童年期被虐待经历对大学生恋爱暴力发生的影响

目的 了解大学生恋爱暴力的发生情况及童年期被虐待经历对大学生恋爱暴力发生的影响。方法 采用滚雪球抽样的方法,对北京市7所大学的1 130名大学生进行不记名自填式问卷调查。结果 1 130名大学生中50.8%最近一年有过恋爱经历,其中遭受和实施恋爱暴力的比例分别为16.9%和11.1%。遭受肢体暴力、情感虐待和性暴力的比例分别为14.1%、10.6%和9.9%,实施肢体暴力、情感虐待和性暴力的比例分别为8.0%、7.1%和3.7%。有509名(45.0%)大学生在童年期曾有被父母虐待的经历,其中被用力徒手打、用物品打、在其他人面前遭到羞辱和目睹父母打架或父母打兄弟姐妹的比例分别为41.6%、24.9%、13.1%和24.5%。具有童年期被虐待经历的大学生遭受和实施恋爱暴力的比例均高于童年期没有被虐待经历的大学生,差异具有统计学意义(P=0.005)。结论 大学生恋爱暴力问题不容忽视,童年期遭受父母虐待经历对大学生恋爱暴力的发生具有一定影响。     

The impact of childhood abuse history, domestic violence and mental health symptoms on parenting behaviour among mothers in Japan

Background To assess the impact of childhood abuse history, domestic violence experiences and mental health symptoms on the parenting behaviour of mothers in Japan who have separated from violent husbands or partners. Methods A self‐administered questionnaire survey was conducted on a sample of mothers (n= 304) and their children (n= 498) residing in 83 mother–child homes in Japan. The survey assessed the mothers' childhood abuse history (physical, psychological and sexual abuse and neglect history), domestic violence experiences, current mental health symptoms (dissociative, depressive and traumatic symptoms) and parenting behaviours after moving into the homes to separate from a violent husband or partner. Results The mothers' childhood abuse history and experience of domestic violence were not associated with their not playing with their children. In contrast, the mothers' dissociative and depressive symptoms were significantly associated with not playing with their children. Although there was no association between the mothers' total childhood abuse history and not praising their children, their childhood physical abuse history was significantly associated with their not praising their children. The dissociative and depressive symptoms were also associated with no praise. Interestingly, the experience of domestic violence showed an inverse association with no praise. Conclusions Mental health symptoms, more specifically dissociative and depressive symptoms, are associated with a decrease in parenting quality. Mothers who were physically abused as children are less likely to praise their own children, independent of maternal mental health symptoms. In contrast, mothers who experienced domestic violence but subsequently separated from their violent husbands or partners are more likely to praise their children. The treatment of mental health symptoms, particularly dissociative and depressive symptoms, therapy for childhood abuse history and separation from violent husbands or partners might be effective ways to enhance the quality of parenting in Japan.     

Two generations of maternal alcohol abuse: impact on cognitive levels in mothers and their children

Transgenerational effects of alcohol on mothers’ and children’s intellectual functioning has been examined in 22 families from very deprived environments. Their psychosocial outcomes and IQ level were evaluated in a follow‐up study on average seven years after they left the support group of a day‐care centre for young children; school data were collected for the offspring. A decrease of 18 IQ points due to fetal alcohol spectrum disorders (FASD) was observed in the two generations (mothers, children). Accumulation of alcohol problems in the families still predicted school failure, even in absence of FASD. The possible gain of IQ points due to the decreasing of alcohol consumption during pregnancy could help them have better school experiences. Providing appropriate ongoing supports would be an important and practical approach to improve the conditions of life of these families.     

Switching on After Nine: Black gay-identified men's perceptions of sexual identities and partnerships in South African towns

ABSTRACT

There is considerable diversity, fluidity and complexity in the expressions of sexuality and gender among men who have sex with men (MSM). Some non-gay identified MSM are known colloquially by gay-identified men in Mpumalanga, Province, South Africa, as ‘After-Nines’ because they do not identify as gay and present as straight during the day but also have sex with other men at night. Based on, key informant interviews and focus group discussions in two districts in Mpumalanga, we explored Black gay-identified men's perceptions of and relationships with After-Nine men, focusing on sexual and gender identities and their social consequences. Gay-identified men expressed ambivalence about their After-Nine partners, desiring them for their masculinity, yet often feeling dissatisfied and exploited in their relationships with them. The exchange of sex for commodities, especially alcohol, was common. Gay men's characterisation of After-Nines as men who ignore them during the day but have sex with them at night highlights the diversity of how same-sex practicing men perceive themselves and their sexual partners. Sexual health promotion programmes targeting ‘MSM’ must understand this diversity to effectively support the community in developing strategies for reaching and engaging different groups of gay and non-gay identified men.     

