Exam 1 Flashcards
1
Q
What model of medicine do Dr. Stu and Dr. Russ practice?
A
Integrative medicine
2
Q
Incidence
A
The number or percent of new cases that have appeared in a population within a specific time
3
Q
Collateral information
A
Information about a child’s health that comes from sources other than the child (e.g., family, teachers, doctors)
4
Q
True/False: The majority of children needing mental health care services receive care.
A
False
5
Q
Ways to monitor adherence to medical treatment:
A
- 24-hour recall interview
- Verbal reports from parent and child
- Recording by child and parents (diaries, forms, computer)
- Pill and bottle counts
6
Q
Disease
A
Characteristic grouping of physical signs and symptoms related to body malfunction
7
Q
True/False: Most of the risky behaviors for killer diseases such as cardiovascular disease and cancer begin in adulthood.
A
False
8
Q
Basic philosophy behind cognitive restructuring
A
Thoughts, behaviors and emotions are interconnected, therefore change in cognitions with lead to changes in emotions, behavior and well-being
9
Q
Tertiary intervention
A
Treatment of an established disease/disorder
10
Q
True/False: According to Ditchek and Greenfield, despite our children being exposed to toxins and carcinogens on a daily basis, our society still values economy more than our children’s health.
A
True
11
Q
What percentage of the time are children watching television shows meant for adults?
A
90%
12
Q
True/False: In the U.S., E-cigarettes are now the most popular tobacco product among middle school and high school students.
A
True
13
Q
True/False: Complementary medicine is used separately from or instead of conventional care.
A
False
14
Q
What percentage of STD cases occur in individuals 15-24 years old?
A
About 2/3
15
Q
Child health and parental income are:
A. negatively correlated
B. positively correlated
C. not correlated
A
B
16
Q
Which of the following was reported by children who spent more hours on social media?
a. Less sick days
b. Improved behavior in the classroom
c. Fewer instances of stomach aches
d. Higher rates of depression
A
D
17
Q
A 30-second commercial can affect the brand choices of a child as young as: A. 6 months of age B. 1 years old C. 2 years old D. 4 years old
A
C
18
Q
True/False: Kids are more vulnerable to environmental hazards because they breathe more air, eat more food, and drink more water per pound of body weight than adults.
A
True
19
Q
True/False: Girls are less physically active than boys as they grow older.
A
True
20
Q
True/False: Most environmental safety standards are based on adult exposure.
A
True
21
Q
True/False Like China and India, Western medicine treats the mind and the body as a whole instead of two separate entities.
A
False
22
Q
What does the term “power tools” mean in terms of mind/body therapies?
a. Methods child can use anytime
b. Techniques that should be learned under the direction of a trained practitioner
c. Methods that require some parental supervision or assistance, at least in getting started
d. Techniques that require children to exert a lot of energy
A
B
23
Q
The type of medicine taught in most U.S. medical schools today: A. Alternative Medicine B. Complementary Medicine C. Conventional Medicine D. Integrative medicine
A
C
24
Q
Adherence to medical recommendations is likely to be (1) higher when the regimen is long term and (2) lower when several components are involved in the treatment.
a. Both 1 and 2 are true
b. 1 but not 2 is true
c. 2 but not 1 is true
d. Neither 1 or 2 is true
A
C
25
True or False? Endocrine disruptors found in everyday household products can contribute to the rise of neurodevelopmental disorders in children
True
26
Which of the following are ways violent images can damage a child psychologically?
X. Make a child overly fearful of the world
Y. Make a child more aggressive
Z. Desensitize a child to the pain and suffering of others
a. X and Y
b. Y and Z
c. X and Z
d. X, Y and Z
D
27
True/False Lead poisoning has dramatically increased over the years, and it is the toxic metal that Ditchek and Greenfield fear the most.
False
28
Provide examples of common ways of measuring children's' cardiovascular fitness.
Step test, pacers, 1 mile walk/run, blood pressure, heart rate
29
According to Ditchek and Greenfield, a child watches an estimated __________ television ads before graduating high school.
a. 3,600
b. 36,000
c. 360,000
d. 3.6 million
C
30
What class term is defined as "Any procedure used to gather information about people”?
Assessment
31
Provide one example of how the family affects child health from a prenatal perspective.
maternal health, maternal stress, maternal health behaviors (diet, substances, exercise), secondhand smoke
32
What does "BMI" stand for in relation to fitness assessment?
Body Mass Index
33
Define "naturalistic observation."
