1
Q
Myth of Cerebral Palsy (CP) Causation
A
- rarely due to “birth asphyxia”
- Most acute severe hypoxia follow intrapartum hypoxic events
- CP’s causes are not well understood but most are thought to preceded labour and birth (genetic, inflammatory, preterm)
- Medico-legal climate encourages blame of the insured
2
Q
Intrapartum mortality:
A
the number of babies dying during labour or birth
- hard to measure!
3
Q
perinatal
A
- around the time of birth
- before and after
4
Q
stillbirth
A
born dead
5
Q
neonatal mortality
A
first 28 days
6
Q
what percent of neonatal deaths do small newborn babies account for
A
> 80%
7
Q
what might cause small size at birth?
A
- born preterm (<37 weeks)
- small-for-gestational age
- both of the above
8
Q
single level of causality
A
- 1 causal relationship
- complications during birth
- solution: medical care?
9
Q
2 levels of causality
A
- 2 causal relationship
- individual factors
- solutions: contraception? counselling? education?
10
Q
3 levels of causality
A
- 3 causal relationships
- societal factors
11
Q
Model 1: number of causes
A
- relatively simple
- easy to intuitively understand
- We can consider the different causes one at a time
-Does not overload working memory capacity
12
Q
model 2: number of causes of causality
A
- Pretty complex
- The more levels, the less intuitive the causality
13
Q
- Working memory and what part of the brain is linked to it
A
- allows us to actively hold in mind and manipulate (limited amount of) information
- linked to prefrontal cortex (PFC) function
- when the task gets harder, PFC gets more active!
14
Q
what parts of the brain deal with working memory?
A
- Prefrontal cortex functions are linked
- Lateral prefrontal cortex as a whole plays a key role in working memory
- the dorsolateral prefrontal cortex (DLPFC) deals with expectations
15
Q
Relational complexity
A
The number of relations that need to be considered simultaneously within working memory
Number of causes VS Number of levels of causality
16
Q
dorsolateral prefrontal cortex role in relational complexity
A
- Thinking about relations one at a time
(e.g., expectations) - especially if the relationship is NEW!!
- however… when there are multiple relations that need to be considered simultaneously, DLPFC is no longer sufficient
17
Q
The rostrolateral prefrontal cortex
(RLPFC) role in relational complexity
A
- Becomes activated when relational integration is necessary.
- When 2 relations must be considered
simultaneously
18
Q
how many relations MAX can we fit into working memory?
A
2
19
Q
The ability of relational integration in working memory in humans
A
- Unique to humans
- Occurs fairly late in child development
- takes a lot of time for evolution, children, and for us as adults to achieve
20
Q
area 10
A
- RLPFC is the lateral portion of Area 10
- is believed to be what allows for relational integration
- bigger and more developed in humans than in chimps
21
Q
preventive measures
A
actually solving the root of the issue
22
Q
mitigative measures
A
doesn’t solve the root
instead addresses the most direct thing
23
Q
what statistics snow that helmets should be optional, not mandatory, and what improves safety
A
- making them does not improve safety, but it does REDUCE the number of people biking
what does improve safety is:
- separated bike lanes (reduce bike/car interactions)
- greater number of people biking because of safety in numbers and drivers becoming more used to paying attention to bikes
24
Q
what kind of measure are helmets?
A
injury mitigation measure
25
Chunking (grouping)
- a way that associative memory can help working memory
- Grouping of items (or elements) based on meaning or previous established associations
- all domains: language, perception, motor skills, memory, thinking
- Conceptual chunks that are already present in our associative (long-term) memory are determined by what we are exposed to
26
chunk
a group of elements that have strong associations with one another
27
Stories
- a way that associative memory can help working memory
- can help us understand complex multi-level causality, but can also obscure the complexity and hinder understanding
- Serve as conceptual chunks that help us remember
- Look to see what solutions are implied by the story and how many levels of causality they take into account
28
how can associative memory help with working memory?
- chunking
- stories
29
Why are we more likely to come up with some counterfactuals but not others?
- **levels of causality (e.g., prevention vs. mitigation)**
- **perceived ease of changeability**
- changing one action (or one individual) is relatively easy to imagine but changing our society or environment is relatively difficult to imagine
- fluency heuristic + attribute substitution
the ease with which we can imagine something changing -> the most effective thing that can be done
- **the model (of causality) the majority of stories promote**
30
the spectrum of childbirth experience (7)
- schedule C-section in a hospital
- hospital birth with an obstetrician
- hospital birth with a family doctor
- birth center birth with a certified midiwfe
- home birth with certified midwife
- home birth with traditional birth attendant (traditional midwife)
- freebirth or unassisted/unattended childbirth
31
hospital birth with an obstetrician
can do all surgeries and itnerventions
32
birth center birth
birth center is attached to hospital with easy access to hospital
33
certified midwife
still adheres to the standards of care
34
traditional birth attendent/midwife
women that have seen many births, study whatever, uses their own practices a philosophy
35
freebirth or unassisted/unattended childbirth
not attended by anyone on whose authority they're relying on
36
how many home births in teh US have "other" listed as birth attendant on their birth certificates
1/3
(other than midwife or doctor; 2/3 of those are planned; might be more because of “oops” births)
37
Freebirth in society
- considered to be growing as a trend
- often presented by the media as ‘deviant’ behaviour
- online newspaper reports tend to attract negative public comments in which freebirthing women are described as irresponsible, selfish, stupid, and rash
- the motivations for considering freebirth are complex and multifaceted
38
what knowledge does freebirthing rely on
visceral knowledge
39
what knowledge does hospital birth rely on
medical knowledge
40
Authoritative knowledge
- the knowledge that counts
- depends on the setting and the participants
- take social interactions into account
41
what makes scientific knowledge unique from traditional midwifery and medical knowledge
it's reliance on statistics
42
parts of scientific knowledge
hormones
neural systems
physiology
43
what was used as oxytocic for centuries before oxytocin was discovered?
