Community Nutrition Test 2

Front 1

policy

Back 1

course of action chosen by public authorities to address a given problem
policies are formed at the governmental level

Front 2

problem

Back 2

"substantial discrepancy between what is and what should be"

Front 3

policy making

Back 3

process by which authorities decide what action to take to address a problem or set of problems
they come up with ways to solve a certain problem

Front 4

what are the 6 steps of the process of policy making?

Back 4

1. problem definition and agenda setting
2. formulation of alternatives
3. policy adoption
4. policy implementation
5. policy evaluation
6. policy termination

Front 5

what is the most effective way to bring together a broad constituency that supports addressing the problem?

Back 5

media

Front 6

what is the goal of problem definition and agenda setting?

Back 6

to convince the public that a problem exists

Front 7

what are some sensitive nutrition issues?

Back 7

infant deaths, childhood obesity

Front 8

what is involved in the formulation of alternatives?

Back 8

interest groups, coalitions, networks of experts, and "grassroots" individuals interested in the problem can be asked to help with DESIGNING ALTERNATIVES to be presented to policy makers

Front 9

what happens in policy adoption?

Back 9

tools and instruments are selected to achieve the policy goal - regulations, funding, tax breaks, government-sponsored programs

Front 10

what levels of government can policy adoption occur?

Back 10

local, state, or national level
examples:
local (Appalachian Dietetic Association)
state (NCDA)
national (USDA)

Front 11

what level is the most involved and effective in implementing policies?

Back 11

the state level

Front 12

what is involved in policy implementation?

Back 12

putting the policy into action after necessary modifications have been made for the target clientele and effected agencies

Front 13

how many people does policy implementation involve?

Back 13

may involve a large number of people and organizations to carry out the process - up to millions

Front 14

when do you start evaluating a policy?

Back 14

start evaluating its effectiveness from the very beginning

Front 15

what should you ask yourself in policy evaluation?

Back 15

is the policy achieving its goals? reaching its intended audience?

Front 16

what are some factors that may lead to policy termination?

Back 16

loss of political support (public officials)
the public need was met or changed
the policy was too costly
private agencies relieved the need

Front 17

who makes policies?

Back 17

public officials
state and federal employees at a higher level
community nutritionists
etc

Front 18

legitimizing policy

Back 18

must have the willingness of the citizens that the government has the right to govern
the government must legitimize each policy choice
you want the public to realize the worth of the policy and to have a willingness to follow the policy

Front 19

laws passed by congress

Back 19

tend to be vague, so they need to make sub-policies
define the broad scope of the policy

the USDA and DHHS handle a lot of the different policies in nutrition once the policies are handed down from congress

Front 20

what is the president's role with a bill?

Back 20

he signs a bill into a law
he can veto and return the bill to legislation (Congress) - needs 2/3 vote by each house to override the president
no action while in session (up to 10 days) - automatically becomes a law without his signature

Front 21

what do conference committees do?

Back 21

the house and senate meet to resolve the differences

Front 22

enactment

Back 22

law is referred to appropriate agency responsible for issuing guidelines or regulations
once the policy is put into place (made into a law), it is handed down to the state level, which puts it into place
the department of the state that is responsible for the law comes up with guidelines and regulations. they then present these guidelines to the public and it is open for comments

Front 23

what is "proposed guidelines"?

Back 23

mandatory comment period of 30-60 days for public response

Front 24

mandatory spending

Back 24

for entitlements - programs that require payments to anyone who is eligible (Ex. social security, medicare, etc.)

Front 25

discretionary spending

Back 25

choices made in defense, energy assistance, nutrition assistance. (ex. WIC)
spending that has more flexibility than mandatory

Front 26

what is budget authorization?

Back 26

establishes programs
sets a ceiling on spending
does not provide money, just sets the goals and regulations for a program to use their funds

Front 27

what is budget appropriation?

