mercoledì 17 maggio 2017

8 Sul gusto musicale

Perché preferiamo certe musiche piuttosto che altre?
A questa domanda cerca di rispondere Daniel Levitine nel suo saggio “My Favorite Things Why Do We Like the Music We Like?” – Our Brain on Music.
La nostra esperienza di ascoltatori inizia nel grembo materno
… Inside the womb, surrounded by amniotic fluid, the fetus hears sounds. It hears the heartbeat of its mother, at times speeding up, at other times slowing down. And the fetus hears music, as was recently discovered by Alexandra Lamont of Keele University in the UK. She found that, a year after they are born, children recognize and prefer music they were exposed to in the womb…
E’ lì che nascono i nostri gusti.
Nell’esperimento di Alexandra Lamont la mamma in attesa ascoltavano musiche ben precise…
… one year later, Lamont played babies the music that they had heard in the womb, along with another piece of music chosen to be matched for style and tempo… Lamont then determined which one the babies preferred…
Ma come si fa a capire quale musica preferisce un bambino di un anno? Ci sono tecniche piuttosto affidabili…
… a technique known as the conditioned head-turning procedure, developed by Robert Fantz in the 1960s, and refined by John Columbo, Anne Fernald, the late Peter Jusczyk, and their colleagues. Two loudspeakers are set up in the laboratory and the infant is placed (usually on his mother’s lap) between the speakers. When the infant looks at one speaker, it starts to play music or some other sound, and when he looks at the other speaker, it starts to play different music or a different sound. The infant quickly learns that he can control what is playing by where he is looking; he learns, that is, that the conditions of the experiment are under his control. The experimenters make sure that they counterbalance (randomize) the location that the different stimuli come from; that is, half the time the stimulus under study comes from one speaker and half the time it comes from the other. When Lamont did this with the infants in her study, she found that they tended to look longer at the speaker that was playing music they had heard in the womb… conditioned head-turning procedure… A control group of one-year-olds who had not heard any of the music before showed no preference…
Sembra che ai piccoli piacciano di più le musiche ritmate.
Ora sappiamo che il gusto musicale precede il linguaggio ma soprattutto che le esperienze fetali non vengono affatto dimenticate…
… It appears that for music even prenatal experience is encoded in memory, and can be accessed in the absence of language or explicit awareness of the memory…
E che dire dell’ “effetto Mozart”? C’è chi ha sostenuto che ascoltare Mozart sia d’aiuto allo sviluppo delle nostre facoltà cognitive. Subito è scattata la richiesta di sussidi
… U.S. congressmen were passing resolutions, the governor of Georgia appropriated funds to buy a Mozart CD for every newborn baby Georgian…
Purtroppo, questi studi sono fallati. Poco male, sarebbe offensivo considerare la musica come “strumentale” ad altro…
… Personally, I found all the hubbub a bit offensive because the implication was that music should not be studied in and of itself, or for its own right, but only if it could help people to do better on other, “more important” things… If I claimed that studying mathematics helped musical ability, would policy makers start pumping money into math for that reason?…
La musica a scuola è sempre il parente povero cosicché si crede di poterne alzare lo status dicendo “che fa diventare più intelligenti” ma così si rischia di peggiorarne l’immagine…
… Music has often been the poor stepchild of public schools, the first program to get cut when there are funding problems, and people frequently try to justify it in terms of its collateral benefits, rather than letting music exist for its own rewards… The problem with the “music makes you smarter” study turned out to be straightforward: The experimental controls were inadequate…
In genere si registrano piccole differenze nelle abilità spaziali ma solo quando la competizione è tra la pratica musicale ed il nulla. Una situazione poco realistica.
