母婴疾病防治领域的新兴医学科技进展

提高妇幼健康水平作为建设健康中国的重要任务之一,需要加强和推动医药健康科技创新,为保障和改善妇幼健康提供有力的科技支撑。因此,本文对基因诊断与基因治疗技术、多组学技术、干细胞技术、组织工程技术等前沿生物技术以及机器人技术、大数据与人工智能技术在母婴健康医学科技领域的发展现状和未来趋势作一概述,对新兴技术在母婴疾病防治中...     

江苏省儿童青少年超重与肥胖流行趋势分析

了解江苏省2005-2015年儿童青少年超重和肥胖的流行趋势,为采取有针对性的干预措施提供参考.方法 选取江苏省2005年、2010年和2015年7~22岁学生体质与健康调研资料,应用中国肥胖工作组(WGOC)“中国学龄儿童青少年超重、肥胖筛查BMI分类标准”,比较超重和肥胖变化情况.结果 江苏省2005年、2010年和2015年7~22岁儿童青少年超重检出率依次为10.67%,12.22%和13.79%,2015年超重检出率高于2005年和2010年(x2值分别为110.383,61.212,P值均<0.05);肥胖检出率依次为5.05%,5.54%和5.61%,2015年肥胖检出率高于2005年(x2=7.74,P<0.01).2005年、2010年和2014年男生超重检出率分别为13.67%,15.96%和17.43%,肥胖检出率分别为6.54%,7.79%和7.54%;女生超重检出率分别为7.65%,8.50%和10.18%,肥胖检出率分别为3.54%,3.29%和3.69%.城市超重检出率分别为13.08%,13.74%和15.08%,肥胖检出率分别为7.51%,6.66%和6.41%;乡村超重检出率分别为8.25%,10.74%和12.52%,肥胖检出率分别为2.57%,4.44%和4.82%.苏南地区(经济较好)超重检出率分别为12.66%,12.91%和12.24%,肥胖检出率分别为5.19%,6.04%和4.68%;苏北地区(经济较差)超重检出率分别为9.70%,12.99%和15.00%,肥胖检出率分别为6.88%,7.01%和9.03%.结论 2005-2015年江苏省7~ 22岁儿童青少年超重、肥胖比例持续增加,其中小学生群体、乡村地区和苏北地区增长迅速.     

Working through resistance in engaging boys and men towards gender equality and progressive masculinities

Over the last two decades, a focus on challenging and transforming dominant forms of masculinity and engaging boys and men towards gender equality and healthy masculinities has permeated South African social and health sciences and the humanities. This focus on men and boys has also been evident in intervention and activist work. However, the turn to boys, men and masculinities has not gone without resistance, contestation and contradictions. A range of localised and global realities has frustrated much of the enthusiasm for rapid, sweeping and concrete changes regarding gender justice and the making of progressive masculinities. Among the discursive and material forces that oppose work that engages boys and men are those to do with income-related issues, race and racism, cultural traditions and gender itself. Because of this, it is contended that engagement with boys and men needs to consider not only gender but also economic inequality, poverty and unemployment, divisions created by race, and struggles around tradition. This paper discusses these forces that undermine and counteract work with boys and men and how we might work through resistance in engaging with men and boys.     

我国地(市)、县级疾病预防控制机构艾滋病防制任务及其工作内容研究

目的研制我国地(市)、县级疾病预防控制机构艾滋病防制任务及其工作内容,为实施艾滋病防制项目管理、人力、财力和物力的项目零基预算界定了工作范围。方法在系统文献查阅的基础上,运用头脑风暴法和焦点小组访谈相结合的方法,对102位专家进行了14轮540人次的咨询与论证,并经过全国180个被调查样本机构和11个模拟运作机构的意向调查加以完善。结果我国地(市)、县级疾病预防控制机构必须开展包括基线调查和制订防制规划、健康教育、艾滋病防制的行为干预、检测实验室网络建设及管理、综合监测、艾滋病自愿咨询检测等在内的11项防制任务及其工作内容,该11项任务及其工作内容得到了全国180个样本机构的高度一致认可(总体认可程度达到了99.0%)。     

Effects of nutritional status on contents of tryptophan, serotonin and 5-hydroxyindoleacetic acid in rat brain]