Back 27

provides money for programs
can be for a single year, a specified period of years, or an indefinite number of years
once budget appropriation has started, they continue to edit it until it is completely agreed upon

Front 28

political action committees (PACs)

Back 28

"political arm" of interest group (works directly with government officials to reveal policies that we want to create and nutrition issues)
raises money to support candidates whose views are favorable aligned with the group's missions and goals
its a sub-group

Front 29

lobbying

Back 29

provide technical information to policy makers to help pass legislation
they provide very factual information to members of legislation

Front 30

building coalitions (networks and other alliances)

Back 30

joining with smaller groups to influence the political system
helps to create awareness of a certain issue

Front 31

policy agenda

Back 31

the set of problems to which policy makers give their attention

Front 32

institutional agenda

Back 32

the issues that are the subject of public policy

Front 33

problem definition and agenda setting

Back 33

the problem is defined and brought to the attention of the public and policy makers. Issues become part of the public agenda when they are considered by a legislature, administrative agency, or court.

Front 34

formulation of alternatives

Back 34

possible solutions to the problem are devised

Front 35

policy adoption

Back 35

the tools or instruments are selected to achieve a given policy goal - namely, the resolution of the problem. The tools may consist of regulations, expenditures, partnerships, programs, or some combination of these

Front 36

policy implementation

Back 36

the strategies chosen for addressing the problem, using the appropriate tools agreed on, are put into place

Front 37

policy evaluation

Back 37

the impact of the policy and the tools used to implement it are evaluated

Front 38

policy termination

Back 38

the policy may be terminated because of loss of support, because it is not achieving its goals, or because it costs too much

Front 39

how can one get an issue placed on the policy agenda?

Back 39

Build public interest so that the issue deserved government attention. Do this through media—radio, television, newspapers, and the internet

Front 40

define legislative body

Back 40

Congress, state legislatures, city councils

Front 41

the iron triangle

Back 41

made up of three powerful participants in the policy-making process:
interest groups, congressional committees or subcommittees, and administrative agencies
(not formal)

Front 42

who makes up interest groups, congressional committees or subcommittees, and administrative agencies

Back 42

government administrators, members of Congress and their staffs, bureau chiefs, interest groups, professionals (dietitians, physicians, bankers, real estate agents, etc), university faculty members, governors, and members of state and local governments, coalitions, and networks

Front 43

interest group

Back 43

a body of people acting in an organized manner to advance shared political interests

Front 44

coalition (alliance)

Back 44

a group of individuals or organizations working together in a common effort toward a common goal to make more effective and efficient use of resources

Front 45

network

Back 45

individuals or organizations who share information, ideas, resources, or goals to accomplish individual or group goals

Front 46

where does formulation of alternatives of "policy formulation" begin?

Back 46

begins at the grassroots level

Front 47

street-level bureaucrats

Back 47

individuals within government who have direct contact with citizens

Front 48

markup session

Back 48

a congressional committee session during which a bill is put into its final form before being reported out of committee

Front 49

receipts or revenue

Back 49

amounts that the government expects to raise through taxes and fees

Front 50

budget authority

Back 50

amounts that government agencies are allowed to spend in implementing their programs

Front 51

budget outlays

Back 51

amounts actually paid out by government agencies

Front 52

entitlements

Back 52

programs that require the payment of benefits to all eligible people as established by law

Front 53

genome

Back 53

a term that combines the words gene and chromosome; the genetic material in the chromosomes of the cell that contains the complete set of instructions (DNA) for making an organism

Front 54

genetic disorder

Back 54

a disease caused in whole or in part by a variation or mutation of a gene

Front 55

how does an idea become a law?

Back 55

a bill is introduced into the senate or house, assigned to a committee, subcommittee hearings and markup are performed, there is a full committee action, a rules committee (in house only), action by the full chamber, a conference committee where the house and senate meet and discuss it, final floor action, and then it is sent to the president

Front 56

what are budgets designed for

Back 56

to count and record income and expenditures, to demonstrate the government's intention regarding the funding and priority of programs, and the control and shape the activities of government agencies

Front 57

what issues are the AND (Academy of nutrition and dietetics) addressing currently?