… Compared to sitting in a room and doing nothing, music listening looked pretty good. But if subjects in the control task were given the slightest mental stimulation—hearing a book on tape, reading, etc.—there was no advantage for music listening…
Inoltre, mancherebbe un rendiconto spiegazione causale
… Another problem with the study was that there was no plausible mechanism proposed by which this might work—how could music listening increase spatial performance?…
Inoltre, è bene distinguere tra il breve e il lungo periodo: le variazioni registrate negli esperimenti del “Mozart effect” riguardano solo l’immediato…
… Glenn Schellenberg has pointed out the importance of distinguishing short-term from long-term effects of music. The Mozart Effect referred to immediate benefits…
Cio’ non toglie che il contatto prolungato con la musica non abbia effetti sul nostro cervello, solo che nessuno è in grado di collegare questa incidenza ad un’ innalzamento delle facoltà cognitive. Lo sperimentatore più serio è al momento Gottfried Schlaug, ecco le sue scoperte…
… the front portion of the corpus callosum—the mass of fibers connecting the two cerebral hemispheres—is significantly larger in musicians than nonmusicians, and particularly for musicians who began their training early…musicians have… larger cerebellums than nonmusicians, and an increased concentration of gray matter… Whether these structural changes in the brain translate to enhanced abilities in nonmusical domains has not been proven…
Torniamo al gusto musicale: se inizia a formarsi nel grembo materno un ruolo importante lo svolge l’ambito culturale in cui cresce il bambino che mostrerà sempre una particolare predilezione per la musica a lui più vicina…
… There were reports a few years ago that prior to becoming used to the music of a foreign (to us) culture, all infants prefer Western music to other musics, regardless of their culture or race…
Il bambino riconosce ed apprezza i suoni consonanti
… infants do show a preference for consonance over dissonance. Appreciating dissonance comes later in life, and people differ in how much dissonance they can tolerate… Appreciating dissonance comes later in life… There is probably a neural basis for this… neurons in the primary auditory cortex—the first level of cortical processing for sound—synchronize their firing rates during dissonant chords, but not during consonant chords. Why that would create a preference for consonance is not yet clear… Trehub also showed that infants are more able to encode consonant intervals such as perfect fourth and perfect fifth than dissonant ones, like the tritone… infants are more able to encode consonant intervals such as perfect fourth and perfect fifth than dissonant ones… In other words, our brains and the musical scales we use seem to have coevolved. It is no accident that we have the funny, asymmetric arrangement of notes in the major scale…
Jenny Saffran e Laurel Trainor hanno lavorato a lungo sulla relazione del bambino con le frequenze dei suoni ascoltati…
… there is evidence that infants can also attend to absolute-pitch cues if the task requires it, suggesting a cognitive flexibility previously unknown…
Trehub e Dowling si sono concentrati sulla melodia e l’orecchio infantile…
… Trehub, Dowling, and others have shown that contour is the most salient musical feature for infants, who can detect contour similarities and differences even across thirty seconds of retention… contour is the most salient musical feature for infants…
Questa sensibilità melodica si riflette sui colloqui tra genitore (specie mamma) e bambino…
… Fernald and Trehub have documented the ways in which parents speak differently to infants than to older children and adults, and this holds across cultures. The resulting manner of speaking uses a slower tempo, an extended pitch range, and a higher overall pitch level. Mothers (and to a lesser extent, fathers) do this quite naturally without any explicit instruction… parents speak differently to infants than to older children and adults, and this holds across cultures… The resulting manner of speaking uses a slower tempo, an extended pitch range, and a higher overall pitch level… motherese helps to call the babies’ attention to the mother’s voice, and helps to distinguish words within the sentence. Instead of saying, as we would to an adult, “This is a ball,” motherese would entail something like, “Seeeeee?” (with the pitch of the eee’s going up to the end of the sentence). “See the BAAAAAALLLLLL?” (with the pitch covering an extended range and going up again at the end of the word ball)…
vocalizzi dei bambini sono un’altra modalità di rapporto con la musica…
… Very early in childhood, most children start to spontaneously vocalize, and these early vocalizations can sound a lot like singing… The more music they hear, the more likely they are to include pitch and rhythmic variations in their spontaneous vocalizations…
La semplicità è la porta attraverso la quale il bimbo entra nel mondo della musica. Poi cominciano le loro esplorazioni su territori più avventurosi…
… Young children start to show a preference for the music of their culture by age two… At first, children tend to like simple songs, where simple means music that has clearly defined themes… and chord progressions that resolve in direct and easily predictable ways… As they mature, children start to tire of easily predictable music and search for music that holds more challenge… Researchers point to the teen years as the turning point for musical preferences. It is around the age of ten or eleven that most children take on music as a real interest…
La nostalgia influenzerà sempre i nostri gusti, cosicché la musica ascoltata nell’infanzia avrà un peso notevole. Dopo i vent’anni la nostra mente si chiude, diventiamo più ottusi, cosicché è molto più difficile fare nuove scoperte…
… As adults, the music we tend to be nostalgic for, the music that feels like it is “our” music, corresponds to the music we heard during these years. One of the first signs of Alzheimer’s disease (a disease characterized by changes in nerve cells and neurotransmitter levels, as well as destruction of synapses) in older adults is memory loss. As the disease progresses, memory loss becomes more profound. Yet many of these old-timers can still remember how to sing the songs they heard when they were fourteen… There doesn’t seem to be a cutoff point for acquiring new tastes in music, but most people have formed their tastes by the age of eighteen or twenty. Why this is so is not clear, but several studies have found it to be the case. Part of the reason may be that in general, people tend to become less open to new experiences as they age… most people have formed their tastes by the age of eighteen or twenty…
L’età dell’adolescenza è cruciale, cerchiamo nuovi gruppi a cui unirci per formare la nostra identità, la musica gioca qui un ruolo di primo piano…
… During our teenage years, we begin to discover that there exists a world of different ideas, different cultures, different people… We also seek out different kinds of music. In Western culture in particular, the choice of music has important social consequences. We listen to the music that our friends listen to. Particularly when we are young, and in search of our identity, we form bonds or social groups with people whom we want to be like, or whom we believe we have something in common with… This ties into the evolutionary idea of music as a vehicle for social bonding and societal cohesion… To some degree, we might say that personality characteristics are associated with, or predictive of, the kind of music that people like…
La funzione principale della musica è quella di avvicinarci al nostro prossimo in un’ intimità che si realizza anche tra sconosciuti…
Dopo i vent’anni cercheremo di ridurre le nuove musiche ascoltate agli schemi per noi tradizionali, e questo sarà fonte di molte incomprensioni e abbandoni.