Effects of nutritional status on the levels of tryptophan (Trp), serotonin (5HT), and its metabolite, 5-hydroxyindoleacetic acid (5HIAA) in six brain regions of rats were investigated. 1) A low-protein high-carbohydrate diet decreased Trp, 5HT and 5HIAA levels in the cortex and hippocampus, and those of 5HT and 5HIAA in the hypothalamus. This diet did not affect the contents of Trp and 5HT in the midbrain, but decreased 5HIAA. No significant changes of Trp, 5HT and 5HIAA were observed in the pons and medulla and striatum. 2) A low-carbohydrate high-protein diet increased the levels of Trp, 5HT and 5HIAA in the striatum, and 5HT and 5HIAA in the cortex, but showed no effect on the contents of Trp, 5HT and 5HIAA in the hippocampus, midbrain, pons and medulla and hypothalamus. 3) An energy-restriction low-carbohydrate diet increased Trp, 5HT and 5HIAA contents in the striatum, and 5HT and 5HIAA in the cortex and pons and medulla. In the hypothalamus, only 5HIAA was increased by this diet. The diet did not influence Trp, 5HT and 5HIAA contents of the midbrain and hippocampus. These results suggest that i) lowered fat and carbohydrate intakes enhance 5HT synthesis and metabolism in the cortex and that lowered carbohydrate intake enhances them in the striatum, ii) energy restriction enhances the 5HT metabolism in the cortex, pons and medulla and hypothalamus, and 5HT synthesis in the cortex and pons and medulla, iii) lowered protein intake inhibits 5HT metabolism in the cortex, midbrain, hippocampus and hypothalamus, and 5HT synthesis in the cortex, hippocampus and hypothalamus.     

Access to and use of NHS Patient Advice and Liaison Service (PALS): the views of children, young people, parents and PALS staff

Background The English National Health Service Patient Advice and Liaison Service (PALS) was set up to provide patients and their relatives with a way of obtaining information or expressing concerns about their health care. This study examined children's, young people's and parents' access to and use of PALS, and how this could be improved. Methods Qualitative and quantitative methods were used to obtain the views of children, young people, parents and PALS staff, on the inclusiveness of the service. These methods included discussion groups and interviews with 30 young people and 16 parents; a postal survey of PALS users, to which 171 (21%) parents responded; and telephone interviews with 14 PALS staff. The data were analysed using qualitative and quantitative methods, and the views of participants on key topics were examined. Results Children and young people were found to be low users of PALS, but thought that the service was potentially useful. They and parents and PALS staff all highlighted ways in which access to and use of the service could be improved. Participants' views on the following topics are reported: awareness of PALS existence and role; access to and use of PALS; effectiveness of and satisfaction with PALS; and training of staff. Conclusions and recommendations Patient Advice and Liaison Service has not been designed and developed in ways that are fully inclusive of children, young people and parents. Based on their views and experiences, and the suggestions of PALS staff, the authors recommend that access to and use of the service could be improved, increasing awareness of PALS, facilitating access to and use of the service, providing training for PALS staff on dealing with young people and their issues, and developing links between PALS and other organizations that deal with young people and parents.     

Position of the American Dietetic Association: food insecurity and hunger in the United States

It is the position of the American Dietetic Association that systematic and sustained action is needed to bring an end to domestic food insecurity and hunger and to achieve food and nutrition security for all in the United States. The Association believes that immediate and long-range interventions are needed, including adequate funding for and increased utilization of food and nutrition assistance programs, the inclusion of food and nutrition education in all programs providing food and nutrition assistance, and innovative programs to promote and support the economic self-sufficiency of individuals and families, to end food insecurity and hunger in the United States. Food insecurity continues to exist in the United States, with over 38 million people experiencing it sometime in 2004. Negative nutritional and nonnutritional outcomes have been associated with food insecurity in adults, adolescents, and children, including poor dietary intake and nutritional status, poor health, increased risk for the development of chronic diseases, poor psychological and cognitive functioning, and substandard academic achievement. Dietetics professionals can play a key role in ending food insecurity and hunger and are uniquely positioned to make valuable contributions through provision of comprehensive food and nutrition education, competent and collaborative practice, innovative research related to accessing a safe and secure food supply, and advocacy efforts at the local, state, regional, and national levels.     

