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利用科学进步减少儿童早期逆境对健康的影响。

Capitalizing on Advances in Science to Reduce the Health Consequences of Early Childhood Adversity.

机构信息

Center on the Developing Child at Harvard University, Cambridge, Massachusetts2Harvard Medical School, Harvard T. H. Chan School of Public Health, Boston, Massachusetts3Harvard Graduate School of Education, Cambridge, Massachusetts.

出版信息

JAMA Pediatr. 2016 Oct 1;170(10):1003-1007. doi: 10.1001/jamapediatrics.2016.1559.

Abstract

Advances in biology are providing deeper insights into how early experiences are built into the body with lasting effects on learning, behavior, and health. Numerous evaluations of interventions for young children facing adversity have demonstrated multiple, positive effects but they have been highly variable and difficult to sustain or scale. New research on plasticity and critical periods in development, increasing understanding of how gene-environment interaction affects variation in stress susceptibility and resilience, and the emerging availability of measures of toxic stress effects that are sensitive to intervention provide much-needed fuel for science-informed innovation in the early childhood arena. This growing knowledge base suggests 4 shifts in thinking about policy and practice: (1) early experiences affect lifelong health, not just learning; (2) healthy brain development requires protection from toxic stress, not just enrichment; (3) achieving breakthrough outcomes for young children facing adversity requires supporting the adults who care for them to transform their own lives; and (4) more effective interventions are needed in the prenatal period and first 3 years after birth for the most disadvantaged children and families. The time has come to leverage 21st-century science to catalyze the design, testing, and scaling of more powerful approaches for reducing lifelong disease by mitigating the effects of early adversity.

摘要

生物学的进步为我们深入了解早期经历如何在身体中形成,并对学习、行为和健康产生持久影响提供了依据。大量针对面临逆境的幼儿的干预措施评估表明,这些措施具有多种积极影响,但效果差异很大,且难以持续或推广。新的关于发展可塑性和关键期的研究,对基因-环境相互作用如何影响压力易感性和适应力的差异的理解不断加深,以及新兴的、能够衡量毒性应激影响的方法变得更加实用,为儿童早期领域的基于科学的创新提供了急需的动力。这一不断增长的知识库提出了 4 种关于政策和实践的思维转变:(1)早期经历会影响终生健康,而不仅仅是学习;(2)健康的大脑发育需要防止毒性应激,而不仅仅是丰富化;(3)要想为面临逆境的幼儿取得突破性成果,就需要支持照顾他们的成年人改变自己的生活;(4)需要在胎儿期和出生后的头 3 年为最弱势的儿童和家庭提供更有效的干预措施。现在是时候利用 21 世纪的科学来促进更强大的方法的设计、测试和推广,以减轻早期逆境的影响,从而减少终生疾病。

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