening, although there have been calls for this to be introduced
51
What are differences between Prenatal Testing and Pre-Implantation Genetic Diagnosis?
Prenatal testing: genetic testing of foetus in established pregnancy. Using Chorionic Villus Sampling (CVS) or amniocentesis between 10 and 15 weeks of pregnancy (depending on what is being tested for)
Pre-Implantation Genetic Diagnosis: alternative to prenatal testing. Genetic testing done at embryonic stage. Embryos created using IVF techniques and those identified as free of a particular condition are transferred to mother’s uterus for gestation
52
What are advantages and disadvantages of reproductive technologies?
Offer parents greater control over reproductive outcomes
Bring up dilemmas and areas where values of clinician and patients may clash (or patient(s) may be conflicted themselves)
53
What are the legal definitions of a child?
UN Convention on rights of the child: A child is
54
What are children's rights?
Right to life, survival and development
Protection rights:(e.g protection from violence, kidnapping, child labour)
Participatory rights: when adults are making decisions that affect children, children have the right to say what they think should happen and have their opinions taken into account
55
What are children's interests?
UNCRC: best interests of children must be primary concern in making decisions that may affect them
Children Act: In any decision made by Court (and by implication others with decision making responsibility) in relation to a child; welfare of child should be paramount concern
GMC 0-18 years: Guidance for all doctors. Assessment of best interests will include what is clinically indicated in a particular case
56
What does the GMC say should be considered with regards to children's interests?
Assessment of best interests will include what is clinically indicated
Views of child or young person including previously expressed preferences
Views of parents
Views of others close to child or young person
Cultural, religious or other beliefs and values of child or parents
Views of other healthcare professionals involved in providing care
to child or young person, and other professionals who have an interest in their welfare
Which choice, if there is more than one, will least restrict child or
young person’s future options
57
Describe how the emphasis of children's rights and interests changes into adulthood
Protection and participation in children
| Becomes self determination and autonomous decision making in adults
58
What does the mental capacity act say on people aged over 16?
Person assumed to have capacity and therefore can consent (need to demonstrate lack of capacity to treat without the person’s consent)
Parental responsibility still in place if aged 16 or 17 therefore a parent can consent
59
What is Gillick competency?
For a particular decision, a young person must:
Show maturity and understand problem, implications, risks and benefits, consequences, alternative options, implications on family
Able to retain information, weigh pros and cons, communicate a reasoned decision about what their wishes are
60
What are the Fraser guidelines?
Specific to contraception, abortion and STI
A doctor could give advice and treatment provided he is satisfied that:
Child (under 16 years of age) will understand his advice
He cannot persuade them to inform their parents or to allow him to inform parents that they are seeking contraceptive advice
Very likely to continue having sexual intercourse with or without contraceptive treatment
Unless they receive contraceptive advice or treatment their physical or mental health are likely to suffer
Best interests require him to give contraceptive advice or treatment without parental consent
61
What advice and treatment on sexual matters (contraception, STIs, abortion) is a medical professional entitled to give to minors?
Any advice on these matters without parental knowledge or consent provided that he or she follows Fraser guidelines
62
What does the Sexual Offences Act say on protection of health care professionals when giving sexual advice or treatment to minors?
They are not guilty of aiding, abetting or counselling commission against a child of an offence if he acts for the purpose of:
protecting child from sexually transmitted infection
protecting physical safety of the child
preventing child from becoming pregnant
promoting child’s emotional well-being by giving advice
63
Children and young persons under 18 years can be treated with the consent of:
Young person (16 or over assumed to have capacity)
Child under 16 if Gillick competent (capacity must be demonstrated)
Someone with parental responsibility
The Court
64
What is over diagnosis?
Correct diagnosis of a disease, but diagnosis is irrelevant because the
disease will never cause symptoms within the patients lifetime
65
What is over treatment?
Unnecessary treatment which does not improve health
66
What is the popularity paradox?
Screen someone with mild form and overtreat them, at end they survive. They tell their friends that it saved their life and then the screening program becomes ever more popular
67
What is a Disease reservoir?
Long-term host of disease
| Often subclinical and so remains asymptomatic and non-lethal
68
What are Incidental findings? And how common are they?