Gender equity and socioeconomic inequality: a framework for the patterning of women's health

This paper explores the interrelationship of gender equity and socioeconomic inequality and how they affect women's health at the macro- (country) and micro- (household and individual) levels. An integrated framework draws theoretical perspectives from both approaches and from public health. Determinants of women's health in the geopolitical environment include country-specific history and geography, policies and services, legal rights, organizations and institutions, and structures that shape gender and economic inequality. Culture, norms and sanctions at the country and community level, and sociodemographic characteristics at the individual level, influence women's productive and reproductive roles in the household and workplace. Social capital, roles, psychosocial stresses and resources. health services, and behaviors mediate social, economic and cultural effects on health outcomes. Inequality between and within households contributes to the patterning of women's health. Within the framework, relationships may vary depending upon women's lifestage and cohort experience. Examples of other relevant theoretical frameworks are discussed. The conclusion suggests strategies to improve data, influence policy, and extend research to better understand the effect of gender and socioeconomic inequality on women's health.     

Parental pressure, dietary patterns, and weight status among girls who are "picky eaters"

OBJECTIVE: To determine whether mothers' fruit and vegetable intake and mothers' use of pressure in the feeding domain when their daughters were 7 years old predicted picky eating and dietary intake when their daughters were 9 years old, and to examine diet and weight status in picky and nonpicky eaters. DESIGN/SUBJECTS: Participants were 173 9-year-old non-Hispanic white girls and their mothers. A longitudinal analysis was used to assess maternal influences on picky eating and diet. A cross-sectional analysis was used to examine diet and weight status between picky and nonpicky eaters. Measures included maternal feeding practices, daughters' pickiness, mothers' fruit and vegetable intake, daughters' food intake, and weight status. STATISTICAL ANALYSES: t tests examined differences between picky and nonpicky eaters. Structural equation modeling examined relationships among mothers' fruit and vegetable intake; child feeding practices; daughters' pickiness; and fruit, vegetable, micronutrient, and fiber intakes. RESULTS: Mothers consuming more fruits and vegetables were less likely to pressure their daughters to eat and had daughters who were less picky and consumed more fruits and vegetables. Picky eaters consumed fewer fruits and vegetables, but also fewer fats and sweets. All girls consumed low amounts of vitamin E, calcium, and magnesium, but more picky girls were at risk for not meeting recommendations for vitamins E and C and also consumed significantly less fiber. In addition, picky eaters were less likely to be overweight. CONCLUSIONS: Mothers influenced daughters' fruit and vegetable intake via their own patterns of fruit and vegetable intake and by influencing their daughters' tendencies to be picky eaters. Both picky and nonpicky eaters had aspects of their diets that did not meet recommendations. Taken together, these findings suggest that parents should focus less on "picky eating" behavior and more on modeling fruit and vegetable consumption for their children.     

医疗纠纷中的因素分析及护理防范

近年来，医疗和护患纠纷逐年上升并呈现出新的趋势和变化。文章参考了近几年来有关医疗纠纷和护患纠纷的文献，分析总结出现阶段医疗和护患纠纷的一些新的特点。同时，从医疗从业人员、患方、以及社会这3个方面对医疗和护患纠纷的产生及其发生变化的原因进行了剖析。归纳总结了一些医院实施减少医疗和护患纠纷的方法，根据国务院最新颁发的《医疗事故处理条例》及相关配套文件的要求，结合现阶段我国的情况提出了对医疗和护患纠纷的防范措施，希望能够对完善我国医疗护理服务；在新形势下建立和维持良好的护患关系；减少医疗和护患纠纷有所帮助。     

疾病预防控制信息化建设标准体系研究及应用

文章以区域卫生信息平台数据交互为核心架构,研制上海市疾病预防控制信息化建设标准体系.基于疾病预防控制数据标准和信息系统基本功能规范,开发标准版应用软件,在试点区安装部署和应用,实现疾病预防控制数据跨业务、跨地区、跨机构交换共享和业务协同.进一步对试点情况进行评估,总结试点经验和服务效果,完善和优化标准版应用软件.在此基...     

Position of the American Dietetic Association: child and adolescent food and nutrition programs

It is the position of the American Dietetic Association that all children and adolescents, regardless of age, sex, socioeconomic status, racial diversity, ethnic diversity, linguistic diversity, or health status, should have access to food and nutrition programs that ensure the availability of a safe and adequate food supply that promotes optimal physical, cognitive, social, and emotional growth and development. Appropriate food and nutrition programs include food assistance and meal programs, nutrition education initiatives, and nutrition screening and assessment followed by appropriate nutrition intervention and anticipatory guidance to promote optimal nutrition status. Food and nutrition programs create a safety net that ensures that children and adolescents at risk for poor nutritional intakes have access to a safe, adequate, and nutritious food supply and nutrition screening, assessment, and intervention. It is important that continued funding be provided for these programs, which consistently have been shown to have a positive impact on child and adolescent health and well-being. Food and nutrition programs serve as a means to prevent or reduce hunger and food insecurity, but also as a vehicle for nutrition education and promotion of physical activity designed to prevent or reduce overweight and prevent chronic disease. It is the role of the registered dietitian to support adequate and sustained funding for food and nutrition programs, universal health care reimbursement for nutrition services, and the use of research and surveillance programs to evaluate and improve these programs. In addition, the registered dietitian and dietetic technician, registered, are responsible for serving as a nutrition resource to all groups and individuals providing services to children and adolescents, acting as an advocate for the establishment of child-care, school, and community settings conducive to the development of good nutrition habits.     

