河北省某贫困县6～23月龄婴幼儿喂养指数

目的 了解某贫困县 6～23 月龄婴幼儿的喂养状况,为解决贫困地区婴幼儿喂养问题提供参考。方法 本数据来自2010 - 2012年全国居民营养与健康状况调查,选取某贫困县监测点221名6～23月龄婴幼儿作为研究对象,按月龄分为6 ～8、9～11和12～23月龄组;采用问卷调查与体格测量的方法收集婴幼儿及其母亲的基本信息、婴幼儿喂养行为和辅食添加等情况;应用喂养指数评价喂养状况,喂养指数体系建立参照ICFI评分标准。结果 共调查婴幼儿221名,ICFI平均得分为（10.6±3.6）分,ICFI合格率为 24.9 %;6～8月、9～11月和12～23月龄组婴幼儿的母乳喂养率分别为 90.3 %、84.5 % 和29.5 %;奶瓶喂养率分别为80.6 %、74.6 % 和 80.7 %;24 h辅食添加种类得分率分别为66.1 %、97.1 % 和 73.9 %;24小时辅食添加次数得分率分别为67.8 %、95.8 % 和 46.6 %。三个月龄组间ICFI合格率差异具统计学意义（χ2 = 58.532,P＜0.001）,不同性别婴幼儿ICFI合格率差异无统计学意义（χ2 = 1.855,P＞0.05）,其中6～8月龄和12～23月龄组ICFI合格率分别为22.6 %和2.3 %,均处于较低水平。结论 婴幼儿喂养合格率较低,缺乏正确辅食喂养的观念,且断乳后添加配方奶以及膳食多样性差是该贫困地区婴幼儿喂养的主要问题。     

Bounding the effects of food insecurity on children’s health outcomes

Previous research has estimated that food insecure children are more likely to suffer from a wide array of negative health outcomes than food secure children, leading many to claim that alleviating food insecurity would lead to better health outcomes. Identifying the causal impacts is problematic, however, given endogenous selection into food security status and potential mismeasurement of true food security status. Using recently developed nonparametric bounding methods and data from the 2001–2006 National Health and Nutritional Examination Survey (NHANES), we assess what can be identified about the effects of food insecurity on child health outcomes in the presence of nonrandom selection and nonclassical measurement error. Under relatively weak monotonicity assumptions, we can identify that food security has a statistically significant positive impact on favorable general health and being a healthy weight. Our work suggests that previous research has more likely underestimated than overestimated the causal impacts of food insecurity on health.     

安徽省酱腌菜生产企业食品卫生现状调查

目的研究安徽省酱腌菜食品生产企业的卫生学状况,为安徽省酱腌菜食品生产企业和产品卫生监督管理提供依据。方法在安徽省的8个市的30家酱腌菜生产企业进行抽样调查。结果酱腌菜食品生产企业存在使用不符合国家标准的食品添加剂、原辅料的索证率低等卫生问题。结论建议尽快国家出台《酱腌菜生产企业良好生产规范》,同时加大对酱腌菜食品生产企业的行政执法力度。     

海南省农村5岁以下儿童生长发育和营养状况分析

目的:了解海南省0～5岁儿童生长发育和营养状况,为促进儿童生长发育提供科学依据。方法:采用横断面研究和多阶段分层整群抽样的方法,在海南省18个市县抽取36个乡镇72个村庄共6 103名0～5岁儿童进行体检,用Z评分法对0～5岁儿童生长发育和营养状况进行生长发育和营养状况的评价。结果:不同性别和不同年龄段儿童的身长别体重、年龄别体重、年龄别身长Z评分均低于WHO标准,并且0～5个月儿童营养状况不良较明显。结论:海南省0～5岁儿童体格发育状况和近、远期营养状况较差,均低于WHO标准,建议采取有针对性措施改善儿童的营养状况并促进儿童体格生长发育。     