Receipt of public assistance during childhood and hypertension risk in adulthood

PurposeWe examined if receipt of public assistance during childhood lowered risk for hypertension by mid-life in a cohort of African Americans in the Southeastern United States.MethodsWe used multiple logistic regression models to assess the relationship between receipt of public assistance during childhood and adult hypertension among 405 male and 737 female adult participants enrolled between 1988 and 2001 in the Pitt County Study, a community-based prospective cohort study of African Americans in North Carolina. Statistical analyses were adjusted for child and adult sociodemographic measures as well as adult psychosocial and lifestyle factors.ResultsWomen who grew up in economically disadvantaged families and who received public assistance during childhood had a 66% decreased odds of hypertension by mid-life compared with women similarly disadvantaged in childhood but who did not receive public assistance, odds ratio = 0.34; 95% confidence interval: 0.14–0.83. No association was observed for African American men.ConclusionsReceipt of anti-poverty federal assistance during childhood was associated with reduced risk for hypertension by mid-life among African American women. It is possible that social expenditures on public assistance programs for families in need could produce long-term health benefits for children.     

纯母乳喂养小婴儿及其母亲维生素D水平相关性研究

目的 分析出生28~42 d出现佝偻病临床表现的纯母乳喂养儿的血清维生素D水平及与其母亲血维生素D水平的相关性,为预防婴儿早期营养性佝偻病的发生提供理论依据。方法 对2016年4月-2017年10月来西北妇女儿童医院儿童保健科正常体检的年龄为28~42 d、并且表现有佝偻病早期症状和(或)体征的119例纯母乳喂养儿及其母亲静脉血25-羟维生素D[25-(OH)D]进行相关性分析。结果 119例母亲血25-(OH)D＞30 ng/ml者15例(12.61%),≤30 ng/ml者104例(87.39%);孕期平均每日补充维生素D≥400 U的母亲19例,血25-(OH)D中位数为28.8 ng/ml,每日补充维生素D＜400 U母亲100例,血25-(OH)D中位数为16.1 ng/ml,两组血25-(OH)D差异有统计学意义(P<0.05);在119例婴儿中补充和未补充维生素D组的婴儿血25-(OH)D中位数分别为20.0 ng/ml和9.5 ng/ml,两者差异有统计学意义(P<0.05);婴儿血25-(OH)D与其母亲血清25-(OH)D水平呈正相关(r=0.349,P<0.01)。婴儿血25-(OH)D水平(＞20 ng/ml和≤20 ng/ml)与其出现佝偻病的症状、体征之间无统计学意义。结论 婴儿及其母亲维生素D整体处于不足水平,两者之间维生素D水平存在相关性。婴儿血25-(OH)D＞20 ng/ml并没有降低其发生营养性佝偻病的风险。建议母亲孕期应积极补充维生素D,同时提倡从新生儿一出生即开始补充维生素D,预防婴儿早期营养性佝偻病的发生。     

生命早期营养不良对成年后超重和肥胖患病危险影响的研究

目的 研究生命早期食物短缺及营养不良对成年后超重和肥胖患病危险的影响，对成年人慢性病的原因溯源，为国家制订妇女儿童营养改善政策提供科学依据。方法 应用2002年中国居民营养与健康状况调查资料，将三年自然灾害（1959—1961年）出生的研究对象作为受灾害影响人群，将灾害之后（1964年）出生的人群作为未受灾害影响人群（对照组），比较两组人群平均体重指数（BMI）及超重和肥胖患病率，并计算受灾害影响组人群患超重和肥胖的相对危险度（OR）。结果1959—1961年出生女性的BMI均值显著高于未受灾害影响的1964年出生的女性（P〈0．01），调整地区等因素后，1959—1961年出生女性的超重患病率均显著高于1964年出生的对照组女性（P〈0．05）；1959、1960年出生女性的肥胖患病率显著高于1964年出生的对照组女性（P〈0．05）。与1964年出生女性比较，生命早期受灾害影响的1959—1961年出生女性患超重的危险性分别增加28．9％（OR值95％CI为1．063～1．565）、37．2％（OR值95％CI为1．136～1．658）、35．2％（OR值95％CI为1．103～1．657），1959、1960年出生女性患肥胖的危险性分别增加46．5％（OR值95％CI为1．088～1．972）、39．6％（OR值95％CI为1．039～1．876）。而男性四组之间的平均BMI水平、超重和肥胖患病率的差异均无统计学意义（P〉0．05）。结论 生命早期遭受食物供应不足及营养不良可能会使成年后患超重和肥胖的危险性增加，制订适合国情的妇女、儿童营养改善政策，特别是控制新生儿低体重的有效措施对预防成年后慢性病的发生具有重要意义。     