死胎及胎儿畸形引产后孕妇心理特征与社会及家庭支持的相关性分析

目的分析死胎及胎儿畸形引产后孕妇心理特征与社会及家庭支持的相关性,为相关临床工作提供指导信息。方法选取甘肃省妇幼保健院2017年12月-2018年12月170例死胎及胎儿畸形引产后孕妇的相关资料进行总结,包括一般资料,焦虑、抑郁发生情况,社会及家庭支持情况。分别采用自制一般资料调查问卷、焦虑自评量表(SAS)、抑郁自评量表(SDS)、社会支持评定量表(SSRS)以及家庭关怀度指数量表(APGAR)进行评估。结果 170例死胎及胎儿畸形引产后孕妇SAS、SDS评分分别为(51.9±4.0)分和(51.3±4.4)分,其中存在焦虑、抑郁的孕妇分别为93例和71例。170例死胎及胎儿畸形引产后孕妇SSRS、APGAR评分分别为(42.9±3.7)分、(7.8±2.0)分。存在焦虑、抑郁的孕妇SSRS、APGAR评分显著低于无焦虑、抑郁的孕妇,评分差异有统计学意义(P<0.05),并且死胎及胎儿畸形引产后孕妇的SAS、SDS评分与SSRS、APGAR评分呈显著负相关(P<0.05)。结论死胎及胎儿畸形引产后孕妇容易出现焦虑、抑郁,且不良心理状态的出现与社会及家庭支持呈显著负相关,临床工作者可以采取针对性措施提高社会及家庭支持度,降低孕妇焦虑、抑郁的发生,促进孕妇的身心康复。     

国境口岸医学媒介生物入侵的形势和管理策略

[目的]控制外来媒介生物的入侵,防止媒介生物性疾病的传播,保障我国的卫生安全。[方法]对国境口岸医学媒介生物入侵的形势和途径进行分析。[结果]全球100种最具威胁的外来生物中,入侵我国的有50余种,外来人侵物种每年对中国造成的经济损失约1 198．76亿元。2005年国境口岸卫生检疫机构共截获入境医学媒介生物1．5亿只,其入境载体主要是交通工具、货物和集装箱。目前我国法定的传染病有36种,其中鼠疫、肾综合征出血热等13种疾病为媒介生物性疾病。[结论]卫生检疫机构防范媒介生物入侵的策略应包括：法规与宣传,技术力量建设与储备、信息数据库建设、预警机制的建立和预防措施的实施。     

达州市妇幼卫生改革30年回顾

30年的卫生改革引领妇幼卫生改革如火如荼。四川省达州市在妇幼卫生基础条件薄弱、服务技术落后、妇女儿童健康水平低下的环境下,依靠政府政策和投入,大胆探索实践。改革探索阶段：恢复机构建设,组织人员培训,开展健康教育,拓展服务市场;改革深化阶段：贯彻落实法规,创建“爱婴医院”和等级妇幼保健院,认真实施妇幼卫生合作项目;改革转折调整阶段：加强妇幼公共卫生体系建设,结合农村新农舍和城市社区服务拓宽服务领域。使妇幼卫生事业较快发展,并获得了成功的基本经验,值得认真总结与回顾。     

Food choice and intake: the human factor

Human perceptions and selection of food are derived from the prevailing and momentary food, agro-economic and cultural environment, cognitive and biological characteristics of individuals, and the real and perceived intrinsic and extrinsic attributes of foods themselves. The range of items typically chosen and consumed within a given population is largely determined by interaction of the external environmental context with guiding sets of implicit and explicit social and psychobiological 'rules'. Within the rather broad limits of biology, individual food choices and intake behaviours relate to and reflect aspects of food availability, existing habitual behaviours, learning mechanisms, and individual beliefs and expectations. Many of the relevant features of these variables are uniquely human, together determining what is 'food', when, how, by and with whom it is chosen and eaten, and in what quantities. They also provide the opportunities for individuals to establish and maintain a relatively stable set of culturally and biologically determined affective responses ('likes') and intake behaviours. Understanding of the potential contribution of these influences under different conditions can serve to explain many of the observed characteristics of human eating, and highlight potential avenues for intervention.     

