151 What Do We Mean When We Say “Social Paediatrics?”: Preliminary Results from a Critical Discourse Analysis
Bibliographic record
Abstract
Social paediatrics provides an orientation to the provision of healthcare that enables learners and practitioners to better identify the social determinants of health (SDH). Its lens helps paediatricians understand how SDH impact the health of certain children and families more so than others, and how these effects might be taken into consideration when providing care. Social paediatrics, however, remains a somewhat vague term with many interpretations. By applying a critical discourse analysis lens to study “social paediatrics,” it is possible to uncover the variable ways in which the term is used as well as how specific ideas about SDH are reinforced through educational and clinical practices. By identifying the operant discourses underlying social paediatrics, we aimed to elucidate the inherent assumptions and values of different ways in which the term is used. Our goal is to use this data to inform the development of robust curricula and workplace-based training in paediatrics. We conducted a critical discourse analysis upon an archive of texts linked to “social paediatrics.” An initial literature search, combined with a secondary search that used expert-identified keywords, retrieved an archive of 238 articles. Five of these articles were purposively chosen to generate an initial thematic framework, which was then applied to the remaining articles. Critical discourse analysis of the first 75 articles was iteratively performed with the intent of identifying discrete discourses and their possible intersections. We are in the process of reviewing the remaining 163 articles in reference to the established analytical framework. Three major discourses have been identified thus far. First, social paediatrics is conceptualized as paediatrics itself. This discourse operates primarily at an individual level, and maintains that all paediatricians must act as social paediatricians. Second, social paediatrics may be understood in relation to “glocalization”; global health is directly tied to local, community health. In this discourse there is an inherent assumption that globalization will improve how we approach paediatric issues. Lastly, social paediatrics is conceptualized as a multidisciplinary practice. Through this discourse, collaboration between healthcare professionals is necessary, though the exact role of the paediatrician in this collaboration is unclear and may cross into the traditional domains of other professions. Preliminary research suggests that “social paediatrics” operates within an ill-defined, liminal area between geographical spaces and throughout healthcare professional practices. Furthermore, concepts of advocacy and community are woven throughout these definitions and, similar to the emergent discourses, find expression in variable educational and practice spaces.
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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 | 0.096 | 0.244 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.002 | 0.002 |
| Bibliometrics | 0.013 | 0.014 |
| Science and technology studies | 0.008 | 0.015 |
| Scholarly communication | 0.014 | 0.013 |
| Open science | 0.003 | 0.008 |
| Research integrity | 0.003 | 0.004 |
| Insufficient payload (model declined to judge) | 0.004 | 0.001 |
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".