Screening is the process of examining a whole population to determine who is showing signs of having a particular condition or disease and who may develop or be liable to a condition or disease. Screening in the UK is available for every child, with the consent of their parents. Screening is important because it enables early intervention where a problem is confirmed and keeps parents informed about their child’s progress or likely progress. Also it highlights the needs for specific areas of stimulation for a child to meet their potential and raise awareness for the future and allows informed decisions to be made, with or without genetic counselling.
There are three main causes of illness: microbiological causes (when a micro-organisms or germ enters the body), genetic causes and environmental causes. Germs which enter the body and cause illness are called micro-organisms, and these are divided into four main groups which are bacteria, viruses, fungi and parasites (which include protozoa). Some germs are non-pathogenic and aren’t harmful to humans, e.g. the lactic acid bacillus which turns milk into yogurt, and the organisms that live in the bowel which manufacture Vitamin K which is essential in the blood clotting process. Diseases caused by microbiological factors are:
· Chickenpox
· Measles
· Gastro-enteritis
· Earache
· Vomiting
· Diarrhoea
· Appendicitis
· Threadworms
· Diabetes (type 1)
· Diabetes (type 2)
Some genetic conditions, such as stickle cell disease, can cause ill health. Sometimes ill health may be caused by microbiological or genetic factor, but then made worse by the environment. For example, a child with sickle cell can be made worse by getting too cold. Diseases caused by genetic factors are:
- Asthma
- Eczema
- Cystic Fibrosis
- Haemophilia
We generally have less control of environmental factors, because they are often organised at national level. In 1998 the Committee on the Medical Effects of Air Pollutants published a report stating that air pollution is thought to shorten about 24,000 lives a year. This can be caused directly by pollutants in the air or by contributing to respiratory problems. Sewage and waste control is essential for community. Illnesses caused by environmental factors are:
- Coughs and colds
- Eczema
- Asthma
- Earache
- Dehydration
Chickenpox is an example of a disease caused by microbiological factors. It is a viral infection called herpes zoster, spread by droplet infection. Measles is a highly contagious virus with a distinctive rash and be a serious condition. It is caused by RNA-containing paramyxovirus, spread by droplet infection. Gastro-enteritis is caused by bacteria and viruses and can be spread in food due to poor hygiene during food handling. Also it can be spread by direct or indirect contact. Earache is mainly caused by microbiological factors but can be caused by the environment. Earache is largely due to problems in either the outer ear (from the earlobe to the ear drum) or the middle ear (behind the ear drum). In some cases, problems in the throat or mouth, such as tonsillitis, can also cause earache. Vomiting usually implies inflammation of the stomach, associated with an infection. Most commonly this is viral in origin and passed on like colds and influenza, but occasionally it may be due to contaminated food. Diarrhoea is usually caused by inflammation of the large intestine, which is where the body removes most of the fluid from digested food. The major cause, in the context that we are referring to, is infection, but there are various other rarer causes which occasionally occur.
Appendicitis is inflammation of the appendix, a small pouch attached to the cecum, the beginning of the colon, on the lower right side of the abdomen. If untreated, an inflamed appendix can burst, causing infection and even death. The cause of appendicitis is usually unknown. It may occur after a viral infection in the digestive tract or when the open connecting the large intestine and appendix is blocked. The inflammation can cause infection, a blood clot, or rupture of the appendix. Because of the risk of rupture, appendicitis is considered an emergency. Threadworm or pinworm (Enterobius vermicularis) is a small, white, thread-like worm between 2.5 and 12mm long. Female threadworms produce large numbers of tiny eggs, which are invisible to the naked eye. The female lays these eggs outside the anus, usually in warm conditions, such as when the host is asleep; inactivity promotes movement of the female to the anus. The female secretes mucus, which causes intense itching and promotes scratching by the host. Re-infection occurs when eggs are ingested either from contaminated hands or food. Diabetes mellitus is an endocrine disorder in which the pancreas does not make enough insulin. Insulin helps the body to use and store sugar. When it is not used efficiently the sugar overflows into the urine. It is often triggered following a severe viral infection and is not an inherited condition, but there is familial trait to diabetes. Diabetes type 2, also known as non-insulin dependent diabetes mellitus (NIDDM), or adult onset diabetes in this type of diabetes there is both a state of insulin resistance and a defect in insulin production.
An asthma attack can be caused by a variety of ‘triggers’ such as:
- Infections
- Going out into the cold air
- Cigarette smoke
- Exercise
- Excitement or stress
- Fumes (such as from smoke)
- Allergies to animals
- Allergies to pollen or dust
- Food allergies
Many children with asthma belong to families where allergies are common. Eczema is a reaction to a ‘trigger factor’. These triggers vary between individuals, with common causes being dairy produce, washing powders and soap. It can also be triggered or worsened by stress or excitement. Cystic fibrosis is inherited as an autosomal recessive condition. Approximately 1 in 2,000 children has cystic fibrosis. It is more common in some ethnic groups than others. The highest incidence is seen in Caucasians (light-skinned people of European, North African, South West Asian and Indian origin). It is rare in families of African-Caribbean origin and almost non-existence in people of Far Eastern origin. Haemophilia is a blood condition in which an essential clotting factor is either partly or completely missing. This causes a person with haemophilia to bleed for longer than normal. Coughs and colds are caused by viral infections and are spread by droplet infection. Coughs can also be part of another condition, such as bronchitis or pneumonia. Dehydration occurs when the amount of water in the body falls below normal, which, in turn, disrupts the balance of sugars and salts (electrolytes) in the body. Many factors can lead to dehydration, including vomiting or diarrhoea, bleeding, certain medications and a variety of diseases.
