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Lifespan development involves the exploration of biological, cognitive, and psychosocial changes and constancies that occur throughout the entire course of life. It has been presented as a theoretical perspective, proposing several fundamental, theoretical, and methodological principles about the nature of human development. An attempt by researchers has been made to examine whether research on the nature of development suggests a specific metatheoretical worldview. Several beliefs, taken together, form the “family of perspectives” that contribute to this particular view.

German psychologist Paul Baltes, a leading expert on lifespan development and aging, developed one of the approaches to studying development called the lifespan perspective. This approach is based on several key principles:

• Development occurs across one’s entire life, or is lifelong.
• Development is multidimensional, meaning it involves the dynamic interaction of factors like physical, emotional, and psychosocial development
• Development is multidirectional and results in gains and losses throughout life
• Development is plastic, meaning that characteristics are malleable or changeable.
• Development is influenced by contextual and socio-cultural influences.
• Development is multidisciplinary.

Development is lifelong

Lifelong development means that development is not completed in infancy or childhood or at any specific age; it encompasses the entire lifespan, from conception to death. The study of development traditionally focused almost exclusively on the changes occurring from conception to adolescence and the gradual decline in old age; it was believed that the five or six decades after adolescence yielded little to no developmental change at all. The current view reflects the possibility that specific changes in development can occur later in life, without having been established at birth. The early events of one’s childhood can be transformed by later events in one’s life. This belief clearly emphasizes that all stages of the lifespan contribute to the regulation of the nature of human development.

Many diverse patterns of change, such as direction, timing, and order, can vary among individuals and affect the ways in which they develop. For example, the developmental timing of events can affect individuals in different ways because of their current level of maturity and understanding. As individuals move through life, they are faced with many challenges, opportunities, and situations that impact their development. Remembering that development is a lifelong process helps us gain a wider perspective on the meaning and impact of each event.

Development is multidimensional

By multidimensionality, Baltes is referring to the fact that a complex interplay of factors influence development across the lifespan, including biological, cognitive, and socioemotional changes. Baltes argues that a dynamic interaction of these factors is what influences an individual’s development.

For example, in adolescence, puberty consists of physiological and physical changes with changes in hormone levels, the development of primary and secondary sex characteristics, alterations in height and weight, and several other bodily changes. But these are not the only types of changes taking place; there are also cognitive changes, including the development of advanced cognitive faculties such as the ability to think abstractly. There are also emotional and social changes involving regulating emotions, interacting with peers, and possibly dating. The fact that the term puberty encompasses such a broad range of domains illustrates the multidimensionality component of development (think back to the physical, cognitive, and psychosocial domains of human development we discussed earlier in this module).

Development is multidirectional

Baltes states that the development of a particular domain does not occur in a strictly linear fashion but that development of certain traits can be characterized as having the capacity for both an increase and decrease in efficacy over the course of an individual’s life.

If we use the example of puberty again, we can see that certain domains may improve or decline in effectiveness during this time. For example, self-regulation is one domain of puberty which undergoes profound multidirectional changes during the adolescent period. During childhood, individuals have difficulty effectively regulating their actions and impulsive behaviors. Scholars have noted that this lack of effective regulation often results in children engaging in behaviors without fully considering the consequences of their actions. Over the course of puberty, neuronal changes modify this unregulated behavior by increasing the ability to regulate emotions and impulses. Inversely, the ability for adolescents to engage in spontaneous activity and creativity, both domains commonly associated with impulse behavior, decrease over the adolescent period in response to changes in cognition. Neuronal changes to the limbic system and prefrontal cortex of the brain, which begin in puberty lead to the development of self-regulation, and the ability to consider the consequences of one’s actions (though recent brain research reveals that this connection will continue to develop into early adulthood).

Extending on the premise of multidirectionality, Baltes also argued that development is influenced by the “joint expression of features of growth (gain) and decline (loss)” This relation between developmental gains and losses occurs in a direction to selectively optimize particular capacities. This requires the sacrificing of other functions, a process known as selective optimization with compensation. According to the process of selective optimization, individuals prioritize particular functions above others, reducing the adaptive capacity of particulars for specialization and improved efficacy of other modalities.

The acquisition of effective self-regulation in adolescents illustrates this gain/loss concept. As adolescents gain the ability to effectively regulate their actions, they may be forced to sacrifice other features to selectively optimize their reactions. For example, individuals may sacrifice their capacity to be spontaneous or creative if they are constantly required to make thoughtful decisions and regulate their emotions. Adolescents may also be forced to sacrifice their fast reaction times toward processing stimuli in favor of being able to fully consider the consequences of their actions.

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Development is plastic

Plasticity denotes intrapersonal variability and focuses heavily on the potentials and limits of the nature of human development. The notion of plasticity emphasizes that there are many possible developmental outcomes and that the nature of human development is much more open and pluralistic than originally implied by traditional views; there is no single pathway that must be taken in an individual’s development across the lifespan. Plasticity is imperative to current research because the potential for intervention is derived from the notion of plasticity in development. Undesired development or behaviors could potentially be prevented or changed.

As an example, recently researchers have been analyzing how other senses compensate for the loss of vision in blind individuals. Without visual input, blind humans have demonstrated that tactile and auditory functions still fully develop and they can use tactile and auditory cues to perceive the world around them. One experiment designed by Röder and colleagues (1999) compared the auditory localization skills of people who are blind with people who are sighted by having participants locate sounds presented either centrally or peripherally (lateral) to them. Both congenitally blind adults and sighted adults could locate a sound presented in front of them with precision but people who are blind were clearly superior in locating sounds presented laterally. Currently, brain-imaging studies have revealed that the sensory cortices in the brain are reorganized after visual deprivation. These findings suggest that when vision is absent in development, the auditory cortices in the brain recruit areas that are normally devoted to vision, thus becoming further refined.

Development is contextual

In Baltes’ theory, the paradigm of contextualism refers to the idea that three systems of biological and environmental influences work together to influence development. Development occurs in context and varies from person to person, depending on factors such as a person’s biology, family, school, church, profession, nationality, and ethnicity. Baltes identified three types of influences that operate throughout the life course: normative age-graded influences, normative history-graded influences, and nonnormative influences. Baltes wrote that these three influences operate throughout the life course, their effects accumulate with time, and, as a dynamic package, they are responsible for how lives develop.

Normative age-graded influences are those biological and environmental factors that have a strong correlation with chronological age, such as puberty or menopause, or age-based social practices such as beginning school or entering retirement. Normative history-graded influences are associated with a specific time period that defines the broader environmental and cultural context in which an individual develops. For example, development and identity are influenced by historical events of the people who experience them, such as the Great Depression, WWII, Vietnam, the Cold War, the War on Terror, or advances in technology.

Other Contextual Influences on Development: Cohort, Socioeconomic Status, and Culture

What is meant by the word “context”? It means that we are influenced by when and where we live. Our actions, beliefs, and values are a response to the circumstances surrounding us. Sternberg describes contextual intelligence as the ability to understand what is called for in a situation (Sternberg, 1996). The key here is to understand that behaviors, motivations, emotions, and choices are all part of a bigger picture. Our concerns are such because of who we are socially, where we live, and when we live; they are part of a social climate and set of realities that surround us. Important social factors include cohort, social class, gender, race, ethnicity, and age. Let’s begin by exploring two of these: cohort and social class. 

A cohort is a group of people who are born at roughly the same time period in a particular society. Cohorts share histories and contexts for living. Members of a cohort have experienced the same historical events and cultural climates which have an impact on the values, priorities, and goals that may guide their lives.

Development is Multidisciplinary

Any single discipline’s account of development across the lifespan would not be able to express all aspects of this theoretical framework. That is why it is suggested explicitly by lifespan researchers that a combination of disciplines is necessary to understand development. Psychologists, sociologists, neuroscientists, anthropologists, educators, economists, historians, medical researchers, and others may all be interested and involved in research related to the normative age-graded, normative history-graded, and nonnormative influences that help shape development. Many disciplines are able to contribute important concepts that integrate knowledge, which may ultimately result in the formation of a new and enriched understanding of development across the lifespan.

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Introduction

“Health care is an important determinant of health. Lifestyles are important determinants of health. But… it is factors in the social environment that determine access to health services and influence lifestyle choices in the first place.” WHO Director-General Dr Margaret Chan

Many factors combine together to affect the health of individuals and communities. Whether a person is healthy or unhealthy is determined by his/her circumstances and environment. To a large extent, factors such as where we live, the state of our environment, genetics, our income and education level, and our relationships with friends and family all have considerable impacts on health, whereas the more commonly considered factors such as access and use of health care services often have less of an impact.