Previously undiagnosed conditions that are discovered unintentionally and are unrelated to the current condition which is being treated or for which tests are being performed
40%
69
What are the Wilson and Jungner Criteria?
Principles and Practice of Screening for Disease, WHO
Condition should be important health problem
Treatment available for condition
Facilities for diagnosis and treatment should be available
There should be a latent stage of the disease
Test or examination available for the condition
Test should be acceptable to the population
Natural history of the disease should be adequately understood
Agreed policy on whom to treat
Total cost of finding a case should be economically balanced in relation to medical expenditure as a whole
Case-finding should be a continuous process, not just a "once and for all" project
70
What questions do the national screening committee ask when making screening decisions?
```
How to define the population?
How frequently to test?
Which test to use?
Which results to use?
How to gain informed uptake?
External pressures
```
71
What antenatal and newborn screening is available in the UK?
```
Down's Syndrome
Fetal Anomaly Ultrasound Scan
Infectious Diseases in Pregnancy
Antenatal Sickle Cell and Thalassaemia
Newborn and Infant Physical Examination
Newborn Blood Spot
Newborn Hearing Screening
```
72
What screening is available for young people adults in the UK?
```
Abdominal Aortic Aneurysm
Diabetic Retinopathy
Breast Cancer
Cervical Cancer
Bowel Cancer
```
73
How can you classify test results?
```
True Positive (TP)
True Negative (TN)
False Positive (FP)
False Negative (FN)
```
74
What is sensitivity?
Proportion of people who have the disease that the test correctly
detects
TP/(TP+FN)
75
What is specificity?
Proportion of people who do not have the disease that the test correctly identifies as not having the disease
TN/(TN+FP)
76
Describe the relationship of sensitivity and specificity to prevalence of a disease
Sensitivity and Specificity measure test performance, and are independent of the prevalence of the disease in the population
Test positive, neither sensitivity or specificity can tell you the probability that you have the disease, as this depends on the prevalence of the disease. Need a positive predictive value for this
77
What measure can be used to predict the probability of disease from population test results?
Positive predictive value
78
What is the positive predictive value?
Probability that a person has the disease given that they have had a positive test result
79
What is the negative predictive value?
Probability that a person does not have the disease given that they have a negative test result
80
What factors are important in deciding whether to implement a screening programme?
Test performance and prevalence of disease
81
If prevalence is reduced what effect does this have on positive predictive value?
PPV is reduced, greater number of people will have to be recalled for further tests to detect each case of disease
82
What are Common Types of Bias in screening?
Healthy Screenee
Length Time Effect
Lead time effect
Overdiagnosis
83
What is healthy screenee bias?
People who attend screening when invited live longer than those that do not, even if the screening test is useless
People who attend screening tend to be healthier than those that don't
People who do not take up invitations are more likely to be smokers, drinkers, have a low income, poor diet, existing medical conditions
Comparisons between self selected screened and unscreened groups are biased
84
What is lead time screening bias?
Screening can detect illness earlier when it is more responsive to treatment and therefore improve survival times
However useless screening can appear to increase survival time by simply detecting the disease earlier but not actually resulting in
longer life
85
What is length time screening bias?
Screening is better at detecting disease that develops more slowly which means that you live for longer
Therefore screen detected disease is likely to have a better prognosis even if it results in no difference in treatment
Screening can detect illness earlier when it is more responsive to treatment and therefore improve survival times
However useless screening can appear to increase survival time by simply detecting disease that develops more slowly but not actually resulting in longer life
86
How can you can define a good teacher?
Content… ‘what she does’: knows the stuff, explains it well, gives tips to help you remember
Process… ‘the way she does it’: cares about the learners, shows
enthusiasm & passion, acts as a role model
87
What are the main domains for motivations for teaching?
```
Transmission
Apprenticeship
Developmental
Nurturing
Social Reform
```
88
What are common theories in medical education?
Knowles – adult learning theory
Vygotsky – social development theory
Bandura – social learning theory – learning in response to experience
Kolb – experiential learning theory – cycle of learning
Grow – Stages of self-directed learning
Schon – reflective practice
89
What is the Adult learners (Knowles) theory?
