G&D Study Guide Part I

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G&D Study Guide Part I
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2013-12-17 09:56:40
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Toxins, adolescent psychosocial
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  1. 1. What does adequately preparing for pregnancy entail? (4)

    2. How many pregnancies are intended?

    3. What are common biomarkers of exposure for paternal effects? (5)

    4. What are some things that affect sperm count, mobility, and morphology?
    (1) Early periconceptional education/care (2) aiming for biological maturity (3) ending bad habits (smoking, drinking, drugs) (4) controlling chronic disorders

    2. 43%

    3. Sperm count, velocity, % mobility, % viable, % w/ normal morphology

    4. Radiation, lead, dibromochloropropane (sterility), (DBCP), ethylene dibromide
  2. 1. What are important determinants of exposure's effects (5)

    2. What are routes of exposure overall? (4)

    3. How do noxious substances get into food and drink? (5)
    1. Routes of entry, timing during development, dose & chronicity, concurrent or multiple exposures, genetic vulnerability

    2. Digestive tract, lungs, eyes, skin

    3. Natural toxic substances (mushroom poisons, fava beans, goitrogens)

    Intentional contaminants (pesticides, additives, salts)

    Environmental contaminants: not intended for food water - dioxins/furans, PCBs, PBDEs, pththalates, benzene, Hg, Pb, As

    Toxic ingredients created/added during preparation: PAHs, heterocyclic amines, aflatoxin, Pb, Hg, As, Tn, Cu

    Added substances not recognized as potentially hazardous: coumadin, phytoestrogens, Ma-Huang
  3. 1. Are natural products/herbals necessarily safe?

    2. Does timing of exposure matter?

    3. What does timing determine? (5)

    4. Gametogenesis vs. spermatogenesis. 

    5. When is ovarian damage greatest in girls from chemotherapeutic agents?
    • 1. No
    • 2. yes

    3. Reversibility of effects, is structure/metabolism/functions are affected, if effect is on mother, or on child, if it will affect child's development only later on in life

    4. Gametogenesis occurs prior to birth, while spermatogenesis requires 87 days

    5. After puberty
  4. 1. When is the death of the embryo/spontaneous abortion common?

    2. What are the 3 stages of pregnancy and typical effects? 

    3. What are examples from the past? (5)
    1. First 2 weeks after conception

    2. Preimplantation (fetal loss), embryogenesis (imp - 55 days; fetal loss, structural/developmental defects), fetal period (55 days to birth) - abnormal growth, functional defects, behavioral defects

    3. Alcohol, DES, DDT, PCBs (never intended for food/distribution), PAHs (from food and on-food sources)
  5. 1. How does alcohol consumed in the 1st,2nd, and 3rd trimester affect baby? 

    2. What are characteristic facial features of fetal alcohol syndrome? (5)

    3. What causes rare vaginal tumor in offspring? 

    4. What is important to consider about fat-soluble materials?

    5. Is tracking and quantifying exposure to identify risk easy or difficult?

    6. How many women use medications (OTC/prescription) during pregnancy?
    1. (1) - affects cell growth and number of cells growing in brain (2) - miscarraige (3) fetal neurologica/growth deficits

    2. small eyes, flat midface, short nose, thin upper lip, small chin. Tracking causes is difficult bc in many cultures, women are indifferent to it

    3. DES causes T-shaped/constricted uterus and adenosis of cervix) AND was ineffective for preventing miscarriage

    4. May be concentrated in breast milk

    5. Difficult

    6. ~90%
  6. 1. What factors need to be understood to better account for how infants can be adversely impacted by drugs? (6)

    2. Limitations of lactation studies? (5)

    3. What physiological changes in pregnant women can alter effectiveness or normal functioning of drugs? (6)
    1. Mother's intake of drug (oral vs. IV), plasma concentration in mom, metabolism of drug, extent of breastfeeding, extent of transfer into breast milk, chemical properties of the drug

    2.

    • 1. Inter-individual maternal and infant variability --> difficulty in generalizing results
    • 2. Absorption, distribution, metabolism, and excretion of drug needs to be accounted for
    • 3. Mother taking multiple drugs
    • 4. Age-related pharmacokinetics
    • 5. Study design (large enough sample size?)