Determinants of Health

The range of personal, social, economic and environmental factors that influence health status are known as determinants of health.
These can be classified as:

1. the social and economic environment,
2. the physical environment,
3. the person’s individual characteristics and behaviours.

There are many commonly accepted determinants of health but there is no single definition.  The Office of Disease Prevention and Health Promotion (ODPHP) has broadly categorised the determinants of health and these have been summarised below:

Policy-making

Policies at the local, state and federal level affect individual and population health. Increasing taxes on tobacco sales, for example, can improve population health by reducing the number of people using tobacco products.

Social Factors

Social and physical determinants of health reflect the conditions of the environment in which people are born, live, learn, play, work and age. Also known as social determinants of health, they impact a wide range of health, functioning and quality-of-life outcomes. They represent economic and political systems, physical and social environments, as well as health service access.

Examples include:

• Availability of resources to meet daily needs, such as educational and job opportunities, living wages or healthful foods
• Social norms and attitudes such as discrimination
• Exposure to crime, violence and social disorder
• Social support and social interactions
• Socioeconomic conditions such as concentrated poverty
• Quality schools
• Transportation options
• Urbanisation and the built environment such as buildings or transportation
• Worksites, schools and recreational settings

Health Services

Both access to health services and the quality of health services can impact health.  Barriers to accessing health services include lack of availability, high cost, lack of insurance coverage and limited language access.  These barriers to accessing health services lead to unmet health needs, delays in receiving appropriate care, inability to get preventive services as well as hospitalizations that could have been prevented.

Individual Behaviour

Individual behaviors such as diet, physical activity, alcohol, tobacco and other drug use also play a role in health outcomes.

Biology and Genetics

Some biological and genetic factors affect specific populations more than others.  Examples of biological and genetic determinants of health include age, sex, inherited conditions and genetic make-up.

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Improving Health World Wide

WHO have identified three “common interventions” for improving health conditions world wide:

1. Education

A large number of studies have demonstrated a strong link between better education and better health, and education has been shown to be a reliable predictor of lower mortality rates. The probability of being in good or very good health is higher for people with university or post-secondary education.

2. Social Protection

Countries with some sort of social protection (i.e. a safety net or social security system) show improved health and economic outcomes in circumstances where people become unable to earn a living.

3. Urban Development

The physical environment where communities live has a great impact on the health of the residents. Factors which have a negative impact on health include overcrowding, damp living conditions and crime (in particular fear of crime). The WHO concludes that health outcomes “are largely determined by the accessibility to adequate housing and to healthy and safe urban environments and by transport conditions”.

Relevance to Physiotherapy

In our contact time with our patients, we spend a lot of time understanding their health and social status. In other words, we explore the determinants that might be affecting their health and in particular ones that we can influence. The model we use to analyse and understand these determinants of health is the biopsychosocial model of health care.

It is essential that health care workers dedicated to improving health increase their effectiveness by addressing the “upstream” causes of health in the community and by engaging in ways to change the broad policies, systems and environments that shape the social and economic conditions that, in turn, so strongly influence health.  Swain et al describe opportunities for the health-care professional to address social determinants of health. They suggest that to be most effective at improving the health of families and communities and to ensure the greatest impact for the investment of resources, health professionals need to expand their repertoire of skills and activities both with their individual patients and in the policy arena.

who’s response

The determinants of health include:

• the social and economic environment,
• the physical environment, and
• the person’s individual characteristics and behaviours.

The context of people’s lives determine their health, and so blaming individuals for having poor health or crediting them for good health is inappropriate. Individuals are unlikely to be able to directly control many of the determinants of health. These determinants—or things that make people healthy or not—include the above factors, and many others:

• Income and social status – higher income and social status are linked to better health. The greater the gap between the richest and poorest people, the greater the differences in health.
• Education – low education levels are linked with poor health, more stress and lower self-confidence.
• Physical environment – safe water and clean air, healthy workplaces, safe houses, communities and roads all contribute to good health. Employment and working conditions – people in employment are healthier, particularly those who have more control over their working conditions
• Social support networks – greater support from families, friends and communities is linked to better health. Culture – customs and traditions, and the beliefs of the family and community all affect health.
• Genetics – inheritance plays a part in determining lifespan, healthiness and the likelihood of developing certain illnesses. Personal behaviour and coping skills – balanced eating, keeping active, smoking, drinking, and how we deal with life’s stresses and challenges all affect health.
• Health services – access and use of services that prevent and treat disease influences health
• Gender – Men and women suffer from different types of diseases at different ages

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The word health refers to a state of complete emotional and physical well-being. Healthcare exists to help people maintain this optimal state of health.

According to the Centers for Disease Control and Prevention (CDC), healthcare costs in the United States were $3.5 trillion in 2017.

However, despite this expenditure, people in the U.S. have a lower life expectancy than people in other developed countries. This is due to a variety of factors, including access to healthcare and lifestyle choices.

Good health is central to handling stress and living a longer, more active life. In this article, we explain the meaning of good health, the types of health a person needs to consider, and how to preserve good health.

What is health?

Regular exercise contributes to good health.

In 1948, the World Health Organization (WHO) defined health with a phrase that modern authorities still apply.

“Health is a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity.”

“A resource for everyday life, not the objective of living. Health is a positive concept emphasizing social and personal resources, as well as physical capacities.”

This means that health is a resource to support an individual’s function in wider society, rather than an end in itself. A healthful lifestyle provides the means to lead a full life with meaning and purpose.

In 2009, researchers publishing inThe Lancet defined health as the ability of a body to adapt to new threats and infirmities.

They base this definition on the idea that the past few decades have seen modern science take significant strides in the awareness of diseases by understanding how they work, discovering new ways to slow or stop them, and acknowledging that an absence of pathology may not be possible.

Types

Mental and physical health are probably the two most frequently discussed types of health.

Spiritual, emotional, and financial health also contribute to overall health. Medical experts have linked these to lower stress levels and improved mental and physical well-being.

People with better financial health, for example, may worry less about finances and have the means to buy fresh food more regularly. Those with good spiritual health may feel a sense of calm and purpose that fuels good mental health.

Health inequities affect all of us differently. Visit our dedicated hub for an in-depth look at social disparities in health and what we can do to correct them.

Physical health

A person who has good physical health is likely to have bodily functions and processes working at their peak.

This is not only due not only to an absence of disease. Regular exercise, balanced nutrition, and adequate rest all contribute to good health. People receive medical treatment to maintain the balance, when necessary.

Physical well-being involves pursuing a healthful lifestyle to decrease the risk of disease. Maintaining physical fitness, for example, can protect and develop the endurance of a person’s breathing and heart function, muscular strength, flexibility, and body composition.

Looking after physical health and well-being also involves reducing the risk of an injury or health issue, such as:

• minimizing hazards in the workplace
• using contraception when having sex
• practicing effective hygiene
• avoiding the use of tobacco, alcohol, or illegal drugs
• taking the recommended vaccines for a specific condition or country when traveling

Good physical health can work in tandem with mental health to improve a person’s overall quality of life.

For example, mental illness, such as depression, may increase the risk of drug use disorders, according to a 2008 study. This can go on to adversely affect physical health.

Mental health

According to the U.S. Department of Health & Human Services, mental health refers to a person’s emotional, social, and psychological well-being. Mental health is as important as physical health as part of a full, active lifestyle.

It is harder to define mental health than physical health because many psychological diagnoses depend on an individual’s perception of their experience.

With improvements in testing, however, doctors are now able to identify some physical signs of some types of mental illness in CT scans and genetic tests.

Good mental health is not only categorized by the absence of depression, anxiety, or another disorder. It also depends on a person’s ability to:

• enjoy life
• bounce back after difficult experiences and adapt to adversity
• balance different elements of life, such as family and finances
• feel safe and secure
• achieve their full potential

Physical and mental health have strong connections. For example, if a chronic illness affects a person’s ability to complete their regular tasks, it may lead to depression and stress. These feelings could be due to financial problems or mobility issues.

A mental illness, such as depression or anorexia, can affect body weight and overall function.

It is important to approach “health” as a whole, rather than as a series of separate factors. All types of health are linked, and people should aim for overall well-being and balance as the keys to good health.

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Factors for good health

Good health depends on a wide range of factors.

Genetic factors

A person is born with a variety of genes. In some people, an unusual genetic pattern or change can lead to a less-than-optimum level of health. People may inherit genes from their parents that increase their risk for certain health conditions.

