Thrills and spills: Young people's sexual behaviour andattitudes in seaside and rural areas

This paper reports on a qualitative study which explored attitudes to sexual risk-taking among young people in rural and seaside areas in England. The research was undertaken in three sites, each comprising a seaside resort and its rural hinterland. Data were collected through group discussions with 341 young people in secondary schools in England and through individual interviews with young people outside school settings, with young parents and with professionals working in the field of sexual health and education. Data analysis adopted a grounded theory approach and incorporated the views of local young people's advisory groups. Key features of the study which appeared specific to the locales studied were the influence of the seaside entertainment industry on young people's sexual behaviour and the high visibility experienced by young people in rural areas. Gender was also identified as playing a crucial role in determining perceptions of risk and influencing behaviour. Sexual health services and health promotion strategies need to acknowledge the relevance of factors such as gender and stigma for young people as well as being responsive to the specific features of local contexts.     

Migration and the diffusion of modern contraceptive knowledge and use in rural Guatemala

This article uses the concept of social networks as it is employed in the research literature on family planning and migration to explore the impact of out-migration on modern contraceptive knowledge and use in rural Guatemala. Data for this study come from the 1995 Guatemalan Survey of Family Health. Results from multilevel regression models indicate that urban migration experience, having migrant kin in urban or international destinations, and living in a community where urban migration is common are all associated with greater contraceptive knowledge. Social ties to urban or international migrants are also associated with a greater likelihood of modern contraceptive use among married women, but this association works primarily through increased contraceptive knowledge. The findings of significant diffusion effects provide support for recent theories of fertility decline that emphasize the role of social interactions.     

Young people's perspectives on the use of reverse discourse in web-based sexual-health interventions

Web-based sexual-health promotion efforts often utilise reverse discourse – the acknowledgement and rejection of shame associated with stigmatised terms – both to challenge judgments about ‘risky’ behaviours (e.g., casual sex) and to appeal to young people. This study examines the use of reverse discourse in Internet-based sexual-health promotion and analyses young people's perspectives on this approach. During in-depth interviews and focus groups with young people (aged 15–24), participants shared their perspectives on written (e.g., clinical language; colloquial language) and visual (e.g., generic, stock images; sexualised images) depictions of sexual-health topics on the websites. More explicit styles elicited negative responses from young people in terms of perceived appeal, trust and quality of websites. Negative social mores were associated with some of the more explicit portrayals of young people's sexual lives on the websites, revealing how reverse discourse re-stigmatises young people by re-emphasising young people's sexual activity as inherently risky or immoral. Reverse discourse was perceived to have negative effects on the saliency and credibility of online sexual-health information. We discuss the theoretical basis for the operationalisation of reverse discourse in this context, and discuss the importance of considering sociotechnical aspects of Internet-based sexual-health interventions.     

凉山州农村未婚青少年偶遇性行为与HIV感染的监测分析

凉山州少数民族地区商业性行为较少,未采取安全措施的偶遇性行为更为常见[1],且存在多性伴现象[2].为探讨凉山州偶遇性行为对HIV传播的影响,2011年凉山州新增设农村未婚青少年人群综合监测哨点,现将结果分析如下.1.对象与方法:按照户籍登记,选择监测点所在县农村辖区内1872名15～25岁常住农村未婚青少年.按距离县城"较远"和"较近"将调查村分为2个层次,采用分层整群抽样方法各抽取5个村,获得知情同意后,对每县10个村共计400名符合入选条件的调查对象进行问卷调查,并采集5 ml静脉血.使用酶免试剂(ELISA-1)进行HIV抗体初筛检测,初筛阳性者使用另一种酶免试剂(ELISA-2)复检,两次检测结果均呈阳性则判定HIV抗体哨点监测阳性.采用EpiData 3.1软件建立数据库并录入数据,SPSS 18.0软件进行数据的描述和分析.     