E’ un po’ come la lingua parlata. Ci sono delle basi neurologiche che spiegano la nostra ottusità nel far evolvere il nostro gusto…
… If a child doesn’t learn language by the age of six or so (whether a first or a second language), the child will never learn to speak with the effortlessness that characterizes most native speakers of a language. Music and mathematics have an extended window, but not an unlimited one: If a student hasn’t had music lessons or mathematical training prior to about age twenty, he can still learn these subjects, but only with great difficulty, and it’s likely that he will never “speak” math or music like someone who learned them early. This is because of the biological course for synaptic growth. The brain’s synapses are programmed to grow for a number of years, making new connections. After that time, there is a shift toward pruning, to get rid of unneeded connections. Neuroplasticity is the ability of the brain to reorganize itself. Although in the last five years there have been some impressive demonstrations of brain reorganization that used to be thought impossible, the amount of reorganization that can occur in most adults is vastly less than can occur in children and adolescents…
L’equilibrio tra semplicità e complessità è decisivo per provare un piacere musicale e naturalmente la collocazione del punto d’equilibrio è affare soggettivo.  Possiamo dire che la percezione del bello dipende da come “abitiamo” questo punto cruciale che ognuno di noi possiede.
… The balance between simplicity and complexity in music also informs our preferences. Scientific studies of like and dislike across a variety of aesthetic domains—painting, poetry, dance, and music—have shown that an orderly relationship exists between the complexity of an artistic work and how much we like it. Of course, complexity is an entirely subjective concept. In order for the notion to make any sense, we have to allow for the idea that what seems impenetrably complex to Stanley might fall right in the “sweet spot” of preference for Oliver…
Ciascuno di noi possiede degli schemi armato dei quali entra in contatto con la musica: difficoltà e semplicità dipendono da come una data musica si adatta ai nostri schemi…
… In a sense, schemas are everything. They frame our understanding; they’re the system into which we place the elements and interpretations of an aesthetic object. Schemas inform our cognitive models and expectations. With one schema, Mahler’s Fifth is perfectly interpretable, even upon hearing it for the first time… listeners will be aware that most symphonies from Haydn to Brahms and Bruckner typically begin and end in the same key. Mahler flouts this convention with his Fifth, moving from C-sharp minor to A minor and finally ending in D major. If you had not learned to hold in your mind a sense of key as the symphony develops, or if you did not have a sense of the normal trajectory of a symphony, this would be meaningless; but for the seasoned listener, this flouting of convention brings a rewarding surprise, a violation of expectations, especially when such key changes are done skillfully so as not to be jarring… Lacking a proper symphonic schema, or if the listener holds another schema, perhaps that of an aficionado of Indian ragas, Mahler’s Fifth is nonsensical…
Un’idea di brutto:
… When a musical piece is too simple we tend not to like it, finding it trivial. When it is too complex, we tend not to like it, finding it unpredictable—we don’t perceive it to be grounded in anything familiar… the right balance between simplicity and complexity in order for us to like it. Simplicity and complexity relate to familiarity, and familiarity is just another word for a schema…
Ma che cosa è “troppo semplice” o “troppo complicato”? Si tratta di concetti che hanno a che vedere con la nostra capacità previsionale…
… An operational definition is that we find a piece too simple when we find it trivially predictable, similar to something we have experienced before, and without the slightest challenge… indeterminacy leads to tension and expectations, and the tension is finally released when the game is over… When music is too predictable, the outcome too certain, and the “move” from one note or chord to the next contains no element of surprise, we find the music unchallenging and simplistic…
Parliamo qui di concetti relativi
… Of course, different people, with different personality types, react differently to such unanticipated journeys, musical or vehicular. Some react with sheer panic (“That Stravinsky is going to kill me!”) and some react with a sense of adventure at the thrill of discovery (“Coltrane is doing something weird here, but what the hell, it won’t hurt me to stick around awhile longer, I can take care of my harmonic self and find my way back to musical reality if I have to”)… Music that involves too many chord changes, or unfamiliar structure, can lead many listeners straight to the nearest exit, or to the “skip” button on their music players… The structure presents a steep learning curve, and the novice can’t be sure that the time invested will be worth it… People may tell you that Schönberg is brilliant, or that Tricky is the next Prince, but if you can’t figure out what is going on in the first minute or so of one of their pieces, you may find yourself wondering if the payoff will justify the effort…
