Chris Bowling

36 timestamped statements across 1 collection — auto-found in recorded discussions, each timestamp jumps to the exact moment.

Featured diaries

▶ Ep 2 · 12:10
Doctor Bowling, that's great. Um, I'm more worried about my child getting shot when they walk out the door rather than them getting exercise to be at a healthy weight.
quote · Pediatric Obesity
▶ Ep 2 · 25:10
You know, I just, I can't even imagine trying to screen for some of these things in the midst of all the other things I'm asked to do as a pediatrician.
quote · Pediatric Obesity

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Pediatric Obesity 36 entries

Social Determinants of Health: Pediatric Obesity 2017

▶ Ep 2 · 4:00
epidemiological Age-standardized mortality rates show clustering of respiratory disease deaths in eastern Kentucky and southern West Virginia coal-mining areas. ↗
▶ Ep 2 · 4:40
epidemiological Cardiovascular disease mortality is very high in the Mississippi Delta region (Arkansas, Tennessee, Mississippi, Louisiana border) and in Appalachia. ↗
▶ Ep 2 · 5:40
epidemiological Eastern Kentucky and southern West Virginia are the epicenter of the current heroin outbreak, with staggering rates. ↗
▶ Ep 2 · 6:10
opinion The heroin epidemic in the Ohio River Valley resulted from a distribution network encountering a population primed by the prescription drug epidemic. ↗
▶ Ep 2 · 6:40
epidemiological Cancer mortality rates are very high in the Mississippi Delta and Appalachia, possibly tied to chronic respiratory illness. ↗
▶ Ep 2 · 7:30
epidemiological Areas with high mortality from multiple diseases (respiratory, cardiovascular, cancer, infections) have a distribution similar to areas affected by pediatric obesity. ↗
▶ Ep 2 · 8:00
epidemiological Common infections (pneumonia, diarrhea) show geographic clustering tied to socioeconomic status, similar to obesity and oral health. ↗
▶ Ep 2 · 10:50
clinical The ACEs (adverse childhood experiences) study was developed in 1997 by Felitti and Anda in San Diego, starting as a dropout study from an obesity treatment program. ↗
▶ Ep 2 · 11:30
clinical Patients succeeding in the obesity program were dropping out at rates equal to those struggling, prompting investigation into other life factors. ↗
▶ Ep 2 · 12:10
quote Doctor Bowling, that's great. Um, I'm more worried about my child getting shot when they walk out the door rather than them getting exercise to be at a healthy weight. ↗
▶ Ep 2 · 14:10
clinical The ten adverse childhood experiences (ACEs) are: physical abuse, sexual abuse, emotional abuse, physical neglect, emotional neglect, mother treated violently, household substance abuse, household mental illness, parental separation/divorce, and incarcerated household member. ↗
▶ Ep 2 · 15:50
epidemiological In families with ACEs, there are increases in smoking, substance abuse, obesity, diabetes, heart disease, stroke, and cancer. ↗
▶ Ep 2 · 16:20
epidemiological Even when controlling for behavioral factors (obesity, smoking, substance abuse), children exposed to ACEs still had higher rates of diabetes, heart disease, stroke, and cancer. ↗
▶ Ep 2 · 17:00
epidemiological Children exposed to ACEs had shortened life expectancy even when controlling for behavioral risk factors. ↗
▶ Ep 2 · 17:30
epidemiological In the ACEs study population, 67% of families reported at least one ACE, 40% had two or more, and 12.5% (1 in 8) had four or more. ↗
▶ Ep 2 · 18:10
epidemiological The effects of multiple ACEs are more than additive—they are almost multiplicative, with profound health impacts as the number of ACEs increases. ↗
▶ Ep 2 · 19:40
clinical Chronic activation of the fight-or-flight response—persistent elevation of epinephrine, cortisol, norepinephrine—has real physiologic consequences over a lifetime. ↗
▶ Ep 2 · 20:40
clinical Toxic stress causes neuronal desensitization and altered neuronal response. ↗
▶ Ep 2 · 21:00
clinical Toxic stress affects the hypothalamic-pituitary-adrenal axis and other parts of the endocrine system. ↗
▶ Ep 2 · 21:20
opinion Overstimulation by norepinephrine, epinephrine, and cortisol may affect leptin resistance and insulin resistance in children with obesity. ↗
▶ Ep 2 · 21:50
clinical Toxic stress decreases the ability to fight off infection and changes immune modulation. ↗
▶ Ep 2 · 22:30
clinical Living in a stressful situation changes gene expression through epigenetic mechanisms—methylation and histone modification—that can result in adverse health outcomes. ↗
▶ Ep 2 · 23:20
clinical Epigenetic changes from toxic stress have profound impacts on development, aging, mental health, diabetes, and cancer. ↗
▶ Ep 2 · 24:10
clinical Social determinants of health can be used as proxy questions to screen for adverse childhood experiences and categorize families by risk. ↗
▶ Ep 2 · 25:00
opinion Barriers to ACEs screening in pediatric practice include provider concerns about parent pushback, time constraints, lack of resources to address identified problems, and poor reimbursement. ↗
▶ Ep 2 · 25:10
quote You know, I just, I can't even imagine trying to screen for some of these things in the midst of all the other things I'm asked to do as a pediatrician. ↗
▶ Ep 2 · 25:40
quote OK, I've uncovered that the mother is in an abusive relationship. Now, what do I do? I have no resources to deal with this. ↗
▶ Ep 2 · 27:00
clinical Bowling's practice partners with Beech Acres Parenting Center, which provides an in-office parenting specialist to counsel families, connect them with resources, and teach behavioral techniques. ↗
▶ Ep 2 · 28:20
clinical The SEEK (Safe Environment for Every Kid) screening tool from the University of Maryland is used at 1-month, 9-month, 2-year, and 3-year well-child visits in Bowling's practice. ↗
▶ Ep 2 · 30:00
clinical Food insecurity is directly connected to adverse childhood experiences and is one of the more commonly answered questions on the SEEK questionnaire. ↗
▶ Ep 2 · 30:40
opinion Unstable or variable housing impacts the ability to maintain healthy food environments and to maintain contact with families in obesity care. ↗
▶ Ep 2 · 31:40
epidemiological The original ACEs study population was 70% white, 70% college-educated, and 100% insured, demonstrating that ACEs are not limited to low-income populations. ↗
▶ Ep 2 · 32:30
epidemiological In Bowling's suburban practice, 10–15% of the population screens positive for adverse childhood experiences on the SEEK tool at a single point in time. ↗
▶ Ep 2 · 33:40
clinical Nadine Burke Harris is a developmental specialist at UCLA who gave a 16-minute TEDMed talk on toxic stress and ACEs. ↗
▶ Ep 2 · 36:20
quote This is all well and good, but you have no idea what I'm dealing with at home. ↗
▶ Ep 2 · 37:40
opinion Motivational interviewing skills are useful for asking ACEs screening questions in a non-threatening way and getting to the root of family issues. ↗