Back 57

aging, child nutrition, food and food safety, health literacy, medical nutrition therapy, nutrition monitoring and research, and obesity

Front 58

what are some ways one can get involved in the political process?

Back 58

expressing your opinion about an issue at a public meeting or writing a letter to the editor of a newspaper; getting involved directly in the political process; joining an interest group; lobbying; and joining a coalition or network

Front 59

infant mortality rate (IMR)

Back 59

number of liveborn infants who die within the first year of life per 1000 births

Front 60

what is used as an indicator of health status and quality of life of populations?

Back 60

Infant mortality rate (IMR)

Front 61

what is the U.S.'s IMR? is this the same as other countries?

Back 61

6.4 deaths/1000 births
no, it is higher than many other industrialized countries

Front 62

which has a higher IMR and by how much? American blacks or whites

Back 62

IMR is more than TWICE as high in American Blacks than Whites

Front 63

what are some things that can cause IMR

Back 63

fetal alcohol syndrome
low birth weight of infants

Front 64

birth weight and length of gestation

Back 64

primary indicators of the infant's future health status

Front 65

low birthweight (LBW)

Back 65

major contributor to infant mortality

Front 66

what is low birth weight a predictor of?

Back 66

poor health in newborn and probable indicator of poor nutrition status in mother during and/or before pregnancy

Front 67

what are some of the leading causes of infant death?

Back 67

SIDS, maternal complications, etc.

Front 68

what actions can significantly improve infants' health and chances of survival?

Back 68

breastfeeding
newborn screening
primary care in infancy

Front 69

what does Healthy people 2020 encompass in terms mothers and infants?

Back 69

maternal and infant health, birth defects, and developmental disabilities

Front 70

what are three things that can affect risk and the outcome of pregnancy?

Back 70

genetic, environmental, and behavioral factors

Front 71

what are the three categories that nutrition assessment and monitoring during pregnancy can be divided into?

Back 71

preconception care
the initial prenatal visit
subsequent prenatal visits

Front 72

T/F the nutrition status of all women should be assessed at their initial prenatal visit

Back 72

TRUE

Front 73

what are some issues contributing to low birthweight?

Back 73

poverty
minority status
lack of access to health care
inability to pay for health care
low education level
unsanitary living conditions
drug use, smoking, alcohol
(ALL OF THESE CONTRIBUTE TO POOR NUTRITION)

Front 74

what are 3 national goals for maternal and infant health?

Back 74

objectives focusing on mortality
objectives addressing risk factors
objectives on incidence of developmental disabilities and folate intake

Front 75

in what areas did Healthy people 2010 improve on?

Back 75

small decline in infant mortality rates of hispanics, white, and blacks
decreased incidence of neural tube defects
increase in breastfeeding among all groups
continued decline in smoking during pregnancy

Front 76

in what areas were there no progress or reverse direction for healthy people 2010?

Back 76

maternal death for african-american women
iron deficiency
low birth weight
proportion of women receiving timely prenatal care

Front 77

what are the national academy of sciences recommendations in terms of weight gain for BMI in pregnancy

Back 77

BMI <18.5 underweight --> 28-40 lbs
BMI 18.5-24.9 normal weight --> 25-35 lbs
BMI 25.0-29.9 overweight --> 15-25 lbs
BMI >/= 30.0 obesity --> 11-20 lbs

Front 78

what percentage of married women gain the recommended weight?

Back 78

75%

Front 79

african-american and adolescent women gain (more/less) than the recommended weight?

Back 79

they gain less

Front 80

what are some things can may cause low weight gain/weight loss in pregnant women?

Back 80

measurement error
edema (can lead to fluctuations in weight quickly)
nausea/vomiting (first trimester)
inadequate access to food
depression
resistance to weight gain? (more in adolescent pregnancies due to peer pressure)
substance use
illness

Front 81

what are some things that may cause excess weight gain in pregnant women?