    3. Increase in women's plasma volume, body fat, decreased albumin concentration (carrier for drugs), decreased gastric emptying, altered hepatic storage/emptying, nausea --> LOWER CIRCULATING AMOUNTS OF DRUG CONCENTRATIONS
  7. 1. When does placental transfer of drugs incrase during pregnancy and why? 3

    2. Define teratogenesis?

    3. When is fetus most vulnerable to drugs/meds?

    4. What is mechanism of drug transfer in breast milk?

    5. What are POPs? What does it stand for? Where is it from? (2) Where does it build up?
    1. 3rd trimester bc of (1) increased maternal blood flow and (2) decreased placental thickness and (3) increased placenta SA

    2. Teratogenesis  - abnormal/defective development in fetus

    3. 2-8 weeks post conception (embryogenesis)

    4. Maternal circulation --> breast milk --> infant

    5. POPs = persistent organic pollutants - lipophilic stable compounds (specifically manufactured/byproduct of incinerated waste) that builds up in the adipose tissue.
  8. 1. What is most widespread in terms of pollutants?

    2. Where are they most widespread? Found in breast milk? Ratio in Americans: Europeans?

    3. Where are they detected?

    4. Are dioxins easy to detect and are they a concern?

    5. How are POPs transferred from women ---> children (2)
    1. Polybrominated diphenyls

    2. Developed countries, yes, 1:10 - 1:100

    3. Meat and fish

    4. No, No because levels are decreasing

    5. Breast milk and last trimester of pregnancy when mother transfers fat to babies
  9. 1. How can POPs affect health outcomes for infants? (4 total. 3 --> 1, 4--> 3)

    2. Given these risks, does WHO recommend breastfeeding?

    3. In ideal world, what periconceptual health factors would be addressed in mothers before becoing pregnant? Why is this often impossible?
    • 1. Low birth weight
    • 2. Neurodevelopmental outcomes
    • 3. High prevalence of infection (lower antibodies after vaccination)
    • 4. Disrupted hormone regulation (thyroid, decreased in age of menarche, increased body size at puberty)


    2. Yes


    3. Ensure optimum nutrition/health (optimum body weight, adequate micronutrient stores, control chronic disorders). Because majority of pregnancies are unplanned.
  10. 1. Difference between toxins and toxicants?

    2. What is a social norm?

    3. Why would a food taboo exist/ Give example of each

    4. What are common times when food taboos exist and who is most likely to be affected?
    1. Toxins - produced by living organisms. Toxicans - umbrella term for harmfuls ubstances

    2. Group held belief about how members should behave in a givencontext

    3. (1) Ecological necessity, (2) monopolized resources( men inhibiting women eating meat), (3) expressing empathy (not eating pets), (4) cohesion/identity/religion, (5) health concerns (don't want a large baby)

    Vulnerable groups tend to be affected (pregnant/lactting women, children esp girls).
  11. 1. What is the term for eating insects?

    2. Pros of eating insects? (4)

    3. Cons? (4)

    4. What are most permanent/temp taboos steeped in?
    1. Anthropoentomophagy

    2. (1) insects have higher energy input/output (2) cheaper to produce (3) require less space (4) reproduce quickly


    3. Cons (1) look gross (2) toxicity (3) cultural taboos (4) religious issues

    4. Superstitution - consumption of a particular animal/plant will bring them ahrm.
  12. 1. What determines food choices and diets? 8

    2. Can cultural/religious practices be considered as social norms?

    3. When is eating weird food used as a delicacy vs. alternative energy source?

    4. What are some examples of weird foods eaten? (2)
    1. Determinants can be biological, economic, physical, social, psychological (mood,stress), belief (religion, attitudes), health determinants, geographic deterinants

    2. Yes - ethical/religious practices such as avoiding meat may limit range of foods people eat. 

    3. Based on SES

    4. Clay - Africans will eat clay that is rich in mineral content. Mopane caterpillar - south Africa - high protein content
  13. 1. Common taboos? (2)

    2. What is discarded and eaten in Ethiopia?

    3. What is the impact of food taboos in moms? (3) in children? (3)

    4. Where must pregnant women eat animals with weaker spirits?

    5. What are food production taboos? (3)
    1. Eggs and fish - eggs may cause women to be infertile.

    2. Discarded: green vegetables, colostrum, fruits. Girls are forced to eat LOTS of food to improve attractiveness

    3. Restricting food of pregnant/lactating women and children is associated with (1) anemia/malnutrition of mom (2) increased risk of pregnancy/labor complications (3) low resistance to infection

    Children: (1) increased risk of infection (2) protein-energy malnutrition (3) poor physical/mental growth. 

