Exam 2 Flashcards

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1
Q

The Pill general info

A
  • combination est & progestin
  • 21 days on, 7 off
  • works by inhibiting ovulation, thickening cervical mucus, endometrium inhospitable for implantation
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2
Q

Quick Start

A
  • with the pill… start pill as soon as prescribed, regardless of day in cycle
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3
Q

Health Risks of Pill

A
  • no increased risks of cervical, uterine, or breast cancer
  • protect against endometrial and ovarian cancer
  • risk of thromboembolic disorders (blood clots)
    - esp women over 35 who smoke
  • BP increase
  • increased risk of STIs
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4
Q

Why increased risk of STIs with pill?

A
  • more likely to not use a condom

- makes vagina more vulnerable to infection

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5
Q

Side effects of the pill

A
  • increased vaginal discharge
  • change in libido, up or down
  • mood changes (20%)
  • antibiotics can decrease effectiveness
  • the pill can change dosage of antibiotic
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6
Q

Risk on pill 5+ years

A
  • increased risk of benign hepatic tumors (liver)
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7
Q

The Patch

A
  • Ortho evra
  • 1 patch/week for 3 weeks
  • estrogen & progestin
  • lack of certainty about dosing, esp over 200lbs
  • possibly higher or lower est levels
  • slightly higher rates of blood clots
  • more consistency with timing
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8
Q

Nuva Ring

A
  • mainly works by stopping ovulation
  • insert ring like diaphragm, leave in for 3 weeks
  • failure rate comparable to pill
  • est & progestin
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9
Q

Seasonale

A
  • 84 days of pills, 7 off

- no additional side effects from normal

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10
Q

Other pills (2)

A
  • Triphasic ( steady est levels, increasing progestin levels in phases)
  • Progestin-only
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11
Q

Progestin-Only pills

A
  • “mini pills”
  • safest for breastfeeding mothers
  • not to be used in first 6 weeks after birth
  • not as effective)
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12
Q

Depo-Provera Injections

A
  • Progestin only
  • inhibits ovulation
  • thickens cervical mucus
  • inhibits growth of endometrium
  • every 3 months
  • works slightly better than pill (no memory needed)
  • possible lag of 6-12 months of fertility
    • most no problems after that
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13
Q

Emergency Contraception

A
  • “morning after pill”
  • 75-89% effective
  • pregnancy rate .5-2%
  • Plan-B one step
  • Ella
  • insertion of IUD within 5 days
  • handful of BC pills
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14
Q

Plan B One-Step (next choice one dose)

A
  • OTC
  • effectiveness decreases longer you wait
  • high dose of synthetic progesterone
  • most effective within 24 hours after intercourse
  • must be within 120 hours (5 days)
  • mode of action depends on what time in cycle
    - prevent ovulation, prevent fertilization, inhibit sperm function, inhibit endometrial growth
  • not abortion, egg not implanted
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15
Q

Ella

A
  • non-hormonal (UPA) (Ulipristal acetate)

- by prescription only (antiprogestin)

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16
Q

LARC

A
  • long acting reversible contraception
  • preferred methods, dont rely on user, have very low failure rates
  • implants, IUDs
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17
Q
  • Implants
A
  • Implanon/Nexplanon
  • single rod, progestin-only
  • lasts 3 years
  • high cost
  • effectiveness (99.95%)
  • work like other progestin only birth controls
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18
Q

IUDs and side effects

A
  • paraguard- copper
  • mirena and skyla - progesterone
  • changes uterine lining making it lethal to sperm and eggs
  • side effects:
    • increased menstrual cramping, flow
    • usually not covered by insurance
  • does not affect tampon use or intercourse
  • can get pregnant immediately after
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19
Q

Copper T

A
  • Paraguard
  • changes enzymes in uterus so implantation unlikely
  • up to 12 years
  • more irregular bleeding
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20
Q

Progestin IUDs

A
  • disrupts ovulation, reduces endometrium
  • Mirena 5 years
    • reduced flow
  • Skyla 3 years
    - smaller
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21
Q

Barrier Methods & Facts

A
  • Diaphragm and Fem Cap
    • metal rimmed, fits over cervix, place spermicide on rim and inner edge
  • work by mechanical blockage of sperm, spermicide kills sperm
  • may insert up to 6 hrs before intercourse
  • needs to stay in 6 hours after, not more than 24
  • one diaphragm can be used for ~2 yrs
  • failure rate ~12%
  • $75 + dr. visit + spermicide
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22
Q