Back 81

measurement error
edema
multi-fetal gestation
drastic change in dietary patterns/physical activity since conception

Front 82

what amount should be gained in pregnancy?

Back 82

2-4 lbs in the 1st trimester, 1 lbs per week after that

Front 83

should pregnant teens gain at the low or high end of the recommended weight gain. why?

Back 83

at the high end because they are nutritionally at risk and require intervention because they still need nutrients to grow. they also don't eat as healthy.

Front 84

what are some risks in adolescent pregnancy?

Back 84

hypertension, iron-deficiency, anemia, premature birth, stillbirth, LBW infants, prolonged labor

Front 85

what three categories can nutrition assessment and monitoring during pregnancy be divided into?

Back 85

preconception care
initial prenatal visit
subsequent prenatal visits

Front 86

what is the goal of preconception gain and what is included in it?

Back 86

goal: identify and correct nutrition problems prior to conception
includes nutrition assessment, counseling, supplementation and referral
preconception care should be available to all women

Front 87

initial prenatal visit includes what?

Back 87

dietary measures (clinical measures, anthropometric measures, laboratory values)
diet history/24 hr recall/food frequency questionnaire
supplement use
cultural attitudes/beliefs towards foods
food resources

Front 88

what do clinical measures assess during pregnancy?

Back 88

assesses pregnancy history and any complications during those pregnancies. also, what were the birth weights of the woman's previous pregnancies

Front 89

what do anthropometrics measures assess during pregnancy?

Back 89

pre-pregnancy weight, current weight, BMI, etc

Front 90

what do laboratory measures assess during pregnancy?

Back 90

iron status (hematocrit and hemoglobin)

Front 91

subsequent prenatal visits include what?

Back 91

monitor weight gain
screening for anemia
assessment of dietary practices
referral to food assistance programs

Front 92

if the patient is found to be anemia in subsequent prenatal visits, what should be done?

Back 92

screen for anemia at least twice during pregnancy and tell them to eat more meats

Front 93

what is the best way to measure infant health status?

Back 93

through growth (Weight gain)

Front 94

what is the growth speed in infants?

Back 94

rapid growth and metabolism - adequate supply of all essential nutrients is imperative

Front 95

how are the nutrient needs of infants compared to other life stages?

Back 95

relative to body weight, infant nutrient needs are >2x more than other life stages

Front 96

how much does weight increase from birthweight in the first 6 months, and then by the first year?

Back 96

6 months- doubles by 6 months
1 year- triples by first year

Front 97

what routine anthropometrics measure what?

Back 97

length, weight, and head circumference

Front 98

what can head circumference detect?

Back 98

can help detect protein-energy malnutrition (PEM)

Front 99

what do NCHS growth charts assess?

Back 99

they assess overweight or failure-to-thrive infants

Front 100

what is used to measure infants up to age 2?

Back 100

recumbent length

Front 101

instead of "overweight" for infants, they are called what?

Back 101

"high weight for length"

Front 102

a weight fluctuation greater than what percentage

Back 102

greater than 2% ranges is something to be concerned about?

Front 103

what are some benefits of breastfeeding?

Back 103

helps protect against infection
protects against allergy development
favors normal tooth and jaw alignment
breastfed babies are less likely to be obese
convenience and lower cost

Front 104

what ethnic groups have lower breast feeding rates? higher rates?

Back 104

non-hispanic blacks and socially disadvantaged groups have lower rates, while asians have higher rates?

Front 105

what are the healthy people 2020 goals for breastfeeding?

Back 105

incidence of breastfeeding at 82% early postpartum
60% at 6 months
34% at one year

Front 106

when should breastfeeding be initiated at first?

Back 106

within the first 30 minutes of birth

Front 107

what are some barriers of breastfeeding promotion?

Back 107

lack of knowledge or experience among mothers and family members
lack of instruction from health care professionals
non-supportive hospital practices
lack of work place accommodation

Front 108

how was the WIC programs helped breastfeeding?