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Environmental factors

Environmental factors play a role in health. Sometimes, the environment alone is enough to impact health. Other times, an environmental trigger can cause illness in a person who has an increased genetic risk of a particular disease.

Access to healthcare plays a role, but the WHO suggest that the following factors may have a more significant impact on health than this:

• where a person lives
• the state of the surrounding environment
• genetics
• their income
• their level of education
• employment status

It is possible to categorize these as follows:

• The social and economic environment: This may include the financial status of a family or community, as well as the social culture and quality of relationships.
• The physical environment: This includes which germs exist in an area, as well as pollution levels.
• A person’s characteristics and behaviors: A person’s genetic makeup and lifestyle choices can affect their overall health.

According to some studies, the higher a person’s socioeconomic status (SES), the more likely they are to enjoy good health, have a good education, get a well-paid job, and afford good healthcare in times of illness or injury.

They also maintain that people with low socioeconomic status are more likely to experience stress due to daily living, such as financial difficulties, marital disruption, and unemployment.

Social factors may also impact on the risk of poor health for people with lower SES, such as marginalization and discrimination.

A low SES often means reduced access to healthcare. A 2018 study in Frontiers in Pharmacology indicated that people in developed countries with universal healthcare services have longer life expectancies than those in developed countries without universal healthcare.

Cultural issues can affect health. The traditions and customs of a society and a family’s response to them can have a good or bad impact on health.

According to the Seven Countries Study, researchers studied people in select European countries and found that those who ate a healthful diet had a lower 20-year death rate.

The study indicated that people who ate a healthful diet are more likely to consume high levels of fruits, vegetables, and olives than people who regularly consume fast food.

The study also found that people who followed the Mediterranean diet had a lower 10-year all-cause mortality rate. According to the International Journal of Environmental Research and Public Health , this diet can help protect a person’s heart and reduce the risk of several diseases, including type 2 diabetes, cancer, and diseases that cause the brain and nerves to break down.

How a person manages stress will also affect their health. According to the National Institute of Mental Health, people who smoke tobacco, drink alcohol, or take illicit drugs to manage stressful situations are more likely to develop health problems than those who manage stress through a healthful diet, relaxation techniques, and exercise.

Preserving health

The best way to maintain health is to preserve it through a healthful lifestyle rather than waiting until sickness or infirmity to address health problems. People use the name wellness to describe this continuous state of enhanced well-being.

“Wellness is the optimal state of health of individuals and groups. There are two focal concerns: the realization of the fullest potential of an individual physically, psychologically, socially, spiritually, and economically, and the fulfillment of one’s roles and expectations in the family, community, place of worship, and other settings.”

Wellness promotes active awareness of and participating in measures that preserve health, both as an individual and in the community. Maintaining wellness and optimal health is a lifelong, daily commitment.

Steps that can help people attain wellness include:

• eating a balanced, nutritious diet from as many natural sources as possible
• engaging in at least 150 minutes of moderate to high-intensity exercise every week, according to the American Heart Association
• screening for diseases that may present a risk
• learning to manage stress effectively
• engaging in activities that provide purpose
• connecting with and caring for other people
• maintaining a positive outlook on life
• defining a value system and putting it into action

The definition of peak health is highly individual, as are the steps a person may take to get there. Every person has different health goals and a variety of ways to achieve them.

It may not be possible to avoid disease altogether. However, a person should do as much as they can to develop resilience and prepare the body and mind to deal with illnesses as they arise.

WHO remains firmly committed to the principles set out in the preamble to the Constitution

• Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.
  
• The enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being without distinction of race, religion, political belief, economic or social condition.
  
• The health of all peoples is fundamental to the attainment of peace and security and is dependent on the fullest co-operation of individuals and States.
  
• The achievement of any State in the promotion and protection of health is of value to all.
  
• Unequal development in different countries in the promotion of health and control of diseases, especially communicable disease, is a common danger.
  
• Healthy development of the child is of basic importance; the ability to live harmoniously in a changing total environment is essential to such development.
• The extension to all peoples of the benefits of medical, psychological and related knowledge is essential to the fullest attainment of health.
  
• Informed opinion and active co-operation on the part of the public are of the utmost importance in the improvement of the health of the people.
  
• Governments have a responsibility for the health of their peoples which can be fulfilled only by the provision of adequate health and social measures

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Public health is “the science and art of preventing disease, prolonging life, and promoting health through the organized efforts and informed choices of society, organizations, public and private communities, and individuals.” — CEA Winslow

Public health: The approach to medicine that is concerned with the health of the community as a whole. Public health is community health. It has been said that: “Health care is vital to all of us some of the time, but public health is vital to all of us all of the time.”

The mission of public health is to “fulfill society’s interest in assuring conditions in which people can be healthy.” The three core public health functions are:

• The assessment and monitoring of the health of communities and populations at risk to identify health problems and priorities;
• The formulation of public policies designed to solve identified local and national health problems and priorities;
• To assure that all populations have access to appropriate and cost-effective care, including health promotion and disease prevention services, and evaluation of the effectiveness of that care.

Public health is defined as the science of protecting the safety and improving the health of communities through education, policy making and research for disease and injury prevention.

The definition of public health is different for every person. Whether you like to crunch numbers, conduct laboratory or field research, formulate policy, or work directly with people to help improve their health, there is a place for you in the field of public health. Being a public health professional enables you to work around the world, address health problems of communities as a whole, and influence policies that affect the health of societies.

Public health involves the application of many different disciplines:

• Biology
• Anthropology
• Public policy
• Mathematics
• Engineering
• Education
• Psychology
• Computer science
• Sociology
• Medicine
• Business
• and others

What do public health professionals do?

As a public health professional, you will be trained to perform one or more of these ten essential services:

• Monitor the health status of a community to identify potential problems
• Diagnose and investigate health problems and hazards in the community
• Inform, educate, and empower people about health issues, particularly the underserved and those at risk
• Mobilize community partnerships to identify and solve health problems
• Develop policies and plans that support individual and community health efforts
• Enforce laws and regulations that protect health and ensure safety
• Link people to needed personal health services and ensure the provision of health care when otherwise unavailable
• Ensure a competent public health and personal health care workforce
• Evaluate effectiveness, accessibility, and quality of personal and population-based health services
• Research new insights and innovative solutions to health problems

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Introduction to Epidemiology

Epidemiology is the “study of distribution and determinants of health-related states among specified populations and the application of that study to the control of health problems.” — A Dictionary of Epidemiology

These materials provide an overview of epidemiology investigations, methods, and data collection.

The Science of Prevention

Public health is responsible for everything from clean air and water to safe workplaces; from controlling the spread of infectious diseases and preventing chronic diseases to improving prenatal nutrition; from reducing automobile accidents to designing quality health systems. Partnering with national and local governments, public health scientists respond to natural disasters, pandemics, and any other threat to population health. And while medicine is vital for each of us when we get sick, public health benefits everyone, young and old, rich and poor, healthy and unhealthy, millions at a time, and in ways that ensure health beyond what any of us alone can accomplish.

The Role of Research and Discovery

Although the history of public health is filled with important discoveries, this is a science that thrives on continuous exploration. Public health scientists examine familiar areas of disease, disability, and safety, as well as conditions that alter the health landscape such as technological advancement, novel infections, and environmental shifts.

The field is divided into several areas of specialty, each with its own approach to improving health. Epidemiology is the cornerstone science of public health defining the causes, distribution, and prevention of disease and disability. When populations experience the effects of ill health, epidemiologists find solutions. Biostatistics, with the capacity to measure, monitor, and analyze complex data, is a force in population sciences, from genetics to precision medicine, from brain science to clinical trials. Biostatisticians extract meaning from big data, leading us to quantifiable evidence used by all public health disciplines.

Environmental Health Sciences examines our environment to explain how it contributes to health, whether measuring the effect of toxic substances on brain development, reducing levels of arsenic found in drinking water, or understanding how climate change and air pollution affect health. When health is impaired due to social forces such as racism, homelessness, or homophobia, Sociomedical Sciences is called upon to explain and alleviate the burdens of ill health.

Considering topics like humanitarian assistance, migration, and reproductive health, Population and Family Health studies the unique issues that affect health for the most vulnerable, including children, refugees, and expectant mothers. Health Policy and Management evaluates health systems to build knowledge of how nations and local organizations can deliver more health at lower cost. Researchers train professionals to become leaders everywhere—from government to nonprofits, from hospitals to the insurance industry.

