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MATERNAL MIDTERM > MIDTERM > Flashcards

MIDTERM Flashcards

1
Q

What % of women will have at least one abortion by age 45?

A

50%

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2
Q

explain the difference between unintended/unplanned and unwanted/mistimed pregnancies?

A

unwanted - women who report that they never intended to give birth or continue childbearing

Mistimed- intended to bear children but not when pregnancy occurred

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3
Q

What % of all pregnancies are unintended?

A

50%

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4
Q

efforts to control fertility date back to ?

A

earliest recorded hx

issue of abandoned children during Renaissance

Socially sanctioned infanticide in the US

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5
Q

Infants/Children have better survival rates if they…?

A

are born to mothers not at extremes of childbearing age

Spacing of at least 2 yrs between births

Family size is limited

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6
Q

Unwanted pregnancy means higher risk for ?

A

mothers less likely to seek prenatal care

more likely to smoke/drink

low birth weight

higher likelihood of being abused (likely mother is abused)

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7
Q

if women have access to contraception they are less likely to…

A

less likely to pursue illegal abortions

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8
Q

some say that denial of pregnancy prevention services …is done why?

A

social control over women

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9
Q

research shows that by providing access to contraceptives and educational material leads to what behavior?

A

more responsible behavior and less unplanned pregnancies

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10
Q

In 1970 Title X was introduced…what was it for?

A

funding for nationwide program of family planning clinics for poor women

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11
Q

1976: legislation stated what?

A

Medicaid funds cannot be used for abortions

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12
Q

Bush era promoted??

Obama ???

A

Bush era: abstinence only education

Obama seeking to raise Title X funding

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13
Q

Name the different Mechanisms of contraception methods

A

Preventing Union of ovum & sperm: diagrams, condoms

Replacing woman’s normal hormonal cycle: pill, patch

Deactivation of sperm: cream, gel

Others: emergency contraception (plan b), sx sterilization

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14
Q

Why are women in the US called “inefficient contractors”

A

interplay of limited educational information, limited access, limited age restrictions, stigma associated with conceptions

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15
Q

what factors have the potential to cause irregularities in a woman’s menstrual cycle?

A

traveling, anything that changes body fat (obesity, anorexia, athletes)

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16
Q

How soon after childbirth does a woman’s period return?

A

dependent on breast feeding

can be up to 6 months

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17
Q

What are the four phases of the menstrual cycle?

A

menstruation

follicular

ovulation

luteal

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18
Q

What is the difference between PMS and PMDD?

A

PMS - normal changes before period

PMDD - unable to function due to hormonal changes - tx hormones and antidepressants

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19
Q

What is POI and how is it tx?

A

POI - Primary Ovarian Insufficiency (early onset menopause)

can be tx with estrogen replacement

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20
Q

What influences MCH policy?

A

Federalism

Interpretation of values in the constitution

Individualism

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21
Q

Key Dates/EVENTS of MCH services in the US (no need to know dates- but must know order)

A

1855: Founding of CHOP
1888: American Pediatric Society founded
1909: First White House conference on Children (Teddy Roosevelt)
1951: American College of Obstetricians & Gynecologists founded
1967: Office of Child Development created
1972: WIC established
1997: State Child Health Insurance Program added to Social Security Act
2010: PPACA

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22
Q

Government participation in MCH was influenced by?

A

Influenced by: developments in sanitation, control of infectious disease, public health education

NYC: led the way for child abuse laws

Industrialization

Keating-Owen Act

Collaboration between social workers and PH officials

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23
Q

What did the Keating-Owen Act do?

A

Prohibited interstate goods provided by children

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24
Q

Who opposed child labor laws?

A

catholic church said government shouldn’t meddle in charitable things

AAP (american academy of pediatrics)- said it was a socialist policy

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25
Q

What did Dr. Josephine Baker do?

A

lead the way for child labor law reform

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26
Q

What did the Sheppard-Towner act do?

A

Gave grants to states to promote child and family health

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27
Q

how many births were directly cared for by MCH after WWII

A

1 out of 7

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28
Q

list the events in order that explain the new roles of government (from the depression up to post WWII)

A

Great Depression (1929): drastically reduced funds for MCH

Changes to the Social Security Act related to MCH:

  • -Aid for dependent children
  • -Welfare services for children with special needs
  • -MCH services for crippled children
  • -Title IV: $$ for mothers who lose fathers’ support for children

Broad public support
World War II: implications for MCH

After WWII: Children’s Bureau loses ground

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29
Q

What MCH polices were put into place in the 1960s?