Observing the patient(s) in their "natural" setting (home, school, etc)
34
True/False In the article “The Lost Art of Parenting,” Kay Hymowitz states that parents today have lost touch with how to be friends with their kids.
False
35
True/False Using illicit substances at younger ages leads to a poorer prognosis than later initiation of use.
True
36
Provide one of the three main categories of adolescent risk-taking behavior.
Use of substances, safety, sexual activity
37
According to Oskamp, how can necessary behavioral changes be accomplished
to achieve a more sustainable society?
a. By focusing technological advances towards pro-environmental goals
b. By using carefully organized group activity to help reduce or prevent environmental damage
c. By living a more simple lifestyle
d. All of the above
D
38
Which of the following is not a principle of Integrative Pediatric Medicine?
a. Recognition of the interaction among body, mind, spirit, family, community,
and environment.
b. A desire to integrate the best of conventional and “unconventional” medicine.
c. The child has every right to make their own decisions regarding treatment.
d. A preference for gentle and inexpensive therapies over invasive expensive ones.
C
39
```
Taking your son to a physician to get him evaluated for ADHD and prescribed
medicine would be an example of:
a. integrative medicine
b. conventional medicine
c. ‘quack’ medicine
d. alternative medicine
```
B
40
All of these are components of biopsychosocial assessment except:
a. family history and dynamics
b. political beliefs and practices
c. cultural and ethnic backgrounds and practices
d. spiritual and religious beliefs and practices
B
41
True/False: Ninety-five percent of adolescents aged 13-18 have access to a smart phone.
True
42
True and false? Messages sent by the mass media are generally motivated by profit rather than a concern for what’s best for our children.
True
43
True or false? The average child now spends more time in front of a screen than doing anything else but sleeping.
True
44
What is a common reason that many kids give up on organized sports and other fitness activities?
a. They prefer more competitive play instead of slow-placed for fun play.
b. They dislike disorganization and believe there is not enough time for practice.
c. They are getting negative feedback from coaches and parents.
C
45
What is true about marketing violence to children?
a. There is a decrease in violence in movies rated G, PG, and PG-13.
b. There is no research that shows that violence is harming children
c. If a child is aggressive at age 8 there is no chance of them being aggressive in adulthood.
d. Prolonged exposure to violence in the media can cause children to become desensitized to violence in real life.
D
46
Which of the following is not a way to reduce stress with your child?
a. Sitting down for family meals together
b. Let them watch TV as long as they would like
c. Give the child emotional vocabulary
d. Laugh more
B
47
Physical fitness
The ability to work and have energy remaining for recreation
48
Illness behavior
How someone acts when they think they're sick
49
Examples of secondary gain from disease/illness
Attention, money
50
Health behaviors
Activities to prevent disease and promote health
51
Developmental issues in working with children
- chronological and mental age must be considered
- knowledge of normal & abnormal development
- children are always changing
52
Contextual issues in working with children
Children's behavior changes depending on context
53
Other considerations in working with children
- building on strengths (communicate the child's strengths to adults)
- communication issues and lack of understanding
- building rapport with child and family
- basic rights of the child
- family involvement is essential
54
Epidemiology
The study of the prevalence, incidence, and co-occurrence of disorders and competencies
55
Prevalence
Number of percent of cases of a disorder in a population during a specific time
56
Point prevalence
Prevalence at a certain point in time
57
Period prevalence
Prevalence within a period of time (most common)
58
Lifetime prevalence
How many people have a disorder at some point in their lifetime
59
Mortality
Death rate
60
How presence of disease rates are measured
- physiological measures (blood tests, MRI)
| - decompensation (dead tissue, atrophy)
61
Aerobic capacity/cardiovascular endurance
Ability of the circulatory system to take up, transport, and use oxygen during physical activity and exercise
62
Other physical health status measurements
- subjective complaints
- functional abilities
- fitness measures
63
Measures of body weight/composition
- weight
- BMI
- body composition
64
BMI definition and healthy range
- (weight in pounds / height in inches / height in inches) x 703
- adult healthy range: 18.5-24.9 (varies by age for children)
65
Definition of body composition
Proportion of lean body mass to body fat
66
How body composition is measured
- underwater weighing
| - special scales
67
Flexibility
The ability to move the joints of the body through their fullest range of motion
68
Measurements of flexibility
- sit and reach test
| - trunk lift (upward facing dog)
69
Muscular strength
The maximum force that a muscle can generate
