HD015

Universal Emotional Needs of Children (6)

Child Stages and parental response

• Primary attachment to caregiver
• Unconditional love
• Continuity of care
• Safety
• Stimulation
• Guidance

Infancy - physical care

Toddler - need for care and control (language/toilet training/ambulation)

Preschool - need for socialization/body image
 clarification/language development

School age - broadened supported experiences

Adolescence - autonomy/parental challenges

HD015

Influences Of Parenting

(Re-read this lecture - Very Fluffy)

Family Structures in Canada

• Parents own childhood experiences
• Timing of first pregnancy
• Parental personality/style
• Parental stability/physical, mental health
• There are tasks associated with becoming a secure adult – leaving parents, developing secure adult relationships, establishment of career, developing confidence in individual identity, consolidate ability to deal with stresses of adult life
• Adverse effects: eg stress, substance use
• Community/cultural environment
• Family and community supports
• Less nuclear families, 2 parents work, inc. use of daycare, inc role of Father

Nuclar Families are for the first time the minority structure when it comes to families in Canada

- Marrying later, living at home, delaying having children, gay couples....

HD054

What is Social Support? (3 types)

Social Integration and Social Network

Social Support vs Social Integration

1. Instrumental = material aid (casseroles, financial assistance, help with daily chores)
2. Informational = providing relevant information
3. Emotional = expressing empathy, caring & reassurance; trust; venting

Social Integration refers to characteristics of one’s social network

A social network represents a web of relationships. You can describe the network by looking at size, density (degree of interconnection), boundedness (extent of closeness such as family, workplace, neighbourhood), and homogeneity (similarity of members within a network).

The essential distinction is that social support refers to BEHAVIOURS, while social integration refers to PEOPLE or SOCIAL NETWORKS. One does not necessarily tell us anything about the other

HD054

Epi of Social Support

Mechanisms of how Social Support FX Health (3)

• Sex: Women have more than men, but also give more. However, males benefit more than women from lower quality support
• Age: younger patients who are diagnosed with cancer that don’t have an intimate partner receive less social support than those who are older and without a partner

Overall: People w/ less social support struggle more with common cold, cancer, HIV infection and cardiovascular diseases (5/8 and 9/10 studies found this)

1. Stress Buffering Hypothesis: social support may reduce or even eliminate the impact of stressful experiences by promoting less threatening interpretations of adverse events, encouraging more effective coping strategies and, in some cases, directly providing the psychological and material resources necessary to deal with stress. Reduces autonomic arousal and wear and tear on our bodies.

Stress buffering is the mechanism of Social Support

2. Main Effect Model

The main-effect model argues that social connectedness is beneficial irrespective of whether one is under stress.

Main effect is the mechanism of Social Integration

3. Relationships as a source of stress

Relationships elicit psychological stress and in turn behavior and physiological concomitants that
increase risk for disease

This is the mechanism of Negative Interactions

3. Integrative Model - a little bit of both - where health care is heading

----- I half read the paper in HD059 - only if you have time later!

HD069

Leading causes of death are ______ in men and women

Mortality for women in the...

20-34, 35-44, 45-49, after age 50

Sex Differences in Health and Disease

The same. Heart Disease > Cancer > Stroke

20-34 - Accidents, and HIV/AIDS
35-44 - Accidents, breast cancer, and ischemic heart disease
45-49 - Breast cancer
after age 50 - Ischemic heart disease

Alzheimer’s

• 2x for Women

Cardiovascular disease

• Dropping for men, Increasing for Women
• CHD presents slightly differently in women, with women being 10-15 years older, and more likely to have co morbidities such as hypertension, congestive heart failure, and diabetes

Diabetes Mellitus

• Prevalence of type 2 diabetes is higher in women
• PCOS involves the triad of insulin resistance, anovulation and increased androgens in the full syndrome (increasing risk for hypertension, hyperlipidemias and overt diabetes.)

