Exam 1 Flashcards

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1
Q

What model of medicine do Dr. Stu and Dr. Russ practice?

A

Integrative medicine

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2
Q

Incidence

A

The number or percent of new cases that have appeared in a population within a specific time

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3
Q

Collateral information

A

Information about a child’s health that comes from sources other than the child (e.g., family, teachers, doctors)

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4
Q

True/False: The majority of children needing mental health care services receive care.

A

False

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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
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6
Q

Disease

A

Characteristic grouping of physical signs and symptoms related to body malfunction

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7
Q

True/False: Most of the risky behaviors for killer diseases such as cardiovascular disease and cancer begin in adulthood.

A

False

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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

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9
Q

Tertiary intervention

A

Treatment of an established disease/disorder

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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

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11
Q

What percentage of the time are children watching television shows meant for adults?

A

90%

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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

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13
Q

True/False: Complementary medicine is used separately from or instead of conventional care.

A

False

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14
Q

What percentage of STD cases occur in individuals 15-24 years old?

A

About 2/3

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15
Q

Child health and parental income are:
A. negatively correlated
B. positively correlated
C. not correlated

A

B

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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

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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

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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

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19
Q

True/False: Girls are less physically active than boys as they grow older.

A

True

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20
Q

True/False: Most environmental safety standards are based on adult exposure.

A

True

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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

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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

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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

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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

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25
Q

True or False? Endocrine disruptors found in everyday household products can contribute to the rise of neurodevelopmental disorders in children

A

True

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26
Q

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

A

D

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27
Q

True/False Lead poisoning has dramatically increased over the years, and it is the toxic metal that Ditchek and Greenfield fear the most.

A

False

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28
Q

Provide examples of common ways of measuring children’s’ cardiovascular fitness.

A

Step test, pacers, 1 mile walk/run, blood pressure, heart rate

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29
Q

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

A

C

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30
Q

What class term is defined as “Any procedure used to gather information about people”?

A

Assessment

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31
Q

Provide one example of how the family affects child health from a prenatal perspective.

A

maternal health, maternal stress, maternal health behaviors (diet, substances, exercise), secondhand smoke

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32
Q

What does “BMI” stand for in relation to fitness assessment?

A

Body Mass Index

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33
Q

Define “naturalistic observation.”

A

Observing the patient(s) in their “natural” setting (home, school, etc)

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34
Q

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.

A

False

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35
Q

True/False Using illicit substances at younger ages leads to a poorer prognosis than later initiation of use.

A

True

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36
Q

Provide one of the three main categories of adolescent risk-taking behavior.

A

Use of substances, safety, sexual activity

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37
Q

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

A

D

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38
Q

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.

A

C

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39
Q
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
A

B

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40
Q

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

A

B

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41
Q

True/False: Ninety-five percent of adolescents aged 13-18 have access to a smart phone.

A

True

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42
Q

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.

A

True

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43
Q

True or false? The average child now spends more time in front of a screen than doing anything else but sleeping.

A

True

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44
Q

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.

A

C

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45
Q

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.

A

D

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46
Q

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

A

B

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47
Q

Physical fitness

A

The ability to work and have energy remaining for recreation

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48
Q

Illness behavior

A

How someone acts when they think they’re sick

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49
Q

Examples of secondary gain from disease/illness

A

Attention, money

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50
Q

Health behaviors

A

Activities to prevent disease and promote health

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51
Q

Developmental issues in working with children

A
  • chronological and mental age must be considered
  • knowledge of normal & abnormal development
  • children are always changing
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52
Q

Contextual issues in working with children

A

Children’s behavior changes depending on context

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53
Q

Other considerations in working with children

A
  • 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
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54
Q

Epidemiology

A

The study of the prevalence, incidence, and co-occurrence of disorders and competencies

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55
Q

Prevalence

A

Number of percent of cases of a disorder in a population during a specific time

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56
Q

Point prevalence

A

Prevalence at a certain point in time

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57
Q

Period prevalence

A

Prevalence within a period of time (most common)