Barrier Method: Sponge

A
  • polyurethane and spermicide

- not very effective

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23
Q

External Condom

A
  • Protection against STIs and pregnancy
  • Latex - don’t use oil based lube
  • lambskin - ineffective (STIs can get through)
  • polyurethane- noisier
  • leave 1/2 inch space at top
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24
Q

External Condom + Spermicide

A
  • not more effective

- may increase risk for STIs b/c of irritation

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25
Q

Dental Dam

A
  • type of external condom
  • rectangle of latex
  • placed over anus/vagina during oral sex
  • some flavored (keep flavoring out of vagina, irritation)
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26
Q

Internal Condom

A
  • polyurethane (noisy)
  • lube inside & outside
  • STIs can be transmitted if it malfunctions/slips
  • two rings, one at each end
  • typical failure rate 21% (perfect 5%)
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27
Q

Spermicides

A
  • foam, vaginal film etc
  • Nonoxynd 9 (N-9)
  • use along with diaphragm
  • 28% failure rate
  • must leave in 6 hours
  • increased risk of STIs b/c of irritation
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28
Q

Douching/Withdrawal

A
  • DONT DO THIS
  • flushing out vagina can push sperm in
  • pre-ejaculate contains sperm
  • failure rate 22%
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29
Q

Rhythm

A
  • Roman Catholic Church approved
  • fertility awareness methods (abstain during ovulation)
  • sperm can survive 5 days
  • eggs can be fertilized 12-24 hours after ovulation
  • Calendar, Standard Days, BBT, Cervical Mucus, Sympto-thermal
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30
Q

Calendar Method

A
  • Rhythm method
  • abstain 3 days before and 2 days after ovulation
  • assume ovulation occurs on days 13-15
  • need 6 months-1 year data to be effective
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31
Q

Standard days method

A
  • Rhythm
  • assume most menstrual cycles 26-32 days
  • abstain days 8-19
  • failure rate 12%
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32
Q

BBT Method

A
  • Rhythm
  • only tracks temp rise AFTER ovulation
  • determine safe days after
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33
Q

Cervical mucus method

A
  • Rhythm
  • right after menstruation: relatively little mucus
  • white & tacky: follicular phase
  • thin: days shortly before ovulation
  • determine safe days before
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34
Q

Sympto-Thermal Method

A
  • mucus + BBT

- best rhythm method

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35
Q

Irreversible Methods

A
  • Sterilization
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36
Q

Irreversible Method: Men

A
  • Vasectomy: cut vas deferens
  • no effect on hormone production
  • 20 mins local anesthetic
  • use contraception 3 months after
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37
Q

Reconnecting Vas deferens

A
  • vasovasectomy
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38
Q

Irreversible Methods: Women

A
  • tubal ligation (laparotomy): cut and tie fallopian tubes

- minilaparotomy: small incision usually immediately after giving birth

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39
Q

Failure Rate Definition

A
  • “if 100 women use this method for 1 year, the % of whom become pregnant”
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40
Q

Effectiveness rate

A
  • 1-failure rate
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41
Q

Perfect vs Typical user

A
  • perfect: perfect

- typical: human error involved

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42
Q

Best method for spacing of births

A
  • rhythm

- don’t care as much

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43
Q

Psychological Aspects of BC

A
  • 750,000 teen pregnancies in US/yr
    • 29% abortion
    • 57% live births
    • 14% miscarriage
  • often as a result of not using contraception
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44
Q

Medical Abortion

A
  • RU-486 (mifepristone): antiprogesterone + prostaglandin (misopristol)
  • within 7-9 wks of conception
  • anti-progesterone sloughs off uterus, prostaglandin makes uterine contractions
  • 92% effective
  • 17% all abortions
  • commonly done in physician’s office
  • shown little negative psychological effects of woman
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45
Q

Methotrexate

A
  • used in medical abortions

- also used as cancer treatment and ectopic pregnancies

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46
Q

New contraceptive methods for men (3)

A
  • new condoms
  • pill or injection to suppress sperm production
  • “switch” on vas
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47
Q

New contraceptive methods for women (3)

A
  • better microbicides: kill sperm and viruses and bacteria (bufferGel)
  • vaginal ring with antiviral to protect against HIV
  • SPRMs: selective progesterone receptor modulators
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48
Q

