RESUMO
Complex perinatal syndromes (CPS) affecting pregnancy and childhood, such as preterm birth, and intra- and extra-uterine growth restriction, have multiple, diverse contexts of complexity and interaction that determine the short- and long-term growth, health and development of all human beings. Early in life, genetically-guided somatic and cerebral development occurs alongside a psychism "in statu nascendi," with the neural structures subjected to the effects of the intra- and extra-uterine environments in preparation for optimal postnatal functioning. Different trajectories of fetal cranial and abdominal growth have been identified before 25 weeks' gestation, tracking differential growth and neurodevelopment at 2 years of age. Similarly, critical time-windows exist in the first 5-8 months of postnatal life because of interactions between the newborn and their environment, mother/care-givers and feeding practices. Understanding these complex relational processes requires abandoning classical, linear and mechanistic interpretations that are placed in rigid, artificial biological silos. Instead, we need to conduct longitudinal, interdisciplinary research and integrate the resulting new knowledge into clinical practice. An ecological-systemic approach is required to understand early human growth and development, based on a dynamic multidimensional process from the molecular or genomic level to the socio-economic-environmental context. For this, we need theoretical and methodological tools that permit a global understanding of CPS, delineating temporal trajectories and their conditioning factors, updated by the incorporation of new scientific discoveries. The potential to optimize human growth and development across chronological age and geographical locations - by implementing interventions or "treatments" during periods of greatest instability or vulnerability - should be recognized. Hence, it is imperative to take a holistic view of reproductive and perinatal issues, acknowledging at all levels the complexity and interactions of CPS and their sensitive periods, laying the foundations for further improvements in growth and development of populations, to maximize global human potential. We discuss here conceptual issues that should be considered for the development and implementation of such a strategy aimed at addressing the perinatal health problems of the new millenium.
RESUMO
We studied neurodevelopmental outcomes and behaviours in healthy 2-year old children (N = 1306) from Brazil, India, Italy, Kenya and the UK participating in the INTERGROWTH-21st Project. There was a positive independent relationship of duration of exclusive breastfeeding (EBF) and age at weaning with gross motor development, vision and autonomic physical activities, most evident if children were exclusively breastfed for ≥7 months or weaned at ≥7 months. There was no association with cognition, language or behaviour. Children exclusively breastfed from birth to <5 months or weaned at >6 months had, in a dose-effect pattern, adjusting for confounding factors, higher scores for "emotional reactivity". The positive effect of EBF and age at weaning on gross motor, running and climbing scores was strongest among children with the highest scores in maternal closeness proxy indicators. EBF, late weaning and maternal closeness, associated with advanced motor and vision maturation, independently influence autonomous behaviours in healthy children.
Assuntos
Desenvolvimento Infantil , Mães , Reforço Psicológico , Desmame , Brasil , Aleitamento Materno , Pré-Escolar , Feminino , Humanos , Índia , Lactente , Recém-Nascido , Itália , Quênia , Desenvolvimento da Linguagem , Masculino , Destreza MotoraRESUMO
The article reviews the process of conformation of the International Center for Genetic Epistemology (CIEG), which functioned at the University of Geneva between 1955 and 1986. This Center led by Jean Piaget had the collaboration of hundreds of researchers from around the world and from different disciplines. We will here review the configuration of the centripetal circuits that led to the constitution of an institution with a double centrality. On the one hand, taking into account the history of international scientific circulations, it is feasible to recognize in the CIEG a reference point from which the radial journeys of social exchanges with different scientific communities can be reconstructed. On the other hand, we can identify a research program that positioned psychology at the core of epistemological debates. To contribute to the historical analysis of this double movement of centration, geography and theory, we examine the development of a series of strategies tending to the start-up of the Center, deployed during the first years of the 1950s.(AU)
O artigo analisa o processo de constituição do Centro Internacional de Epistemologia Genética (CIEG), localizado na Universidade de Genebra entre 1955 e 1986. Este centro liderado por Jean Piaget contava com a colaboração de centenas de pesquisadores de todo o mundo e de diferentes disciplinas. Aqui, revisaremos a configuração dos circuitos centrípetos que levaram à constituição de uma instituição com dupla centralidade. Por um lado, levando em conta a história das circulações científicas internacionais, é viável reconhecer no CIEG um ponto de referência a partir do qual as viagens radiais de trocas sociais com diferentes comunidades científicas podem ser reconstruídas. Por outro lado, podemos identificar um programa de pesquisa que posicionou a psicologia no centro dos debates epistemológicos. Para contribuir com a análise histórica desse duplo movimento de centralização, geografia e teoria, examinamos o desenvolvimento de uma série de estratégias, do Centro, implantadas nos primeiros anos da década de 1950.(AU)
El artículo revisa el proceso de conformación del Centro Internacional de Epistemología Genética (CIEG), radicado en la Universidad de Ginebra entre 1955 y 1986. Este Centro liderado por Jean Piaget contó con la colaboración de cientos de investigadores de todo el mundo y de diversas disciplinas. Aquí, nos ocuparemos de revisar la configuración de los circuitos centrípetos que desembocaron en la constitución de una institución con una doble centralidad. Por un lado, atendiendo a la historia de las circulaciones científicas internacionales, es factible reconocer en el CIEG un lugar de referencia desde el cual pueden reconstruirse los trayectos radiales de intercambios sociales con diferentes comunidades científicas. Por otra parte, podemos identificar un programa de investigación que posicionó a la psicología en el núcleo de los debates epistemológicos. Para contribuir al análisis histórico de este doble movimiento de centralización, geográfica y teórica, examinamos el desarrollo de una serie de estrategias tendientes a la puesta en marcha del Centro, desplegadas durante los primeros años de la década de 1950.(AU)