What Is the Definition of Development in Health and Social Care

What Is the Definition of Development in Health and Social Care

Erikson postulated eight stages of psychosocial development. The LCA framework highlights the potential benefits of long-term investments in health that begin early in life and continue throughout life. Given the federal government`s significant financial interest in delaying and avoiding health care costs and increasing national productivity, government, not the private sector, appears to be the most likely candidate to launch new LCHD-style financing strategies that increase investments in health capital. While this is a prevention-oriented and investment-oriented approach to health spending, it would require different types of spending and possibly higher spending in the short term. Without a solid vision of how this could be done in a way that can surpass our current Medicare fiscally, it will be difficult to convince policymakers and payers that new “investments” are more than rebranded “expenses.” The health development model shows how early experience and exposure to risk factors can influence subsequent health status, including the course of decline (Figure 4). Trajectory heuristics are supported by a significant body of evidence showing that the number, type, timing and context of risk and protective factors influence outcomes differently (Boyce et al., 1998; Sameroff et al., 1993; Steinberg and Avenevoli 2000) by cumulative and programmable mechanisms (Ben-Shlomo and Kuh, 2002; Powers and Hertzman, 1997). Risk factors reduce the course of health development, and promoting factors help increase the course. As shown in Figure 4, health outcomes can be understood as the product of competing positive and negative influences over time. For example, in a child with asthma, exposure to allergens or infections during periods when the immune system is programmed, as well as the alterative influence of adaptive or maladaptive parenting, can affect the type, frequency and persistence of asthma attacks and long-term lung function. Other risk factors, such as additional exposure to allergens and poor pest control or limited access to health care, can affect a child`s functional airways.

In contrast, breastfeeding support, antigen exposure management, behavioural and educational interventions, and adequate access to quality health care can serve as protective factors that minimize asthma exacerbations and maximize functional outcomes. For both individuals and populations, the number and type of risk and protective factors can lead to different health trajectories and disparities in health outcomes. Growth and development take place at all stages of life and focus on the physical, intellectual, emotional and social changes that people go through. The micropathways that connect and influence the functioning of human biobehavioral systems are not fully functional at birth. Rather, they are adaptively programmed to respond to different experiences and short- and long-term changes in functional status through various feedback and feedback processes. Despite this complex developmental programming, some processes in the endocrine, immune, neurological, respiratory and other systems have similar functional trajectories over the course of a person`s life. The developmental trajectory of each of these biobehavioural systems follows the same general pattern: first, steady curvilinear growth in functional capacity; maintenance of functional integrity; and, finally, compensation for decline, which often follows a less smooth and more gradual pattern (Baltes and Graf, 1996). This basic diagram of the life cycle functional trajectory for several systems is shown in Figure 3. Although each person`s endocrine system has the same basic design and functional architecture, each functions slightly differently due to genetic variations and environmental influences, resulting in hormone levels that vary five times from individual to individual (Worthman 1999). Anthropologists such as Worthman have begun to investigate how different human ecologies can explain variations in endocrine function by altering set points; modulation of the intensity of functional interactions between the endocrine, immune and nervous systems; age-specific transformation of developmental changes; and influence on regulatory functions (Worthman, 1999). Other biobehavioral systems have evolved in similar ways, with unique design features that influence how they are programmed and how they control changes in functional ability throughout life. Knowing the life stages of human growth and development can help nurses better understand their patients` needs.

A second important temporal issue for health development is the series of biological, psychological and social transitions and turning points that individuals experience throughout their lives. As mentioned earlier, developmental plasticity and vulnerability are complementary expressions of the same idea, with episodes of rapid change creating periods of increased vulnerability. This relationship implies that development trajectories can be changed more easily in sensitive periods of rapid developmental change than in other periods. Each transition represents an important point in development where negative and beneficial inputs can have a relatively greater impact on future health. Life transitions, such as entering kindergarten, entering college, entering the labour market, or leaving the labour market, strain adaptive and regulatory systems, forcing the developing individual to adapt to new routines and adopt new response patterns. In young children, neuroendocrine changes are associated with the development of social competence in a new peer group. Other simultaneous transitions in physiological and social development may occur during puberty or menopause. In future research, these transition and inflection points are likely to provide important clues about the nature of biological and behavioural programming (Boyce et al. 2001). How life transitions and turning points are managed can lead to different stress response patterns, different allostatic loads, and different functional trajectories. Not much is yet understood about the mechanisms, determinants and development of health and disease.

Future research should include more integrative longitudinal studies of children examining the effects of the life course. These studies should begin before or before conception to assess the maternal neuroendocrine environment prior to pregnancy (Wadhwa, Sandman, & Garite, 2001). They should collect data during predictable biological, psychological and social transitions, when humans must adapt to new environments, and when gene-environment interactions are easiest to measure. What happens in critical and sensitive phases and what its biological and psychological effects are should be further investigated. We need to understand how early programming initiates preclinical disease pathways and how these signaling pathways are linked to specific disease states. We also need to understand how evolving functional systems interact, react and program with each other. Such efforts are particularly relevant to unravelling the recently observed increase in childhood asthma, adult diabetes and mental health problems. Every clinician and nurse caring for paediatric patients should be well aware of the early intervention referral service for appropriate patients. Interprofessional collaboration between clinicians, mid-level practitioners, and nurses can improve patient outcomes, as developmental delays require immediate intervention if detected, and the sooner the better. Children under three years of age with developmental delays are referred to early intervention programs, and children over three years of age are referred to special education services. The development of the nervous system demonstrates the importance of critical periods when a person must undergo evolutionary normative experiments and associated neural activities in order to create an optimal pattern of neural connections in adulthood (Carlson & Earls, 1997; Penn and Shatz, 1999).

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