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58
Q

Lifetime prevalence

A

How many people have a disorder at some point in their lifetime

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59
Q

Mortality

A

Death rate

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60
Q

How presence of disease rates are measured

A
  • physiological measures (blood tests, MRI)

- decompensation (dead tissue, atrophy)

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61
Q

Aerobic capacity/cardiovascular endurance

A

Ability of the circulatory system to take up, transport, and use oxygen during physical activity and exercise

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62
Q

Other physical health status measurements

A
  • subjective complaints
  • functional abilities
  • fitness measures
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63
Q

Measures of body weight/composition

A
  • weight
  • BMI
  • body composition
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64
Q

BMI definition and healthy range

A
  • (weight in pounds / height in inches / height in inches) x 703
  • adult healthy range: 18.5-24.9 (varies by age for children)
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65
Q

Definition of body composition

A

Proportion of lean body mass to body fat

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66
Q

How body composition is measured

A
  • underwater weighing

- special scales

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67
Q

Flexibility

A

The ability to move the joints of the body through their fullest range of motion

68
Q

Measurements of flexibility

A
  • sit and reach test

- trunk lift (upward facing dog)

69
Q

Muscular strength

A

The maximum force that a muscle can generate

70
Q

Muscular endurance

A

The ability to do continuous muscular work

71
Q

Agility

A

The ability to move with quickness and balance

72
Q

Infant mortality rate (2019, “America’s children” well-being study)

A

558.3 per 100,000

73
Q

Mortality rate for 1-4 years old

A

23 per 100,000

74
Q

Mortality rate for 5-14 years old

A

13 per 100,000

75
Q

Mortality rate for 15-19 years old

A

49 per 100,000

76
Q

Rate of chronic illness

A

40%

77
Q

Rate of activity limitation for ages 5-17 (2018)

A

10%

78
Q

Percentage of children with behavior disorders and mental illness

A

13-20%

79
Q

Cost of childhood behavior disorders and mental illness

A

$250 billion annually

80
Q

Percentage of children in need of mental health services who are getting them

A

Fewer than 10%

81
Q

Percentage of parents who describe their kids as being in very good or excellent health

A

83%

82
Q

Steps of a biopsychosocial mental health assessment

A
  • cognitive
  • affective
  • psychopathology
  • personality
  • stress and coping
  • activities of daily living (ADLs)
  • social functioning
  • school and work
  • recreation
  • legal troubles
  • cultural influences
83
Q

Steps of assessment related to medical and health issues

A
  • health status and behaviors
  • medical information
  • physiological measures
84
Q

Sources of information in a biopsychosocial assessment

A
  • observation
  • interview
  • collateral information
  • naturalistic observation
  • questionnaires and records
  • testing
  • psychophysiological measures
85
Q

General mechanisms through which family influences children

A
  • 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
Q

Pathways through which family influences child health behaviors

A
  • modeling
  • education & attitudes
  • direct behaviors
87
Q

Pathways through which parental smoking influences the child

A
  • 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
Q

Findings of research on psychosocial intervention

A
  • alters the course and outcomes of disease

- saves money in healthcare system

89
Q

Developmental perspective on intervention

A
  • normal coping mechanisms change over time
  • level of understanding of the problem changes over time
  • type of intervention changes with age
90
Q

Systems levels at which intervention may occur

A
  • individual
  • family & caregivers
  • school
  • healthcare professionals & system
  • societal
91
Q

Primary intervention

A

Intervention before the problem starts

92
Q

Secondary intervention

A

Intervention at the early stages of a disease/disorder

93
Q

Placebo effects

A

Improvement in symptoms from a drug that has no actual active ingredients; the improvement occurs because the patient expects it to

94
Q

Placebo effects

A

Improvement in symptoms from a drug that has no actual active ingredients; the improvement occurs because the patient expects it to

