HLST 152 Final Exam- Ch 14-22 Flashcards
DNA and Experience
- experiences chemically change DNA
- set in place during critical stages of development
Early Childhood
prenatal to eight
Determinants of Good Childhood Development
- physical
- social
- emotional
- language
- cognitive
Serve and Return
-speaking and waiting for baby’s response to develop neural pathways
Toxic Stress
- lack of response from adult keeps stress response prolonged in child
- delays neuron connection development
What factor has the biggest influence on child development?
nurturant qualities of the environment where the child grows up
Childhood Development Influences…
- well-being
- basic learning
- school success
- economic participation
- social citizenry
- health
Successful Development Depends On…
- health (parent and child)
- nutrition
- parenting
- strong social supports
- stimulating interactions with others
3 Factors Contributing to Positive Child Outcomes
- Adequate Income
- Supportive Environment
- Effective Parenting
3 Risks to Healthy Child Development
- Poverty
- Inadequate Care Giving
- Child Abuse
Latency Effects
- low birth rate
- cardiovascular disease
- Rubella, drinking, or smoking during pregnancy
- Breastfeeding reducing cancer in mother and baby
Pathway Effects
- early life environment sets trajectory
- readiness for school effecting educational attainment
Cumulative Effects
- multiple exposures over a lifetime who’s health effects combine
- accumulated disadvantage leading to learned helplessness
Attachment Connection
- care increases sensory stimuli activating developing areas of brain
- involves physical and emotional proximity
- effects personality
Emotional Social Support
demonstrating care, empathy, love, trust and acceptance
Instrumental Social Support
tangible support or action; assisting with a task
Informational Social Support
providing advice or suggestions
Appraisal Social Support
providing constructive feedback that is useful in self-evaluation
Social Networks
web of social relationships surrounding an individual
Mutual Aid
activities in which members mutually benefit
Perceived Support
resources sensed as being available and helpful
Received Support
support actually provided
Social Support is usually_____ than the social network
smaller
Social Integration
-degree of involvement or participation in the social network
People who are social isolated have…
an increased risk of death from a number of causes
Prevention of Loneliness
- better approach than helping once loneliness has occurred
- identifying high risk groups
- educational intervention
Social Support Helps People…
- learn to deal with adversity
- maintain mastery and control over life
- solve problems
It is not the ____ of relations that matter but the _____.
- quantity
2. quality
Social Support and Stress
- buffers impact
- decreases occurrence of stress
- decreases physiologic reactivity to stress
Social Capital
the social investments of individuals in society in therms of their membership in formal and informal groups, networks, and institutions
Social Exclusion
social exclusion is an expression of unequal relations of power among groups in society, which then determine unequal access to economic, social, political, and cultural resources
Roseto Effect
features of social support and social cohesion that accounted for the difference in health status between Roseto’s men and those of nearby communities
First Generation
people born outside Canada
Second Generation
includes individuals who are born in Canada with at least one parent born outside Canada
Third Generation
includes individuals who are born in Canada who’s parents were both born in Canada
Culture Influences…
- interaction with healthcare system
- participation in health prevention and promotion programs
- access to health information
- health related lifestyle choices
- understanding of health and illness
Healthy Immigration Effect
health transition of immigrants signal importance of SDOH or factors outside formal healthcare
-morbidity and mortality
There are Ethnic Differences in…
- perception and understanding of symptoms
- health care behaviour
- SDOH
Cultural ___ and ____ play important role in individual’s understanding of health
- beliefs
2. values
Different different ethnic groups have different ______ what constitutes appropriate treatment
expectations
Components of Culturally Competent Health Care
- appropriate language
- overcoming linguistic barriers
- culturally appropriate services
- reducing economic barriers
Complementary and Alternative Medicine (CAM)
diverse range of healing approaches, many of which originate in ancient healing systems and indigenous cultures
CAM
- usually outside conventional medicine
- not usually covered by benefits
- complementary
- alternative
Three Central Beliefs of Integrative Medicine
- Health is a holistic phenomenon
- Healing relationships should be patient/client
centered - Treatments must be evidence-based
Two Central CAM Concepts
- holism
- vitalism (healing is innate to human body)
Spirituality or Health Today?