Adults are internally motivated and self-directed
Adults bring life experiences and knowledge to learning experiences
Adults are goal and relevancy oriented
Adults are practical
Adult learners like to be respected
Learning most effective when: Learner understands reason, Learner has control
90
What is the Vygotsky theory of medical education?
Social development theory & the zone of proximal development
What you learn with help is vastly greater than what you can learn alone: we are designed to learn with others
91
What is Bandura’s social learning theory?
The importance of role modelling
Learners imitate what they experience
4 factors: Attention (they need to see you)
Retention (they need to remember what they see)
Reproduction (they need to be able to act out what they experience)
Motivation (they need to want to)
92
What is Kolb’s learning cycle?
Teaching, like any skill, should involve a process of planning and reflecting so that you continually learn and develop
93
What are the Grow – Stages of self-directed learning?
Dependent learner
Interested learner
Involved learner
Self-directed learner
94
What are the 3 steps to explicit long term memory?
Registration
Retention
Recall
95
How can you make multiple links in memory formation?
Make it relevant and important to you
Make it personal/emotional
‘Play’ with the information in different formats
Make it ‘memorable’/chunk it’/use memory tricks
Rehearse it
96
How do you set aims and objectives?
```
Aims = the ‘WHAT’ what do I want to achieve?
Objectives = the ‘HOW’ steps I will take to achieve the aims
```
97
What is the WHARF mnemonic for learning aims and objectives?
W – What new things will the student be able to do/understand?
H – How am I going to teach that?
A – Assessment: how can I check that they have achieved aims?
R – Rescue: how can I help those who have not yet achieved aims?
F – Fine tuning: How can I review and alter the session for the future?
98
A good teacher/facilitator does what?
Asks good questions
Gets people thinking, facilitates discussion
Listens and observes
Identifies whats known, targets what isnt, teaches new understanding
Helps students understand WHAT they need to know and WHY
Cares about students’ learning: treats them as individuals
Supports contributions of others: makes sure things are not missed
Asks ‘why’, checks underlying understanding
Pays attention to process: who is talking? Who is silent? How are
decisions made?
Addresses any anxieties (makes it safe to speak up and learn)
99
What negative things can disability in a child be associated with?
Limited development and social participation
Poor educational, health and employment outcomes
Pain and sometimes death
100
What is child disability? And how does this differ from impairment?
Results from interactions of an individual’s impairments and conditions with the context of in which they live (physical, social and attitudinal barriers)
Impairment is the bodily, mental or intellectual limitation or
condition
Disability is the loss or limitation of opportunities to take part in society, on an equal basis with others
101
How is disability measured?
ICD10/DSM: some impairments and conditions
Limiting long-standing illness/disability (UK census and Equality Act) Census has questions on impairments
International Classification of Functioning: Children and Youth (ICF-CY)
102
What are the main sources for prevalence data of childhood disability?
Cross-sectional surveys
| Administrative sources e.g. registers of conditions
103
What are data sources for risk factors for childhood disability?
Cross-sectional surveys
Cohort studies of whole populations
Case-control studies
104
Define disability
A person is disabled if they have a physical or mental impairment or condition that has a substantial and long-term effect on their ability to carry out normal day-to-day activities
105
What is the prevalence of childhood disability in the UK?
0.8 million disabled children and young people age 0-18 in UK
6%of all children
106
What types of childhood disability are most prevalent in the UK?
Neurodevelopmental disorders
107
Why are the prevalence estimates for ADHD rising?
Associated with increased recognition and diagnostic practices
108
What are prevalence estimates for autism rising?
Increased awareness, new administrative classifications and diagnostic practices
109
Which is the most prevalent functional impairment experienced by disabled children?
Memory, concentration and learning
110
What factors can be associated with childhood disability?
Impairments/conditions resulting from purely genetic or purely social/environmental conditions are rare
Most result from social and genetic factors coming together in complex ways, often across generations
Importance of the lifecourse
111
What are some common risk factors for childhood disability?
```
Pregnancy outcomes (birthweight and prematurity)
Age
Sex
Ethnicity
Socio-economic disadvantage
Parental behaviours
Communicable diseases
Unintentional injuries
```
112
What effects can pregnancy outcomes have on childhood disability?