95
Q

Points in time when intervention may occur

A
  • first diagnosed
  • new to setting
  • crisis
  • difficulty coping & functioning
  • psychiatric symptoms
  • specific problem
  • psychophysiological issue
  • rehabilitation
96
Q

Steps in intervention

A
  • assessment
  • goal setting
  • treatment planning
  • implementation
  • evaluation
  • termination
97
Q

Important aspects of goal-setting in treatment

A
  • range
  • achievable
  • measurable
  • motivation
98
Q

Examples of intervention methods and techniques

A
  • psychoeducation
  • self help/support
  • diaries & journaling
  • relaxation-based
  • biofeedback
99
Q

Biofeedback

A

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
Q

Indirect factors affecting child health

A
  • government policy
  • income/wealth
  • education
  • race
101
Q

Example of a direct factor influencing child health

A

Ingesting lead

102
Q

Reasons parents & children struggle to adhere to a treatment regimen (Sattler)

A
  • do not understand treatment
  • lack of communication
  • side effects
  • parents/children may not think the illness is serious
  • treatment could be too difficult
103
Q

Reasons adolescents specifically may struggle to adhere to a treatment regiment (Sattler)

A
  • 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
Q

What are some ways to monitor adherence & drawbacks to each approach? (Sattler)

A
  • 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
Q

What are some ways to improve adherence? (Sattler)

A
  • 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
Q

Secondary gain

A

The advantage that occurs secondary to stated or real illness

107
Q

Principles of integrative pediatric medicine (D&G Chapter 1)

A
  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
Q

Conventional medicine

A

Mainstream medicine in the industrial world

109
Q

Alternative medicine

A

Therapies/philosophies not generally taught in American medical schools or offered in American hospitals; used separately from or instead of conventional care

110
Q

Complementary medicine

A

Therapies added to conventional treatment but not clinically integrated

111
Q

Integrative medicine

A

Combines conventional treatment with therapies from complementary and alternative medicine (CAM)

112
Q

Percentage of school-age children at risk for cardiovascular disease and cancer as adults

A

30-35%

113
Q

Percentage of young people (12-21) that are not vigorously active on a regular basis

A
  • 1/2 are not vigorously active on a regular basis
  • 25% do not participate in any vigorous activity
  • 15% are sedentary
114
Q

% of kids ages 6-17 who meet minimum standards for cardiovascular fitness, flexibility, and abdominal and upper-body strength

A

32%

115
Q

% of children who have at least one modifiable risk factor for heart disease by age 12

A

60%

116
Q

Number of states that require daily PE from kindergarten through 12th grad

A

One (IL)

117
Q

% of schools that offer daily PE classes

A

4/10

118
Q

Which age group watches the most TV

A

Children ages 2-5

119
Q

Key ingredient for success in kid fitness program

A

Parents’ enthusiastic involvement and example

120
Q

Most inactive gender and age group of all children

A

Girls ages 14-16

121
Q

SNAPs (Wiger & Huntley)

A

Strengths, Needs, Abilities, and Preferences

122
Q

How many people can the Earth’s resources support generally? In “relative prosperity”? What is the current Earth population? (Oskamp)

A
  • current (at time of article): 6 billion
  • 3 billion can be supported in perpetuity
  • 1-2 billion in relative posterity
123
Q

What are the two main sources of Earth’s environmental problems? (Oskamp)

A
  • human population growth

- overconsumption of natural resources

124
Q

Six possibilities for action in promoting change (Oskamp)

A
  • 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
Q

What percentage of climate-change-related illnesses and injuries occur in children under five according to the WHO? (Perera and Kinney)

A

88%

126
Q

Effects of endocrine disruptors (Lu)

A
  • affect the way estrogen, androgen, and thyroid hormones are produced, transmitted, and metabolized
  • disrupt dopamine levels
  • affect developing brains and reproductive health
127
Q

Endocrine disruptors are particularly implicated for which disorders and symptoms?

A
  • behavioral and learning problems

- autism and ADHD

128
Q

Sources of exposure to endocrine disruptors

A
  • pesticides
  • plastics
  • fire repellants
  • can be transmitted in utero
129
Q

What are phthalates, and what are the concerns related to them?