A

Kennedy: interested in mental retardation

  • -posited that it could possibly be prevented by adequate prenatal care
  • -projects that provided comprehensive medical services/hopitaliztion

Child abuse

  • -“battered child syndrome” - article 1962
  • -PH responded immediately
30
Q

What are Office of Economic Opportunity and what did they do?

A

OEO - 1964

Neighborhood health centers
–free to users
–governed by community members
–later called “community” health centers
(centers were funded directly from federal government and CUT the state out of the decision on how funds should be spent)

31
Q

what is Omnibus Budget Reconciliation Act and what did it do?

A

Expanded maternal/infant home visit programs

Enhanced states’ abilities to provide combined health/social services (“one stop shopping” model)

Increased participation of OB-GYNs and pediatricians in Medicaid

Projects for women & children in rural environments

Expanded community-based services

32
Q

1996 Personal Responsibility and Work Opportunity Reconciliation Act (PRWORA) what did it do?

A

federal funding guidelines for States:

Welfare

Child support

Teen mothers

Non-citizens

Limited enrollment

33
Q

explain government responsibility for children in legislation?

A

legislation to support children and to support the rights of families responsibility for children

34
Q

what is meant by the fundamental argument : are children a “community resource” ?

A

children are seen as a community resource - and therefore the responsibility of all citizens….or should childcare be undertaken by families and their immediate communities

35
Q

kids that live with grandparents tend to be…?

A

living in poverty and uninsured

36
Q

what are the most common types of households?

A

married, living alone

37
Q

postwar families changed how?

A

smaller families-fewer children

more one parent families

more people living alone

more people delaying (or not having) children

female-headed family households increasing

38
Q

What were the effects of women in the workforce when the Economic downturn occurred?

A

more women quit jobs to take care of kids because daycare is a major expense

39
Q

What % of the population recieves MTCA (means tested cash assistance) and what are the common services?

A

Means tested cash assistance - 14 % of the population

most are female headed families with children

most common services: Medicaid, free/reduced school lunches, and food stamps

40
Q

what % of children live in poverty?

how about extreme poverty?

A

1/3 of all those in poverty are children

1/12 children live in extreme poverty

41
Q

______ and ______ families are 2-3x more likely to live in poverty than ____families

A

black and hispanic families

white families

42
Q

Children in female headed families are more than _____ likely to be poor compared to married couple families

A

4x

43
Q

in general most mothers who receive government assistance ______ at least part time.

A

work

44
Q

Name BROAD types of studies

A

Descriptive

Relational

Causal

45
Q

List types of studies

A

Experimental

Observational

Cohort-retrospective or Prospectdale

Case-control

Cross-sectional-main limitation-exposure at one point in time-you can’t ascertain causality

Ecological-big data sets, population data not individual

46
Q

Describe a cross-sectional study and indicate it’s main limitation

A

Exposure at one point in time and you can’t ascertain causality

47
Q

Which study design is best for identifying long term effects of a rare exposure

A

Cohort studies are good for where exposures-give you information about the nature of the disease

48
Q

Which study design is best for identifying the short-term health effects of the new exposure about which Little is known?

A

cohort

49
Q

Which study is being described-

Study that examines death rates from cervical cancer in each of the 50 US states in relation to average percentage of women in each state undergoing annual Pap smear screening?

A

cohort (depending on means of collecting data (death certificates etc…) could be prospective or retrospective)?

50
Q

What kind of study is being described here-

Study comparing prevalence of back pain among current members of plumbers union’s with that of members of the bakers and confectionery union?