```
Low birthweight: cerebral palsy, reduced cognitive function, epilepsy
Premature births (born before 37 weeks gestation): 7% of babies born prematurely, extremely premature babies (born before 25 weeks gestation) greater risk of poor health outcomes and neurodevelopmental disabilities than babies born at term
```
113
What changes to pregnancy outcomes have been seen recently?
Increased survival rates, preterm births -improvements in neonatal care
EPICure 2 study more children born extremely prematurely (26 weeks or less) are surviving disability free
But no reduction in proportion of children at age 3 years with moderate or severe impairments/conditions
EPICure 1 study: children born in 1995, at age 11 years, more than half have no or only minor impairment
114
What effect can sex have on risk of childhood disability?
Prevalence of all-cause disability higher in boys in early years but by late teens prevalence for girls is similar to boys
Neurodevelopmental disabilities more common in boys
May be associated with genetic differences, under-identification in
girls due to diagnostic characteristics
115
What effect does ethnicity have on the risk of childhood disability?
Studies controlling for socio-economic status found increased risk for all-cause disability among children of mixed ethnicity and African/Caribbean origin
Neurodevelopmental disability: 7-15 year olds, lower in minority ethnic groups
Exceptions: higher rates of less severe intellectual disability among Gypsy/Roma and Traveller children of Irish heritage
More severe forms of intellectual disability among Pakistani and Bangladeshi heritage
116
What effect does low socio economic status have on the risk of childhood disability?
Prevalence of disability increases as socio-economic status decreases
Systematic review of high income countries: odds of having intellectual disability 2 times greater for children in low SES households, than children in high SES households
117
Socio-economic disadvantage and disability: what is the link?
Exposure to socio-economic disadvantage in childhood predisposing factor for later onset of a disabling impairment/condition
Children in low SES households more exposed to social and environmental risk factors in prenatal and early childhood periods:
poverty, poor nutrition, unsafe housing, environmental pollutants, hazards, infections, unintentional injuries and negative parental behaviours
118
What effects can parental behaviours have on risk of childhood disability?
Parental smoking associated with low birthweight, preterm birth and autism
Alcohol consumption associated with reduced growth before and after birth, educational outcomes, fetal alcohol syndrome
Unsupportive and unstimulating parenting linked with intellectual disabilities and conduct disorders
Many parental behaviours associated with poor health outcomes are linked to poor personal and household resources
119
What effect do communicable diseases on risk of childhood disability?
Rubella and other infections acquired during pregnancy
Measles and mumps acquired later in childhood
Greatest risk for children not immunised: not registered with a GP, looked after children, some minority ethnic children
120
What effect do unintentional injuries have on the risk of childhood disability?
Unintentional injuries can lead to childhood disability
Risk increases as children get older
At all ages, children in poorer households and neighborhoods at
greater risk
121
Describe Leavell and Clarks 3 levels of prevention
Primary Prevention: Pre-Disease, Preventing a disease/impairment in the first place
Secondary Prevention: Latent Disease or Early Stage of Disease, Find and treat disease/impairment early,in order to halt/slow progression
Tertiary Prevention: Symptomatic Disease. i.e. with irreversible
disease or disability. Manage associated health problems of disease to prevent further deterioration, achieve high a level of functioning as possible, maximise quality of life
122
What are issues with primary preventions used to reduce childhood disability?
Talk of reducing incidence of preventable impairments/conditions sometimes seen as contentious, associated with devaluating lives of disabled children
But child disability can be associated with pain and restrictions
Ethical reasons to reduce preventable impairments/conditions
123
What primary prevention measures are likely to contribute to reducing the prevalence of child disability?
Strategic interventions at national and local levels to:
Reduce socio-economic disadvantage across life course: living wages, employment and adequate welfare benefits
Improve material environments: safe, healthy housing, schools, workplaces
Reduce exposure to environmental hazards: air pollutants, environmental, industrial pollutants, lead
Reduce exposure to parental and other sources of environmental
tobacco: smoke in utero, infancy and childhood
Promote safe alcohol consumption in pregnancy
Ensure adequate dietary intake of key nutrients: folic acid, vitamins and minerals, among women of childbearing age to protect against neural tube conditions and other consequences of vitamin deficiency. Vulnerable groups may require supplementation around time of conception
Achieve population coverage of immunisation against common
communicable diseases: rubella, sufficient to ensure herd immunity to protect both foetus from pregnancy-acquired infection and children against complications of diseases
124
What current secondary preventions are in place for antenatal and newborn screens?
