Gender, Family and Culture Flashcards
Define attachment
An enduring emotional relationship between two people (child and primary caregiver)
What are some features of attachment?
- can start as early as 7 months of a child’s life
- involves proximity seeking
- provokes separation anxiety
- provides comfort, care, security and a safe base for exploration
Infants are pro- social. TRUE OR FALSE
Define pro- social
TRUE
They have a social behaviour that intents to benefit people or society as a whole.
List some innate behaviour strategies infants display
CRYING:
it is a clear signal of distress, them wanting attention > carers respond to signals in the appropriate way (for example by feeding the baby etc.)
LOOKING:
communication strategy > reinforces attachment
SMILING:
starts as a reflex at about 2 months but then becomes social > children realise that when they smile they receive a positive interaction from people
CUDDLING:
Human reflex that allows contact
PREFERENCE: for caregiver’s face, voice, smell and touch
What are the features of securely attached children?
- have a sensitive, warm and responsive parents
- know that carer is available to meet their needs
- children develop and have a positive view of themselves and others, trust and confidence in carers, sense of security
Implications of secure attachment
- Emotional and social competence
- Greater resilience
- Higher self esteem and independence
- Positive peer relations
- Better psychological health (and also perform better at school)
What are the characteristics of caregivers that lead to avoidant/ambivalent attachment
- they are rejecting
- indifferent
- unavailable
- inconsistent carers
- insensitive
What are the characteristics of caregivers that lead to disorganized
- Neglectful
- Abusive
- Carers are the source of distress
What the signs of insecurly attached children
- unresolved fear
- trauma
- permanent feelings of lack of control
- helplessness, confusion
- fear, discomfort, anxiety
- develop distorted view of themselves: unworthy of love, emotionally unavailable
Implications of insecure attachment
- poor regulation of emotions
- difficulties at school, more likely to be bullied
- difficult in showing empathy
- poor emotional and social competence
- unregulated biological stress
- lower self esteem etc
- emotional and behavioural problems: e.g anger, aggression etc
When is attachment relevant to clinical practice?
- during pre- and post natal reviews
- children do not reach the normal development milestones such as physical development ,language etc
- when children struggle at school because of behavioural and emotional difficulties
- clinical anxiety and depression etc.
Why are insecurely attached children more likely to develop emotional/behavioural problems than securely attached ones?
They develop a negative view of themselves and other
What is intersectionality?
It is the study of how being part of a social group intersects with another and might create exacerbations of already existing phenomena
What is intersectionality of ethnicity and gender
- Sex is a biological aspect of gender
- Gender is the social and cultural expression of sex
Give examples of psychosocial stressors
- Experience of bullying, violence, threats of violence and discrimination
- Experience of being rejected
- Feelings of shame or guilt as result of religious or cultural upbringing
- Poor self- regard hinders health seeking
- Anxiety over how family and friends will respond to their sexual and gender identity
Consequences of intersectionality
E.g women suffering from HIV/AIDS
Diabetes is 4 times higher in ethnicities of south Asian origin
Why are STIs difficult to control
- they tend to be asymptomatic
- increasing density and mobility of human populations
- absence of vaccines for almost all STIs
Name some common STIs
- Papillomaviruses (vaccine is available and it is most common in the US and causes genetic warts)
- Chlamydia trachomatis (most easily cured STI in the US and causes non-specific urethritis)
- Candida albicans (causes vaginal thrush)
- Herpes simplex type 1 and type 2 (causes genital herpes - problem of latency and reactivation)
Neisseria gonorrhoea - causes gonorrhoea - very common and resistant
HIV - causes aids (worldwide problem)
What is the easiest entry point for microbials in STIs?
- Urogenital tract > from there microbes can easily spread from one part of the tract to another (the distinction between vaginitis and urethritis is not always easy or necessary )
Name some unstable microbes
upon drying on a surface
Require close respiratory contact:
- Neisseria meningitis
- Streptococci
- Influenza virus
- Measles virus
Require close sexual contact:
- HIV
- Gonococci
- Treponema pallidum
Spread via water, food
- Vibrio cholera
- Leptospira
Spread via vectors:
- Malaria
- Yellow fever
- Trypanosomes
Name some stable microbes
upon drying on a surface
Spread in air
- tubercle bacilli
- staphylococci
Spread in soil
-C.diff
Vaginal defences
- Vaginal pH is acidic
Benign lactobacilli colonize the vagina and metabolize glycogen to produce lactic acid > pH drops to 5.
- Normal vaginal secretions contain up to 10^8/ml of these bacteria
All sexually transmitted infections are more common in …………………… males
Uncircumcised
Which bacteria are common invaders of the urinary tract?
Intestinal bacteria
> mainly E.coli
Symptoms of an STI and UTI are easy to differentiate. TRUE or FALSE
TRUE
What pathogen is syphilis caused by?
Treponema pallidum
Treponema pallidum is a spirochete. What is a spirochete?
Flexible, spirally bacterium (very difficult to culture)
What how is syphilis/treponema pallidum transmitted?
It is transmitted by small abrasions on the skin or mucous membranes
Why does T. Pallidum need personal contact in order for it to spread?
Because the organism does not survive well outside the body and is very sensitive to drying, heat and disinfectants
How does horizontal and vertical spread occur with T. pallidum and define those terms.