pendulum swinging more towards spirituality
Studies Say… (spiritual and health)
religion and spirituality play a significant role in prevention of illness and health outcomes
Spiritual Well-Being
spiritual elements can effect mental and physical well-being
Spiritual Health
impacts the experiences of life stressors, turning distress into eustress
-impacts all areas of health
Examples of CAM
- reflexology,
- massage
- meditation
- natural health products
- reiki
- chiropractic
- tai chi
- yoga
- aromatherapy
- herbalism
Stress
a biological and biochemical process that begins in the brain and spreads through the nervous system causing hormone release and eventually exerting an effect on the immune system
Stressors
- events that activate stress response systems
- act as stimuli
- internal or external
Internal Stress
- biological
- fever
- hunger
- infection
External Stress
- motivational prompts for writing an exam
- devastating personal events
- more emotional
Distress
- bad stress
- out of control
- feel like victim
Eustress
- good stress
- euphoric stress
- exhilarating
- promotes productivity
- facilitates our effort
Three Types of Stress
- Physical
- Psychological
- Psychosocial
Categorizing Distress
- work stress
- family stress
- acute stress
- chronic stress
- trauma
- crisis
- daily hassles
Endocrine System and Stress: Catecholamines
- adrenaline (epinephrine) and norepinephrine
- increases heart rate, blood vessels constrict, muscles tense, respiration increases, blood thickens, more energy is release, brain becomes more alert
Endocrine System and Stress: Corticosteroids
- cortisone and cortisol
- suppresses immunity, leads to insulin resistance, weight increases, increase in BP and nerve loss
Fight or Flight
- increased mental activity
- bronchiolar dilation
- dilated pupils
- increased respiratory rate
- increased heart rate
- increased cardiac output
- increased glucose levels
- increased fatty acids
- increased BP
Pregnancy and Stress
- Stress in 2nd and 3rd trimesters cause more adverse outcomes
- predictor of timing of birth and birth weight
Cardiovascular Disease and Stress
stress increases chance of getting coronary artery disease
Infectious Diseases and Stress
- increased illness during exam periods
- immune system is weakened
Chronic Stress
deleterious effects on a number of biological systems and give rise to a number of illnesses
Hans Selye’s Conceptualization of Stress
- point where organism’s ability to perform easily is exceeded by the demands put on it
- resulting strain can be tempered by organism’s coping ability and moderating factors
Selye’s General Adaptation Syndrome
- Alarm Reaction
- stressor disturbs homeostasis “fight or flight” - Resistance
- almost right after alarm, increased immune response - Exhaustion
- body reaches limit
- health consequences appear
3 Factors Causing Stress
- Individual
- Behavioural
- Lifestyle
Behavioural Approach to Health
focus on personal health practices
Coping skills help people face challenges without resorting to ______.
risk behaviours
Transaction Model of Stress
- stress is seen as a process
- person-environment interactions determine stress response
- interactions and reactions are called transactions
- central feature is cognitive appraisal
Emotion Based Coping
- regulating emotion tied to the stressful situation
- no change to realities of the situation
Problem-Based Coping
-used when we feel competent to deal with the stressor
Steps of Problem Based Coping
- Define Problem
- Generate and Evaluate Solutions
- Learn skills to manage stressor
- Reappraise
Locus of Control
-individual’s perception of where the underlying responsibilities of like events reside
Learned Helplessness
- opposite of control
- learned belief that there is nothing you can do to fix it
Influence of Control on Health
- more control = less risk of illness
- control is important indicator of health behaviours
Resilience
-children of disturbed or incompetent parents learn to adapt to adverse circumstances through a variety of coping strategies
Resilience Attachment Theory
- based on attachment theory
- importance of mother-infant relationship
- sense of security helps coping with separation and adversity
Resilient Personality
-certain personality traits keep us well, boost out immunity, and improve our immune system
Traits of Resilient Personality
- self-esteem
- confidence
- optimism
- hope
- autonomy
- ability to cope
- sociability
- capacity for many emotions
- positive attitude
Family Resiliency
ability of a family to respond positively to an adverse event
Health Canada Mission Statement
committed to improving health of all Canadians and making Canada the healthiest country in the world
-measured by longevity, lifestyle, and effective healthcare
Role of Federal Government
- financing
- enforcing compliance with CHA
- delivering services to specific target groups
- functions on world stage with WHO
Federal Health Service Provided Target Groups
- inmates
- vetrans
- police