Chickenpox may be prevented by:
· Stay away from others especially pregnant woman and newborn babies.
· Vaccine. This is not used in all countries. It can be given as a protective measure to immunocompromised people, especially children with leukaemia or organ transplants.
Measles can be prevented by:
· MMR vaccine at 12 to 15 months, booster given before children start school.
Coughs and colds can be prevented by:
· Keeping away from crowded, enclosed or stuffy places.
· Good hygiene.
Eczema may be prevented by:
- Use the cream or ointment which your doctor recommends on a regular basis, and as a soap substitute, to keep the skin supple and to prevent drying.
- Avoid scratching when you itch. If you can not stop yourself, then gently rubbing, with the flat of your hand, is less likely to do damage.
- Avoid exposure to chemicals and strong detergents. It is usually better to avoid using biological agents altogether. Use protective gloves when you use such things in the house or at work.
- If you have been found to be allergic to a specific substance, avoid contact with it, if this is possible.
- Use your treatments according to the instructions from your doctor, and the pharmacist.
Gastro-enteritis can be prevented by:
- Frequent hand-washing
- Prompt disinfection of contaminated surfaces with household chlorine bleach-based cleaners.
- Prompt washing of soiled articles of clothing.
- If food or water is thought to be contaminated, it should be avoided.
- No immunisation.
- Own hygiene equipment.
Asthma can be prevented by:
- If possible avoid known triggers of asthma.
- Cover all beds with protective covering that does not allow the house dust mites to come through. It is also more hygienic because it can be easily wiped clean.
- Vacuum regularly with a vacuum cleaner with an efficient micro filter. If possible do this daily, including the mattress (if it doesn’t have a protective covering) which is where the house dust mites breed. It is better if the person who suffers from the asthma does not have to do this, as even with a high efficiency filter the actual process of vacuuming stirs up dust in the room air.
- Inhalers
Cystic Fibrosis can be prevented by:
- No prevention but is hoped that gene therapy may someday be used to prevent the disease from developing.
Haemophilia can be prevented by:
- Understanding the form of inheritance
- Unfortunately, nothing can be done to prevent spontaneous changes occurring in the genes that code for the clotting factors.
The early year’s worker and other professionals help to alleviate the negative effects of socio-economic factors in many ways. Children whose parents receive Income Support, Income-based Job Seekers Allowance, or support under Part VI of the Immigration and Asylum Act 1999 are entitled to free school meals. Children who receive these benefits in their own right are also entitled to school meals. It can be argued, from the evidence presented, the school is therefore giving them at least one decent balanced meal a day which helps them get the nutrients they need. Also the school allow the children to exercise during break times and when they have a physical education lesson which makes them more healthy and fit. The government can ensure catering and leisure professionals are trained in healthy eating and physical needs, providing the children with the best care. Local players can improve access to a variety of affordable food in deprived areas and provide facilities for physical education and relaxation and decent transport to help people get to them.
School nursing provides a vital role in promoting and protecting that health – by working with the whole school community, forming partnerships with parents/carers, school staff, and other healthcare professionals to create the best environment possible for children. I think children will get screened and immunised meaning illness can be caught early and treated. The government can encourage doctors and nurses and other health professionals to give advice on healthier training.
The government can improve areas of deprivation through urban regeneration and tackle social exclusion and joblessness. Some areas have the Sure Start Scheme which aims to help people in deprived areas to get out and socialise more.
The Sure Start Scheme, were central government has allocated £1.4 billion throughout the Department of Health, Education and Social Security to target 500 ‘high need’ deprived areas and improve local community services for families and young children. I have experienced the Sure Start Scheme myself and think it is a good scheme which should be developed more throughout the country. Yeo (2002) states that the Sure Start Initiative is a policy which is specifically aimed at ‘multiple problem’ families, these may include poor health, deprived living conditions low education attainment, unemployment, social problems such as, alcohol, physical or drug abuse or lack of local amenities. Even though I think this is a good scheme, I think it should be open to everyone for them to interact and develop the social skills no matter what class or background they come from. The Sure Start Scheme is mainly funded by central government and expects local authorities to work in ‘partnership’ with the statutory services such as health, education, and social services departments and local ‘private’ businesses, charities (Kidscape, The Children’s Fund and the NSPCC are examples) and training organisations who make up the ‘mixed economy’ of service provision and contribute as service providers.
These agencies ‘work together’ to provide a range of local services some of which include family support, childcare facilities, training courses for adults to enable them to return to work, help and advice on parenting (parenting plus course), adult Literacy and Numeracy classes, computer courses, and a range of ‘other’ courses to improve awareness and skills in a range of different areas. I think all these services help provide the adult and their children with a better and brighter future.
Bibliography
BUTTLE J NOTES, 14th October 2002
BUTTLE J NOTES, 11th November 2002
BUTTLE J NOTES, 18th November 2002
BUTTLE J NOTES, 25th November 2002
GREEN S, (2002) BTEC National Early Years, Cheltenham, Nelson Thornes.
YEO A and LOVELL T, (2002) Sociology and Social Policy for the Early Years, 2nd Edition, London, Hodder and Stoughton.