Understanding the links between tuberculosis and overcrowding in turn-of-the-century New York City brought about massive changes in housing, sanitation, and treatment—and a dramatically lower rate of TB infection.

To expand access to antiretroviral HIV medication across sub-Saharan Africa, massive systems were designed to create access to medicine and care, and improve disease prevention in countries without any reliable healthcare infrastructure, saving millions of lives and changing the course of the AIDS pandemic.

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For many people, sex is mainly synonymous with penile-vaginal intercourse. Yet there are many ways to have sex. There are also several ways to have lesbian sex, which can involve a variety of techniques, including oral sex, fingering, and the use of sex toys.

The logistics of lesbian sex can vary depending on several factors, which include:

• a person’s gender identity
• the sex assigned to a person at birth
• a person’s body parts
• a person’s relationship with their bodies

For example, a woman whom doctors designated male at birth may use her penis during sex or may wish to avoid all contact with her penis.

With a variety of techniques available and different understandings of what constitutes good sex, communication is crucial.

In this article, we will define what sex is, debunk myths surrounding lesbian sex, and suggest how people may prepare for lesbian sex.

Sex definition

Lesbian sex can be pleasurable, creative, and satisfying.

There is no consensus on the single medical definition of sex. Doctors and researchers usually assume it involves some form of genital contact. However, sex extends well beyond penile-vaginal intercourse.

Many people consider sex to be a mutually voluntary activity with other people that involves sexual contact. However, this is open to interpretation, and sex may mean different things to different people. Some people even consider kissing a form of sex.

This means there is no single definition for lesbian sex, nor any specific sex act that all lesbians enjoy. Some types of lesbian sex may include:

• Oral sex: Orally stimulating a partner’s genitals.
• Manual sex: Stimulating a partner’s genitals or other erogenous zones with the hand or fingers.
• Mutual masturbation: Engaging in manual sex simultaneously, so that each partner stimulates the other.
• Penetrative sex: Penetration with a penis, for example, when a lesbian is assigned male at birth. Or it could involve sex toys or a strap-on dildo.
• Masturbation: Masturbating, sometimes while talking to or kissing a partner.
• Scissoring or humping: Mutual genital contact, where each partner rubs their genitals on the other’s genitals.

Debunking myths about lesbian sex 

Some myths about lesbian sex include:

Each partner plays a gender role in the relationship: For example, one partner always penetrates the other. Lesbians, like all other people, may embrace a wide range of roles. Sometimes, one partner might always be the one who penetrates the other, but often partners switch roles or have different types of sex.

All lesbians have sex by scissoring: There are many ways to have lesbian sex, and many lesbians never scissor.

Lesbian sex is safe: While pregnancy is not possible if both partners were female at birth, it can still be possible with a trans woman. Also, lesbians can and do transmit sexually transmitted infections (STIs). People should not presume to be at low or no risk based on their sexual orientation.

Lesbian sex cannot be violent, and there is no such thing as lesbian rape: Lesbians can and do rape other women, and research suggests that intimate partner violence occurs among lesbian couples.

Lesbians feel disinterested or lose interest in sex: This myth draws upon sexist stereotypes about women’s sexuality. Like everyone else, lesbians’ interest in sex varies from person to person, and across the lifespan.

Being lesbian means someone was born female, or cannot be transgender: Gender identity is not the same as sexuality or assigned sex. The gender label a person receives at birth does not matter. A person labeled male or female at birth can still identify as lesbian.

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How to prepare 

There is no right time to have sex, just as there is no right way for sex. Whether a person has sex for the first time, or they have had years of sex with the same partner, consent and communication are key. Some strategies that can help prepare a person for sex include:

• talking with a partner about views on sex and sexuality
• getting tested for STIs
• communicating during sex about what feels good

Manual stimulation 

During manual stimulation, one partner stimulates the other partner’s genitals, often the clitoris and vagina. Every person has different preferences and different anatomies, so it is important to talk about what feels good.

Some partners like to masturbate mutually, which means they stimulate each other simultaneously.

Oral sex 

Oral sex involves the use of the mouth and tongue to stimulate a partner’s genitals. Many lesbians find stimulation on the clitoris is pleasurable.

Some people also like to include aspects of manual stimulation into oral sex. People who enjoy oral stimulation can position themselves so each partner can perform simultaneous oral sex on each other.Medical News Today NewsletterKnowledge is power. Get our free daily newsletter.

Penetrative sex 

Many people believe penetrative sex is impossible in a lesbian relationship. This is untrue. Some lesbians might have penises if they were assigned as males at birth. Others choose other forms of penetration. People who enjoy penetrative sex may use:

• one or more fingers, with techniques that may provide more intense stimulation, such as fisting
• sex toys, such as dildos or vibrators
• a strap-on, some of which may offer mutual penetration

Safer sex tips 

The safest way to have sex as a lesbian is to use barrier methodsTrusted Source, such as dental dams, to ensure people do not share bodily fluids. Those who want to avoid this practice can have safer sex by:

• minimizing the number of partners they have
• avoiding sex with men
• cleaning all sex toys before and after use
• seeing a doctor for any pain, itching, burning, or other signs of STIs

Summary 

Lesbians can have many different types of sex. A person can explore various sexual activities in a consensual way to help them achieve sexual satisfaction.

Creativity, open communication, and a focus on safety can help partners enjoy the experience.

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Lymphedema refers to swelling that generally occurs in one of your arms or legs. Sometimes both arms or both legs swell.

Lymphedema is most commonly caused by the removal of or damage to your lymph nodes as a part of cancer treatment. It results from a blockage in your lymphatic system, which is part of your immune system. The blockage prevents lymph fluid from draining well, and the fluid buildup leads to swelling.

While there is presently no cure for lymphedema, it can be managed with early diagnosis and diligent care of your affected limb.

Symptoms

Lymphedema signs and symptoms, which occur in your affected arm or leg, include:

• Swelling of part or all of your arm or leg, including fingers or toes
• A feeling of heaviness or tightness
• Restricted range of motion
• Aching or discomfort
• Recurring infections
• Hardening and thickening of the skin (fibrosis)

The swelling caused by lymphedema ranges from mild, hardly noticeable changes in the size of your arm or leg to extreme changes that make the limb hard to use. Lymphedema caused by cancer treatment may not occur until months or years after treatment.

When to see a doctor

Make an appointment with your doctor if you notice persistent swelling in your arm or leg.

If you already have the diagnosis of lymphedema of a limb, see your doctor if there is a sudden dramatic increase in the size of the involved limb, as it may suggest a new process is occurring.

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Causes

Your lymphatic system is crucial to keeping your body healthy. It circulates protein-rich lymph fluid throughout your body, collecting bacteria, viruses and waste.

products. Your lymphatic system carries this fluid and harmful substances through your lymph vessels, which lead to lymph nodes. The wastes are then filtered out by lymphocytes — infection-fighting cells that live in your lymph nodes — and ultimately flushed from your body.

Lymphedema occurs when your lymph vessels are unable to adequately drain lymph fluid, usually from an arm or leg. Lymphedema can be either primary or secondary. This means it can occur on its own (primary lymphedema), or it can be caused by another disease or condition (secondary lymphedema). Secondary lymphedema is far more common than primary lymphedema.

Causes of secondary lymphedema

Any condition or procedure that damages your lymph nodes or lymph vessels can cause lymphedema. Causes include:

• Surgery. Removal of or injury to lymph nodes and lymph vessels may result in lymphedema. For example, lymph nodes may be removed to check for spread of breast cancer, and lymph nodes may be injured in surgery that involves blood vessels in your limbs.
• Radiation treatment for cancer. Radiation can cause scarring and inflammation of your lymph nodes or lymph vessels.
• Cancer. If cancer cells block lymphatic vessels, lymphedema may result. For instance, a tumor growing near a lymph node or lymph vessel could enlarge enough to block the flow of the lymph fluid.
• Infection. An infection of the lymph nodes or parasites can restrict the flow of lymph fluid. Infection-related lymphedema is most common in tropical and subtropical regions and is more likely to occur in developing countries.

Causes of primary lymphedema

Primary lymphedema is a rare, inherited condition caused by problems with the development of lymph vessels in your body. Specific causes of primary lymphedema include:

• Milroy’s disease (congenital lymphedema). This disorder begins in infancy and causes lymph nodes to form abnormally.
• Meige’s disease (lymphedema praecox). This disorder often causes lymphedema around puberty or during pregnancy, though it can occur later, until age 35.
• Late-onset lymphedema (lymphedema tarda). This occurs rarely and usually begins after age 35.