江西省农村贫困地区6～18月龄婴幼儿营养干预效果分析

目的 了解江西省赣州市农村贫困地区6～18月龄婴幼儿的生长发育和营养健康状况,并对干预组婴幼儿发放婴幼儿辅食营养包（简称营养包）实施营养干预,经过6个月的营养干预以后,评价营养包的干预效果。方法 采用多阶段分层随机抽样方法,在江西省赣州市抽取经济水平相当的3个县分别是赣县、于都和兴国县,其中赣县和于都的483名婴幼儿为干预组进行营养包发放,兴国县的248名婴幼儿为对照组暂不发放营养包。采用自制问卷调查婴幼儿家庭及父母的基本情况,分别测量干预前后2组婴幼儿的身长、体重和血红蛋白浓度,采用WHO Anthro软件测评婴幼儿的生长发育状况,分析干预组和对照组婴幼儿年龄别身高（HAZ）、年龄别体重（WAZ）、身高别体重（WAZ）分值的差异以及2组之间低体重率、生长迟缓率和消瘦率之间的差异,并采用SPSS21.0进行数据统计分析。结果 经过6个月的营养干预后,干预组婴幼儿平均身长增加8.2 cm、平均体重增长了2.0 kg ,与对照组相比,差异有统计学意义(t = 6.25, P = 0.03;t = 8.53, P＜0.01）;干预组的HAZ和WHZ与对照组相比差异有统计学意义（t = 7.23, P = 0.02;t = 9.67, P＜0.01）;干预组婴幼儿血红蛋白平均浓度由（108.5 ±14.4） g/L增加到（117.4 ±12.1） g/L,并且高于对照组婴幼儿,干预组贫血检出率由 53.9%降至 24.8%（χ2 = 15.49,P = 0.04）,差异有统计学意义。结论 通过实施营养干预给婴幼儿添加营养包,能够明显的改善婴幼儿的营养不良现状和贫血状况,促进婴幼儿体格发育。     

Obstacles to modern contraceptive use among married women in southern urban Maldives

This study aimed to clarify the current state of, and factors associated with, modern contraceptive use among married women in the Maldives. A total of 205 women participated in interviews with structured questionnaires. Four sessions of FGIs were conducted to obtain in-depth information about the problems that they faced in using modern contraceptives. Both modern contraceptive users (MCUs) and those who were not modern contraceptive users (NMCUs) had a good knowledge of, and availability and accessibility to, contraceptives and social support for contraceptive use. NMCUs were more likely to have a husband who disapproved of modern contraceptive practice, to have difficulty communicating with their husband, to be afraid of side effects and to be dissatisfied with sexual sensation when using modern contraceptives. Moreover, NMCUs cited more perceived barriers against the use of modern contraceptives and preferred larger families than MCUs.     

Delaying sexual debut amongst out-of-school youth in rural southwest Uganda

This paper focuses on ‘sexual debut’ among out-of-school youth in Masaka District, Uganda, factors influencing its timing and assistance young people feel they need to delay sexual initiation. Data were drawn from a sexual health needs assessment using applied anthropological techniques with young people aged 13–19 years. Parents, guardians and community leaders were also consulted. All participants felt that young people begin their sexual lives too early. Young men feel under pressure from friends and older men to prove their masculinity. Most delay further activity after debut and want assistance to resist the pressure. Young women's debut after physical maturation prompts ‘pestering’ for sex from boys and men who offer gifts. After debut, young women remain sexually active but believe younger women need assistance to resist pressure. Programmes are needed to help young people achieve these goals. Structurally, the community needs to develop means of preventing men from pestering young women for sex and of redeveloping both the social role and pathway to marriage for young women who are marrying later than is traditional.     

Understanding unmet contraceptive needs among rural Khasi men and women in Meghalaya

There is a global push for increased access to contraception to respond to unmet contraceptive needs. Meghalaya state, with a majority of Indigenous people, has one of the highest unmet contraceptive needs and the lowest contraceptive prevalence rates in India. This qualitative study explores the reasons for the low uptake of contraceptives among Khasi people in a rural district. While policy makers assume that individuals may not be practising family planning because of religion and lack of education, couples actually do use a variety of ‘natural’ or ‘traditional’ contraceptive methods to obtain their desired family composition and size. Health providers focus on the provision of hormonal contraceptives, such as the pill, and on technologies such as IUDs and tubectomies that require regular follow-ups by trained medical staff. Health concerns, distrust of contraceptive technologies, the inadequate local health system and a desire to have more than two children are important factors in the low uptake of available contraceptive technologies. Contraceptive choices in rural areas are shaped by the historically problematic political engagement of Indigenous people with the central state, with policy implementation taking place on the basis of widespread assumptions rather than on evidence from contextually relevant behavioural sciences research.     