    4. Orang Asli in Malaysia. 

    5. Women are hunters not gatherers

    • - Cannot till land during pregnancy
    • - Cannot plant trees during menstruation
  14. 1. What are harmful traditional practices? (4)
    1. Starvation in third trimester (to ease delivery), female genital mutilation, early marriage with dowries (must sell half of farm to sell daughter off), child deliveries with traditional birth attendants
  15. 1. What is adolescence - what type of changes (8)?

    2. What are the beginning and ends of each of these?

    3.
    1. Starvation in third trimester (to ease delivery), female genital mutilation, early marriage with dowries (must sell half of farm to sell daughter off), child deliveries with traditional birth attendants

     Biological - onset of puberty --> end of puberty/full reproducing ability

    Emotional: begin individuation --> fully developed separate identity

    Cognitive: emerging abstract thought --> advanced reasoning abilities

    Interpersonal: Interest in peers --> intimate peer relationsSocial: Begin transition to adult roles --> adult status/privileges

    Educational: junior high --> complete schoolingLegal: juvenile status attained --> majority status

    Cultural: training for a ceremonial right of passage --> completion of ceremonial right of passage

    Chronological: Age 10- Adulthood (22-24)
  16. 1. Why do the effects of biological, cognitive, and social changes vary from person to person? 

    2. What are the 5 sets of psychosocial development issues during adolescence?

    3. What are the 6 main theories of what shapes adolescence? brief description and who?

    4. What are 2 other theories?
    1. Psychological development is product of interplay between different families, schools, environments, etc . 

    2. Identity, autonomy, intimacy, sexuality, achievement

    3.

    • 1, Biologic (G Stanley Hall) - strum und drang - raging hormones
    • 2, Organismic (Freud, Erik Erikson - crisis of identity vs. identity diffusion 8 stages, Carol Gilligan - gender diff, Piaget - changes in cognitions over emotions & biology): biological changes in context of psychological crisis (demands of society)
    • 3. Learning (BF skinner - operant conditioning, Albert Bandura): emphasis on operant conditioning and social learning theory (modeling)
    • 4. Sociological (Lewin & Hollinghead - power struggles bt teens and adults; Coleman - generation gap)- social norms of that society emphasis on common factors rather than individual factors
    • 5. Historical (Elder and HIne) - historical periods vary so cannot generalize about degree of stress, nature of familial relationships, developmental tasks)

    6. anthropological (Benedict + Mead) - historically what roles your society has given to adolescents (can't generalize) - culturally defined. If view as strum und drang it would be that way vs. viewing as peaceful and calm. 



    4. Relational developmental Systems theory - Positive Youth Development is basedon this. Potential for change exists across lifespan, relative plasticity.

    Ecosocial theory - individual develops within a context/ecology.
  17. 1. What occurs in brain during adolescence? (4)

    2. When do you see gray matter loss? (2)

    3. What does brain development have bidirectional flow with?

    4. In boys, what is early puberty associated with? (5)

    5. In girls, what is early puberty associated with? (4)
    1. (1) Synaptic pruning, (2) NT levels change (dopamine/serotonin more emotionality, increased stress responsivity, lower sensitivity to rewards) (3) Complete maturation of prefrontal cortex  (4) Dynamic process in which separate functional networks become more strong-linked over time

    2. Alzheimer's. In adolescents --> schizophrenia.

    3. Biological, cognitive, and social transitions

    4. Popularity, self-esteem/image, antisocial deviant behavior, drugs/etoh use, and risky behavior

    5. Negative affect (depression/self-esteem, anxiety, eating disorders), delinquency, drug and alcohol use, and early sexual activity.
  18. 1. What cognitive transitions occur? (5)

    2. What is the way to assess adolescent intelligence?

    3. What is Robert Sternberg's Triarchic theory?

    4.  What is Howard Gardner's Theory of Multiple Intelligence?

    5. What is the Zone of Proximal Development?
    1. Deductive reasoning, abstract thought develops, metacognition (self-monitoring of cognition), multidimensional thinking, understanding that knowledge is relative.

    2. IQ-testing (Stanford-binet, WISC)

    3. 3 distinct, inter-related types of intelligence (1) componential - acquire, store process info (2) experiential - insight and creativity (3) contextual - thinking practically, introduced notion that those with lower IQs may be smart in different ways and society needs a mix of all of these.

    • 4.
    • 7 distinct types of intelligence (verbal, mathematical, spatial, kinesthetic, self-reflective, interpersonal, musical) Standard IQ tests only emphasize first two. 

