keeping people healthy week 4 Flashcards
What initiates puberty?
puberty starts with the de-inhibition of the pulse generator of the arcuate nucleus
Leptin levels rise in the body throughout childhood and play a part in allowing the arcuate nucleus to resume operation
release of gonadotropin-releasing hormone from the hypothalamus
Pituitary gland secretes FSH and LH
These signal the start of sexual development
Describe puberty in girls
Ages 10-14
ovaries start to produce oestrogen
body matures in preparation for pregnancy
first sign is normally breast development
then hair grows in pubic area and axillae
menstruation usually occurs last
Describe puberty in boys
ages 12-16
sperm and hormone production
testosterone responsible for most changes in the body
puberty begins with testicle and penis enlargement
then hair grows in pubic area and axillae
muscles grow, voice deepens, facial hair develops
What are the first signs of puberty due to?
increased secretion of adrenal androgens, possibly under the influence of adrenocorticotropin hormone
What can cause delayed puberty?
constitutional delay hypogonadotropin hypogonadism chronic illness psychological stress anorexia nervosa excessive exercise endocrine disease
Describe constitutional delay
most common cause of delayed puberty
affected children are healthy and usually more than 2.5 SDs below the median height for their age throughout childhood
often family history
in constitutional delay bone age will be less than chronological age
What effects can delayed puberty have?
in young skeleton oestrogen deficiency leads to increased osteoclast formation and enhanced bone resorption
oestrogen inhibits the differentiation of osteoclasts
the effect is probably mediated by IL1 and IL6
what is a risk factor?
an aspect of personal behaviour or lifestyle, an environmental exposure, or inherited characteristics that on basis of scientific evidence, is known to be associated with meaningful health related conditions
What are risk factors for cardiovascular disease?
smoking alcohol inactivity inappropriate diet genetics mental health diabetes
What is the life course approach?
the study of long term effects on later health or disease risk of physical or social exposures during gestation, childhood, adolescence, young adulthood or later in adult life
What is programming?
the process whereby a stimulus or insult at a sensitive period of time has lasting effect on the structure and function of the body
What is the Barker hypothesis?
the impact of poor foetal nutrition across different sensitive periods results in changes in body structure and function which prepare the baby for austerity
What are the risk factors in the adverse childhood experiences study?
abuse- emotional, physical or sexual
household challenges- mother treated violently, household substance abuse, mental illness in household, parental operation, criminal household behaviour
neglect - physical or emotional
What are the ACE risk factors for?
alcoholism COPD depression foetal death illicit drug use liver disease poor work performance financial stress risk of partner violence STIs smoking suicide unplanned pregnancies risk of sexual violence poor academic achievement
What can adverse childhood experience do?
disrupt neurodevelopment, causes social, emotional and cognitive impairment, adoption of health risk behaviours, disease, disability and morbidity, early death
What are possible interventions during the life course?
action of socioeconomic status action on parenting support earlier permanency intervention at school intervention through gangs intervention in prison
what is the definition of a drug?
a chemical substance used in the treatment, cure, prevention, diagnosis of disease or used to otherwise enhance physical or mental well being
What are the social impacts of drugs and alcohol?
employment
crime
relationships
child care
what are the health impacts of drugs and alcohol?
minor symptoms GP consultations infections hospitalisations affection services death
What are the determinants of drug use?
availability
affordability
social acceptability
promotion
What is contained in cigarettes?
nicotine
carbon monoxide
tar
arsenic, cyandie, ammonia, acetone, benzene, formaldehyde, cadmium, hydrogen cyanide etc
What is addiction?
compulsive physiological and psychological need for a habit-forming substance
characterised by compulsive drug-seeking and use even in face of negative health consequences
What effect does nicotine have?
stimulates adrenal glands - increases heart rate, BP, breathing, release glucose, surpasses insulin
Binds to “nicotinic” ACH receptors - brain creates more receptors, if these are not activated causes cravings
Dopamine is also released in response to nicotine - pleasure pathway - enjoyment and relaxation
tolerance is quickly acquired
What is second hand smoke associated with?
SIDs Asthma lower respiratory tract infections, pneumonia, bronchitis glue ear bacterial meningitis
What are examples of oestrogen and progesterone contraceptives?
combined pill
patch
vaginal ring
What are examples of progesterone only contraceptives?
progesterone only pill
injectable
implant
progesterone release IUD (mirena coil)
What are examples of barrier methods of contraceptives?
condom - male and female
diaphragm and cervical caps
What are natural methods of contraception?
billings (mucus) temperature rhythm withdrawal persona
What types of sterilisation are there?
female - tubal ligation
male - vasectomy
What factors influence contraceptive choice?
knowledge and understanding of method personal features - e.g forgetfulness method characteristics lifestyle and occupation motivation not to be pregnant alcohol and drug use peer / partner pressures embarrassed to discuss with health professional concerns re confidentiality poor access to services cultural / religious influences
Who are at increased risk of STIs?
adolescents men who have sex with men people from or who partners from, countries with high rates of STIs frequent partner change previous bacterial STI early onset sexual activity alcohol or substance abuse
What are the fraser guidelines?
the young person understands the professional’s advise
the young person cannot be persuaded to tell their parents
the young person is likely to begin, or to continue having, sexual intercourse with or without contraception
unless the young person receives contraception, their physical or mental health, or both, are likely to suffer
the young person’s best interests require them to receive contraceptive advise or treatment with or without parental consent
What shows that a young person has capacity?
they are able to;
understand the treatment, its purpose and nature and why it is being proposed
understand the benefits, risks and alternatives
understand in broader terms what the consequences of treatment will be
retain the information for long enough to use it and weight it up in order to arrive at a decision