SPRMs

A
  • selective progesterone receptor modulators (ella)
  • useful for emergency contraception
  • depending on time in cycle when used either prevent LH surge or prevent implantation
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49
Q

Surgical Abortion

A
  • vacuum aspiration (suction and curretage)
  • 1st trimester up to 14 weeks
  • outpatient
  • dilation of cervix and suction of fetus
  • most common method early abortion
  • 88% abortions (& in first 12 weeks)
  • dilation and evacuation (D&E) 2nd trimester abortions
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50
Q

Ekiti Yoruba

A
  • S.W. Nigeria
  • 200,000-500,000 pregnancies aborted/yr
  • 10,000 women die/yr
  • believe “real child” isn’t formed until 4th month
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51
Q

Turnaway study

A
  • 3 groups: 1st trimester abortions, near limit abortions, & turnaways
  • found good adjustment and mood of those who had abortion to those who didn’t
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52
Q

How many partners knew about abortion?

A
  • 82% knew

- 80% of those were supportive

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53
Q

Masters & Johnson

A
  • Masters: father of human sexual response

- Johnson: recruited by Masters, later married

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54
Q

“Glass Penis”

A
  • insertable EMG sensor

- measured blood flow, muscle contractions, took pictures

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55
Q

Basic Phys Processes of sexual response

A
  • Vasocongestion

- Myotonia

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56
Q

Stages of Sexual Response

A
  • excitement
  • orgasm
  • resolution
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57
Q

Male Excitement Phase

A
  • testes elevated, penis elevates
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58
Q

Male Late Excitement Phase

A
  • testes fully elevated, color of penis deepens, secretion of cowper’s gland
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59
Q

Male Orgasm: Stage 1

A
  • internal sphincter of bladder closes
  • prostate and seminal vesicle contracts
  • rectal sphincter closes
60
Q

Male Orgasm: Stage 2

A
  • ejaculation

- urethral contractions

61
Q

Male Resolution

A
  • scrotum thins
  • erection disappears
  • testes descend
62
Q

Refractory Period

A
  • time after ejaculation where male cannot have another erection
  • increases with age
63
Q

Female Excitement Phase

A
  • vaginal lubrication
  • clitoris swells
  • labia swell
  • bladder shifts
64
Q

Female Late Excitement

A
  • expansion of upper 2/3 of vagina
  • clitoris retracts
  • color change in labia
  • uterus elevates
  • orgasmic platform forms (Front side of vagina)
65
Q

Female Orgasm

A
  • rhythmic contractions in uterus and orgasmic platform

- rectal sphincter contracts

66
Q

Female Resolution

A
  • uterus lowers
  • vagina to normal size
  • orgasmic platform disappears
  • semen pools under cervix
  • no refractory period (multiple orgasms possible)
67
Q

____% of women never experience an orgasm

A
  • 10%

- likely physiological problem

68
Q

Breast Response (excitement, orgasm, resolution

A
  • size increase
  • nipples erect
    * excitement
  • areolar enlargement
  • sex flush
  • veins visible
    * orgasm
  • sex flush disappears v rapidly
    * resolution
69
Q

Extragenital Response; Excitement

A
  • nipple erection

- sex flush (late excitement –> orgasm)

70
Q

Extragenital Response; Orgams

A
  • carpopedal spasm

- increased HR, BP

71
Q

Extragenital Response; Resolution

A
  • sweating, hyperventilation
72
Q

Viagra

A
  • 1998

- developed originally for prevention of heart attacks

73
Q

Erection: Spinal Reflex

A
  • Psychogenic Stimulation (visual, auditory..)

- Reflexogenic Stim (tactile stim)

74
Q

Psychogenic Stim (Spinal Reflex)

A
  • from brain through T11-L2
75
Q

Reflexogenic Stim (Spinal Reflex)

A
  • tactile stim of the genitals
  • bowel or bladder stim
  • sacral erection center (S2-S4)
76
Q

Erection Mechanism

A
  • smooth muscle relaxation lets blood flow in (parasymp), smooth muscle contraction at venules keeps blood there
  • NO –> cGMP –> Muscle Relaxation
77
Q

PDE5 and viagra

A
  • viagra inhibits PDE5 which usually degrades cGMP… viagra keeps muscles relaxed to let blood flow in
78
Q

If spinal cord is severed above S2 what can happen?