某儿童成长配方奶粉对微量营养素不足饲料喂养大鼠生长发育、骨量及钙吸收的影响

目的 探讨采用儿童成长配方奶粉(以下简称配方奶粉)进行营养加强或营养补充后,对大鼠生长发育及骨密度等指标的影响。方法 断乳SD大鼠雌雄各半62只随机分成3组,分别饲以微量营养素不足饲料、营养素加强饲料、营养素补充饲料,监测大鼠身长和体重,8周后进行钙吸收实验。12周后测定全身、脊柱、四肢骨密度(BMD)和骨矿量(BMC)。结果 与营养素不足组相比,营养素加强组及营养素补充组雌性大鼠体重增长加快(均P<0.05),全身、脊柱与四肢BMD增加(均P<0.05),全身及四肢BMC增加(均P<0.05),营养素补充组雌性大鼠身长增长加快(P<0.05);与营养素不足组相比,营养素补充组雄性体重及身长增长加快(均P<0.05),营养素加强组及营养素补充组雄性大鼠全身、脊柱及四肢BMD增加(均P<0.05),全身及四肢BMC增加(均P<0.05),营养素补充组雄性大鼠脊柱BMC增加(P<0.05)。与营养素不足组相比,营养素加强组及营养素补充组雌雄大鼠钙吸收率上升(均P<0.05)。与营养素加强组相比,营养素补充组雄性大鼠体重、身长增长加快,全身BMC及四肢BMD和BMC增加(均P<0.05)。结论 配方奶粉强化AIN-93G饲料或在微量营养素不足饲料中添加配方奶粉对营养素不良饲料喂养的大鼠其身长、体重、BMD、BMC及钙吸收率均有所改善。且在雄性大鼠中,在微量营养素不足饲料中添加配方奶粉可实现对强化饲料在体重增长、BMD、BMC等方面的追赶。     

兰州市7～13岁儿童生长发育与营养状况评价

目的:了解兰州市7～13岁儿童生长发育与营养状况,为儿童生长发育和卫生保健提供科学依据.方法:采用分层随机整群抽样方法随机抽取兰州市10所小学,对所有在校学生身高、体重、胸围等形态指标进行测量.结果:兰州市7～13岁儿童的生长发育符合一般发育规律,身高、体重、胸围等形态指标明显高于2005年全国汉族儿童生长发育水平(P＜0.01);儿童超重和肥胖率分别为9.64％和6.57％,其中男生分别为12.75％和8.58％,女生分别为6.21％和4.35％,不同性别在超重和肥胖率间差异有统计学意义(P＜0.01).结论:兰州市7～13岁儿童生长发育水平高于2005年全国,但营养状况不容乐观.     

2004-2016年四川省食物中毒事件调查报告质量评价

目的 评价四川省食物中毒事件调查报告质量,为提高调查能力和规范撰写调查报告提供科学依据。方法 根据突发公共卫生事件管理信息系统,收集2004-2016年四川省发病人数大于20人的食物中毒事件调查报告,计算调查报告完整率;依据相关指南,挑选关键指标对结案报告内容开展评价。结果 调查报告完整率为51.6%,有112起事件的结案报告纳入分析。仅17.9%报告明确了病例定义,34.8%报告计算了罹患率。50%以上的报告描述了潜伏期、时间分布特征、人群分布特征,仅17.9%报告绘制了发病曲线。仅有5份报告开展分析性流行病学研究。40.2%报告调查了可疑食物加工过程,27.7%报告分析了食品污染环节。90%以上的事件进行了实验室采样和检验工作,仅6.3%报告对检验结果进行了解释与分析。60.7%事件查明了致病因子,27.7%事件查明了致病食品。结论 四川省基层疾病预防控制机构食物中毒事件的流行病学调查能力及调查报告撰写质量有待进一步提高。     

Association between Parents’ Perceptions of Preschool Children’s Weight,Feeding Practices and Children’s Dietary Patterns: A Cross-Sectional Study in China

Parental perception of children’s weight may influence parents’ feeding practices, and in turn, child dietary intake and weight status; however, there is limited evidence generated for preschoolers. The aim of this cross-sectional study was to investigate associations between Chinese parents’ perceptions of child weight, feeding practices and preschoolers’ dietary patterns. Participants (1616 parent-child pairs) were recruited from six kindergartens in Hunan, China. Parents’ misperception, concern, and dissatisfaction on child weight were collected through a self-administered caregiver questionnaire. Parental feeding practices and children’s dietary intake were, respectively, assessed using the Child Feeding Questionnaire and a Food Frequency Questionnaire. Linear regression models were applied to analyze associations between parental weight perceptions, feeding practices, and preschooler’s dietary patterns. Associations between parents’ weight perceptions and dietary patterns were significant only among underweight children. Regardless of child weight status, parental weight underestimation and preference for a heavier child were positively associated with pressure-to-eat. Parental weight concern was positively associated with restriction in normal weight child, but this was not found in other weight groups. In conclusion, Parents’ misperception, concern, and dissatisfaction about child weight are associated with parents’ feeding practices and may influence preschoolers’ dietary quality, but the relationships vary by children’s actual weight status.     

