4,658 research outputs found
Child developmental follow up in obstetric RCTs: a unique opportunity
No full textFor many obstetric-outcome focused randomised controlled trials (RCTs), the long-term developmental follow up of offspring is often not prioritised beyond the neonatal period. Obstetric RCTs, however, offer a unique opportunity to answer nuanced, hypothesis-focused questions about child development, in a manner in which observational birth cohorts, including those specific to child development, cannot. Often, by controlling for certain significant influences associated with adverse obstetric outcomes, such as maternal illness, and socio-economic status, in their design, these RCTs also inherently control for many factors evidenced to be associated with adverse child developmental outcomes.A good example of such an effort is provided in this issue’s paper by Ellingsen et al. (BJOG 2020;127:508–17). While the RCT's primary objective was to determine whether a regular, moderate intensity exercise intervention during pregnancy could prevent pregnancy complications such as gestational diabetes, the follow-up sample allowed the authors to test the effect of regular antenatal exercise on child developmental outcomes at 18 months and 7 years of age. Moreover, this follow up permitted the investigation of a question which, though nuanced, may not necessarily be considered as important as current priority topics in child development research such as child malnutrition, infectious diseases, and poverty (Richter et al. Lancet 2017;389:103–18). The public health message of such work cannot be underestimated and will, I hope, reassure pregnant women about the safety of regular, moderate intensity exercise during pregnancy in the context of their children’s developmental abilities.Well-conducted obstetric RCTs are more likely than non-randomised studies to produce similar comparison groups, and are therefore particularly suited to estimating the effects of antenatal interventions, including on the developing brain whose most sensitive period is during the first 1000 days of life. As a paediatrician and a researcher in international early child development, I am acutely aware of the technical and logistical challenges of comprehensive, standardised neurodevelopmental assessments. I commend the authors of this paper for assessing multiple dimensions of child development, including motor, language, and social skills, executive function and emotional/behavioural problems, in children aged 7 years. The authors chose to utilise the 90th percentile cut-off in their own control group to characterise problem scores, rather than using the Five to Fifteen’s scales' Swedish references (Trillingsgaard et al. Eur Child Adolesc Psychiatry 2004;13:39–63). It is unfortunate that there is a lack of international standards for child development testing. Although international standards exist to monitor growth in utero and during early childhood (Papageorghiou et al. Lancet 2014;384:869–79; WHO Multicentre Growth Reference Study, and deOnis. Acta Paediatr 2006;95:76–85), no comparable standards as yet exist for child development: researchers and clinicians must therefore select one among many region-specific references, or create their own set of norms. Such un-standardised practice results in a plethora of references with little cross-population applicability, confounding true comparisons between studies and raising questions about the validity of findings; a limitation that even well-conducted RCTs cannot overcome.Despite these challenges, the long-term developmental follow up of children enrolled in obstetric RCTs provides unique opportunities to answer nuanced questions of scientific, clinical, and public interest which may not otherwise be addressed, as elegantly demonstrated in this paper by Ellingsen et al
A community-based responsive caregiving program improves neurodevelopment in two-year old children in a middle-income country, Grenada, West Indies. Psychosocial Intervention