- indigenous
Role of Provincial Governments
- administers and delivers health care services
- each system is unique to their needs
- insurance as mandated by CHA
- health promotion and prevention
- approves hospital budget and negotiates physician’s fees
Canada Health Act
- combination of hospital Insurance and Diagnostic Services Act and Medical Care Act
- provinces must meet 5 criteria, 2 conditions
5 Criteria of CHA
- Public Administration
- Comprehensiveness
- Universality
- Portability (outside the country)
- Accessibility
2 Provisions of CHA
Discourage financial contributions by patients through…
- user charges
- extra billing
Medicare
- ten provincial and three territorial insurance schemes providing free access to medically necessary health care
- funded by general taxation
- landed immigrants and citizens
Social Safety Net
network of national and provincial social programs needed to protect the most vulnerable people of Canadian society
Extended Health Care Services Examples
- intermediate care in nursing homes
- adult residential care services
- home care
- ambulatory health care services
5 Levels of Care
- Health Promotion
- Disease and Injury Prevention
- Diagnosis and Treatment
- Rehabilitation
- Supportive Care
Which level of care relates to the Ottawa Charter
Level 1. Health Promotion
Strategies for Disease and Injury Prevention
- Clinical Actions (screening, immunizations)
- Behavioural Aspects (lifestyle changes and support groups)
- Environmental Action
Three Levels for Diagnosis and Treatment
- Primary Care (first contact with healthcare system)
- Secondary Care (specialized, further investigation)
- Tertiary Care (specialized, unusual)
Palliative Care
services for people living with progressive, life-threatening illness or conditions
Respite Care
provides short term relief or time off for family care providers
Tertiary Care
specialized and highly technical
Secondary Prevention
-activities that promote early detection of disease
Primary Prevention
activities that protect against a disease before signs and symptoms appear
Alma Ata
- 1978
- representatives from countries gathered and committed to achievement of health for all by 2000 through primary health care
- found inadequate illness management systems were not creating healthier societies
- WHO in charge of unjust suffering and death
Primary Health Care (PHC)
- focus on promoting health/wellness and preventing illness
- focus on what makes people sick
- attention on healthy people
- upstream focus
Social Justice: CAN Definition
- fair distribution of society’s benefits, responsibilities, and their consequences
- focus on relative position of one social group to another and root causes of disparities and solutions
Equity
-fair distribution of resources and access within and among various populations
Two Events for Primary Health Care
- Ottawa Charter
2. Developing an Alternative Strategy for Achieving Health for All
PHC Says Health is…
- fundamental right
- individual and collective responsibility
- equal opportunity concept
- essential part of socio-economic development
5 Primary Health Care Principals
- Health Promotion and Illness Prevention
- Accessibility
- Public Participation
- Appropriate Technology
- Intersectoral Collaboration
Health Promotion and Illness Prevention Requires a Shift From…
From... -disease based -reactive -downstream To... -capacity wellness -proactive -upstream
Accessibility Requires a Shift From…
From... -physician gatekeeper -fragmentation -weak links To... -clients direct their own care -choose access points -integration -interdisciplinary links
Barriers to Accessibility
- poverty/socioeconomic status
- cultural minorities
- geography/rural communities
- stigma
- lack of education or information
Public Participation Requires a Shift From…
From…
-expert perception and control
To…
-informed public participation and decision making
Appropriate Technology Requires a Shift From…
From... -use of technology without appropriate assessment of cost and benefits To... -use of technology based on evidence -low tech or alternative therapies
Barriers to Appropriate Technology
Canadians value expensive technology and quick fix cures
Intersectional Collaboration Requires a Shift From…
From…
-health care is the sole responsibility of health sector
To…
-integration with education justice, social services, and labor sectors
Intersectional Collaboration Barriers
- focus on autonomy
- lack of trust between professionals and agencies
- ambiguity of roles and responsibilities
- inadequate information systems
- lack of formal evaluation criteria
- Lack of incentives (financial) to participate
Primary Health vs Primary Care
Primary Health -community focused -promotion and prevention -provided by wide variety of people -self reliant Primary Care -first level of contact -individual focused -emphasis on cure -professional dominance
AHS and Primary Health
- primary care initiatives
- model of compromise
- physician remains gatekeeper