A
  • phthalates are added to plastics to make them more flexible
  • they leach into the environment
  • they alter levels of some thyroid hormones
130
Q

How are gender and timing related to endocrine disruptor effects?

A
  • 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
Q

Challenges related to the study of chemical effects, and the removal of toxic chemicals from the market

A
  • 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
Q

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?

A

70,000; less than 20%

133
Q

What aspects of cultural messages and marketing make children more vulnerable to them?

A
  • 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
Q

Amount of money spent on marketing to children per year (Levin and Linn)

A

$12 billion

135
Q

Number of commercials the average child sees on TV annually

A

40,000

136
Q

Amount of time per week U.S. children ages 2-14 spend with electronic media

A

40 hours

137
Q

Aggressive behavior at this age is predictive of aggression in adulthood

A

8 years

138
Q

Viral marketing

A

Marketers identify the most popular children and give them free products to distribute to other children

139
Q

Nag factor

A

Corporations market to kids so they will nag their parents until they give in

140
Q

Parent-advocates (Hymowitz)

A

Parents who take their child’s side whether the child is right or wrong

141
Q

Average screen time use for under 2-year-olds

A

42 minutes per day

142
Q

Percentage of adolescents with access to computers

A

88%

143
Q

Percentage of adolescents who report being online “almost constantly”

A

45%

144
Q

Social media

A

Any digital tools or applications that allow users to interact socially; users can both consume and create content

145
Q

Breath work

A

Controlling one’s mental state through breathing

146
Q

Progressive muscular relaxation

A

Tightening and then relaxing muscles in the body

147
Q

Meditation

A

The self-directed process of focusing on a sound, image, or thought to still the mind and relax the body

148
Q

Purpose of hypnosis or visualization

A

To strengthen self-control

149
Q

Mind/body medicine

A

Using the mind to heal the body

150
Q

Self-regulation

A

Other term for mind/body medicine used in pediatrics

151
Q

Magic feather

A

Use of the placebo effect to help a child overcome a problem

151
Q

Magic feather

A

Use of the placebo effect to help a child overcome a problem

152
Q

Forms of nonadherence (Sattler)

A
  • refusing treatment
  • failing to take medications as prescribed
  • failing to keep appointments
  • choosing alternative, unorthodox treatments
153
Q

Key elements for successful public health campaigns (Wilson)

A
  • credible scientific evidence
  • advocates committed to their cause
  • ongoing partnerships with the media
  • effective laws and regulation
154
Q

Two basic steps to break bad habits (Chapman)

A
  • minimize or avoid the immediate reward

- make the long-term negative consequence seem more immediate

155
Q

Adolescence

A

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
Q

Three stages of adolescence

A
  • puberty (10-16 years)
  • 16-24 years
  • 18-29 years
157
Q

How does the brain change during puberty/adolescence?

A
  • 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
Q

Reward-drive tendencies

A

Various behaviors that are associated with dopaminergic-driven reward experiences

159
Q

Peak periods of risk for substance use initiation

A
  • early adolescence (pubertal maturation)

- transition to young adulthood

160
Q

Two main pathways for risk of early substance involvement

A
  • externalizing

- internalizing

161
Q

Reasons for adolescent alcohol use

A
  • enhancing positive feelings
  • facilitating social interaction
  • coping with negative emotions
162
Q

Reasons for adolescent cigarette use

A
  • curiosity and peer influence for experimenters

- pleasure, relaxation, and difficulty quitting for regular smokers

163
Q

Potential consequences of e-cig use

A
  • 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
Q

Problems with persuasive messages (Dingfelder)

A
  • they tend to give incomplete information

- when people realize the facts have been tweaked, they may distrust all the information provided

165
Q

Activities of pediatric psychologists (Roberts et al)

A
  • 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
Q

Pediatric psychology settings (Roberts et al)

A
  • 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