Il gradimento potrebbe essere rappresentato da una U invertita dove sulle ascisse mettiamo il grado di complessità della musica. Ogni ascoltatore possiede la sua U rovesciata ma cio’ non implica una concezione estetica relativistica poiché il punto di massimo della U rovesciata è un assoluto…
… The orderly relationship between complexity and liking is referred to as the inverted-U function because of the way a graph would be drawn that relates these two factors. Imagine a graph in which the x-axis is how complex a piece of music is (to you) and the y-axis is how much you like it… relationship between complexity and liking is referred to as the inverted-U function… The inverted-U hypothesis is not meant to imply that the only reason you might like or dislike a piece of music is because of its simplicity or complexity. Rather, it is intended to account for this variable. The elements of music can themselves form a barrier to appreciation of a new piece of music…
Un altro elemento che informa il nostro gusto musicale è la dinamica dei pezzi ascoltati…
…But even the dynamic range of a piece—the disparity between the loudest and softest parts—can cause some people to reject it. This can be especially true for people who use music to regulate their mood in a specific way. Someone who wants music to calm her down, or someone else who wants music to pep him up for a workout, is probably not going to want to hear a musical piece that runs the loudness gamut all the way from very soft to very loud, or emotionally from sad to exhilarating (as does Mahler’s Fifth, for example)…
Le frequenze possono essere altrettanto importanti…
… Pitch can also play into preference. Some people can’t stand the thumping low beats of modern hip-hop, others can’t stand what they describe as the high-pitched whininess of violins. Part of this may be a matter of physiology; literally, different ears may transmit different parts of the frequency spectrum, causing some sounds to appear pleasant and others aversive…
E che dire del ritmo?…
… Rhythm and rhythmic patterns influence our ability to appreciate a given musical genre or piece. Many musicians are drawn to Latin music because of the complexity of the rhythms. To an outsider, it all just sounds “Latin,” but to someone who can make out the nuances of when a certain beat is strong relative to other beats, Latin music is a whole world of interesting complexity: bossa nova, samba, rhumba, beguine, mambo, merengue, tango—each is a completely distinct and identifiable style of music… For other listeners, rhythms that are too simple are the deal-breaker for a style of music. The typical complaint of my parents’ generation about rock and roll, apart from how loud it seemed to them, was that it all had the same beat…
Il timbro, un parametro a lungo trascurato, oggi è ridiventato centrale. Qui la familiarità sembra particolarmente importante poiché la memoria gioca un ruolo centrale…
… The first time I heard John Lennon or Donald Fagen sing, I thought the voices unimaginably strange. I didn’t want to like them. Something kept me going back to listen, though—perhaps it was the strangeness—and they wound up being two of my favorite voices… Having listened to thousands of hours of both these singers, and tens of thousands of playings of their songs, my brain has developed circuitry that can pick out their voices from among thousands of others, even when they sing something I’ve never heard them sing before. My brain has encoded every vocal nuance and every timbral flourish, so that if I hear an alternate version of one of their songs—as we do on the John Lennon Collection of demo versions of his albums—I can immediately recognize the ways in which this performance deviates from the one I have stored in the neural pathways of my long-term memory…
Per le preferenze le precedenti esperienze risultano imprescindibili, una povertà di esperienze pregresse potrebbe precluderci molti generi musicali…
… As with other sorts of preferences, our musical preferences are also influenced by what we’ve experienced before… If you had a negative experience once with pumpkin—say, for example, it made you sick to your stomach—you are likely to be wary of future excursions into pumpkin gustation. If you’ve had only a few, but largely positive, encounters with broccoli, you might be willing to try a new broccoli recipe… The types of sounds, rhythms, and musical textures we find pleasing are generally extensions of previous positive experiences we’ve had with music in our lives… We take pleasure in the sensory experience, and find comfort in its familiarity
Con l’ascolto condividiamo una bellezza e ci abbandoniamo mostrando la nostra vulnerabilità, a volte, per farlo, è necessario sentirsi sicuri, è necessario abbracciare non solo la musica ma i valori dell’autore. Anche per questo certe persone non riescono ad apprezzare, per esempio, il Wagner proto-nazista. Questa esigenza ci fa capire anche la propensione all’idolatria dell’artista.
