PAEDIATRIC SCHOOL OUTREACH: DEMOGRAPHICS AND CLINICAL NEEDS OF A UNIQUE INNER-CITY STUDENT POPULATION
Bibliographic record
Abstract
Abstract BACKGROUND Paediatric School Outreach (PSO) clinic is a school-based health centre housed in a Kindergarten-Grade 8 public school. It serves an inner-city community impacted by the social determinants of health, such as language and income, which are barriers to accessing health care. This clinic focuses on developmental/behavioural, mental health and educational concerns. OBJECTIVES To characterize demographics, social determinants of health and some clinical characteristics of patients accessing services at PSO. By gaining a better understanding of the challenges of patients, services may be tailored to better suit patient/family needs. DESIGN/METHODS We conducted a retrospective chart review of children enrolled at PSO from November 2015 to March 2017. Data were obtained from demographic questionnaires and the electronic medical record. Analyses were performed in Microsoft Excel and SPSS (version 23) and are primarily descriptive. This work was funded by a faculty of medicine student research program and approved by research ethics boards at our hospital and school board. RESULTS 138 children, between the ages of 2 and 15 years (average birth year 2008) enrolled at PSO during the study period. 73% were male. 70% of patients were in Grade 1 or above at enrolment. Children tended to be Canadian born to immigrant mothers; 74% of children were born in Canada but only 34% of mothers were also Canadian-born. After Canada, Hungary was the second common maternal place of birth (12%). English was the most common language spoken by patients (71%), followed by Hungarian, Tibetan, Portuguese and Spanish. 58% of patients’ families had a household annual income (HAI) of <$30,000 and 18% a HAI of $30,000–49,999. 84% of 138 patients reported having a family physician. Referrals were made by school support team (54%), teacher (36%) or principal (28%). The common presenting concerns were behaviour (81%), school performance (60%), followed by social communication (51%) and emotional presentation (49%). Among 132 patients with clinical records, 13% were on any medication at enrolment; and 3% (4/132) on psychostimulants. 14% of patients were started on medication during the study period, most frequently psychostimulants (11%, 15/132). CONCLUSION PSO patients are culturally diverse and at least three quarters have HAIs below our city’s median of $65,829 (2015). The majority reported having a family physician but accessed our clinic for educational/behavioural concerns, suggesting PSO may be a stream-lined approach. With knowledge of maternal languages, we can begin to translate questionnaires and clinic materials. Further data analyses will better describe diagnoses and referrals made at the clinic.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".