Influences on healthcare-seeking during final illnesses of infants in under-resourced South African settings

To examine how health caregivers in under-resourced South African settings select from among the healthcare alternatives available to them during the final illness of their infants. Qualitative interviews were conducted with 39 caregivers of deceased infants in a rural community and an urban township. Nineteen local health providers and community leaders were also interviewed to ascertain opinions about local healthcare and other factors impacting healthcare-seeking choices. The framework analysis method guided qualitative analysis of data. Limited autonomy of caregivers in decision-making, lack of awareness of infant danger-signs, and identification of an externalizing cause of illness were important influences on healthcare-seeking during illnesses of infants in these settings. Health system factors relating to the performance of health workers and the accessibility and availability of services also influenced healthcare-seeking decisions. Although South African public-health services are free, the findings showed that poor families faced other financial constraints that impacted their access to healthcare. Often there was not one factor but a combination of factors occurring either concurrently or sequentially that determined whether, when, and from where outside healthcare was sought during final illnesses of infants. In addition to reducing health system barriers to healthcare, initiatives to improve timely and appropriate healthcare-seeking for sick infants must take into consideration ways to mitigate contextual problems, such as limited autonomy of caregivers in decision-making, and reconcile local explanatory models of childhood illnesses that may not encourage healthcare-seeking at allopathic services.     

儿童期营养状况对成年期健康状况影响的分析研究

目的探讨儿童青少年期营养状况对成年期健康状况的影响。方法使用"中国居民健康与营养调查"项目1991年到2006年间的6轮中在1991年调查时满2周岁、未满18周岁且每次调查时都保存在研究队列中并且有完整调查结果者。利用重复测量数据的混合效应模型分别研究男女对象从儿童期到成年期BMI的变化趋势。利用Cox比例风险模型,研究成年期发生高血压的风险概率。结果儿童期的消瘦、超重肥胖状态,对成年期显示出了轨迹性的影响。儿童期营养状况和父母教育水平是成年后发生高血压的危险因素,男性研究对象蛋白质摄入每增加1g,不发生高血压的风险比为0.991。女性研究对象能量摄入每增加1kcal/d,不发生高血压的风险比为0.9997。结论儿童期的营养健康状况表现出对成年期健康状况会发生持续影响的趋势。     

儿童期腹型肥胖对成年期腹型肥胖的影响

目的 探讨儿童期腹型肥胖对成年期腹型肥胖的影响。方法 基于"中国居民健康与营养调查"1993-2011年的研究数据，该调查要求研究对象在儿童期（7~17岁）和成年期（≥ 18岁）至少各随访一次。本研究选取儿童期第1次和成年期最后1次随访数据，最终纳入1 366名（男性占61.4%）研究对象。采用偏相关分析探讨儿童期腰围与成年期腰围的相关性。采用Cox回归模型分析儿童期腹型肥胖对成年期腹型肥胖的影响。结果 研究队列的中位随访时间为10.4年。36.4%（28/77）的儿童期腹型肥胖会持续至成年期。儿童期腰围与成年期的腰围存在中度关联（r=0.32，P<0.001）。与腰围正常儿童相比，腹型肥胖儿童在成年期发生腹型肥胖的风险增加（HR=7.54，95%CI：4.91~11.58）。结论 儿童期腹型肥胖显著增加成年期腹型肥胖的发生风险。     

Portion size effects on daily energy intake in low-income Hispanic and African American children and their mothers

BACKGROUND: Portion size influences children's energy intakes at meals, but effects on daily intake are unknown. OBJECTIVE: Effects of large portions on daily energy intake were tested in 5-y-old Hispanic and African American children from low-income families. Maternal food intake data were collected to evaluate familial susceptibility to portion size. DESIGN: A within-subjects experimental design with reference and large portion sizes was used in a study of 59 low-income Hispanic and African American preschool-aged children and their mothers. The portion size of 3 entrées (lunch, dinner, and breakfast) and an afternoon snack served during a 24-h period were of a reference size in one condition and doubled in the other condition. Portion sizes of other foods and beverages did not vary across conditions. Weighed food intake, anthropometric measures, and self-reported data were obtained. RESULTS: Doubling the portion size of several entrées and a snack served during a 24-h period increased energy intake from those foods by 23% (180 kcal) among children (P < 0.0001) and by 21% (270 kcal) among mothers (P < 0.0001). Child and maternal energy intakes from other foods for which portion size was not altered did not differ across conditions. Consequently, total energy intakes in the large-portion condition were 12% (P < 0.001) and 6% (P < 0.01) higher in children and mothers, respectively, than in the reference condition. Child and maternal intakes of the portion-manipulated foods were not correlated. CONCLUSIONS: Large portions may contribute to obesigenic dietary environments by promoting excess daily intakes among Hispanic and African American children.     