A
  • can still get erection by tactile stim
79
Q

Triphasic Model

A
  • Kaplan
  • Sexual Desire, Vasocongestion, Myotonia all need for sexual arousal
  • “good sex needs good friction and good fantasy”
80
Q

Sexual Excitation-Inhibiton Model

A
  • “dual control model”

- need balance between the two models

81
Q

High excitation, low inhibition

A
  • risky behavior
82
Q

Low excitation, high inhibition

A
  • sexual disorders
83
Q

Study with emotions and arousal

A
  • both extremes of mood correlated with higher arousal
84
Q

G-Spot

A
  • Grafenberg’s Spot
  • Skene’s gland (female prostate)
  • female ejaculation
  • uterine orgasms “Freudian mature orgasm”
85
Q

What does some female ejaculation have in it?

A
  • PSA (prostate specific antigen
86
Q

Phermones

A
  • biochems secreted outside the body
  • McClintock and Stern
    - menstrual synchrony and pads
  • mechanism: vomernasal cells have chemoreceptors
87
Q

McClintock and Stern

A
  • Menstrual Synchrony

- Pad experiment (underarms and necklaces)

88
Q

Endocrine Influences

A
  • Organizing Effects

- Activating Effects

89
Q

Organizing Effects

A
  • Prenatal Development hormones
  • cause relatively permanent change of structures in nervous or repro systems
  • critical period for these
90
Q

Activating Effects

A
  • Hormones that activate/deactivate certain behaviors
91
Q

Sexual Behaviors influence _____, and _____ influences sexual behaviors

A
  • testosterone levels
92
Q

Antiandrogen drugs

A
  • “chemical castration”
  • tried on pedophiles, sexual assaulters
  • should also have psychotherapy b/c sexual behavior of humans controlled by both hormones and brain
93
Q

Women and Testosterone

A
  • effects on desire

- adrenal-ectomy: decreased sexual desire.. take T injections to return libido levels to normal

94
Q

Components of a reflex

A
  • Receptors
  • Transmitters
  • Effectors
95
Q

Receptors (Reflex)

A
  • sensory neurons that detect stim & transmit messages to brain or spinal cord
96
Q

Transmitters (Reflex)

A
  • centers in spinal cord or brain that receive the messages, interpret, and send out a message to produce a response
97
Q

Effectors (Reflex)

A
  • neurons or muscles that respond to stim.
98
Q

Ejaculation Reflex

A
  • muscular response (not vasocongestion)
99
Q

Retrograde Ejaculation

A
  • ejaculate empties into bladder
  • creates “dry orgasm”
  • can be caused by illness, psychoses drugs, and prostate surgery
  • external sphincter closes, internal opens (backwards)
100
Q

Brain Control of Sexual Response

A
  • 3 phases
    - anticipatory
    - consummatory
    - post-orgasmic
101
Q

Anticipatory Phase

A
  • Brain Control of Sexual Response
  • sexual interest, desire, beginnings of arousal
  • limbic system activation
102
Q

Consummatory Phase

A
  • Brain Control of Sexual Response
  • corresponds roughly to excitement and late excitement
    • motor and somatosensory cortex
  • orgasm
    • decreased prefrontal cortex
103
Q

Post Orgasmic Phase

A
  • Brain Control of Sexual Response

- dearousal neural network

104
Q

Anticipatory and Consummatory Phase of sexual response neurotransmitters

A
  • dopamine, melanocortins, oxytocin, NE
105
Q

Post Orgasmic Phase of sexual response neurotransmitters

A
  • opioids, endocannabinoids, serotonin
106
Q

Measuring Sex (4)

A
  • Self-reports
  • behavioral measures
  • implicit measures
  • biological measures
107
Q

Self-Reports

A
  • questionnaires
108
Q

Behavioral Measures

A
  • direct observation
  • eye tracking
  • police reports
109
Q

Problem with police reports as behavioral measures

A
  • have some wrongly accused, underreported
110
Q

Implicit Measures

A
  • measures nonconscious attitudes

- ex) slow rxn time between gay and good

111
Q

Biological Measures

A
  • genital measure
  • plethsmograph
  • MRI and fMRI
  • pupil dilation
112
Q

Plethsmograph

A
  • measures arousal in women (tampon-like camera to view vagina during arousal) and men (penialgage)
113
Q

fMRI function

A
  • measures relative blood flow in brain
114
Q

Population vs. Sample

A
  • population: everyone of interest

- sample: small group of everyone of interest

115
Q

Sampling: random vs probablity

A
  • random: each member of population has an equal chance of being selected
  • probability: target a group of people more than others.. known probability of being chosen
  • both considered representative sample
116
Q