Risk factors

Factors that may increase your risk of developing lymphedema after cancer, from cancer treatment or from other secondary causes include:

• Older age
• Excess weight or obesity
• Rheumatoid or psoriatic arthritis

Complications

Lymphedema in your arm or leg can lead to serious complications, such as:

• Infections. Possible infections that can result from lymphedema include a serious bacterial infection of the skin (cellulitis) and an infection of the lymph vessels (lymphangitis). The smallest injury to your arm or leg can be an entry point for infection.
• Lymphangiosarcoma. This rare form of soft tissue cancer can result from the most-severe cases of untreated lymphedema. Possible signs of lymphangiosarcoma include blue-red or purple marks on the skin.

Prevention

If you have had or you are going to have cancer surgery, ask your doctor whether your procedure will involve your lymph nodes or lymph vessels. Ask if your radiation treatment will be aimed at lymph nodes, so you’ll be aware of the possible risks.

To reduce your risk of lymphedema, try to:

• Protect your arm or leg. Avoid injury to your affected limb. Cuts, scrapes and burns can invite infection. Protect yourself from sharp objects. For example, shave with an electric razor, wear gloves when you garden or cook, and use a thimble when you sew. If possible, avoid medical procedures, such as blood draws and vaccinations, in your affected limb.
• Rest your arm or leg while recovering. After cancer treatment, exercise and stretching are encouraged. But avoid strenuous activity until you’ve recovered from surgery or radiation.
• Avoid heat on your arm or leg. Don’t apply ice or heat, such as with a heating pad, to your affected limb. Also, protect your affected limb from extreme cold.
• Elevate your arm or leg. Whenever possible, elevate your affected limb above the level of your heart.
• Avoid tight clothing. Avoid anything that could constrict your arm or leg, such as tightfitting clothing and, in the case of your arm, blood pressure cuffs. Ask that your blood pressure be taken in your other arm.
• Keep your arm or leg clean. Make skin and nail care high priorities. Inspect the skin on your arm or leg daily, watching for changes or breaks in your skin that could lead to infection. Don’t go barefoot.

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Chest trauma accounts for 25-50% of all trauma-related deaths in the world. Trauma to the chest can result in broken ribs, pulmonary injury, cardiac injury, and blood vessel damage. Stove-in chest is a complex type of flail chest injury. Flail chest describes damage to the chest due to significant blunt force trauma, such as in a car accident or act of violence. Stove-in chest is a rare type of trauma to the thorax that occurs most often in car accidents. Here are the facts about this serious injury.

Diagnosing Stove-In Chest

Victims of stove-in chest may visit the emergency department with severe chest pain and difficulty breathing, or dyspnea. Doctors may use tracheal intubation, mechanical ventilation, or chest tube insertion to enable breathing while assessing a chest injury. Diagnosing stove-in chest requires scans, x-rays, and radiographs. This type of chest injury occurs when a segment of the chest wall collapses.

Stove-in chest differs from typical flail chest in that the latter describes only blunt force trauma to the chest. Flail chest happens when part of the chest wall moves due to fractures of three or more ribs, posteriorly and anteriorly in each rib. There are several different types of flail chest injuries depending on the location of the fractures. Stove-in chest occurs when the wall of the chest collapses, due to three or more ribs breaking upon impact.

Flail chest and stove-in chest require significant force over a large area of the chest, such as the thorax, to cause multiple rib fractures at once. Striking the steering wheel in a car accident, for example, could cause flail chest or stove-in chest. In some cases, the force of impact of a seatbelt across the chest can cause impact injuries. These injuries are so dangerous because they can easily affect the heart and lungs, leading to pulmonary contusion, respiratory insufficiency, and death.

Prognosis and Treatments for Stove-In Chest Injuries

Stove-in chest has a high rate of immediate mortality, but there is a chance of recovery with proper medical treatment. If the patient does not die upon impact, doctors can confirm stove-in chest using x-rays.

The chest wall will show collapse due to abnormal motion in three or more ribs. Depending on the nature of the injury, doctors will choose the appropriate treatment method moving forward. Here are two examples:

• Vehicle accident – Blunt force trauma can break multiple adjacent ribs in several places, leading to a part of the chest wall moving independently. Patients with stove-in chest from car accidents typically require surgery to fix the fractures and physiotherapy reduce the risk of complications.
• Assault or act of violence – Gunshot wounds or stabbings can lead to penetration injuries, typically requiring surgery. Patients with penetrating chest trauma may deteriorate rapidly depending on the nature of the injury. However, they may also recover faster than patients with blunt chest injuries.

Doctors will also have to treat related injuries, such as those to the lung, airways, heart, blood vessels, and other structures within the torso. Complex flail chest and stove-in chest injuries require tailored medical treatment according to each individual patient. The risk of complications is too high for one type of treatment to work across the board. For example, in one fatal stove-in chest injury, failure to ventilate the patient early (the patient exhibited good gas exchange) may have contributed to the formation of the empyema, or pus buildup in the pleural space, that caused the patient’s death.

Stove-in chest is one of the most life-threatening injuries that can occur in an accident. If you or someone you loved suffered this type of injury, seek help from an experienced attorney. Someone may be liable to pay for your physical injuries, pain and suffering, and emotional distress.

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Gangrene is death of body tissue due to a lack of blood flow or a serious bacterial infection. Gangrene commonly affects the arms and legs, including the toes and fingers, but it can also occur in the muscles and in organs inside the body, such as the gallbladder.

Your risk of gangrene is higher if you have an underlying condition that can damage your blood vessels and affect blood flow, such as diabetes or hardened arteries (atherosclerosis).

Treatments for gangrene include surgery to restore blood flow and remove dead tissue, antibiotics if there is an infection, and hyperbaric oxygen therapy. The earlier gangrene is identified and treated, the better your chances for recovery.

Gangrene is when part of your body tissue dies. This often occurs because the tissue is not getting enough blood from your circulatory system.

Gangrene usually affects your extremities — the areas farthest from your heart, such as your toes and fingers. However, it can affect other parts of your body as well. Gangrene can even affect your internal organs.

The condition typically starts in a specific body part, such as a leg, hand, or internal organ. Gangrene can spread through your body and cause you to go into shock if left untreated. Shock is a condition marked by a variety of symptoms including low blood pressure. Shock can be life-threatening and is considered a medical emergency.

Gangrene is a medical emergency that could lead to amputations or death. Recognizing and treating the condition as fast as possible will improve your outlook.

Types of gangrene

Dry gangrene

All of your organs (such as your liver, heart, and muscles) need oxygen to function properly and survive. The oxygen is carried to different parts of your body by your blood. Dry gangrene occurs when one of your body parts isn’t getting enough oxygen. Eventually, the body part will start to deteriorate and die. With dry gangrene, the skin is closed and there is no evidence of infection.

Wet gangrene

Wet gangrene happens when your body tissues become infected with some type of bacteria. The tissues react to the presence of the bacteria by growing moist and breaking down. This process causes the death of your tissues. It’s more of an emergency than dry gangrene because of the possibility of infection spreading to other parts of the body.

Gas gangrene

Bacteria called Clostridia cause gas gangrene. These bacteria create an infection that causes gas bubbles and toxins to develop inside the affected area. The resulting gases cause tissue death. This type of gangrene can be fatal, though it’s rare in the United States.

Internal gangrene. Gangrene that affects one or more of your organs, such as your intestines, gallbladder or appendix, is called internal gangrene. This type of gangrene occurs when blood flow to an internal organ is blocked — for example, when your intestines bulge through a weakened area of muscle in your stomach area (hernia) and become twisted.

Left untreated, internal gangrene can be deadly.Fournier’s gangrene. Fournier’s gangrene involves the genital organs. Men are more often affected, but women also can develop this type of gangrene. An infection in the genital area or urinary tract causes this type of gangrene. Meleney’s gangrene. This rare type of gangrene — also called progressive bacterial synergistic gangrene — is usually a complication of surgery. People with Meleney’s gangrene develop painful skin lesions one to two weeks after their operations.

Symptoms

When gangrene affects your skin, signs and symptoms may include:

• Skin discoloration — ranging from pale to blue, purple, black, bronze or red, depending on the type of gangrene you have
• Swelling
• Blisters
• Sudden, severe pain followed by a feeling of numbness
• A foul-smelling discharge leaking from a sore
• Thin, shiny skin, or skin without hair
• Skin that feels cool or cold to the touch

If you have a type of gangrene that affects tissues beneath the surface of your skin, such as gas gangrene or internal gangrene, you may also have a low-grade fever and generally feel unwell.