城乡哺乳期妇女避孕现状比较分析

目的分析比较城乡哺乳期妇女避孕方法的使用情况、获得渠道和选择决定者，以及未避孕原因等。方法利用国家人口和计划生育委员会2001年全国计划生育／生殖健康调查的原始数据，对城乡哺乳期妇女避孕方法的使用现状进行描述性统计分析。结果我国哺乳期妇女的避孕率为78％，城乡哺乳期妇女的避孕率、未避孕原因虽然没有较大差异，但在选择避孕方法、避孕工具获得渠道和选择决定者等方面差异有统计学意义。结论我国妇女对哺乳期避孕的必要性缺乏足够认识，需从多方面加强干预。     

Hearing impairment among young Chinese in a rural area

To evaluate hearing levels in Chinese young people, audiometry was carried out at a rural village in Shandong Prefecture. The subjects were 282 healthy school children and students ranging in age from 7–17 y. All subjects were asked to complete a brief questionnaire on otological symptoms, personal histories and use of noisy playthings. Audiometric threshold testing was performed at the audiomeric frequencies of 0.5, 1, 2, 4 and 8 kHz. Cluster analysis was used to estimate the associations between questions in the questionnaire and hearing impairment. Fifty-six subjects (20% subjects) were excluded from the normal groups. Twenty-two ears of the excluded subjects showed 4 kHz-dip and 38 ears showed high frequency hearing loss. An increased prevalence of hearing impairment was found when compared with young Japanese (1% from the nationwide school health survey) and with young Chinese in Shandong Prefecture (0.5%). In the questionnaire, 4 questions on dizziness, head trauma, aminoglycoside administration, and suspicion of Meniere's syndrome, were included in the cluster of hearing impairment. The cause of this hearing impairment was proposed to be the potentiating effects of aminoglycoside antibiotics and exposure to noise.     

陕西省部分地区5岁以下儿童健康干预的效果评价

【目的】 对陕西省部分地区5岁以下儿童健康干预的效果进行评价,为后续项目提供经验。 【方法】 于2007-2010年间开展包括“母子系统保健项目”,采用不等概率抽样方法,分别在2006年和2010年开展基线和终末两次横断面调查,通过对干预前后5岁以下儿童生长发育、健康结局、看护人保健认知与行为指标进行比较,对项目的干预效果进行评价。 【结果】 儿童生长迟缓率在项目干预后下降至少50%,由6.9%降低到3.4%(P<0.01);儿童贫血检出率、近两周疑似肺炎患病率与近两周腹泻率均未有明显降低(P>0.05);看护人保健认知及儿童就医行为在项目后有明显改善,两种疾病患病后就诊率在干预后均提高到85%以上。 【结论】 项目的干预措施在一定程度上促进了项目地区5岁以下儿童健康及保健水平,但儿童的贫血问题依然严峻,腹泻、疑似肺炎患病率降低不明显,需进一步结合地方突出问题,细化各种干预措施,加大干预强度。     

2015-2019年江门市区农饮水健康风险评估

目的 了解本地区农饮水菌落总数、总大肠菌群、耐热大肠菌群、铁、游离氯5个指标风险程度,探究灰聚类分析方法评估农饮水水质对健康影响风险的可行性.方法 以江门市某区2015-2019年5年期间均使用当地农饮水为饮用水源的本地区某乡镇12条行政村为评估对象,采用国标方法对菌落总数、总大肠菌群、耐热大肠菌群、铁、游离氯5个指标...     

湖北农村地区6~23月龄婴幼儿贫血状况分析

目的 了解湖北省农村地区6~23月龄婴幼儿贫血状况。方法 采用整群随机抽样的方法,对8个农村县的婴幼儿喂养行为进行入户问卷调查,对血红蛋白和身长、体重进行现场测量。结果 813名6~23月龄婴幼儿中,贫血患病率为30.6%,男童为29.2%,女童为32.2%;6~11月龄婴幼儿贫血患病33.6%,高于12~17月龄的31.2%和18~23月龄的24.6%（P<0.05）;母亲贫血的婴幼儿贫血患病率37.6%,高于母亲不贫血婴幼儿的28.8%（P<0.05）;有初乳喂养史的婴幼儿贫血患病率27.4%,低于无初乳喂养者的48%（P<0.01）;产后1~24 h内开奶的婴幼儿贫血患病率18.4%,低于24 h后开奶者的39.9%（P<0.01）;营养不良的婴幼儿贫血患病率32.7%,高于无营养不良婴幼儿的22.2%（P<0.05）。结论 尽早开奶、初乳喂养、改善母亲贫血和儿童营养不良状况有助于降低农村地区婴幼儿贫血患病率。