Back 108

they have increased breastfeeding rates. they pair up with moms that come in and help them from the start on their pregnancy and through breastfeeding
they do peer counseling among low-income women

Front 109

what are rooming-in practices

Back 109

where they allow mom and baby to be together most of the time in the hospital

Front 110

T/F any time an infant is hungry should be a time for breastfeeding

Back 110

true, this is breastfeeding on demand

Front 111

T/F artificial nipples are a good idea to use on children

Back 111

FALSE, no artificial nipples or pacifiers should be given to breastfeeding newborns (At least within the first month or else they will get confused)

Front 112

Best Start project?

Back 112

focus groups - women in the community who were on nutrition assistance programs, complications breast feeding, didn't want to breast feed, etc. this would give breastfeeding education materials

Front 113

why is it not recommended for infants in their first year of life to drink cow's milk?

Back 113

because of allergies and they can't digest the lactose or the proteins in the milk either

Front 114

T/F a lot of women wean after 6 months. why?

Back 114

True, because they have to go to work

Front 115

what are the two recommended infant feeding sources within the first 6 months?

Back 115

breast milk or iron-fortified formula

Front 116

when are solid foods added? what in particular is first?

Back 116

at 6 months
cereal is first

Front 117

what are 2 nutrition-related problems in infants?

Back 117

iron deficiency
food allergies

Front 118

what can cause iron deficiency in infants?

Back 118

from continuing breast feeding after 6 months without iron supplementation
the use of cow's milk earlier than recommended

Front 119

how can food allergies be prevented in infants?

Back 119

breastfeed infants
introduce foods singly to detect any allergies

Front 120

what are some USDA maternal and infant nutrition programs?

Back 120

WIC (increased fruit and veggie consumption)
supplemental nutrition assistance (Food stamps) (SNAP)
WIC farmers' market nutrition program
commodity supplemental food program (similar to WIC)
expanded food and nutrition education program (specifically education)

Front 121

the majority of participants involved in WIC are who? children, women, or infants?

Back 121

children (age 1-4 years)

Front 122

DHHS maternal and infant nutrition programs

Back 122

Title V Maternal and Child Health Program
Medicaid and EPSDT
Health Center Program
Healthy Start Program (focuses on early prenatal care)

Front 123

what are some things we can improve on in the health of mothers and infants?

Back 123

insure quality nutrition counseling is available and accessible

Front 124

how can we insure quality nutrition counseling is available and accessible

Back 124

use MCH money
ask voluntary health organizations to help
worksite health promotion programs
adolescent pregnancy counseling in the classroom and individually

Front 125

to ensure that all pregnant women have access to satisfactory prenatal services in the future, what should be done?

Back 125

food supplementation and nutrition education available to pregnant low-income women
additional federal funds in order to make WIC available to all pregnant low-income women
health insurance policies should include prenatal nutrition counseling as reimbursable service for all pregnant women in the U.S.

Front 126

what can the use of timely prenatal care identify?

Back 126

women who are at high risk of high blood pressure or any other maternal complications

Front 127

healthy people 2020 takes a broad scope, encompassing what?

Back 127

maternal and infant health, birth defects, and developmental disabilities

Front 128

what 3 factors affect the risk and outcome of pregnancy?

Back 128

genetic, environmental, and behavioral factors

Front 129

when should the nutrition status of all women be assessed?

Back 129

at their initial prenatal visit

Front 130

what is the major indicator of the infants nutritional status?

Back 130

their growth

Front 131

what growth charts are used to analyze measure of growth status in infants?

Back 131

the National Center for Health Statistics

Front 132

T/F breastfeeding offers both emotional and physical health advantages

Back 132

true

Front 133

what are some barriers to achieving the nation's health objective of increasing the incidence of breastfeeding?

Back 133

lack of knowledge
absence of work policies and facilities that support lactating women
lack of breastfed support for low-income women