If the germs that caused the gangrene spread through your body, septic shock can occur. Signs and symptoms of septic shock include:

• Low blood pressure
• Fever, although some people may have a body temperature lower than the normal 98.6 F (37 C)
• Rapid heart rate
• Lightheadedness
• Shortness of breath
• Confusion

When to see a doctor

Gangrene is a serious condition and needs emergency treatment. Call your doctor right away if you have persistent, unexplained pain in any area of your body along with one or more of the following signs and symptoms:

• Persistent fever
• Skin changes — including discoloration, warmth, swelling, blisters or lesions — that won’t go away
• A foul-smelling discharge leaking from a sore
• Sudden pain at the site of a recent surgery or trauma
• Skin that’s pale, hard, cold and numb

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Causes

Causes of gangrene include:

• Lack of blood supply. Your blood provides oxygen and nutrients to your body. It also provides your immune system with antibodies to ward off infections. Without a proper blood supply, your cells can’t survive, and your tissue decays.
• Infection. An untreated bacterial infection can cause gangrene.
• Traumatic injury. Gunshot wounds or crushing injuries from car crashes can cause open wounds that let bacteria into the body. If the bacteria infect tissues and remain untreated, gangrene can occur.

Recognizing the signs of gangrene

External gangrene

Sometimes the first sign of dry gangrene is a reddish line that develops around the affected tissue. This line may later turn black.

Other signs that might indicate you have gangrene include:

• a wound that is red, sore, or swollen
• a wound that is filled with pus or gives off a bad smell
• an isolated area of your body feels cold
• lacking a sense of touch in an isolated area
• sores that keep coming back in the same place on your body
• part of your skin has turned an unusual color (greenish-black, red, blue, or bronze)

Internal gangrene

It’s also possible to experience internal gangrene, which affects your inner tissues or organs. In this case, you may not have any symptoms on your skin or limbs. However, you may have pain, an unexplained fever that lasts a long time, or low blood pressure. You may also experience confusion.

How is gangrene diagnosed?

Your doctor may suspect that you have gangrene based on your medical history and symptoms. They may also use a combination of additional diagnostic methods to determine your condition.

Lab analysis of tissue or fluid samples

A scraping of tissue from your affected body part may be examined with a microscope to look for dead cells.

Blood tests

An abnormally high white blood cell count can indicate a gangrenous infection.

Medical imaging

Some kinds of imaging are helpful in diagnosing the spread of gangrene in your internal tissues. These tests could include X-rays, MRI scans, or CT scans.

An anarteriogram test may be performed if doctors suspect that your gangrene is related to a circulatory problem. This test uses X-rays to monitor the flow of a special dye through your arteries, showing whether any arteries are blocked.

Risk factors

Several factors increase your risk of developing gangrene. These include:

• Diabetes. If you have diabetes, your body doesn’t produce enough of the hormone insulin (which helps your cells take up blood sugar) or is resistant to the effects of insulin. High blood sugar levels can eventually damage blood vessels, decreasing or interrupting blood flow to a part of your body.
• Blood vessel disease. Hardened and narrowed arteries (atherosclerosis) and blood clots also can block blood flow to an area of your body.
• Severe injury or surgery. Any process that causes trauma to your skin and underlying tissue, including an injury or frostbite, increases your risk of developing gangrene, especially if you have an underlying condition that affects blood flow to the injured area.
• Smoking. People who smoke have a higher risk of gangrene.
• Obesity. Obesity often accompanies diabetes and vascular disease, but the stress of extra weight alone can also compress arteries, leading to reduced blood flow and increasing your risk of infection and poor wound healing.
• Immunosuppression. If you have an infection with the human immunodeficiency virus (HIV) or if you’re undergoing chemotherapy or radiation therapy, your body’s ability to fight off an infection is impaired.
• Medications or drugs that are injected. In rare instances, certain medications and illegal drugs that are injected have been shown to cause infection with bacteria that cause gangrene.
• Complications of COVID-19. There have been a few reports of people getting dry gangrene in their fingers and toes after having COVID-19-related blood clotting problems (coagulopathy). More research is needed to confirm this association.

Complications

Gangrene can lead to serious complications if it’s not immediately treated. Bacteria can spread quickly to other tissues and organs. You may need to have a body part removed (amputated) to save your life.

Removal of infected tissue can lead to scarring or the need for reconstructive surgery.

Prevention

Here are a few suggestions to help you reduce your risk of developing gangrene:

• Care for your diabetes. If you have diabetes, make sure you examine your hands and feet daily for cuts, sores, and signs of infection, such as redness, swelling or drainage. Ask your doctor to examine your hands and feet at least once a year, and try to maintain control over your blood sugar levels.
• Lose weight. Excess pounds not only put you at risk of diabetes but also place pressure on your arteries, constricting blood flow and putting you at risk of infection and slow wound healing.
• Don’t use tobacco. The chronic use of tobacco products can damage your blood vessels.
• Help prevent infections. Wash any open wounds with a mild soap and water and try to keep them clean and dry until they heal.
• Watch out when the temperature drops. Frostbitten skin can lead to gangrene because frostbite reduces blood circulation in an affected area. If you notice that any area of your skin has become pale, hard, cold and numb after prolonged exposure to cold temperatures, call your doctor.

Gangrene treatment

Antibiotics

Your doctor may prescribe antibiotics if bacteria are present. These are typically given intravenously, or through a needle directly into the bloodstream.

Vascular surgery

For people with poor circulation that results in gangrene, vascular surgery (surgery on the arteries or veins) may be recommended in order to improve the flow of blood through the veins to body tissues.

Hyperbaric oxygen chamber

Placing a person with gas gangrene in a special oxygen-rich environment can slow the growth of bacteria. This allows the skin to begin healing. It also brings oxygen to the damaged tissue to promote healing.

Tissue debridement

In serious gangrene cases, the dead tissue or body part may need to be removed. This process is called debridement. Debridement can be done with surgical tools or with chemicals. The goal of this type of surgery is to remove the affected areas to prevent the spread of infection and rid the body of the dead tissue.

One alternative form of debridement, known as maggot debridement, uses fly larvae to eat away bacteria and dead tissue. Though rare, this practice can still be used by physicians in the United States and abroad.

Doctors are sometimes able to restore the flow of oxygen to the affected area. Skin grafts can repair any damaged tissue. This procedure uses a piece of your healthy skin from elsewhere on the body to cover the damaged area.

Amputation

For severe cases, amputation of a limb, finger, or toe could be necessary to save your life. People who must have part of an arm or leg amputated due to gangrene may be fitted with a prosthesis, or artificial limb, to replace the missing body part.

What is the long-term outlook for gangrene?

Gangrene can sometimes be treated without serious complications, especially if it is caught early. However, it can lead to amputation in some serious cases, particularly if it’s not treated quickly.

Gangrene can even be fatal for some individuals. This is rare, but it can occur if:

• you have other serious medical issues that complicate your treatment
• the gangrenous area covers a large part of your body
• treatment is not provided quickly enough

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5 Important Concepts in Social Psychology

Social psychology is a branch of psychology concerned with how social influences affect how people think, feel, and act. The way we perceive ourselves in relation to the rest of the world plays an important role in our choices, behaviors, and beliefs. Conversely, the opinions of others also impact our behavior and the way we view ourselves.

Understanding social psychology can be useful for many reasons. First, we can better understand how groups impact our choices and actions. There are some basic aspects of social behavior that play a large role in our actions and how we see ourselves.

Social Behavior Is Goal-Oriented

Our interactions serve goals or fulfill needs. Some common goals or needs include the need for social ties, the desire to understand ourselves and others, the wish to gain or maintain status or protection, and the need to attract companions.

The way people behave is often driven by the desire to fulfill these needs.1 People seek friends and romantic partners, strive to gain social status, and attempt to understand the motivations that guide other people’s behaviors.

Situations Help Determine Outcome

In many instances, people behave very differently depending upon the situation. To fully understand why people do the things they do, it is essential to look at individual characteristics, the situation and its context, and the interactions among all these variables.

For example, someone who is normally quiet and reserved might become much more outgoing when placed in some type of leadership role. Another example is how people sometimes behave differently in groups than they would if they were by themselves. Environmental and situational variables play an important role and have a strong influence on our behavior.

Social psychology allows us to gain a greater appreciation for how our social perceptions affect our interactions with other people.