Position of the Academy of Nutrition and Dietetics: Child and Adolescent Federally Funded Nutrition Assistance Programs

It is the position of the Academy of Nutrition and Dietetics that children and adolescents should have access to safe and healthy foods that promote physical, cognitive, and social growth and development. Federally funded nutrition assistance programs, such as food assistance, meal service, and nutrition education, play a vital role in ensuring that children and adolescents have access to the foods they need and in improving the overall nutrition and health environments of communities. Federally funded nutrition assistance programs help to ensure that children and adolescents receive safe, healthy foods that provide adequate energy and nutrients to meet their growth and development needs. These programs provide access to adequate food supplies to combat hunger and food insecurity; provide healthy foods to children and adolescents who have nutritional or medical risk factors, such as iron deficiency anemia; and provide nutrition education. In addition, federally funded nutrition assistance programs serve as a means to prevent or reduce obesity and other chronic diseases. It is important that permanent and full federal funding be provided for these programs, which have been consistently shown to have a positive impact on child and adolescent nutrition and health outcomes. Registered dietitian nutritionists and nutrition and dietetic technicians, registered—trained in food science, nutrition, and food systems to implement programs to monitor, evaluate, and improve the nutritional status of children and adolescents—are preeminently qualified to implement and evaluate nutrition assistance programs for children and adolescents.     

HIV/AIDS, sexual and reproductive health: intersections and implications for national programmes

HIV and AIDS have a myriad of effects on sexual and reproductive health and rights, and sexual and reproductive health services are critical for women and men with HIV and AIDS. Yet there has been a dearth of visible, in-depth mainstream attention to the links between sexual and reproductive health and prevention and treatment of HIV/AIDS since the early 1990s among major stakeholders internationally. This paper argues that access to essential sexual and reproductive health care should be provided in HIV/AIDS prevention, care and treatment programmes, and appropriate forms of prevention and treatment of HIV/AIDS should be included in all sexual and reproductive health services as a public health priority, particularly in sex education, family planning and abortion services, pregnancy-related care, sexually transmitted infection (STI) services and services addressing sexual violence. The paper analyzes existing barriers to linking and integrating these services, e.g. at country level due to the traditional training of health workers to implement vertical programmes, separate sources of funding for National AIDS Control Programmes and sexual and reproductive health services, and in international donor programme and UN agency structures. This paper calls for leadership to be exercised by donors, all the UN agencies working together, governments, health service managers and providers, NGOs and advocates in both fields to develop and implement these linkages at country level. Finally, it is crucial that UNAIDS, WHO, UNFPA, UNICEF, the Global Fund to Fight AIDS, TB and Malaria and those working to reach the targets set by the Millennium Development Goals come on board in these efforts.     

14家医院细菌真菌感染诊治能力建设的定性比较

目的探究我国二级以上医院细菌真菌感染诊治能力建设的影响因素及路径，为医院感染科建设提供依据。方法基于三力模型，运用清晰集定性比较分析法，分析5省14家二级以上医院细菌真菌感染诊治能力建设的因素组态及作用机制。结果形成3条影响医院细菌真菌感染诊治能力建设的路径。路径1:领导支持+配套政策+政策重视程度+会诊价值感受；路径2:领导支持+政策重视程度+培训和学习机制；路径3:领导支持+培训和学习机制+会诊价值感受。路径1属于政策驱动机制，路径2和路径3属于自主提升机制。结论领导支持是二级以上医院细菌真菌感染诊治能力建设的关键。政策驱动机制和自主提升机制分别从外部和内部影响二级以上医院细菌真菌感染诊治能力建设。     

中文科技期刊的定位与作用再认识

【目的】 明确中文科技期刊的定位和作用,为全方位提升中文科技期刊办刊能力,培育世界一流科技期刊提供思路与参考。【方法】 对中外文科技期刊的定位与作用、中外文期刊论文的认知维度和中外文科技期刊的差距进行比较分析,以澄清当前学界、业界相关认识误区。【结果】 中外文科技期刊和中外文期刊论文侧重于不同的范畴和维度,不能只从单一的维度进行简单比较与评价。【结论】 中文科技期刊应服务国家科技创新,服务国内科学研究,服务科技人才培养,不断提升我国的国际学术话语权。