Hepatitis B, HIV, syphilis, susceptibility to rubella
Sickle cell and thalasseamia
Developmental dysplasia of hip, eye disease, congenital heart disease Phenylketonuria, congenital hypothyroidism, medium chain acyl-CoA dehydrogenase deficiency
Hearing
Vision - Childhood
125
What things can lead to early identification of child disability? Besides screening
Developmental assessments (Healthy Child Programme)
Parents
Contact with other services (non-health)
126
What is sociology?
Understand how society works
Provide insights into forms of relationship, formal and informal, between people
Understand how relationships form fabric of society including social groupings and institutions
Explain how people recognise social groupings and institutions and orientate themselves (their wants, needs, desires and actions) with them
127
What does sociology bring to the evaluation of complex interventions?
Understands complex interventions as: Socially constructed, Embedded in a social context Influenced by how society works
Provides insights into: lived experience of illness and health care, negotiation of illness within society
Identifies and explains social determinants of health
Methodology
128
Describe complex intervention development from a sociology perspective
Experience of illness
Meaning of illness and health care
Why people do/don’t do what health professionals think is right?
Why don’t people get better when health professionals think they should?
Gendered nature of experience of illness and care giving
129
Describe sociology process evaluation
Context – where and when intervention implemented?
Reach – of target population, who received intervention?
Dose Delivered – what do those providing intervention think they delivered; what is observed to be delivered (fidelity)?
Dose Received – what was received by those to whom intervention was delivered (e.g. did they read manual, did they understand message in the educational materials, did they engage with group in the therapy session)?
Impact – what was the impact of the intervention – beyond the main outcomes (including unintended impacts)?
130
Describe how you can evaluate context in sociology
Describe local community from census data
| Understand the organisational context
131
How can you measure the dose delivered in a sociology process evaluation?
Observation
132
How can you measure the dose received in a sociology process evaluation?
Interviews
133
How can you measure the impact in a sociology process evaluation?
Standardised questionnaires
Standardised observation
Interviews
134
What are qualitative methods of data collection?
Observation: context and actions
Talking: interview, conversation during observation – experience, understanding, meaning
Documents
135
What is a mixed method of data collection?
Qualitative and quantitative data in same study
Consecutive
In parallel
Qualitative analysis of quantitative data
Quantitising qualitative data
136
What aspects of qualitative sampling are key for research?
Include the diversity of population/settings
Sampling continues to data saturation: only appropriate if sample is appropriately diverse
Methods of sampling as appropriate to research setting e.g. random, consecutive
137
What is reflexivity and how can we achieve it in qualitative research?
Consider influences:
on data sources e.g. social desirability bias
on our analysis e.g. preconceptions
Involve a research team including interested lay people
138
How do we analyse qualitative data?
Close reading of the data
Coding data (identifying data that is about thesame thing)
Comparison across qualitative dataset
Comparison with existing theory/published research
139
What is a qualitative to quantitative analysis?
Comparison across qualitative data set
Development of categories
Categorisation of cases (people, events)
Use of categories as variable in quantitative analysis
140
What 3 domains are identified on the “CAF triangle”?
Child’s developmental needs
Parenting capacity
Family and environmental factors
141
Identify 3 factors that can impact on parenting capacity
Parental substance misuse
Domestic Violence
Parental mental health
142
What is a LSCB?
Local Safeguarding Children Board
143
How is abuse categorised?
Physical
Sexual
Emotional
Neglect
144
What category of abuse is usually always present?
Emotional
145
Who should the referral be made to if abuse is suspected?
Children's social services
146
The local authority has a duty to make enquiries if a child is likely to suffer significant harm, is under an Emergency protection Order or a court order has been contravened. What is this called (under the Children Act 1989)?
Section 47
147
What category of abuse is the most common reason for a child to be made subject to a Child Protection Plan?
Neglect
148
What 4 things should you ensure when you communicate with children?
Treat them with respect
Listen to their views
Answer their questions (to the best of your ability)
Provide information in a way they can understand