extract of ERGOT FUNGI had been used as oxytocic for centuries
44
oxytocic and how were they used
**a substance or drug that speeds up labor by stimulating the uterus to contract**
- Prior to 1900s, oxytocics had been used in obstetrics to produce uterine contractions
- To speed up labor, cause abortion, reduce post-partum hemorrhage
- oksys (Greek) = “swift”; tokos (Greek) = “birth”
45
how was oxytocin discovered
- by accident in 1909 by Sir Henry Dale
- extract of the posterior lobe of the pituitary gland from oxen produced powerful contractions of the uterus in pregnant cats and dog
46
the scientific method
- A body of techniques for investigating phenomena, acquiring new knowledge, or correcting and integrating previous knowledge
- To be termed scientific, a method of inquiry must be based on empirical and measurable evidence subject to specific principles of reasoning
47
The paradox of scientific knowledge in relation to childbirth and in general
- To the extent that being observed alters the process of human childbirth, the scientific method in its current form is limited in how much knowledge it can yield about undisturbed birth
- Observation and measurement change what we observe and measure
- However, introspective observation may be different (to some extent)
- Paradox not limited to birth (e.g., spontaneous thought)
48
the myths of human exceptionalism
- humans are unique among all animal species because they are the only animals that receive and provide mechanical assistance to each other during childbirth
- the mechanism of human childbirth is unique among all animal species because human babies are the only animals to be born facing away from the mother's face (which requires mechanical assistance)
- wider hips in human females allow for easier births but reduce the efficiency of walking or running upright (the ‘obstetric dilemma’)
- human babies are born helpless and underdeveloped because human pregnancy is shorter compared to the pregnancies of other mammals to allow our babies to be born before their head gets too big to pass through the birth canal
49
what does traditional midwifery tend to emphasize
- Low-tech solutions
- Where two ways of doing something are thought to exist, choose the one that involves less technology
- philosophy is that we should not rely too much on technology
- variability and uniqueness; rejection of medical norms
50
Indigenous Midwifery
- pathway that supports the regeneration of strong Indigenous families by bringing birth closer to home
- by restoring the emphasis on birth as normal, rather than approaching it as an illness in need of treatment.
51
Indigenous Knowledge
- local knowledge
- knowledge that is unique to a given culture or society
- historical continuity with pre-colonial and/or pre-settler societies
- strong link to territories and surrounding nature
- distinct language, culture and beliefs
- acquired through interaction with one’s physical environment and other people (in contrast to the more symbolic/abstract knowledge most Western industrialized societies promote)
52
cultural ideals for birth
The involvement of people other than the mother and baby in the process of giving birth is common across many cultures
But unassisted birth is the cultural ideal among some cultures:
- San (!Kung) hunter-gathers of South Africa (the Kalahari desert)
- Angagen people, Papua New Guinea
- Bariba people, Benin (North Africa)
53
The birth paradox
Scientific knowledge suggests that:
- birth is crucially dependent on the “shy hormone” oxytocin
- privacy, quiet, and seclusion are important conditions for successfully and safely birthing our babies
But then why have many cultures and societies developed customs and practices that generally reduce the sense of privacy, quiet, and seclusion during birth?
54
theories explaning the birth paradox
The involvement of people other than the mother and baby during childbirth may serve to:
1. Provide mechanical assistance during birth that increased our species’ survival chances (i.e., it improved birth safety)
2. Increase the bond between the baby and those other people who were involved in the baby’s birth (i.e., it increases the child’s survival chance by creating additional substitute parents)
3. Decrease the bond between mother and baby for purposes that may benefit the survival of the group
55
The cultural evolution of knowledge
- Our customs, cultural practices, and traditional knowledge have evolved through a cultural selection process
- Similarly to natural selection, certain cultural practices and beliefs have proven to be more beneficial than others and have thus become adopted, while others have been abandoned
- We should always ask (ourselves): Are these customs still beneficial? And if so, who are they beneficial to?
56
cerebral palsy and C section
- Major cause of caesarean escalation
- however...No association of elective or emergency cesarean with CP outcomes
- CP incidence the same in western and resource-poor settings (e.g., India)
PSYC 207
flashcards
Decks in class (9)
# Cards
-
1-KNOWLEDGE ABOUT Labour pain83
-
2- associative memory45
-
2-Medical interventions, medicolegal stuff and yah74
-
2-neuro shit39
-
reasoning about childbirth3
-
CAUSUAL COMPLEXITY AND KNOWLEDGE56
-
oxytocin and Pitocin and stuff10
-
post midterm medical interventions and medicolegal stuff9
-
1-neuro bit about pain perception18