… Safety plays a role for a lot of us in choosing music. To a certain extent, we surrender to music when we listen to it—we allow ourselves to trust the composers and musicians with a part of our hearts and our spirits; we let the music take us somewhere outside of ourselves. Many of us feel that great music connects us to something larger than our own existence, to other people, or to God… We want to know that our vulnerability is not going to be exploited. This is part of the reason why so many people can’t listen to Wagner. Due to his pernicious anti-Semitism, the sheer vulgarity of his mind (as Oliver Sacks describes it), and his music’s association with the Nazi regime, some people don’t feel safe listening to his music. Wagner has always disturbed me profoundly, and not just his music, but also the idea of listening to it. I feel reluctant to give into the seduction of music created by so disturbed a mind and so dangerous (or impenetrably hard) a heart as his, for fear that I might develop some of the same ugly thoughts. When I listen to the music of a great composer I feel that I am, in some sense, becoming one with him, or letting a part of him inside me… This accounts for the fandom that surrounds popular musicians—the Grateful Dead, the Dave Matthews Band, Phish, Neil Young, Joni Mitchell, the Beatles, R.E.M., Ani DiFranco. We allow them to control our emotions and even our politics—to lift us up, to bring us down…
L’arte realizza una connessione intima con l’autore, per questo gran parte delle canzoni hanno per oggetto l’amore…
… The power of art is that it can connect us to one another, and to larger truths about what it means to be alive and what it means to be human. When Neil Young sings “Old man look at my life, I’m a lot like you were . . . . Live alone in a paradise that makes me think of two. we feel for the man who wrote the song…” We hear vulnerability in unlikely places and it brings us closer to the artist. David Byrne (of the Talking Heads) is generally known for his abstract, arty lyrics, with a touch of the cerebral. In his solo performance of “Lilies of the Valley,” he sings about being alone and scared. Part of our appreciation for this lyric is enhanced by knowing something about the artist, or at least the artist’s persona, as an eccentric intellectual, who rarely revealed something as raw and transparent as being afraid… This may explain why the most common form of musical expression, from the Psalms of David to Tin Pan Alley to contemporary music, is the love song…
L’esplorazione di nuove musiche è un’attività che non tutti possono permettersi, abbiamo visto come dopo i vent’anni il nostro fisico ci gioca contro, ma nell’era di internet e degli accessi facilitati è una qualità valorizzata…
… Some of us are more open to experimentation than others in all aspects of our lives, including music; and at various times in our life we may seek or avoid experimentation… As Internet radio and personal music players are becoming more popular, I think that we will be seeing personalized music stations… I think it will be important that whatever form this technology takes, listeners should have an “adverturesomeness” knob they can turn that will control the mix of old and new, or the mix of how far out the new music is from what they usually listen to…
Lo schema con il quale “ascoltiamo” puo’ esserci tramandato ma più spesso nasce spontaneamente dagli ascolti ripetuti. Da quello schema dipenderanno le nostre preferenze future…
… Our music listening creates schemas for musical genres and forms, even when we are only listening passively, and not attempting to analyze the music. By an early age, we know what the legal moves are in the music of our culture. For many, our future likes and dislikes will be a consequence of the types of cognitive schemas we formed for music through childhood listening… our early exposure is often our most profound, and becomes the foundation for further musical understanding…
COMMENTO PERSONALE
Una trattazione convincente di come nasce il gusto musicale, almeno a livello fisiologico. Mi chiedo come queste informazioni possano in qualche modo informare una teoria estetica. David Levitine sostiene che il gradimento potrebbe essere rappresentato da una U invertita dove sulle ascisse viene posto il grado di complessità della musica. Poiché si insiste sulla soggettività di concetti come “semplice” e “complesso” parrebbe che siano favorite delle concezioni estetiche relativiste. Ma così potrebbe non essere poiché il punto di massimo della U rovesciata è un assoluto, nel senso che in alcuni ascoltatori puo’ situarsi più in alto che in altri.

