Tác động suốt đời của nghịch cảnh thời thơ ấu và stress độc hại

American Academy of Pediatrics (AAP) - Tập 129 Số 1 - Trang e232-e246 - 2012
Jack P. Shonkoff, Andrew S. Garner, Ben Siegel, Mary I. Dobbins, Marian F. Earls, Laura McGuinn, John M. Pascoe, David L. Wood

Tóm tắt

Báo cáo Kỹ thuật này đã được ngừng phát hành vào tháng 11 năm 2021. Những tiến bộ trong các lĩnh vực nghiên cứu đa dạng như khoa học thần kinh, sinh học phân tử, gen học, tâm lý học phát triển, dịch tễ học, xã hội học và kinh tế học đang catalyze một sự thay đổi mô hình quan trọng trong sự hiểu biết của chúng ta về sức khỏe và bệnh tật trong suốt vòng đời. Khoa học đa ngành hợp nhất này về phát triển con người có những ý nghĩa sâu sắc đối với khả năng của chúng ta trong việc nâng cao triển vọng sống của trẻ em và tăng cường cấu trúc xã hội và kinh tế của xã hội. Dựa trên những dòng nghiên cứu nhiều chiều này, báo cáo này trình bày một khuôn khổ sinh thái - phát triển biểu sinh, minh họa cách mà những trải nghiệm sớm và ảnh hưởng môi trường có thể để lại một dấu ấn lâu dài lên các xu hướng di truyền ảnh hưởng đến kiến trúc não đang phát triển và sức khỏe lâu dài. Báo cáo cũng xem xét những bằng chứng rộng rãi về tác động gây rối của stress độc hại, cung cấp những hiểu biết thú vị về các cơ chế nguyên nhân liên kết nghịch cảnh sớm với các khiếm khuyết trong học tập, hành vi cũng như sức khỏe thể chất và tinh thần. Các ý nghĩa của khuôn khổ này đối với thực hành y học, nói chung, và nhi khoa, cụ thể, có khả năng mang tính chuyển đổi. Chúng đề xuất rằng nhiều bệnh ở người lớn nên được xem xét như là những rối loạn phát triển bắt đầu sớm trong cuộc sống, và rằng những chênh lệch sức khỏe kéo dài liên quan đến nghèo đói, phân biệt đối xử hoặc hành hạ có thể được giảm bớt thông qua việc giảm bớt stress độc hại trong thời thơ ấu. Một khuôn khổ sinh thái - phát triển biểu sinh cũng nhấn mạnh nhu cầu về tư duy mới về trọng tâm và ranh giới của thực hành nhi khoa. Nó kêu gọi các bác sĩ nhi khoa đóng vai trò vừa là người bảo vệ hàng đầu cho sự phát triển khỏe mạnh của trẻ em, vừa là những lãnh đạo cộng đồng có vị trí chiến lược để thông báo những chiến lược mới dựa trên khoa học nhằm xây dựng nền tảng vững chắc cho thành công trong giáo dục, năng suất kinh tế, công dân có trách nhiệm và sức khỏe lâu dài.

Từ khóa


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