A

case control

51
Q

In 1998 the IOM (Institute of medicine) published the future of Public health what was its mission and what did it do

A

Mission was to provide an environment where people could be healthy

The balance-individuals versus communities

Recognition of children as individuals-children should not be treated as a means to an end

52
Q

What is the progressive era

A

Started the movement of children’s rights (not a whole lot) early 20th-century the gaining of momentum

parents had not been required to act in the best interest of children until recent history

53
Q

In reference to children’s rights the quote “valid claims that imply a reciprocal duty”

A

Positive versus negative

Positive-rights to have something tangible-school

Negative-right to be left alone-protection against unlawful interference by a government, freedom of religion

54
Q

Satisfying positive right to require’s resources

Societies need rules for fair allocation of resources what is this also known as

A

Distributive justice

55
Q

Based on principles of utility what should individuals be allowed

A

Individuals act to maximize own happiness or utility

Just allocation equals balance of pros and cons utilities for each individual and group

Those who are ill or at risk of becoming ill should have more resources

All members of the community benefit from healthy children

56
Q

Theory of Justice-based on rules and duties states what

A

Treat all people as in and not as a means to an end

Means the desirable titles and rolls are accessible to all… And it’s okay as long as the system benefits the poor (redistribution)

Robin Hood redistributing the wealth to those who need it

57
Q

List the two major theories of justice

A

Based on principle of utility

Based on rules and duties

58
Q

List the three models of social policy

And briefly explain each

A

-Residual welfare model-people’s needs can be met either through the family or through the feeding market (example when the US shifted from entitlement to achievement)

Industrial achievement/performance-benefits redistributed on basis of need, but the political decisions end up allocating resources based on one’s “status” (not equal status)

Industrial redistributive model-disproportionally more social benefits are allocated to the worst off (communism)

59
Q

cohort study description

A

A study in which subsets of a defined population can be identified that are, have been, or may in the future be exposed, or not exposed, to a factor that is thought to influence the probability of occurrence of a given disease or other outcome.

60
Q

describe case control study

A

A study that starts with the identification of individuals with the disease (or other outcome variable) of interest, and a suitable control group of individuals without the disease. The diseased group are called cases and the non-diseased group are called controls. Cases and controls are compared with respect to the occurrence of the exposure of interest.

61
Q

describe cross sectional study

A

In a cross-sectional study, the frequency of a particular exposure(s) and / or outcome(s) in a defined population is measured at a particular point in time.

62
Q

Medical focas in this nation has been on tx “temporally proximate” what does this mean?

A

treating symptoms (giving pain meds for ha)

63
Q

what is meant by life course perspective in health care?

A

focusing on potential long-term health impacts of experiences, exposures, and behaviors over individuals entire life span
(thinking about things like how do childhood/adolescent experiences impact reproductive health in 20’s, 30’s, 40’s)

–studies have attempted to link birth weight to adult outcomes

64
Q

explain the principle of timing

A

health is shaped not only by what happens to us BUT also by when it happens, how long it lasts, and in what order it occurs

ex. . impact of childbearing on female educational attainment is influenced by mothers age at the time of birth
ex. .. consequences of family instability in a childs life depends on age of child at onset of such instability

65
Q

what is the principle of linked lives?

A

health and well being are shaped by social networks to which we belong and relationships with significant others

ex…link between maternal and infant health

66
Q

explain the principle of historical time and place?

A

highlights how period, cohort and contextual factors influence the life course

ex…Great depression, great recession, economic stress w/i household

67
Q

what are the 3 key components in life course theory?

A

Trajectories - dynamic descriptors of health that describe a substantial period of the life span (can capture a long-term picture of a persons health)

Transitions - embedded w/i trajectories
take place w/i a relatively brief time frame (onset of parenthood)

Turning Points - a redirection of the life course through chugs in situation meaning or behavior (ex..transition to parenthood)

68
Q

explain the overall concepts of life course epidemiology

A

the idea that the body records all life experiences and tells a story of one’s past and that of the preceding generation

(in order to understand health in the present we must consider experiences that may have occurred years, decades, generations earlier)

69
Q

explain: latency, cumulative, pathway

A

Latency - biological chain of risk

Cumulative - accumulation of risk (ex…multiple risk factors like pregnant woman smoking and drinking)

pathway - social chains of risk (social trajectories)
ex..adolescence STIs or drinking and driving

70
Q

explain the differences between comprehensive healthcare services for women and their families over the life span.
Vertical, horizontal, and longitudinal

A

vertical - w/i the healthcare sector (basic healthcare continuity)

Horizontal - social services

Longitudinal - over the lifespan

MATERNAL MIDTERM (1 decks)

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