Mamme che se la bevono

The Vices: Caffeine, Alcohol and Tobacco - Expecting Better: Why the Conventional Pregnancy Wisdom is Wrong and What You Really Need to Know by Emily Oster
La donna in gravidanza che vuole informarsi sui rischi che corre è, all'apparenza, sommersa di info a portata di click...
... Finding information on the Internet about caffeine, alcohol and tobacco during pregnancy is easy. There are official recommendations from national organisations, there are recommendations from specific doctors and books and there are other people, on chat boards and blogs. There is no shortage of opinions, but there is a definite shortage of agreements...
Ma s'imbatte in info contraddittorie, anche quando si affida all'ufficialità...
... The fact that people on chat boards argue is a given (what else are these boards for?). What I found more surprising was that official recommendations disagreed with one another...
Alcol: c'è chi raccomanda l'astinenza e chi la moderazione...
... In the case of alcohol, although all the pregnancy organisations in the United States recommend a policy of abstinence, similar organisations in some other countries indicate that occasional drinking is fine...
L'esempio inglese...
... In the UK, the National Institute for Health and Clinical Excellence (NICE) advises healthcare professionals to tell their patients to avoid drinking in the first three months and if they do choose to drink, they should drink no more than one or two UK units of alcohol once or twice a week...
E con il caffè andiamo ancora peggio, la confusione è massima...
... Caffeine is similar – recommendations differ across countries, yes, but also across books and across obstetricians and GPs within the same country. My obstetrician said having less than 200 milligrams a day (about 475 millilitres of coffee) was fine. My sister-in-law’s obstetrician told her no more than 300 milligrams. My best friend’s said no caffeine. When we turn to books, the aptly named The Panic-Free Pregnancy takes the stance that caffeine in moderation (up to 300 milligrams) is fine. The Mayo Clinic Guide to a Healthy Pregnancy rules out caffeine in any dose... What to Expect When You’re Expecting goes with the 200-milligram rule but indicates that you should check with your obstetrician...
Se poi vuoi conoscere le evidenze su cui si basano i consigli dati, l'impresa si fa ardua e le info si diradano improvvisamente...
... I still would have wanted to know what evidence backed it up. But my desire for evidence was made even more extreme by the fact that people disagreed...
Perché tanta diversità? Sono i dati a differire o le interpretazioni?
Chi va a fondo scopre che anche la qualità delle ricerche disponibili varia...
... When I got into that, I saw why these recommendations differed so much and were so confusing: the quality of the medical research on this varies enormously...
La metodologia ottimale delle ricerche è il random trial. Di cosa parliamo?...
... At the end of the day we wanted to be able to say something like: “If we gave more people televisions, attitudes towards women would improve.” One great way to do this would be to randomly pick some people to get televisions. You could watch them over time and see if their attitudes changed more than the people to whom you didn’t give TVs. This method is called a randomised trial...
Ma spesso è impossibile seguirla...
But randomised trials are not always possible... …In the case of something like caffeine in pregnancy, the issues are ethical. Imagine an experiment in which some women are told to drink nine cups of coffee a day and some are told to drink none...
Cosicché si mettono delle toppe. A questo punto la qualità della toppa è tutto...
... in most of the studies of this question, the best they can do is use statistical analysis to adjust for basic differences across people – age and education, for example...
Ci ritroviamo con una marea di lavori apparentemente simili ma in realtà molto diversi...
... There are literally hundreds of studies published in the medical literature on caffeine and miscarriage (this is the big concern with coffee during pregnancy). And from the outside, from the basic description, they all look pretty similar – comparing women who drank coffee with those who did not. But when you get into the details, into the nuts and bolts, some of the papers are pretty good and some are terrible...
È qui che interviene l'esperto. Non il medico, non l'ostetrica... in casi del genere l'esperto è l'economista...
... So we have developed techniques, statistical methods, to try to learn as much as possible from non-randomised data...
Da un’indagine sommaria degli studi disponibili appare chiara una distorsione nel senso di un eccesso di prudenza
… I pretty quickly realised that the official recommendations were extremely cautious, so I decided that sticking to them was safe until I figured it all out. I kept myself at two cups of coffee a day and I avoided alcohol. This was added incentive to do the research fast. Ultimately, I concluded that these recommendations were not just very cautious, they were too cautious. In moderation, pregnant women should feel comfortable with both alcohol and caffeine…
Alcol:
… For alcohol, this means up to one drink a day in the second and third trimesters and a couple of drinks a week in the first. In fact, for the most part studies fail to show negative effects on babies even at levels higher than this. By a drink here I mean a standard drink – 120 millilitres of wine, 30 millilitres of hard spirits, 350 millilitres of beer. No yard-long margaritas!…
Caffè…
… Caffeine is actually a little more complicated. I ultimately concluded that three to four 235-millilitre cups of coffee per day (more than many people drink, although actually not more than I drink) are fine…
Ma perché queste distorsioni? Due ragioni: 1) troppo peso a studi superficiali e 2) paternalismo…
… So why did my conclusions differ from theirs? At least two reasons. One is overinterpretation of flawed studies. But the bigger thing, I think, is the concern (which was expressed to me again and again by doctors) that if you tell people they can have a glass of wine, they’ll have three (or one giant “bowl-o-wine”)…
***
Entriamo più nel dettaglio parlando dell’uso di alcolici.