‘Le moment de la lune’. An auto‐ethnographic tale of practice about menarche in a children’s hospital

Introduction: Auto‐ethnographic accounts can highlight unsaid moments of professional practice. In this case, my auto‐ethnographic tale ‘Le moment de la lune’ re‐inscribes subjugated knowledge about menstruation and occupational therapy practice in the era before adolescent wards. Methods: This fictional tale is written in direct dialogue with an article that was published in this journal at a particular point in my own career as an occupational therapist. In the tale I am ‘writing in’ what was not written about in my article and in occupational therapy generally. This ‘writing‐in’/re‐inscribing is the research method. Findings: My previous article ‘Normal spaces’ published in this journal in 1985, was organised around principles and generalities of youth‐specific practice. The original article had little locating the personal or evoking the body and a heavy reliance on the literature. Issues of gender and culture were largely absent, or, perhaps, ‘written out’. The corresponding tale of embodied sexuality, ‘Le moment de la lune’, articulates something of local complex practice and the particularity of individual therapeutic work to do with menstruation in self‐care. Discussion: Points of tension in ‘Normal spaces’ are elaborated and I explain how ‘Le moment de la lune’ problematises supporting menarche in a children’s hospital. Now practice has moved on with dedicated adolescent wards in all major children’s hospitals. Nevertheless, occupational therapy practice around issues of menstrual self‐management is still under‐documented. Writing about unspoken moments of practice can have ethical implications for expanding the ways occupational therapy practice can be written and understood.     

比较牛奶激发试验与血清特异性抗体诊断婴幼儿牛奶蛋白过敏的临床研究

目的 通过对牛奶激发试验与血清特异性抗体的比较,明确牛奶激发试验诊断婴幼儿牛奶蛋白过敏的临床意义。方法 收治苏州大学附属儿童医院2015年2-11月共57例疑似牛奶蛋白过敏的婴幼儿住院进行牛奶激发试验,并进行血常规检测,采用酶联免疫方法(ELISA)进行血清总IgE抗体、血清特异性牛奶蛋白IgE检测;采用免疫印迹法进行特异性牛奶蛋白IgG检测,比较和分析与激发结果的关系。结果 57例婴幼儿中牛奶激发试验阳性者占40.4%(23/34)。比较阳性组与阴性组的白细胞数、嗜酸性粒细胞比率、中性粒细胞比率、血小板计数变化,差异均无统计学意义(P＞0.05);仅有阳性组激发后中性粒细胞比率较激发前增高,差异有统计学意义(P=0.02);阳性组与阴性组的血清总IgE、特异性牛奶蛋白IgE及特异性牛奶蛋白IgG检测结果比较,差异无统计学意义(P＞0.05)。结论 对疑似牛奶蛋白过敏婴幼儿行血清总IgE及血清特异性牛奶蛋白IgE检测的临床意义不大,不推荐特异性牛奶蛋白IgG用于诊断牛奶蛋白过敏。应提倡牛奶激发试验应用于临床诊断婴幼儿牛奶蛋白过敏。     

吉林地区2009年玉米和稻谷卫生状况调查

目的 了解2009年吉林地区玉米、稻谷粮食卫生安全状况,为粮食卫生安全管理以及预防因粮食污染引发人群疾病提供参考依据.方法 按照吉林省《粮食质量调查工作方案》的要求,选择吉林市区及其周围5县(市)的45份稻谷和玉米样品进行重金属、农药残留和真菌毒素等卫生指标检测.结果 10份稻谷和7份玉米样品均检测出黄曲霉毒素B1;稻谷铅检出率100.00％,镉检出率97.37％,汞检出率68.42％,无机砷检出率为100.00％;玉米中检测脱氧雪镰刀菌烯醇均数为(38.286±16.782)μg/kg,检测赤霉烯酮均数为(1.100±0.100)μg/kg.结论 稻谷和玉米检测的卫生指标均未超过我国《粮食卫生标准》和《食品中农药最大残留限量》的限量标准,但砷含量的最高值达到了国家标准上限.建议粮食、卫生和农业部门应联合加强对吉林地区粮食砷污染的监管,并对人群健康危害进行评价.     

合肥市中小学学生生长发育状况及长期趋势的分析

目的 了解合肥市历年来中小学学生生长发育状况及长期趋势。方法 对历年合肥市学生体质健康调研资料进行对比分析。结果 从2000年合肥市学生体质健康调研资料可以看出：学生身高、体重、胸围三项身体形态指标随年龄增长而增长，且城市男生增长最快；城市和农村男生首次遗精平均年龄均为14．6岁，城市女生月经初潮平均年龄为12．6岁，而农村女生为13．3岁；将1957年、1979年和1991年合肥市学生体质健康调研资料与2000年资料比较发现：学生身高发育呈现一个长期增长的趋势，但近年来增长趋势渐缓；同时，学生身体素质有下降趋势。结论 学生身高发育呈现一个长期增长的趋势，但是学生身体素质呈现下降趋势，需引起高度重视。     