Social Situations Form Self-Concept

Our social interactions help form our self-concept and our perceptions. One method of forming self-concept is through the reflected appraisal process,2 in which we imagine how other people see us. Another method is through the social comparison process, whereby we consider how we compare to other people in our peer group.

Sometimes we engage in upward social comparison where we rate ourselves against people who are better off than us in some way. In other instances, we might engage in downward social comparison where we contrast our own abilities to those of others who are less capable.

We Analyze the Behavior of Others

One common phenomenon is the expectation confirmation, where we tend to ignore unexpected attributes and look for evidence that confirms our preexisting beliefs about others.4 This helps simplify our worldview, but it also skews our perception and can contribute to stereotyping.

If you expect people to behave in a certain way, you might look for examples that confirm your belief while at the same time ignoring evidence that conflicts with your existing opinions.

We Believe Behavior Reflects Personality

Another influence on our perceptions of other people can be explained by the theory of correspondent inferences.5 This occurs when we infer that the actions and behaviors of others correspond to their intentions and personalities. For example, if we see a woman helping an elderly person cross the street, we might assume that she is kind-hearted. While behavior can be informative, it can also be misleading.

If we have limited interaction with someone, the behavior we see may be atypical or caused by the specific situation rather than by the person’s overriding dispositional characteristics. In the previous example, the woman might only be helping the elderly person because she has been employed to do so instead of out of the kindness of her heart.

What is the Importance of Social Psychology in Society?

 The importance of social psychology is shown in all the interactive aspects of the individual’s social life and all the environments in which he coexists, which can affect the individual’s interactions and personality.
As social psychology studies the behavior of individuals and groups, everyone who deals with and communicates with different community groups needs this science; to understand and guide individuals and to study various responses within the community.
For example, the teacher needs in his class to analyze the students’ personalities and their interdependence and understand the relationships between them, and strategies that fit the patterns and mechanisms to convince them for a particular idea, in addition to the partnership among themselves and cooperation and competition and behaviors based on their presence within the group.
Social psychology also requires social specialists to understand the philosophy of society, the secrets of its composition, the relative appearance, and absence of phenomena, and link to societal behaviors.
The individual in his daily life is able to explain his behavior and self-behavior around him properly, understanding the interaction and harmony that takes place between the individual among others.
Thus the understanding of social and cultural being, which in turn determines the expected behavioral patterns in different social attitudes, in addition to this science, gives the individual the ability to differentiate between people, the possibility of accepting a certain category and move away from another category.
The importance of social psychology was highlighted directly in daily life situations, in addition to its great importance in the field of life of the international community and the world and social issues experienced by people from situations of war, slavery, freedom, and security.  These are separated as follows:

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What is the Importance of Social Psychology in Society?

 The importance of social psychology is shown in all the interactive aspects of the individual’s social life and all the environments in which he coexists, which can affect the individual’s interactions and personality.
As social psychology studies the behavior of individuals and groups, everyone who deals with and communicates with different community groups needs this science; to understand and guide individuals and to study various responses within the community.
For example, the teacher needs in his class to analyze the students’ personalities and their interdependence and understand the relationships between them, and strategies that fit the patterns and mechanisms to convince them for a particular idea, in addition to the partnership among themselves and cooperation and competition and behaviors based on their presence within the group.
Social psychology also requires social specialists to understand the philosophy of society, the secrets of its composition, the relative appearance, and absence of phenomena, and link to societal behaviors.
The individual in his daily life is able to explain his behavior and self-behavior around him properly, understanding the interaction and harmony that takes place between the individual among others.
Thus the understanding of social and cultural being, which in turn determines the expected behavioral patterns in different social attitudes, in addition to this science, gives the individual the ability to differentiate between people, the possibility of accepting a certain category and move away from another category.
The importance of social psychology was highlighted directly in daily life situations, in addition to its great importance in the field of life of the international community and the world and social issues experienced by people from situations of war, slavery, freedom, and security.  These are separated as follows:

Practical importance

All people who engage in groups and individuals need to study the principles of social psychology continuously in order to understand and guide social behaviors. The importance of these groups is as follows:
Teacher: The teacher in the classroom needs to understand the social-behavioral characteristics of the students as a micro-social environment based on the relationships and interactions among their members, as well as the importance of identifying the steps of socialization that are manifested in the behavioral interaction among individuals such as competition, cooperation, learning, and collective thinking.
Social Specialist: The importance of social psychology to social specialists in understanding and studying social organization and its orientation towards social cohesion, trends, intolerance, and leadership.
Businessmen: Social psychology helps to understand the nature of the laws of human relations that exist between categories of workers in a given domain, and the important relationship between the level of moral spirit and mental health and the level of production and achievement.
Normal Human: The study of social psychology in everyday life helps to achieve as much as possible the individual’s understanding of his own behavior and the external behavior of other individuals, thus understanding the dynamics of interaction and communication with others, as well as the cultural and social backgrounds in which patterns and behaviors are determined. Good judgment in using the proper way to deal with others, either by accepting and sacrificing in some situations or with distaste and dislike in other situations.

Global importance

Since the first emergence of social psychology, it deals with future issues by warning against crises and inevitable problems, optimism about the sound construction of this future, and providing suggestions and predictive and remedial plans for economic and political problems such as the problems of war and aggression and its consequences and global financial crises. Global Inclusiveness seeks to create a society of excellence in which the opportunities available to individuals in all fields are equal to all members of society.
It also has an important role in spreading the highest human ideals among individuals within one society in the effective study of psycho-social phenomena, research, and experimental study. The following points can be summarized as follows:
Warning of future problems: It is possible to warn against future problems and crises by predicting initial signs and symptoms that may indicate the possibility of a particular problem in a given area and warning people without intervening in the course of events. However, it is possible to direct social activity in light of current events.
Building the future: Human scientists emphasize that a person can change the course of his life by directing his activities appropriately with achieving his goals and solving problems. Just as human beings used biological sciences to raise the level of health efficiency, it is possible to use social psychology to seek social justice and the future.
Addressing political and economic problems: These problems arise as a result of the imbalance in the distribution of tasks, work, resources, and efforts in appropriate activities.
This results from ignorance of the understanding of the social characteristics of man, which is the subject of psychological and social research, which in turn creates the basic laws and principles of social life together.

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Cognitive development is the construction of thought processes, including remembering, problem solving, and decision-making, from childhood through adolescence to adulthood.

It was once believed that infants lacked the ability to think or form complex ideas and remained without cognition until they learned language. It is now known that babies are aware of their surroundings and interested in exploration from the time they are born. From birth, babies begin to actively learn. They gather, sort, and process information from around them, using the data to develop perception and thinking skills.

Cognitive development refers to how a person perceives, thinks, and gains understanding of his or her world through the interaction of genetic and learned factors. Among the areas of cognitive development are information processing, intelligence , reasoning, language development , and memory.

The 4 Stages of Cognitive Development

Jean Piaget’s theory of cognitive development suggests that children move through four different stages of mental development. His theory focuses not only on understanding how children acquire knowledge, but also on understanding the nature of intelligence.1 Piaget’s stages are:

• Sensorimotor stage: birth to 2 years
• Preoperational stage: ages 2 to 7
• Concrete operational stage: ages 7 to 11
• Formal operational stage: ages 12 and up

Piaget believed that children take an active role in the learning process, acting much like little scientists as they perform experiments, make observations, and learn about the world. As kids interact with the world around them, they continually add new knowledge, build upon existing knowledge, and adapt previously held ideas to accommodate new information.

How Piaget Developed the Theory

Piaget was born in Switzerland in the late 1800s and was a precocious student, publishing his first scientific paper when he was just 11 years old. His early exposure to the intellectual development of children came when he worked as an assistant to Alfred Binet and Theodore Simon as they worked to standardize their famous IQ test.

Much of Piaget’s interest in the cognitive development of children was inspired by his observations of his own nephew and daughter. These observations reinforced his budding hypothesis that children’s minds were not merely smaller versions of adult minds.

Up until this point in history, children were largely treated simply as smaller versions of adults. Piaget was one of the first to identify that the way that children think is different from the way adults think.

Instead, he proposed, intelligence is something that grows and develops through a series of stages. Older children do not just think more quickly than younger children, he suggested. Instead, there are both qualitative and quantitative differences between the thinking of young children versus older children.

Based on his observations, he concluded that children were not less intelligent than adults, they simply think differently. Albert Einstein called Piaget’s discovery “so simple only a genius could have thought of it.”