A criminological perspective on the prenatal abuse of substances during pregnancy and the link to child abuse in South Africa

The increase in drug abuse in South Africa has had major social implications in the country. Problems associated with drug dependency are poverty, unemployment, a heavier burden on the health care system, the disintegration of family systems and drug‐related crimes. Another area of concern is the link between drug abuse and child abuse. While child abuse is a crime in South Africa, the law does not consider the abuse of drugs during pregnancy as a crime and research on prenatal drug abuse as a form of child abuse is still limited. The issue of prenatal drug abuse as a crime is controversial, to say the least, since society tends to take two stances regarding the use and abuse of psychoactive substances during pregnancy. The harm reduction approach views prenatal drug abuse as a social welfare issue, whereas the punitive approach views the abuse of substances during pregnancy as a crime. Drug‐related child abuse cannot be looked at simplistically by merely assessing the physical damage sustained at birth. Harm done to the foetus may result in lifelong problems for the child. Literature on the subject indicates that drug abuse does cause harm to the foetus but that this level of harm in each case should be individualized. Some studies show that substance abuse treatment during pregnancy has been proved to be effective in both reducing the risk of drug exposure before birth and improving the drug user’s parenting skills. The paper highlights the situation in South Africa regarding the problem of drug dependency by pregnant mothers, and makes recommendations for further research on prenatal substance abuse. In addition, a call is made for the development of a drug policy dealing with drug dependency in the pregnant mother. Research is also necessary to determine whether drug policy should bring about the criminalization of substance abuse by pregnant women.     

The impact of violence on mothers’ and children’s needs during and after parental separation

Men’s violence against mothers and children as a context of separation significantly increases the immediate and longer‐term parenting needs of affected children, according to a South Australian study of single mothers’ transition and adaptation to living in a single parent household. Qualitative research interviews with 18 separated mothers who cited violence as the main reason for ending their relationship included mothers’ views on how the violence had impacted on their children. Mothers who had fled violence named continuing concerns with their children’s behaviour including withdrawal, anxiety and aggression, as well as the children’s continuing exposure to violence during contact with their father. These mothers reported that access to professionals to seek help with their concerns about their children’s needs was often inadequate.     

Rapid weight gain during infancy and obesity in young adulthood in a cohort of African Americans

BACKGROUND: Obesity is increasing in the United States. Evidence-based prevention is a public health priority and should target well-defined risk factors and critical periods. OBJECTIVE: We tested the hypothesis that rapid weight gain during early infancy is associated with obesity in African American young adults, a group at increased risk of obesity. DESIGN: A cohort of 300 African Americans born at full term was followed from birth to 20 y of age. A pattern of rapid weight gain was defined as an increase in weight-for-age > or = 1 SD between birth and 4 mo. RESULTS: About 29% of subjects had a pattern of rapid weight gain during infancy; 8% were obese [body mass index (in kg/m(2)) > or = 30] at age 20 y. One-third of the obesity at age 20 y could be attributed to rapid weight gain in the first 4 mo of life. After adjustment for confounding factors, subjects with rapid weight gain during early infancy were more likely to become obese at age 20 y (odds ratio = 5.22; 95% CI: 1.55, 17.6; P = 0.008). The results were confirmed by using a combination of body mass index and skinfold thickness (odds ratio = 6.72; 95% CI: 1.93, 23.4; P = 0.003). CONCLUSIONS: The results of the present study provide evidence that a pattern of rapid weight gain during early infancy is associated with obesity not only in childhood but also in young adulthood. We propose that early infancy constitutes a critical period for the development of obesity. Mechanisms of action and prevention strategies require further investigation.     