Convenience sample

A
  • when researchers fails to obtain a random or probability sample
  • use who’s around
117
Q

volunteer bias

A
  • those who volunteer for study have something different about them that makes them want to volunteer vs those who don’t
118
Q

Issues in sex research (3)

A
  • accuracy of measurement of self reports
  • accuracy w/ behavioral observations or biological measures
  • ethics
119
Q

Problems with Self Reports

A
  • purposeful distortion
  • memory
  • ability to estimate
120
Q

Ways to make self reports better

A
  • increase anonymity

- computer assisted self interviews (CASI)

121
Q

CASI

A
  • computer assisted self interviews

- reads questions to participant

122
Q

Ethics of sex research

A
  • 3 pillars
    • informed consent
    • protection from harm
    • justice
123
Q

Ethics: Informed Consent

A
  • participants need to be informed on what is expected and be able to give consent
124
Q

Ethics: Protection from Harm

A
  • minimize stress

- protect anonymity

125
Q

Ethics: Justice

A
  • cost of research should be born equally
  • benefits of research should be born equally
    - ex) BC tested on low-income puertorican women.. not same effects as other women
  • do costs outweigh risks?
126
Q

Kinsey Report

A
  • 1938-1949
  • interviews with >11,000 people (over half interviewed by Kinsey himself)
  • Indiana University
  • Sampling: mostly well educated students, or people of interest to kinsey
  • interviewing techniques: good
    • nonjudgmental
127
Q

Books By Kinsey

A
  • 1948: Sexual behavior in the human male

- 1953: Sexual behavior in the human female

128
Q

NHSLS

A
  • 1994
  • National Health & Social Life Survey
  • Laumann**
  • U of Chicago
  • probability sample of households
  • 79% response rates
  • 3,500 participants
  • mostly face to face interviews
129
Q

NSSHB

A
  • 2009
  • National Survey of Sexual Health & Behavior
  • Indiana University
  • Probability sample: random digit dialing
  • Ages 14-94
  • 53% response rate
  • n=5865
  • answered survey on website
  • 69% white, 14% hispanic, 11% black, 7% other
130
Q

British and Australian Surveys

A
  • similar to NSSHB and NHSLS
  • better funding
  • larger samples
131
Q

Ethnicity in US surveys

A
  • interviewer same sex & ethnicity as participant: better response rate/honesty of response
  • can be profoundly different cultural conceptualizations of same ideas
132
Q

Magazine Surveys

A
  • can reach large population

- do not know who sample is.. hard to make conclusion

133
Q

Web-Based Surveys (Strengths & Weaknesses)

A
  • Strengths
    • large samples at low cost
    • access to hidden populations, recruited through specialty websites
  • Weakness
    • lose control of samplings
134
Q

Snowball Sampling

A
  • existing participants suggest names of future participants to recruit
135
Q

Daily Diary Method of Sampling

A
  • improved self reporting.. log every day
136
Q

Media Content Analysis

A
  • set of procedures to make valid interference about text
137
Q

Intercoder Reliability

A
  • multiple researchers measuring same thing, look @ their consistency
138
Q

Masters and Johnson Experiment

A
  • 1966
  • Lab Study
  • Biological Measures
  • Behavioral Measures
  • n=694
139
Q

Quan vs. Qual Methods

A
  • Quan: assign #s to attributes
    • surveys, experiments
  • Qual: “thick description” gain indepth understanding of behavior
    - interviews, words, not #s
140
Q

Participant-Observer Studies Examples

A
  • Inis Beag, Mangaia
  • Humphrey’s Tearoom Trade
  • Moser = S&M parties
141
Q

Humphrey’s Tearoom Trade

A
  • 1970

- followed those who left bathroom after sex to see what their lives were like

142
Q

Moser Participant-Observer Study

A
  • S/M parties
143
Q

Meta-Analysis

A
  • quantitative lit review
  • method for combining results of numerous studies on a given question
  • Effect Size: d=Mn-Mw/Sw
144
Q

What we learn from meta-analyses

A
  • whether there is an effect
  • how big the effect is
  • whether it replicates across many studies
145
Q

What is the gold standard for conclusions in medicine, ed, and psych?

A
  • meta-analyses
146
Q

Measures of discrimination

A
  • formal: permission to interview

- informal: # words spoken