Piaget’s stage theory describes the cognitive development of children. Cognitive development involves changes in cognitive process and abilities.2 In Piaget’s view, early cognitive development involves processes based upon actions and later progresses to changes in mental operations.

The Stages

Through his observations of his children, Piaget developed a stage theory of intellectual development that included four distinct stages:

The Sensorimotor Stage

Ages: Birth to 2 Years

Major Characteristics and Developmental Changes:

• The infant knows the world through their movements and sensations
• Children learn about the world through basic actions such as sucking, grasping, looking, and listening
• Infants learn that things continue to exist even though they cannot be seen (object permanence)
• They are separate beings from the people and objects around them
• They realize that their actions can cause things to happen in the world around them

During this earliest stage of cognitive development, infants and toddlers acquire knowledge through sensory experiences and manipulating objects. A child’s entire experience at the earliest period of this stage occurs through basic reflexes, senses, and motor responses.

It is during the sensorimotor stage that children go through a period of dramatic growth and learning. As kids interact with their environment, they are continually making new discoveries about how the world works.

The cognitive development that occurs during this period takes place over a relatively short period of time and involves a great deal of growth. Children not only learn how to perform physical actions such as crawling and walking; they also learn a great deal about language from the people with whom they interact. Piaget also broke this stage down into a number of different substages. It is during the final part of the sensorimotor stage that early representational thought emerges.

Piaget believed that developing object permanence or object constancy, the understanding that objects continue to exist even when they cannot be seen, was an important element at this point of development.

By learning that objects are separate and distinct entities and that they have an existence of their own outside of individual perception, children are then able to begin to attach names and words to objects. The Sensorimotor Stage of Cognitive Development

The Preoperational Stage

Ages: 2 to 7 Years

Major Characteristics and Developmental Changes:

• Children begin to think symbolically and learn to use words and pictures to represent objects.
• Children at this stage tend to be egocentric and struggle to see things from the perspective of others.
• While they are getting better with language and thinking, they still tend to think about things in very concrete terms.

The foundations of language development may have been laid during the previous stage, but it is the emergence of language that is one of the major hallmarks of the preoperational stage of development.3

Children become much more skilled at pretend play during this stage of development, yet continue to think very concretely about the world around them. 

At this stage, kids learn through pretend play but still struggle with logic and taking the point of view of other people. They also often struggle with understanding the idea of constancy.
For example, a researcher might take a lump of clay, divide it into two equal pieces, and then give a child the choice between two pieces of clay to play with. One piece of clay is rolled into a compact ball while the other is smashed into a flat pancake shape. Since the flat shape looks larger, the preoperational child will likely choose that piece even though the two pieces are exactly the same size. Preoperational Stage of Cognitive Development in Young Children

The Concrete Operational Stage

Ages: 7 to 11 Years

Major Characteristics and Developmental Changes

• During this stage, children begin to thinking logically about concrete events
• They begin to understand the concept of conservation; that the amount of liquid in a short, wide cup is equal to that in a tall, skinny glass, for example
• Their thinking becomes more logical and organized, but still very concrete
• Children begin using inductive logic, or reasoning from specific information to a general principle

While children are still very concrete and literal in their thinking at this point in development, they become much more adept at using logic.2 The egocentrism of the previous stage begins to disappear as kids become better at thinking about how other people might view a situation.

While thinking becomes much more logical during the concrete operational state, it can also be very rigid. Kids at this point in development tend to struggle with abstract and hypothetical concepts.

During this stage, children also become less egocentric and begin to think about how other people might think and feel. Kids in the concrete operational stage also begin to understand that their thoughts are unique to them and that not everyone else necessarily shares their thoughts, feelings, and opinions. The Concrete Operational Stage in Cognitive Development

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The Formal Operational Stage

Ages: 12 and Up

Major Characteristics and Developmental Changes:

• At this stage, the adolescent or young adult begins to think abstractly and reason about hypothetical problems
• Abstract thought emerges
• Teens begin to think more about moral, philosophical, ethical, social, and political issues that require theoretical and abstract reasoning
• Begin to use deductive logic, or reasoning from a general principle to specific information

The final stage of Piaget’s theory involves an increase in logic, the ability to use deductive reasoning, and an understanding of abstract ideas.3 At this point, people become capable of seeing multiple potential solutions to problems and think more scientifically about the world around them.

The ability to thinking about abstract ideas and situations is the key hallmark of the formal operational stage of cognitive development. The ability to systematically plan for the future and reason about hypothetical situations are also critical abilities that emerge during this stage. 

It is important to note that Piaget did not view children’s intellectual development as a quantitative process; that is, kids do not just add more information and knowledge to their existing knowledge as they get older. Instead, Piaget suggested that there is a qualitative change in how children think as they gradually process through these four stages.4 A child at age 7 doesn’t just have more information about the world than he did at age 2; there is a fundamental change in how he thinks about the world. Formal Operational Stage of Cognitive Development

Important Concepts

To better understand some of the things that happen during cognitive development, it is important first to examine a few of the important ideas and concepts introduced by Piaget.

The following are some of the factors that influence how children learn and grow:

Schemas

A schema describes both the mental and physical actions involved in understanding and knowing. Schemas are categories of knowledge that help us to interpret and understand the world.

In Piaget’s view, a schema includes both a category of knowledge and the process of obtaining that knowledge.3 As experiences happen, this new information is used to modify, add to, or change previously existing schemas.

For example, a child may have a schema about a type of animal, such as a dog. If the child’s sole experience has been with small dogs, a child might believe that all dogs are small, furry, and have four legs. Suppose then that the child encounters an enormous dog. The child will take in this new information, modifying the previously existing schema to include these new observations.

Assimilation

The process of taking in new information into our already existing schemas is known as assimilation. The process is somewhat subjective because we tend to modify experiences and information slightly to fit in with our preexisting beliefs. In the example above, seeing a dog and labeling it “dog” is a case of assimilating the animal into the child’s dog schema. Assimilation and Jean Piaget’s Adaptation Process

Accommodation

Another part of adaptation involves changing or altering our existing schemas in light of new information, a process known as accommodation. Accommodation involves modifying existing schemas, or ideas, as a result of new information or new experiences.5 New schemas may also be developed during this process.

Equilibration

Piaget believed that all children try to strike a balance between assimilation and accommodation, which is achieved through a mechanism Piaget called equilibration. As children progress through the stages of cognitive development, it is important to maintain a balance between applying previous knowledge (assimilation) and changing behavior to account for new knowledge (accommodation). Equilibration helps explain how children can move from one stage of thought to the next.



Cognitive development
Age	Activity
One month	Watches person when spoken to.
Two months	Smiles at familiar person talking. Begins to follow moving person with eyes.
Four months	Shows interest in bottle, breast, familiar toy, or new surroundings.
Five months	Smiles at own image in mirror. Looks for fallen objects.
Six months	May stick out tongue in imitation. Laughs at peekaboo game. Vocalizes at mirror image. May act shy around strangers.
Seven months	Responds to own name. Tries to establish contact with a person by cough or other noise.
Eight months	Reaches for toys out of reach. Responds to “no.”
Nine months	Shows likes and dislikes. May try to prevent face-washing or other activity that is disliked. Shows excitement and interest in foods or toys that are well-liked.
Ten months	Starts to understand some words. Waves bye-bye. Holds out arm or leg for dressing.
Eleven months	Repeats performance that is laughed at. Likes repetitive play. Shows interest in books.
Twelve months	May understand some “where is…?” questions. May kiss on request.
Fifteen months	Asks for objects by pointing. Starting to feed self. Negativism begins.
Eighteen months	Points to familiar objects when asked “where is…?” Mimics familiar adult activities. Know some body parts. Obeys two or three simple orders.
Two years	Names a few familiar objects. Draws with crayons. Obeys found simple orders. Participates in parallel play.
Two-and-a-half years	Names several common objects. Begins to take interest in sex organs. Gives full names. Helps to put things away. Peak of negativism.
Three years	Constantly asks questions. May count to 10. Begins to draw specific objects. Dresses and undresses doll. Participates in cooperative play. Talks about things that have happened.
Four years	May make up silly words and stories. Beginning to draw pictures that represent familiar things. Pretends to read and write. May recognize a few common words, such as own name.
Five years	Can recognize and reproduce many shapes, letters, and numbers. Tells long stories. Begins to understand the difference between real events and make-believe ones. Asks meaning of words
SOURCE : Miller-Keane Encyclopedia and Dictionary of Medicine, Nursing, and Allied Health, 5th ed . and Child Development Institute, http://www.childdevelopmentinfo.com.

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