Summary
BIOL 111 Exam 3 Summary
- Course
- Basic Biology
- Institution
- Campbell University
This is a comprehensive and detailed summary on Exam 3 for Bio 111. An Essential Study Resource!!
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1ACES and Maltreatment- Effects on long term health
● What are ACES = Adverse Childhood Experiences
○ Caused by Toxic Stress
■ Constant production of cortisol because you are in a constant state of
stress
■ Causes the mind and body stays on alert and can no longer regulate their
emotions
○ Affects long term health into adulthood
■ Persons who had experienced ACES had 4- to 12-fold increased health
risks for alcoholism, drug abuse, depression, and suicide attempt;
■ A 2- to 4-fold increase in smoking, poor self-rated health, ≥50 sexual
intercourse partners, and higher risk of sexually transmitted disease
■ A 1.4- to 1.6-fold increase in physical inactivity and severe obesity.
■ The higher the exposure the greater their chances for ischemic heart
disease, cancer, chronic lung disease, skeletal fractures, and liver disease.
● ACES Study:
○ The CDC-Kaiser Permanente Adverse Childhood Experiences (ACE) Study is one
of the largest investigations of childhood abuse and neglect and household
challenges and later-life health and well-being.
○ The original ACE Study was conducted at Kaiser Permanente from 1995 to 1997
with two waves of data collection. Over 17,000 Health Maintenance Organization
members from Southern California receiving physical exams completed
confidential surveys regarding their childhood experiences and current health
status and behaviors.
● Categories of ACES
○ 1. Abuse
■ Emotional*– verbal abuse of the child (“you’re stupid”)
■ Physical– spanking, hitting, burning
■ Sexual– inappropriate touching to full sexual penetration
○ 2. Neglect→ know the difference
■ Emotional*– not fulfilling emotional needs (not being there when the kid
needs you)
■ Physical– not meeting physical needs (not getting fed, bathed)
○ 3. Household Challenges
■ Mother treated violently
■ Household substance abuse
■ Household mental illness
■ Parental separation or divorce
■ Incarcerated household member
○ Other ACES
■ Peer victimization– bullying
■ Teen dating violence– could be sexual assault, control, stalking, physical
■ Loss of parent
, 2
■ Community violence
■ Historical trauma– something that happened in the past that is still
traumatic to the family
■ War
■ Poverty
How bad is the problem?
● ACEs are common.
● Preventing ACEs could potentially reduce a large number of health conditions.
● Some children are at greater risk than others.
● ACEs are costly.
● What are the consequences?
○ Lasting negative effects on health, well being, opportunity
○ Increase risk of injury, sexually transmitted diseases; maternal and childhealth
problems, teen pregnancy
Risk Facto rs for ACE’s
● Family/Individual
○ Low income
○ Low education
○ High parenting or economic stress– multiple children, children with special
needs/chronic illness, single parenting, parenting in a divorced family
○ Inconsistent discipline– not the same rules at both houses
○ Use of negative communication styles
○ Acceptance of violence– violence becomes normal
● Community
○ High rates of violence
○ High unemployment
○ High poverty
○ Low community involvement
○ Food insecurity
○ Unstable housing
Protective Factors
● Family and Individual
○ Families who create safe, stable nurturing relationships
○ Children who do well in school and form positive peer relationships
○ Children who have positive adult role models outside of the family
○ Families able to meet basic needs of food, shelter and health
○ Families that engage in fun activities together
● Community
○ Access to safe, stable housing
○ Access to safe nurturing childcare and high-quality preschools.
○ Engaging after school programs
, 3
○ Violence is not tolerated
○ Residents feel connected and are involved in the community
Preventing ACE’s
● Strengthen economic supports to families– better access to jobs, housing, daycare, food
● Promote social norms that protect against violence and adversity
● Ensure a strong start for children
● Teach skills
○ Teach postnatal care (how to care for their child, if they grew up getting spanked
they may think it's the norm)
○ Teach safe dating
● Connect youth to caring adults and activities
● Intervene to lessen immediate and long-term harms
Raising Awareness of ACE’s
● Change how people think about the causes of ACEs and who could
help prevent them.
● Shift the focus from individual responsibility to community
solutions.
● Reduce stigma around seeking help with parenting challenges or
for substance misuse, depression, or suicidal thoughts.
● Promote safe, stable, nurturing relationships and environments
where children live, learn, and play.
● Let’s help all children reach their full potential and create
neighborhoods, communities, and a world in which every child can thrive.
Maltreatment of Infants and Children
● Maltreatment
○ Physical, sexual, and emotional abuse, physical neglect, emotional neglect
Risk factors for maltreatment:
● Caregiver
○ Young/uneducated, Unrelated partner of child, Low income, Social isolation/lack
of support, Low self esteem, Lack of parenting knowledge, History of abuse
● Child
○ Less than 1 year of age
○ Unwanted, hyperactive, or with physical or mental disabilities
○ Premature infants
● Environment
○ Chronic stress, SA, divorce, unemployment, poverty, substitute caregivers
Warning Signs of Abuse
● Physical evidence– bruises in different stages, marks that aren’t easily explained
● Vague or changing history of injury– one parent says a different story than the other
, 4
● Other injuries
● Delay in seeking care**- old fractures
● Inappropriate responses– “he’s always so clumsy”
Findings of Maltreatment- Physical
● Physical Neglect
○ FTT, Lack of hygiene, Frequent injuries, Delay in seeking healthcare, Dull affect,
School absences, Self stimulating activities
● Physical Abuse
○ Bruises in various stages of healing, Bruising in a non-mobile child, Multiple
fractures in different stages of healing, Burns, laceration, Fear of parents, Lack of
emotional response
Findings of Maltreatment- Emotional
● Emotional Neglect and Abuse
○ FTT, Eating disorder, Enuresis (peeing themselves at night), Sleep disturbances,
Self stimulating behaviors, Withdrawal, Developmental delay, Suicide attempts
○ Caregivers behavior with emotional neglect/abuse
■ Rejection of child, terrorizing child, ignoring child, verbally assaulting
child, pressuring child excessively
Findings of Maltreatment- Sexual
● Bruises, lacerations, Bleeding of genitalia, anus or mouth, STD, Difficulty walking or
standing, UTI, Regressive behavior, Withdrawal, Use of sexually explicit language
inappropriate for age or development, Unusual body odor, Bloody or torn underwear
● Sexual Abuse – the employment, use, persuasion, or inducement of a child to engage
in any sexually explicit conduct. Includes pedophilia, prostitution, incest, molestation,
or pornography
Shaken Baby Syndrome– Infant abuse
● Usually, child is forcibly shaken from excessive crying
● Can be from a blow to the head from a fist or object
● May not be seen until severe symptoms emerge
● Findings
○ Early Normal exam, vomiting, poor feeding, Respiratory distress, Retinal
Hemorrhages (first thing you assess), Seizures, posturing, Alterations in
LOC, Apnea/Bradycardia, Blindness, Unresponsiveness
● Nursing Care
○ Full assessment for other injuries– anytime you suspect abuse!
○ NOTIFY authorities
○ Remove the child from the care of the alleged abuser
○ Make clear and objective notes about physical findings– “dad yelled at mom” not
“its seems like the dad is yelling at the mom”
○ Be honest, direct, and professional
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