70
Muscular endurance
The ability to do continuous muscular work
71
Agility
The ability to move with quickness and balance
72
Infant mortality rate (2019, "America's children" well-being study)
558.3 per 100,000
73
Mortality rate for 1-4 years old
23 per 100,000
74
Mortality rate for 5-14 years old
13 per 100,000
75
Mortality rate for 15-19 years old
49 per 100,000
76
Rate of chronic illness
40%
77
Rate of activity limitation for ages 5-17 (2018)
10%
78
Percentage of children with behavior disorders and mental illness
13-20%
79
Cost of childhood behavior disorders and mental illness
$250 billion annually
80
Percentage of children in need of mental health services who are getting them
Fewer than 10%
81
Percentage of parents who describe their kids as being in very good or excellent health
83%
82
Steps of a biopsychosocial mental health assessment
- cognitive
- affective
- psychopathology
- personality
- stress and coping
- activities of daily living (ADLs)
- social functioning
- school and work
- recreation
- legal troubles
- cultural influences
83
Steps of assessment related to medical and health issues
- health status and behaviors
- medical information
- physiological measures
84
Sources of information in a biopsychosocial assessment
- observation
- interview
- collateral information
- naturalistic observation
- questionnaires and records
- testing
- psychophysiological measures
85
General mechanisms through which family influences children
- genetic
- prenatal
- source of stress leading to increased risk
- source of support
- influences on coping (positive or negative)
- influences on health behaviors
- supervision
- acceptance of risk-taking/health-compromising behavior
- health care access and utilization
- influences on illness behaviors
- care when ill
86
Pathways through which family influences child health behaviors
- modeling
- education & attitudes
- direct behaviors
87
Pathways through which parental smoking influences the child
- prenatal smoking = fetal mortality, lower birth weight
- higher rates of SIDS, asthma, short stature, cancer, hospital admissions, & hearing disorders
- risk of house fires
- kids of smoking parents are more likely to smoke
- economic issues due to the cost of smoking
- kids more likely to have sex early
- smoking in parents is the strongest predictor of risky behaviors in kids
88
Findings of research on psychosocial intervention
- alters the course and outcomes of disease
| - saves money in healthcare system
89
Developmental perspective on intervention
- normal coping mechanisms change over time
- level of understanding of the problem changes over time
- type of intervention changes with age
90
Systems levels at which intervention may occur
- individual
- family & caregivers
- school
- healthcare professionals & system
- societal
91
Primary intervention
Intervention before the problem starts
92
Secondary intervention
Intervention at the early stages of a disease/disorder
93
Placebo effects
Improvement in symptoms from a drug that has no actual active ingredients; the improvement occurs because the patient expects it to
94
Placebo effects
Improvement in symptoms from a drug that has no actual active ingredients; the improvement occurs because the patient expects it to
95
Points in time when intervention may occur
- first diagnosed
- new to setting
- crisis
- difficulty coping & functioning
- psychiatric symptoms
- specific problem
- psychophysiological issue
- rehabilitation
96
Steps in intervention
- assessment
- goal setting
- treatment planning
- implementation
- evaluation
- termination
97
Important aspects of goal-setting in treatment
- range
- achievable
- measurable
- motivation
98
Examples of intervention methods and techniques
- psychoeducation
- self help/support
- diaries & journaling
- relaxation-based
- biofeedback
99
Biofeedback
the use of instrumentation to mirror psychophysiological processes of which the individual is not normally aware and which may be brought under voluntary control
100
Indirect factors affecting child health
- government policy
- income/wealth
- education
- race
101
Example of a direct factor influencing child health
Ingesting lead
102
Reasons parents & children struggle to adhere to a treatment regimen (Sattler)
- do not understand treatment
- lack of communication
- side effects
- parents/children may not think the illness is serious
- treatment could be too difficult
103
Reasons adolescents specifically may struggle to adhere to a treatment regiment (Sattler)
- may be more rebellious
- adolescents are expected to be more independent, but they may not follow a treatment play on their own
- adolescent turmoil
- misunderstanding between parents and adolescents regarding whose responsibility it is to follow the treatment
- regime may be too complicated/exhausting for very sick adolescents
104
What are some ways to monitor adherence & drawbacks to each approach? (Sattler)
- daily diary (clients may forget or lie)
- verbal reports (clients may say what they think the doctor wants to hear; parent & child reports may differ)
- pill bottle checks (clients could have thrown out pills or taken wrong doses)
- 24 hour recall interview (parent & child reports sometimes conflict)
105
