GROWTH STATUS OF CHILDREN IN NORTH WEST SYRIA: A COMPARISON OF THREE RURAL LIVELIHOOD GROUPS

Undernutrition, a multifactorial phenomenon, has severe consequences. A study was conducted in Syria to compare nutritional differences in children from three rural livelihood groups: a “barley-livestock” group in the southeast (Khanasser), and an “olive/fruit tree” group and an “irrigation” group in the northwest of Aleppo province (Afrin). An anthropometric assessment was conducted on 541 rural children from 207 rural households and 199 urban children (2-10 years) from a middle income urban group. Comparisons were made with the 1978 NCHS/WHO (National Center for Health Statistics/ World Health Organization) international growth reference (WHO, 1995) and a -2 SD Z-score was used as a cut-off. Prevalence rates and mean Z-scores were calculated and independent sample t-tests used to compare totals and age-group disaggregated children (both boys and girls). Total stunting prevalence was highest in the barley-livestock group (23%) and lowest in the irrigation group (12.5%). Girls in the barley-livestock group displayed the highest rates of stunting (28.3%), followed by the boys (22%) and the girls (21.08%) in the olive/fruit tree group. The prevalence of underweight children was highest in the barley-livestock and olive/fruit tree livelihood groups (14.29% and 13.25%, respectively). Wasting rates were very low. The rates of stunting and underweight were higher in the barley-livestock and olive/fruit tree groups, as compared with the country-level estimates of 20.8 percent and 12.9 percent respectively, in children under five. A comparison of rates and mean scores indicates that, amongst rural groups, there was considerable variation: the barley-livestock and olive/fruit tree group, belonging to drier and poorer areas, exhibited higher rates and lower mean scores.     

我国5岁以下儿童及其母亲贫血状况及相关因素分析

目的 :　分析我国城市与农村 5岁以下儿童贫血状况、影响因素以及儿童贫血与母亲贫血的关系。方法 :　用 HEMOCUE光度计 ,测定指血血红蛋白。统计分析方法采用描述性与多因素 Logistic回归分析方法。结果 :　城市 5岁以下儿童贫血患病率 1 2 .2 8% ,农村 2 6.71 % ,全国平均 2 1 .67%。母亲贫血率城市 1 1 .8% ,农村 2 6.2 8% ,全国平均 2 0 .1 4%。通过 Logistic回归分析 ,1 8m以内婴幼儿贫血因素有 :哺母乳 OR=3 .92 ,母亲贫血 OR=2 .2 3 ,低出生体重 OR=1 .65 ,未加蛋类 OR=1 .3 8,未加奶类 OR=1 .5 4。 1 8～ 60个月儿童贫血因素有 :母亲贫血 OR=2 .74,哺母乳 OR=1 .87,生长迟缓 OR=1 .85 ,低体重 OR=1 .60。结论 :　我国农村 5岁以下儿童及母亲贫血率均高于城市。儿童贫血与低出生体重、辅食添加、哺母乳和母亲的营养状况都有密切关系。     

中国八省学前儿童的膳食摄入和生长发育状况

目的：了解我国八省在改革开放时期学龄前儿童的营养状况以及变化趋势。方法：以１９８９～１９９８年间开展的中美长期合作课题“中国健康与营养调查”的资料为依据，分别对１９８９年和１９９１年调查的１４３９名和１２６５名学前儿童进行分析。结果：八省学前儿童的膳食摄入和生长发育状况城市和县城明显优于郊区和农村。１９９１年儿童的营养素摄入和生长发育状况比１９８９年得到明显改善。而儿童营养状况性别间差异不明显。不同年龄的学前儿童营养素摄入和生长发育状况有明显差异，其中１岁以下的儿童生长发育状况较好，１岁以上儿童的营养素摄入和生长发育状况较差。结论：我国八省学前儿童的膳食和生长发育状况仍有待进一步改善，特别在农村地区，应受到政府部门和营养工作者的重视     