沧州市早产儿血清维生素D水平及其母亲认知情况调查分析

目的 了解沧州市早产儿血清维生素D水平及母亲对其影响因素,为防治早产儿佝偻病提供依据。 方法 选取沧州市人民医院158例早产儿进行血清25-(OH)D测定,对其母亲进行相关营养知识问卷调查。结果 早产儿普遍存在维生素D缺乏,维生素D缺乏比例为97.4%,与母亲维生素D认知水平、摄入水平低下密切相关,仅有6.9%的人补充了含维生素D的钙剂,而且服用不规律,未达到中国营养学会对妊娠期孕妇的推荐摄入量要求。 结论临床工作者加强对孕产妇的健康教育,使其认识到合理补充维生素D的重要性。     

Prevention of violence,abuse and neglect in early childhood: a review of the literature on research,policy and practice

Today, levels of mistreatment of children are internationally reported as having reached epidemic proportions. Throughout recorded history babies and young children have suffered acts of violence by parents, care providers and others. However, ‘some believe that, for the first time in history, we are beginning to face the true prevalence and significance of child abuse’ (Hopper, J. (2010). Child abuse. Statistics, research and resources. Retrieved December 10, 2011, from http://www.jimhopper.com). In this review of the literature, we will use ECVAN (early childhood violence, abuse and neglect) to refer to violence, abuse and neglect of children, birth to eight years, in harmony with the UN Convention on the Rights of the Child (1989). The review has been undertaken using a comprehensive series of data bases across all major disciplines which have regard to the heath, well-being and development of young children from birth to 8 years – and beyond wherever appropriate. The paper is guided by a socio-ecological model of contexts, participants and interactional complexity. There is no simple explanation for the abuse of young children – sometimes systemic in particular cultures – as there is no simple mechanism for the early identification of possible abusers and hence preventative practice. A wide range of contemporary research literature has enabled us to draw out significant issues related to abuse and abuse prevention. Central to all this we suggest is community engagement with the issue of child health, the establishment or refinement of public health policies and practices which through routine surveillance, parent support, education and multisectoral actions bring best practice to the fore within and on behalf of families and communities.     

Relationship of alcohol, cigarette, and drug abuse in adulthood with alcohol, cigarette and coffee consumption in childhood.

The age of beginning intake of alcohol, nicotine, and coffee in a group of young, male, alcohol and drug abusers was compared with a similar group of nonabusers. There was a significantly greater percentage of abusers than nonusers of hashish, amphetamines, opiates, and alcohol who reported that they commenced use of alcohol, cigarettes, and coffee at age 12 or younger. Data reported here and in other reports raise the question whether the withholding of alcohol, cigarettes, and coffee until age 13 or older will prevent adult abuse of alcohol and drugs by some persons.     

Pathways of care-seeking during fatal infant illnesses in under-resourced South African settings

The purpose of this study was to examine care-seeking during fatal infant illnesses in under-resourced South African settings to inform potential strategies for reducing infant mortality. We interviewed 22 caregivers of deceased infants in a rural community and 28 in an urban township. We also interviewed seven local leaders and 12 health providers to ascertain opinions about factors contributing to infant death. Despite the availability of free public health services in these settings, many caregivers utilized multiple sources of care including allopathic, indigenous and home treatments. Urban caregivers reported up to eight points of care while rural caregivers reported up to four points of care. The specific pathways taken and combinations of care varied, but many caregivers used other types of care shortly after presenting at public services, indicating dissatisfaction with the care they received. Many infants died despite caregivers' considerable efforts, pointing to critical deficiencies in the system of care serving these families. Initiatives that aim to improve assessment, management and referral practices by both allopathic and traditional providers (for example, through training and improved collaboration), and caregiver recognition of infant danger signs may reduce the high rate of infant death in these settings.     

Effects of combining public assistance and employment on mothers and their young children

One goal of recent welfare reform legislation is to move welfare-dependent mothers with young children into the paid labor force. However, prior to the new legislation, many welfare-dependent women were already engaged in employment activities. In this paper we examine whether child or maternal well-being is influenced by a mother's strategy of combining work and public assistance receipt in the late 1980s. Measures of well-being include children's cognitive test scores and behavior problems, parenting behavior, and maternal mental health, social support, and coping strategies collected when children were 2 1/2 to 3 years of age. Data from the Infant Health and Development Program (a sample of low birthweight, premature infants born in 8 sites in 1985) were used to identify low-income families (incomes under 200% of the poverty threshold; N = 525). Comparisons were made among mothers in the following groups: (a) Work Only, (b) Some Work-Some Welfare, (c) Some Work-No Welfare, (d) No Work-No Welfare, and (e) Welfare Only. Mothers in the Some Work-Some Welfare group had children with cognitive and behavioral scores similar to children whose mothers were in the Work Only group; these two groups also had similar mental health, social support, and coping scores. However, not working and receiving welfare (Welfare Only) was associated with negative cognitive and behavioral outcomes for children, with less stimulating home learning environments, lower maternal mental health, less social support, and more avoidant coping strategies. We discuss the proposition that welfare and work may be complementary rather than opposing strategies, in terms of putting together a family income package.