What are some ways to improve adherence? (Sattler)
- actively involve the whole family in treatment planning
- encourage active participation of the whole family in the treatment
- set realistic goals
- evaluate children and parents' perception of the treatment plan
- help children improve self-mastery
- encourage patients to offer suggestions for improvement
106
Secondary gain
The advantage that occurs secondary to stated or real illness
107
Principles of integrative pediatric medicine (D&G Chapter 1)
1. A belief in the innate healing power of the body
2. Recognition of the interaction among body, mind, spirit, family, community, and environment
3. A conviction that it is better to prevent disease now than treat it later
4. The belief that treatment should be customized to individuals
5. A preference for gentle and inexpensive therapies over invasive or expensive ones
6. A desire to integrate the best of conventional and “unconventional” medicine
7. A determination to forge a healing partnership with patients and parents
8. An acknowledgement that patients and parents have good instincts about their health
9. The realization that children are not small adults
108
Conventional medicine
Mainstream medicine in the industrial world
109
Alternative medicine
Therapies/philosophies not generally taught in American medical schools or offered in American hospitals; used separately from or instead of conventional care
110
Complementary medicine
Therapies added to conventional treatment but not clinically integrated
111
Integrative medicine
Combines conventional treatment with therapies from complementary and alternative medicine (CAM)
112
Percentage of school-age children at risk for cardiovascular disease and cancer as adults
30-35%
113
Percentage of young people (12-21) that are not vigorously active on a regular basis
- 1/2 are not vigorously active on a regular basis
- 25% do not participate in any vigorous activity
- 15% are sedentary
114
% of kids ages 6-17 who meet minimum standards for cardiovascular fitness, flexibility, and abdominal and upper-body strength
32%
115
% of children who have at least one modifiable risk factor for heart disease by age 12
60%
116
Number of states that require daily PE from kindergarten through 12th grad
One (IL)
117
% of schools that offer daily PE classes
4/10
118
Which age group watches the most TV
Children ages 2-5
119
Key ingredient for success in kid fitness program
Parents' enthusiastic involvement and example
120
Most inactive gender and age group of all children
Girls ages 14-16
121
SNAPs (Wiger & Huntley)
Strengths, Needs, Abilities, and Preferences
122
How many people can the Earth's resources support generally? In "relative prosperity"? What is the current Earth population? (Oskamp)
- current (at time of article): 6 billion
- 3 billion can be supported in perpetuity
- 1-2 billion in relative posterity
123
What are the two main sources of Earth's environmental problems? (Oskamp)
- human population growth
| - overconsumption of natural resources
124
Six possibilities for action in promoting change (Oskamp)
- voluntary simplicity
- specific, concrete actions
- providing clear behavioral norms
- focusing technological advances toward proenvironmental goals
- organized group activity
- war against the common enemy of an uninhabitable Earth
125
What percentage of climate-change-related illnesses and injuries occur in children under five according to the WHO? (Perera and Kinney)
88%
126
Effects of endocrine disruptors (Lu)
- affect the way estrogen, androgen, and thyroid hormones are produced, transmitted, and metabolized
- disrupt dopamine levels
- affect developing brains and reproductive health
127
Endocrine disruptors are particularly implicated for which disorders and symptoms?
- behavioral and learning problems
| - autism and ADHD
128
Sources of exposure to endocrine disruptors
- pesticides
- plastics
- fire repellants
- can be transmitted in utero
129
What are phthalates, and what are the concerns related to them?
- phthalates are added to plastics to make them more flexible
- they leach into the environment
- they alter levels of some thyroid hormones
130
How are gender and timing related to endocrine disruptor effects?
- prenatal exposure is more likely to be associated with IQ drops and behavior issues in boys
- BPA exposure in early childhood may affect girls more than boys
131
Challenges related to the study of chemical effects, and the removal of toxic chemicals from the market
- proving causation is difficult
- some chemicals may be more harmful in small exposures than large exposures
- -chemicals are taken in in many ways
- exposures may affect one developmental stage but not another
- effects may vary according to genetics
- effects may not show up for a long time
- chemicals may interact with each other
- poverty may be an extraneous variable
- lifestyle factors may outweigh effects from chemicals
- the EPA can only require evidence that a new product is safe if it poses an "unreasonable" risk to humans
- even if a chemical is taken off the market, the replacement chemical may be worse
132
How many chemicals are registered with the EPA for sale and use, and what percentage of them have been assessed for potential harm to children?