    5. Adolescents learn best when tasks are posted slightly more challenging than current capabilities permitting for them to solve problems on their own. Learning occurs through close collaboration with instructor and instructors provide scaffolding for learning. LEV VYGOTSKY
  19. 1. What are components of social transition in adolescence? (2) 1-4, 2-2

    2. What is the true stress of adolescence?

    3. How are adolescents viewed in wartime vs. economic depression?

    4. What is the reason for adolescents viewing risk taking differently than adults?
    1. Status - age, interpersonal, political, economic (work) 

    2. Legal status - emancipated minor and mature minor law (allows healthcare providers to treat youth as adults based on assessment and documentation of independence)

    2. Psychopathology- will not simply be outgrown. 

    3. Brave, strong component vs. immature, unstable, bad.

    4. Biological basis/emotional factors + social factors --> influence decision making.
  20. 1.What are the 3 components of identity?

    2. What is the difference between gender identity and gender (sex) roles? When are each established by?

    3. Difference between orientation and identity?

    4. Difference between behavior vs. orientation vs. identity?
    1. Gender identity, gender (sex) roles, personality

    2. Gender identity - personal sense of being male or female, determined by age 3. 

    Gender (sex) roles - sociocultural beliefs, attitudes, and expectations of male/female behavior - outward expressions of male and femaleness. Established by age 3-7.

    3. Sexual orientation - spectrum of sexual behaviors from exclusively heterosexual to homosexual. Influences identity

    4. Sexual activity is a behavior (voluntary), while sexual orientation is a component of identity (non-voluntary).
  21. 1. What are the health effects of stigma and discrimination? (4)

    2. How does US teenage sex activity differ from other countries? How does pregnancy/birth rates/abortions differ?

    3. What does the term "young adulthood" mean? 

    4. When does transition to young adulthood occur?

    5. When are rates of injury, substance abuse, and homicide highest?
    1. Mental health, substance abuse, eating disorders, STI/HIV - can all affect adolescent nutrition and weight status. 

    2. Similar to all other countries, but US teens have higher pregnancy, birth rates, and abortion rates. 

    3. Applies to young people who (1) don't live in their own home (2) not financially indep (3) no children

    4. Social safety nets weakened (no shared environment, such as school)

    5. Early adulthood.
  22. 1. What are patterns of obesity and social status among adolescents?

    2. What are important moderators of this?

    3. What is association between increasing SES inequality and rise of pediatric obesity? (4)

    4. Is SES a predictor of BMI? In which genders? What ethnicity?

    5. What factor has a stronger influence on obesity than income and why?
    1. Subjective social status is negatively associated with obesity (lower waist:hip ratio).

    2. Race and gender

    3. PE cut from schoools, fast foods with low nutr value in cafeterias, lack of available healthy options in low SES neighborhoods, increased food marketing

    4. SES was good predictor for adolescent girls, NOT BOYS. Strongest predictor in white girls.

    5. Proximal risk factors - diet and physical activity; subjective social statusparental education - coping styles/interpersonal skills.
  23. 1. What are some models of thought on how health inequalities occur?

    2. What is food security?

    3. What is food insecurity?
    1. Higher SES has greater resources, social causation - obesity mediates association bt SES and subjective social status, social drift - obesity has negative social economic consequences in adulthood.

    2. Respond yes to 2 or fewer questions in Core Food Security Module (CFSM) - access by al people at all times to enough food for active, healthy life

    3. Limited/uncertain unavailability of nutritionally adequate or safe foods/uncertain ability to acquire acceptable foods in a socially acceptable way.
  24. 1.  What was the
    association between food insecurity and overweight/obesity in children and
    adolescents in their meta analysis?

    2. What did the findings indicate about impact of food assistance programs on food security + overweight prevalence?

    3. What is trend in obesity prevalence, poverty rates and income inequality?

    4. What is relationship between SES and adolescent obesity?
    1. Mixed results - difficult to deduce that food insecurity is associated with child/adolescent overweight bc inconsistent measurements

    2. Reduces prevalence of overweight in food insecure children, suggesting protective role.

    3. All have increased

    4. Greater SES --> lower risk of obesity.

    Lower parental SES --> more processive stress (HPA axis, cytokines, ANS --> childhood obesity --> processive stress --> social isolation, depression, lower self-esteem leading to adult obesity --> increased obesity risk in offspring.
  25. 1. What is Positive Youth Development? Describe how this was put into effect in PRIORITY Community Initiative?

    2. What effect did it have?
    1. Emphasized competence (positive views of one's interpersonal, cognitive, decision-making abilities), confidenceconnectioncharacter, and caring. 



    2. Decreased sexual risk, substance use behaviors.

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