No full textMany young children in low- and middle-income countries (LMICs) are at risk of developmental delays. Early child development (ECD) interventions have been shown to improve outcomes, but few interventions have targeted culturally normative violence such as corporal punishment (CP). We partnered with an existing community-based ECD organization in the LMIC of Grenada to implement a parallel controlled-trial single-blind responsive caregiving intervention that educates parents about the developing brain and teaches alternatives to corporal punishment while building parental self-regulation skills and strengthening social-emotional connections between parent and child. Parents and primary caregivers with children under age two were eligible. Allocation to the intervention and waitlist control arms was unblinded and determined by recruitment into the program. Neurodevelopment was assessed by blinded testers when each child turned age two. Primary comparison consisted of neurodevelopmental scores between the intervention and waitlist control groups (Clinicaltrials.gov registration xxx NCT04697134). Secondary comparison consisted of changes in maternal mental health, home environment, and attitudes towards CP. Children in the intervention group (n = 153) had significantly higher scores than children in the control group (n = 151) on measures of cognition (p = .022), fine motor (p < .0001), gross motor (p = .015), and language development (p = .013). No difference in secondary outcomes, including CP, was detected
SPM in situ data at Patos Lagoon estuary in 4 stations: Feitoria, Marambaia, Praticagem, and Porto Rei - Fernandes (1998)
No full textFernandes (Fernandes, E. H.: Modelling the Hydrodynamics of the Patos Lagoon, Brazil, Ph.D. thesis, University of Plymouth, 2001) aimed to calibrate the hydrodynamic model TELEMAC for the Patos Lagoon for the first time. The author executed SPM field measurements at 4 stations: Feitoria, Marambaia, and Praticagem (between 27-29 October, 1998), and at Porto Rei (between 05-06 November, 1998) and measurements were carried out at the surface, middle depth and bottom using horizontal bottle samplers. These consist of a simple PVC pipe closed at the ends by rubber stoppers and released by a messenger sent from the surface. Sub-samples were stored in plastic bottles for further filtration and determination of SPM content. Samples were filtered through CA filters of 45 μm pore size as in Baumgarten et al. (Baumgarten, M., Rocha, J., and Niencheski, L.: Manual de Análises em Oceanografia Química, FURG, Rio Grande, Brazil, 1996)
Does prenatal maternal depression predict foetal and infant development? A study of mothers and infants in rural South India
No full textIntroduction: Prenatal maternal depression is associated with an increased risk of psychopathology in childhood. The understanding of the mechanisms underlying this association is limited. Further, despite high rates of prenatal depression in the developing world, no research investigating this issue exists from these settings.Objectives: The primary objectives of this thesis are to study the association between prenatal maternal depression and the following early offspring outcomes in a non-smoking, non-alcohol consuming prenatal sample from rural, South India:i. Foetal stress responsivity, measured through foetal heart rate (FHR)ii. Infant stress responsivity, measured through infant cortisol response to immunisationiii. Infant temperament.Methods: 194 pregnant women from Solur, India were assessed for depression. The first 67 mothers with elevated symptoms of prenatal depression and the first 66 controls underwent FHR monitoring to study foetal stress responsivity. 58 mother-infant dyads returned at 1.5-3 months post birth. Infant salivary cortisol was measured before and after immunisation. Information on infant temperament and maternal postnatal depression (PND) was also collected.Results: Twenty nine mothers (14.9%) met a diagnosis of major depression during pregnancy while 67 (34.5%) had elevated symptoms of prenatal depression.Whilst there were no linear association between prenatal depression and foetal responsivity, a curvilinear (U shaped) association existed with the foetuses of mothers with very high and very low levels of prenatal depression having elevated stress responses compared to those with moderate levels of prenatal depression.Prenatal depression predicted infant cortisol responsivity independent of PND (B=13.08, p=0.02).The relationship between infant cortisol responsivity and prenatal depression was also U shaped.There was no association between prenatal depression and infant temperament.Conclusions: This is the first study from the developing world investigating the relationship between prenatal depression and offspring outcomes. It provides evidence suggestive of the programming influence of prenatal depression on the developing offspring
A pregação da virtude em Gonçalo Fernandes Trancoso
No full textIn the sixteenth century, in Portugal, Gonçalo Fernandes Trancoso writes his Contos e Histórias de Proveito & Exemplo with pedagogical-moralizing intent, disillusioned at the