Quali sono i danni dell’alcol al feto?…
… Foetal alcohol spectrum disorders (FASD) refer to a range of mental and physical disabilities that can result from drinking during pregnancy. Physical symptoms include low birth weight, small head circumference and facial abnormalities (flattened cheekbones and small eye openings)… There is no question that very heavy drinking during pregnancy is bad for your baby…
Uno studio esemplare…
… In one Australian study, women who binged in the second or third trimester were 15 to 20 percentage points more likely to have children with language delays than women who didn’t drink.1 This is repeated again and again in other studies…
Non ci sono molti dati sull’ assunzione occasionale di alcol…
… However, this does not directly imply that light or occasional drinking is a problem. When I looked at the data, I found no credible evidence that low levels of drinking (a glass of wine or so a day) have any impact on your baby’s cognitive development…
Usa e Ue adottano standard differenti nelle raccomandazioni sull’alcol senza ottenere risultati differenti…
… Heavy drinking is frowned upon everywhere, but many places in Europe have recommendations suggesting that a few drinks a week are fine. An occasional glass of wine or beer is much more common there. Yet there is no evidence of more foetal alcohol syndrome in continental Europe; if anything, rates are higher in the United States….
Il senso comune ci dice: molto alcol, molti danni. Meno alcol, meno danni.
Non è proprio così, per capirlo bisogna ripassare i processi biologici di base…
… When you drink, alcohol enters your digestive system and is passed into your bloodstream. Your liver processes the alcohol into a chemical called acetaldehyde and then into acetate. The acetaldehyde is toxic to other cells and depending on how quickly you drink, it can remain in your bloodstream. You share your blood with your baby through the placenta; acetaldehyde, which remains in your bloodstream, is therefore shared with the foetus. Your baby actually can process some alcohol, but not as much as an adult (obviously). If too much acetaldehyde is passed to the baby, it can get into his tissues and impact development. The key is that problems arise only if significant amounts of alcohol get into the foetal tissues…
Il problema degli studi in queste materie: etica e selection bias…
… There are no randomised trials here; the ethics are just too complicated. This means the studies compared women who chose to drink different amounts of alcohol. All these studies have the problem that the kinds of women who drink are different from those who do not…
Ecco l’esempio di uno studio attendibile…
… Among the best studies of the behaviour issue is one published in 2010 in the British Journal of Obstetrics and Gynecology.4 There are a few things that make this a reliable study: it’s pretty large (3,000 women) and they collected information about maternal drinking during pregnancy (at 18 and 34 weeks). Asking people about their behaviour while they are doing it tends to be more reliable than asking them to remember later on. The study also followed the children of these women from birth through the age of 14; they looked at behaviour problems starting at age two…. it was run in Australia, where recommendations condone the occasional drink during pregnancy…
Esito: un uso moderato dell’alcol non nuoce al feto. Perlomeno per quel che riguarda i problemi comportamentali del bimbo…
… there is no evidence that more drinking leads to higher levels of behaviour problems. In fact, the statistics in the paper show that light drinkers (that’s two to six drinks per week) are actually significantly less likely to have children with behaviour problems than women who do not drink at all….
Un altro possibile danno dell’alcol al feto è la riduzione dell’ IQ.
Uno prototipo di studio attendibile nel merito…
… my favourite study on this issue comes out of Australia. It has a lot of the same high-quality features: large study, drinking information collected during pregnancy, long-term follow-up. And, of course, the fact that it was run in Australia. This study started in the early 1980s by asking about 7,200 pregnant women about their drinking during pregnancy. Roughly 5,000 of their children completed an achievement test at age 14…
Esito: nessun danno per assunzioni moderate…
… Just as in the study of behaviour, there is no evidence here to suggest that the children of light drinkers are worse off than those of women who drink nothing. In fact, their scores are higher on average… The researchers concluded there is no evidence of worse test performance, even among the children of mums who have a drink or more per day…
Altra ricerca di qualità…
… A very similar study in England interviewed women in early pregnancy about drinking patterns and then gave their children an IQ test at age eight.6 Same result: no impact of drinking on IQ…
Ma se stiamo sulla ricerca di qualità è difficile imbattersi in risultati differenti…
… I was surprised at how consistent the findings were. It’s simply very, very difficult to find good evidence that a small amount of alcohol has any negative impact whatsoever on long-term child behaviour or IQ….