THE STATUS OF RURAL NURSING IN AUSTRALIA: A REVIEW

ABSTRACT: While much has been written about the practice roles of remote area nurses in Australia, less is known about the role and function of the rural nurse. The majority of rural nurses practise in rural hospitals, community health settings and nursing homes. In contrast, the remote area nurses work setting is generally involved with Aboriginal and Torres Strait Islander primary health care services. Rural nurses' practice setting is usually located in a larger organisation than that of the remote area nurse. There is usually at least one medical practitioner in the town or on-call close by. Nurses who are employed in the smaller rural hospitals have what has been described as a 'specialist generalist' role. This means that they are required to be multi-skilled and competent in a wide range of nursing and non-nursing practice. In contrast, nurses who work in base/provincial hospitals, may have either a generalist or specialist role. This paper provides a summary of the literature on Australian rural nurses and develops some of the themes contained therein.     

河南省农村地区5岁以下儿童营养状况分析

[目的]分析河南省农村地区5岁以下儿童营养状况,为制定农村地区营养干预措施提供科学依据.[方法]采用横断面调查设计和分层多阶段整群随机抽样的方法,抽取1195名5岁以下儿童,测量身高(身长)和体重,采用2006年WHO儿童生长发育标准,用Z评分法评价儿童的身高体重发育状况. [结果]河南省农村地区5岁以下儿童平均身高为90.44 cm,平均体重为12.99 kg.生长迟缓、低体重的发生率分别为7.62％、3.18％,均低于全国平均水平.消瘦率是4.10％,高于全国平均水平.[结论]河南省农村地区5岁以下儿童的营养状况较好,但仍存在营养不良,应有针对性地加以改善.     

十堰市城区3-6岁儿童维生素A营养状况分析及比较

目的了解十堰市3-6岁儿童维生素A(VA)营养状况,将结果与湖北省往年的调查结果相比较,并对VA缺乏者进行干预。方法选取十堰市某幼儿园中班和大班的所有儿童进行膳食调查,健康检查和VA水平检测,对血清视黄醇浓度<1.05 mol/L的儿童给予口服VA补充剂,三个月后再次抽血检测血清中视黄醇浓度。结果十堰市3-6岁儿童VA平均水平为1.27±0.40 mol/L,亚临床缺乏(<0.07 mol/L)占5.3%,可疑亚临床缺乏(0.7-1.05 mol/L)占21.4%,与往年的调查结果比较有一定改善,但是并不显著。膳食调查发现VA摄入不足,视黄醇当量占供给量77.8%。口服VA补充剂三个月后再次检测发现血清视黄醇浓度明显上升,补充前后的差异有统计学意义(paired t-test,t=14.86,P<0.001)。结论儿童VA的营养状况并没用显著改善,提示我们发展经济的同时,也要加强营养宣教,普及婴幼儿科学喂养知识,降低儿童VA亚临床缺乏患病率,进一步提高儿童健康水平。     

河北省农村2岁幼儿营养状况和体格发育状况分析

[目的]了解农村2岁幼儿营养状况和体格发育情况。[方法]选择河北省石家庄市某农村2岁左右儿童36名(19～31个月,男女各18名)为调查对象,采用称重法进行膳食调查,并进行体格测量和血红蛋白检测。[结果]农村2岁幼儿能量、蛋白以及维生素摄入量偏低。低体重发生率为11.1%,生长发育迟缓率为11.1%,贫血患病率为36.1%。[结论]农村2岁幼儿营养状况较差,生长迟缓、低体重发生率和贫血患病率较高。     

苏北农村卫生需求状况与卫生人力资源调查分析

[目的]探讨苏北农村卫生需求状况与卫生人力资源,为建立合理的农村医疗保障制度提供依据.[方法]典型抽样、入户调查、描述性统计分析.[结果]农村居民卫生服务需求与利用存在“三高五低”现象.从卫生资源人力结构上看,学历结构以中专学历最多,占51%.职称结构以初级职称为主,占35%,初级及以下职称占65%.说明本地区卫生资源相对贫乏,居民卫生服务利用不足,结构不合理.[结论]苏北地区农村经济相对落后,应从医疗保障制度加大对该地区的卫生扶持,解决该地区农民因病致贫,因病返贫的问题.     