Hypertension

• After age 60 hypertension is more common in women

Autoimmune disorders

• More common in women - possibly fetal antigens?
• Ex. Rheumatoid arthritis, scleroderma, multiple sclerosis, autoimmune thyroid disease, lupus

Osteoperosis

• Greater in women -> more hip fractures in women

Psychological disorders

• Depression, anxiety and affective and eating disorders are more common in women
• Major depression 2x for women
• 10-15% in the post-partum period (Women)
• Depression carries a worse prognosis in women, with longer episodes and a lower rate of spontaneous remission

Surgical Procedures

• Hips and most surgeries the same in M and W
• Knee replacement rates and cataract surgery > in women
• Vasectomy > tubal ligation

HD068

STIs in women

Smoking in youth

Cancers in Women (4 main types)

• Rates of Chlamydia and gonorrhea are highest in women ages 15-19, followed by women ages 20-24 (Both 2x that of them men, weird eh?)
• HIV is easier for women to get, and effects them worse (more rapid decreases in their CD4 counts, cervical dysplasias and cancers a high risk)
• Median age at first intercourse-17.3

Women more likely to try smoking, but men who do smoke, smoke more often

Cervical Cancer:

• Risk factors
• Young age at first intercourse
• Multiple sexual partners or a partner with multiple partners
• Young age at first pregnancy
• High parity
• Low socio-economic status
• Smoking
• Ranks eleventh among cancers in women in developed countries.

Uterine Cancer

• Most common gynecological malignancy
• Very treatable
• Highest risk in obese, low parity

Ovarian Cancer

• Fifth most common cancer among females
• Leading cause of death among gynecologic cancers

Breast cancer

• In any given decade a woman’s risk for breast cancer never exceeds 1 in 34 (except for at risk individuals)
• Death rates from breast cancer have been falling since the 1990’s due to improvements in therapy.
• After age 85 the life time risk of developing breast cancer is 1 in 9, but she is most likely to die from heart disease

HD068

 Hormone Replacement Therapy (HRT)

HD050

Some shifts into midlife

Generativity

• ↑risk of breast cancer, CHD, stroke, pulmonary embolus – overall ↑15% in adversities
• but, ↓hip fractures, colon cancers & absolute risk of any adverse event very small

In youth
            ...what do you care to DO?
            ...who do you care to BE?
In young adulthood
            ...who do you care ABOUT?
In midlife
            ...what and who can you TAKE CARE OF?

• “Anything that contributes to the life of the generations.”  (Erikson)
• …to make be (bring into being)
• About guiding the next generation and/or producing something that endures
• Contrasted with Stagnation…self-absorption,  interpersonal impoverishment

HD050

How is generativity expressed?

Time, health and mortality in midlife

• Parenthood, in the sense of guiding the next generation, not baby-making as such
• Includes mentoring, teaching
• Productivity; “build it to last against time.”
• Creativity
• I have no idea what this means, missed the lecture

• The pressure of time leads to reappraisal
• Do my dreams require modification or abandonment?
• Does this lead to satisfaction or disappointment?
• Does the young rebel become a mentor or does she/he settle down to a tedious routine? (quiet despair)

HD073

Male Gender Roles/Perspectives

1. Conservative – provider, ♂ = provider & ♀ = house keeper
2. Profeminist – ex. “super dad” - male who supports women as equal at home and workplace
3. Men’s rights – men who are trying to find equality and look for injustices in our society (ex custody laws, domestic violence, paternity leave)
4. Mythopoetic/absent father – men who struggle with having grown up without a father figure (dead, negligent, absent,e tc.) → no knowledge as to how to be a father
5. Socialist – blue collar workers in hierarchical society -> associated with work-related injuries
6. Gay/bisexual/transgender/two-spirited – struggle with masculinity; challenge of expressing one’s sexuality
7. Racial – ex. first nation → ↑probability of incarceration
8. Evangelical Christian/religious

Look through the rest of this lecture/JYYs thoroughly. Nothing too concrete