Uno studio danese, stessi risultati…
… It was a large study, run in Denmark, showing no impact of drinking up to eight drinks a week on child’s IQ at age five.7 Articles written in the popular press acted like this was a huge surprise…
Ma perché allora tanta prudenza nelle raccomandazioni?
Ecco uno studio che giunge a risultati diversi dai precedenti…
… One that gets cited frequently was published in the journal Pediatrics in 2001.8 On the face, this study looks similar to the ones I discussed above. Women were interviewed about their drinking during pregnancy and were re-contacted for a child-behaviour assessment when the child was about six. The study is a bit smaller (only about 500 kids)… When the authors compared women who didn’t drink during pregnancy to those who had one drink or less per day, they found more evidence of aggressive behaviour (although not of other behaviour problems)…
Il difetto: si confrontano gruppi disomogenei
… One of the very nice things about the previous studies – the ones I liked – was that the groups of women who drank different amounts were not that different in other ways. If this were not the case, we would be worried that the other differences among the women – not the drinking – were responsible for the behaviour problems…
In questo senso lo studio dei pediatri è altamente deficitario…
… This last paper failed on this count. In this study, cocaine use during pregnancy was reported by 18 percent of the women who didn’t drink at all and 45 percent of the women who had one drink per day. Presumably your first thought is, really?…
Possiamo buttare tutto nel cestino.
Un altro possibile problema per chi beve in gravidanza: aborti spontanei e parti prematuri.
Evidenza su aborti spontanei
… In the case of premature birth, the answer is no. You can see this in studies in both Denmark and Italy (among other places). In the Italian study, women who drank up to one drink per day were actually less likely to have premature babies than those who did not drink at all…
Evidenza su parti prematuri
… The evidence on miscarriage in the first trimester is a bit more mixed. A review article from 2007 summarised a number of studies. Several suggested there was no relationship between light drinking (in their case, up to one drink a day) and miscarriage. There were studies that suggested a link in particular subgroups (like among smokers), but the review dismissed these as largely unreliable. They concluded that there was no strong evidence for (or against) a relationship between light drinking and miscarriage…
Sembra che non esistano collegamenti, almeno quando si beve in modo moderato.
Ma ecco comparire uno studio con risultati originali
… a new study released in early 2012 that analysed the behaviour of almost 100,000 Danish women and found that even light drinking (two or more drinks a week) was associated with an increased risk of miscarriage in the first trimester…
Difetto: non controlla con la nausea. La nausea è sintomo di gravidanza ottimale e, al contempo, neutralizza la voglia di bere. Bisogna tenerne conto. Questo studio non lo fa…
… This study wasn’t perfect; they were not able to control for nausea, which other studies have shown to be an important mitigating factor (women who are nauseous drink less and nausea is a good sign about a healthy pregnancy – more on this in the discussion of coffee)…
Cestino.
Lo stereotipo da sfatare:
… One phrase I kept coming across was “no amount of alcohol has been proven safe”…
Tutto in eccesso fa male, anche le banane. Ma noi non diciamo: “meglio non mangiarle affatto”…
… too much of many foods can be bad. If you have too many bananas (and I mean a LOT of bananas), the excess potassium can be a real problem. But no doctor is going around saying “No amount of bananas have been proven safe!”…
In poche parole: l’evidenza che assolve il bere moderato è la medesima che condanna il bere pesante. Non si puo’ accogliere l’una rigettando l’altra…
… what is all this evidence if not proof? It’s exactly this type of evidence that leads us to conclude that binge drinking is problematic….

Cattarina- incontro al tirinnanzi

Per avere la mia libertà devo avere la possibilità di scegliere anche cio' che desidero.

La comunità ha delle regole. Ma anche la vita.

La delusione sul volto della madre è segno di una delusione che viene da qualcosa di più grande.
Libertà è dire sì.

Perché non hai fiducia in me? Hai ragione, non ho fiducia. Però ho una grande speranza. E comunque, tu in me hai fiducia?

Lo sguardo è verso l'anima dell'altro. Non solo verso l'altro.

L'autostima viene dalla stima degli altri.

Non sappiamo più dire le cose. Il linguaggio mi blocca.