A LONGITUDINAL STUDY OF GROWTH USING SKELETAL AGE IN CHILDREN AND ADOLESCENTS

This article reports the relationship of skeletal age to body height in singletons and twins, sexual develo opment, menarche, serum levels of growth hormone, testosterone, DHEAS, E_2, LH,FSH and IQ etc. It has ben proved that skeletal age can be widely applied in the study of various aspects of child and adolescent growth up to maturity.     

健康儿童血浆游离氨基酸与体格生长的研究

本文采用丹酰氯聚酰胺薄层分析法研究了65名3～7岁健康儿童的血浆游离氨基酸,研究其与体格生长的关系.结果表明:赖氨酸,甘氨酸,羟脯氨酸,与年龄别身高、体重和身高别体重百分位成正相关.并有显著意义.异亮氨酸.赖氨酸.甘氨酸在营养优组中显著高于差组.提示血浆游离氨基酸对健康学龄前儿童的体格生长发挥重要的生理作用.     

A COMPARISON OF MEDICAL STUDENT EXPERIENCES IN RURAL SPECIALTY AND METROPOLITAN TEACHING HOSPITAL PRACTICE

ABSTRACT: One factor in solving the rural medical workforce shortage is to foster student interest by greater exposure to rural medicine. However, many medical school teachers are concerned that this may cause students to be disadvantaged by missing core lectures, tutorials and ward rounds in the setting of the high quality of teaching hospital medicine. This paper compares the rural specialty experience of 28 fifth-year volunteers with 28 'pairs' who remained in the city teaching hospitals. Rural students saw double the number of medical conditions, assisted in or performed six times as many procedures, and all but three students were sure that they had a better educational experience than their city counterparts. This is a strong academic argument for greater medical student exposure to rural specialty practice.     

农村儿童铁缺乏症的防治研究

作者对江苏省江都县农村3月到6岁儿童进行铁缺乏症的防治研究。结果表明,贫血患病率达51.2％,患病高峰年龄为6月～2岁儿童.缺铁性贫血占总贫血患病率的83.1％.铁缺乏症患病率为77.5％,缺铁性贫血占铁缺乏症的54.9％。通过1年半大规模的群防群治,贫血及铁缺乏症患病率明显降低。     

农村3岁以下儿童健康影响因素分析

对四川仁寿县4个乡7岁以下的儿童进行健康普查,发现3岁以下儿童三种营养性疾病和两种常见病(肺炎、腹泻)的发病率高于其它年龄儿童,随机抽出3岁以下儿童584例进行健康影响因素的调查。结果表明:出生体重小于2.5kg,四月内非母乳喂养,母亲文盲,出生产次>3次等因素对小儿的上述疾病分别有所影响,且上述疾病及这些影响因素与小儿现体重关系密切。     

OBSTETRIC OUTCOMES IN AN ABORIGINAL COMMUNITY: A COMPARISON WITH THE SURROUNDING RURAL AREA

Antenatal, intranatal and postnatal features of all Aboriginal women who lived at Cherbourg Aboriginal Community and delivered during 1990, 1991 and 1992 were compared with all non-Aboriginal women in the same rural area who delivered at Kingaroy Base Hospital during 1991. Almost all the Aboriginal women also delivered at Kingaroy. The data for 146 Aboriginal and 139 non-Aboriginal women were taken from the hospital records. The Aboriginal women were generally younger at delivery (Aboriginal 35% younger than 20 years vs non-Aboriginal 12%), made their first antenatal visit later (Aboriginal 49% after 20 weeks vs non-Aboriginal 10%) and made fewer antenatal visits (Aboriginal 43% < 4 visits vs non-Aboriginal 2% < 4 visits). They were more likely to be anaemic (Aboriginal 65% < 110 g/L vs non-Aboriginal 13% < 110 g/L), have a sexually transmitted disease (STD; Aboriginal 13% vs non-Aboriginal 2%) and drink alcohol (Aboriginal 54% vs non-Aboriginal 32%). After making an allowance for repeat Caesarean sections, there was no significant difference in the proportion of abnormal deliveries, but birthweights of Aboriginal infants were lower. Postnatally, the only significant difference between the two groups was a lower incidence of jaundice in Aboriginal infants. Multifactorial analysis showed that birthweights were significantly decreased by primagravidy, alcohol intake and STD. It is likely that the effects of STD and alcohol on birthweight were due to associated lifestyle factors. When these factors were allowed for, ethnic background had no significant effect on birthweight.     