70,000; less than 20%
133
What aspects of cultural messages and marketing make children more vulnerable to them?
- glorification of violence
- promotion of unhealthy eating
- promotion of unattainable beauty standards
- prevalence of trying to get attention in the media
- kids under the age of 8 cannot tell the difference between ads and TV shows
- kids know very little about healthy nutrition
134
Amount of money spent on marketing to children per year (Levin and Linn)
$12 billion
135
Number of commercials the average child sees on TV annually
40,000
136
Amount of time per week U.S. children ages 2-14 spend with electronic media
40 hours
137
Aggressive behavior at this age is predictive of aggression in adulthood
8 years
138
Viral marketing
Marketers identify the most popular children and give them free products to distribute to other children
139
Nag factor
Corporations market to kids so they will nag their parents until they give in
140
Parent-advocates (Hymowitz)
Parents who take their child's side whether the child is right or wrong
141
Average screen time use for under 2-year-olds
42 minutes per day
142
Percentage of adolescents with access to computers
88%
143
Percentage of adolescents who report being online "almost constantly"
45%
144
Social media
Any digital tools or applications that allow users to interact socially; users can both consume and create content
145
Breath work
Controlling one's mental state through breathing
146
Progressive muscular relaxation
Tightening and then relaxing muscles in the body
147
Meditation
The self-directed process of focusing on a sound, image, or thought to still the mind and relax the body
148
Purpose of hypnosis or visualization
To strengthen self-control
149
Mind/body medicine
Using the mind to heal the body
150
Self-regulation
Other term for mind/body medicine used in pediatrics
151
Magic feather
Use of the placebo effect to help a child overcome a problem
151
Magic feather
Use of the placebo effect to help a child overcome a problem
152
Forms of nonadherence (Sattler)
- refusing treatment
- failing to take medications as prescribed
- failing to keep appointments
- choosing alternative, unorthodox treatments
153
Key elements for successful public health campaigns (Wilson)
- credible scientific evidence
- advocates committed to their cause
- ongoing partnerships with the media
- effective laws and regulation
154
Two basic steps to break bad habits (Chapman)
- minimize or avoid the immediate reward
| - make the long-term negative consequence seem more immediate
155
Adolescence
The developmental phase during which individuals transition from children with high dependency on parents and/or caregivers to adults who are independent members of society
156
Three stages of adolescence
- puberty (10-16 years)
- 16-24 years
- 18-29 years
157
How does the brain change during puberty/adolescence?
- growth spurt in cortical neural development
- reduction of grey matter leading to stability of grey matter neural density
- growth of white-matter connections accelerates
- adolescents have heightened neural sensitivity to rewards
158
Reward-drive tendencies
Various behaviors that are associated with dopaminergic-driven reward experiences
159
Peak periods of risk for substance use initiation
- early adolescence (pubertal maturation)
| - transition to young adulthood
160
Two main pathways for risk of early substance involvement
- externalizing
| - internalizing
161
Reasons for adolescent alcohol use
- enhancing positive feelings
- facilitating social interaction
- coping with negative emotions
162
Reasons for adolescent cigarette use
- curiosity and peer influence for experimenters
| - pleasure, relaxation, and difficulty quitting for regular smokers
163
Potential consequences of e-cig use
- nicotine alters the development of the prefrontal cortex
- may lead to attention problems & heightened risk of cognitive impairments and psychiatric disorders over time
- possible long-term cardiovascular damage from nicotine
164
Problems with persuasive messages (Dingfelder)
- they tend to give incomplete information
| - when people realize the facts have been tweaked, they may distrust all the information provided
165
Activities of pediatric psychologists (Roberts et al)
- psychosocial services for issues related to pediatric health conditions
- psychological services for mental health problems appearing in medical settings along with a pediatric problem
- assessment and treatment for psychological problems presenting in a medical setting without a concomitant medical condition
- programs for health promotion, disease and injury prevention, and early intervention
- assessment, intervention, and programming to improve functioning for children and adolescents with intellectual and developmental disabilities
- advocacy for public policy supporting children and families and promoting public health advancements
166
Pediatric psychology settings (Roberts et al)
- medical outpatient clinics with pediatricians or family medicine physicians in primary care
- inpatient units in children's hospitals for initial diagnosis and intensive treatment
- psychology or interdisciplinary outpatient clinics and child guidance clinics
