04 Children and youth in alternate care
Notice bibliographique
Résumé
Abstract Background Children in alternate care often face unmet medical, emotional, and developmental needs due to a range of factors, including poverty, prenatal drug exposure, parental mental illness, and domestic violence, which are compounded by inconsistent supervision and care. While the overall paediatric population is declining, the number of children in out-of-home care is increasing in our province. In response to this, the CAYAC clinic was established in September 2019 and, as part of the provincial government’s healthcare strategy, was expanded to full-time operation in 2024. This multidisciplinary clinic, staffed by paediatricians, allied health professionals, and in-care social workers, provides trauma-informed care for children and youth referred by social workers, family doctors, and paediatricians. The clinic is also supported by ongoing research, evaluation, and paediatric resident training. Objectives The aim of this study was to describe the demographic characteristics, quantify the medical, developmental, and mental health conditions and analyze risk factors associated with children/youth in alternate care who are referred to this new outpatient service. Design/Methods A cross-sectional study was conducted involving children and youth aged 0 to 17 years who attended their first appointment at the CAYAC clinic between September 2019 and September 2021. Results Data from the first 103 patient charts revealed that all the children experienced at least one type of abuse, with neglect and emotional abuse being the most common (68.9%). Care types included interim (24.3%), temporary (25.2%), continuous (29.1%), and other (21.4%). Placement types were non-relatives (50.5%), relatives (26.2%), group homes (17.5%), and other (5.8%). Most children attended school (70.9%) or daycare (88% for children under 5 years old). Common identified conditions and issues included sleep disturbances (60.7%), nutritional problems (37.9%), gastrointestinal/neurologic issues (25.2% each), aggression/behavioral challenges (45.6%), ADHD (43.7%), and developmental delays/intellectual disabilities (30.1%). Medication use ranged from none (24%) to three or more medications (26%), with stimulants being the most common. Risk factors associated with increased time in placement were older age (p=0.0003), increased number of ACE’s (p=0.0271), type of placement (living in a group home; p=0.0042) and higher BMI percentile (p=0.0446). Going to school was associated with shorter time in care (p=0.0331). Conclusion The clinic has received approximately 500 new referrals and has attended approximately 5,000 appointments with children and youth presenting with complex needs and developmental trauma. As service demand grows, the clinic plans to expand provincially and improve facilities. Future steps include securing funding for additional staff and expanding services to meet the increasing need.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,001 | 0,000 |
| Communication savante | 0,001 | 0,000 |
| Science ouverte | 0,000 | 0,001 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,009 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».