某区外来流动儿童免疫规划现状及影响因素调查

[目的]了解绍兴市越城区外来流动儿童免疫规划状况及影响因素。[方法]在全区各镇（街道）抽取外来人口较集中的1～2个社区（村）中的1—7周岁273名流动儿童和273名常住儿童进行现况调查。[结果]流动儿童的建卡、建证率，卡介苗、口服脊髓灰质炎疫苗、百白破联合疫苗、麻疹疫苗、乙肝疫苗接种率和五苗全程覆盖率，均非常显著地低于常住儿童的相应指标（x^2分别为96．49、99．27、107．32、82．94、91．42、90．47、63．64、143．65，P均〈0．005）；流动儿童未接种的主要原因：不知道要接种的占33．88％。[结论]提示城市免疫规划应重视流动儿童，加大对流动人群的免疫规划宣传力度。提高对免疫规划的知晓率，尤其是对户籍在外省的流动儿童和居住在乡村的流动儿童的免疫规划管理。     

汶川地震灾后农村老年人生存质量现状试点调查

[目的]了解汶川地震灾区两年后农村老年人的生存质量现况及其影响因素。[方法]采用世界卫生组织生存质量测定量表简表(中文版),对地震灾区绵竹市的东北镇、西南镇及九龙镇的600名农村老年人的生存质量进行测量,同时收集他们的一般信息。[结果]绵竹市农村老年人生存质量总体评价得分为(13.4±1.5)分,与全国常模相比较低(P﹤0.05)。影响生存质量的因素主要包括患病状况、收入、婚姻状况、家庭关系和亲人残疾情况,其中影响最大的因素分别是患病状况和收入。[结论]地震灾区农村老年人的生存质量较差,应得到较高的关注。     

北京市0～24月儿童体格发育纵向研究

作者对1987年12月1～10日出生的80例健康新生儿进行纵向监测.结果提示,超过出生2倍和3倍的体重在生后3和11个月时出现,超出生时1.5倍身长在生后11～12个月时出现.最大速率在生后第一年,其顺位,体重为2月>3月>1月,身长和头围为1月>2月>3月。生后第3个月是婴儿期生长的第一个关键时期.结果还表明3种不同喂养方式的小儿在1岁内各月龄的体重和身长的均值无差异。前囱闭合月龄为10～22月,出牙月龄为4～12月。     

某部队幼儿园3~7岁儿童生长发育评价

目的了解某部队幼儿园学龄前儿童的生长发育状况,为指导学龄前儿童的保健工作提供依据。方法对某部队幼儿园306名3~7岁学龄前儿童进行体格检查,并采用Z分法进行相关评价和分析。结果各年龄组男童、女童的身高、体质量与2005年全国标准相比较,6~7岁年龄组差异具有统计学意义。采用Z分法对身高、体质量和头围3个生长发育指标进行分级评价表明,每一项生长发育指标均以中等水平所占比例最高。肥胖者和超重者在各个年龄组中均有发生,并随着年龄的增长呈现逐渐升高的趋势,其中在6~7岁的儿童中发生率最高,分别达到30.8%和20.5%。消瘦者和低体质量者除了在6~7岁年龄组中未出现外,3~4岁、4~5岁、5~6岁3个年龄组中均有发生,并随着年龄的增长呈现逐渐降低的趋势,其中在3~4岁年龄组中发生率均为2.4%。在3~4岁和4~5岁年龄组中存在生长迟缓的现象,分别占2.4%和2.2%。结论该部队幼儿园中的3~7岁学龄前儿童总体生长发育情况良好,但仍存在营养过剩和营养不良等问题,这是今后部队幼儿园儿童保健工作的重点。