Horizontal spread - from one individual to another
- Occurs through sexual contact
Vertical spread- from one generation to another
- Occurs via the transplacental infection of the fetus
What are the 3 stages of syphilis after initial contact
`
- Initial contact (2-10 weeks)
- no symptoms, multiplication of treponemas at site of infection - Primary syphilis (1-3months)
- enlarged inguinal nodes, spontaneous healing - Secondary syphilis (2-6 weeks)
- flue like illness, myalgia, headache, fever etc. - Latent syphilis (3-30 years)
- treponemas dormant in liver or spleen - Tertiary syphilis
- progressive destructive disease
- cardiovascular syphilis, aortic lesions, heart failure etc.
Features of vertically transmitted syphilis
- serious infection can cause intrauterine death
- congenital abnormalities
- silent infection > might not appear until about 2 years of age (e.g facial and tooth deformities)
Serological tests of syphilis
Non specific tests/ non- treponemal tests:
- VDRL(venereal disease research laboratory) test
- rapid plasma reagin (RPR) test
Difference between non-treponemal and treponemal tests
indirect method in that they detect biomarkers that are released during cellular damage that occurs from the syphilis spirochete. In contrast, treponemal tests look for antibodies that are a direct result of the infection thus, anti-treponeme IgG, IgM and to a lesser degree IgA
How is syphilis treated?
Antibiotics
- very effective: Penicillin
- prevention of secondary and tertiary disease depends upon early diagnosis
- congenital syphilis is completely preventable if women are screened serologically early in pregnancy (<3months)
What is gonorrhoea caused by?
- Gram - negative bacteria > Neisseria gonorrhoea
- Women have a 50% chance of being infected after a single sexual intercourse with an infected man
- Men have a 20% chance following sexual intercourse with an infected woman
What virulence factors does Neisseria gonorrhoea have?
- Pilus
- antigenically active and make the bacterium very transmittable - Por proteins aids with the binding
What are the clinical features of gonorrhoea infection
- Usually asymptomatic in many women but can cause infertility
- Infection is usually localized
- persistent untreated infection can result in chronic inflammation
- symptoms usually develop within 2-7 days of infection and are characterized by:
- —– dysuria in the male
- —– vaginal discharge in women
What asymptomatic GU infection?
- pelvic inflammatory disease
- chronic pelvic pain
- infertility resulting from damage to the fallopian tubes
What testing are available for gonorrhoea and how is it diagnoses?
- molecular tests
- penicillinase- producing N. gonorrhoea
- vaccines are not available
What are the different serotypes of trachomatis
- Chlamydia trachomatis
- C. psittaci
- C.Pneumoniae
Clinical syndromes of chlamydia infections in men
- Urethritis, epididymitis, proctitis, conjunctivitis
Complications
- systemic spread, Reiter’s syndrome
Clinical syndromes of chlamydia infections in women
- Urethritis, cervicitis, conjunctivitis
Complications
Ectopic pregnancy, systemic spread and peri hepatitis
Clinical syndromes of chlamydia infection in neonates
Clinical syndrome
- Conjunctivitis
Complications
- Interstitial pneumonitis
Entry and replication of chlamdyia process
- Enters host through minute abrasions in the mucosal surface
- They bind to specific receptors on the host cells and enter the cells by parasite-induced endocytosis
- Once inside the cell, fusion of the chlamydia- containing vesicle with lysosomes is inhibited by an incompletely understood mechanism.
How is chlamydia diagnosed?
Investigations:
- Nucleic acid based tests are available
Treatment:
- Prevented or treated with doxycycline or azithromycin
What is the most common cause of Genital herpes?
- Herpes simplex virus (HSV 2) BUT (hsv-1) is detected more frequently
Why is genital herpes transmitted easily?
- up to 75% do not r have symptoms and might therefore transmit this infection
Why does HSV-2 infection increase the risk of developing HIV?
Because it is likely to breach the mucosal barrier as a result of the HSV ulcers
How does genital herpes present?
- Ulcerating vesicles that can take up to 2 weeks to heal
- the virus in the lesion travels up sensory nerve endings to establish latent infection in dorsal root ganglion
- from this site it can reactivate and travel down nerves to the same area and cause genital cold sores
What is a rare complication of meningitis?
- Aseptic meningitis or encephalitis
How is genital herpes diagnosed?
- Clinical appearance
- HSV DNA can be detected and typed in vesicle fluid or ulcer swabs
- more classic techniques involve isolation by immunofluorescences and using monoclonal antibodies
Management of genital herpes?
- Aciclovir can be used as treatment and prophylaxis
What condition does the human immunodeficiency virus cause?
AIDS
What are the transmission routes of HIV
Mucosal surfaces in particular penile, rectal and cervicovaginal
OR intravenous or percutaneous routes
What is the windows for detecting the virus?
7-21 days as HIV multiplies in the mucosa and draining lymphoreticular tissue
What cells get destroyed first in HIV
CD4 receptor-bearing cells
this includes monocytes, Langerhans cells, and other dendritic cells and macrophages
What illness is HIV infection usually accompanied by?
-Mononucleosis-type illness (includes muscle ache, rash and maybe slight fever)
Investigations for HIV
Serological tests
Molecular analysis
Management of HIV
Antiviral therapy