dissolution of the customs brought by the overseas conquests. The author makes use of a resource
of the medieval era - the exempla - to show himself as a champion that fights for the values of the
Virtue. The purpose of this article is to analyze how the author mounts his preaching stories by
analyzing the narrative techniques used to show how these stories have become a pleasurable and
uplifting readingNo século XVI, em Portugal, Gonçalo Fernandes Trancoso escreve seus Contos e Histórias de Proveito & Exemplo com intenção pedagógico-moralizante, desiludido ao assistir à dissolução
dos costumes trazida pelas conquistas ultramarinas. Vale-se de um recurso próprio do medievo –
os exemplos – para mostrar-se como paladino que luta pelos valores da Virtude. O objetivo desse
artigo é analisar como o autor monta seus contos de pregação, analisando as técnicas narrativas
utilizadas para mostrar como esses contos tornaram-se leitura prazerosa e edificant
Florestan Fernandes revisited
No full textA AUTORA descreve a biografia intelectual de Florestan Fernandes em três etapas. A primeira, que ela designa "fase científico-acadêmica", abrange o período 1941-1968. A segunda, a "fase político-revolucionária", corresponde aos anos 1970-1986. Por fim, na terceira etapa, que ela chama de "fase solitário-militante" (1986-1995), todas as facetas do itinerário de Fernandes se unem sob o título "intelectual", segundo a definição de Jürgen Habermas.THE AUTHOR describes Florestan Fernandes\u27 intellectual biography in three phases. The first phase, which she calls the "cientific-academic stage", covers the period 1941-1968. The second phase, the "political-revolutionary stage", corresponds to the years 1970-1986. Finally, the third phase is what she calls the "lonely militant stage" (1986-1995), in which all facets of Fernandes\u27 itinerary come together under the heading of the "intellectual", in Jürgen Habermas\u27 definition
From acculturation to formation: the role of immigration studies in the work of Florestan Fernandes
No full textHaving received little attention from the interpreters of Florestan Fernandes’ work until recently, the author’s migratory studies, although revisited by specialists in this field, have been the object of implicit or explicit accusations of blame for the poor development of the theme in sociology, and especially at Escola Sociológica Paulista, from the 1940s onwards. This work aims to respond to this “sociology of abandonment” in the interpretation of Fernandes’ work, showing, through a systematic interpretation, that the author’s supposed departure from migratory studies did not happen without the provisions of an accumulative movement, characteristic of the formative model that the author fought for. Tendo recebido pouca atenção dos intérpretes da obra de Florestan Fernandes até pouco tempo, os estudos migratórios do autor, conquanto revisitados por especialistas deste campo, tem sido objeto de acusações, implícitas ou explícitas, de culpa pelo pouco desenvolvimento da temática na Sociologia, e especialmente na Escola Sociológica Paulista, a partir da década de 1940. Este trabalho tem como objetivo responder a esta “sociologia do abandono” na interpretação da obra de Fernandes, mostrando, através de uma interpretação sistemática, que o suposto afastamento do autor relativamente aos estudos migratórios não se deu sem as providências de um movimento acumulativo, próprio do modelo formativo por que pugnava o autor
Florestan Fernandes revisited
No full textA AUTORA descreve a biografia intelectual de Florestan Fernandes em três etapas. A primeira, que ela designa "fase científico-acadêmica", abrange o período 1941-1968. A segunda, a "fase político-revolucionária", corresponde aos anos 1970-1986. Por fim, na terceira etapa, que ela chama de "fase solitário-militante" (1986-1995), todas as facetas do itinerário de Fernandes se unem sob o título "intelectual", segundo a definição de Jürgen Habermas.THE AUTHOR describes Florestan Fernandes' intellectual biography in three phases. The first phase, which she calls the "cientific-academic stage", covers the period 1941-1968. The second phase, the "political-revolutionary stage", corresponds to the years 1970-1986. Finally, the third phase is what she calls the "lonely militant stage" (1986-1995), in which all facets of Fernandes' itinerary come together under the heading of the "intellectual", in Jürgen Habermas' definition.Em processament
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