牛奶蛋白过敏婴儿血清IL-10及TGF-β水平的表达研究

目的 比较牛奶蛋白过敏婴儿血清IL-10及TGF-β水平,分析其在婴儿牛奶蛋白过敏中的作用。 方法 选取2018年1-6月在深圳市妇幼保健院住院经回避激发试验确诊为牛奶蛋白过敏患儿20例为牛奶蛋白过敏组,选取同期健康婴儿15例作为对照组,采用ELISA检测两组婴儿血清IL-10、TGF-β及IgG4水平,同时检测食物过敏原总IgE以及牛奶特异性IgE。 结果 牛奶蛋白过敏组总IgE＞200者5例,总IgE 100～200者2例,总IgE＜100者13例。血清IL-10、TGF-β及IgG4水平均较对照组降低(t=-3.130、-2.811、-3.463,P＜0.05)。在牛奶蛋白过敏组中,IgE阳性亚组与IgE阴性亚组IgG4水平比较,差异无统计学意义(t=-0.781,P＞0.05)。 结论 IL-10及TGF-β在婴儿牛奶蛋白过敏的发病中起重要作用,IgG4与IgE可能无关。动态观察IL-10及TGF-β水平变化,对尽早了解牛奶蛋白过敏婴儿疾病的转归或耐受有积极作用。     

Infant food marketing strategies undermine effective regulation of breast‐milk substitutes: trends in print advertising in Australia, 1950–2010

Objective : This study addresses the issue of whether voluntary industry regulation has altered companies’ marketing of breast‐milk substitutes in Australia since the adoption of the World Health Organization (WHO) International Code on the Marketing of Breast‐milk Substitutes 1981. Methods : Print advertisements marketing breast‐milk substitutes were systematically sampled from the Australian Women's Weekly (AWW) magazine and the Medical Journal of Australia (MJA) for the 61 years from 1950 to 2010. Results : Breast‐milk substitute advertising in both the MJA and the AWW peaked and began declining before the introduction of the WHO Code in 1981. Although there was almost no infant formula advertising in AWW after 1975–79, other breast‐milk substitute advertising has been increasing since 1992, in particular for baby food, toddler formula and food and brand promotion. Conclusions : Companies have adopted strategies to minimise the effects of the Code on sales and profit in Australia, including increasing toddler formula and food advertisements, increasing brand promotion to the public, and complying with more limited voluntary regulatory arrangements. Implications : Comprehensive regulation is urgently required to address changed marketing practices if it is to protect breastfeeding in Australia.     

The impact of hearing impairment on Aboriginal children’s school attendance in remote Northern Territory: a data linkage study

Objective: To investigate the association between hearing impairment (HI) and Year 1 school attendance in Aboriginal children in the Northern Territory (NT) of Australia. Methods: Observational cohort study (n=3,744) by analysing linked individual‐level information for Aboriginal children from the NT Government school attendance records, NT Perinatal Register and Remote Hearing Assessment dataset, and community level data for relative remoteness, socioeconomic disadvantage and housing crowdedness. Results : Children with unilateral hearing loss, mild HI and moderate or worse HI had significantly lower Year 1 attendance than those with normal hearing, attending 5.6 (95%CI, ?9.10 ～?2.10), 4.0 (95%CI, ?7.17 ～?0.90) and 6.1 (95%CI, ?10.71 ～?1.49) days fewer, respectively. Other variables that yielded significant association were: male gender, having attended preschool less than 20% of available days, speaking English as second language, twin birth and average household size >5. Conclusions: Aboriginal children with any level of HI are likely to have lower school attendance rates in Year 1 than their peers with normal hearing. Implications for public health: In this population, where the prevalence of otitis media and accompanying HI remains extremely high, the early detection and management of hearing loss on entry into primary school should be included in the measures to improve school attendance.     

河北省涞水县5～7月龄婴儿喂养行为研究

[目的]探讨要儿喂养行为及其与行为改变理论变量的关系,为儿童保健及喂养的干预研究提供参考.[方法]采用横断面研究,分析河北省涞水县526名5～7月龄婴儿的喂养状况,喂养行为及其与母亲知识、态度、准则信念和对周围人的依从等行为改变理论变量的关系. [结果]调查地区5月龄婴儿基本纯母乳喂养的比例为21.4%,从6月龄开始添加辅食的比例为39.2%,采取正确腹泻时喂养行为的占18.6%.Logistic回归分析结果显示,母亲具有正确态度(OR=1.30,95%CI:1.04～1.63),容易采取基本纯母乳喂养行为;要儿月龄越大(OR=12.32,95%CI:7.88～19.27),周围人对合理时间添加辅食知识越认同(OR=1.22,95%CI:1.05～1.40),婴儿在合理时间添加辅食的比例越高.独生子女(OR=1.69,95%CI:1.01～2.78)、母亲具有正确知识(OR=1.73,95%CI:1.02～2.93)和态度(OR=1.40,95%CI:1.03～1.91)、以及周围人对腹泻时正确喂养知识越认同(OR=1.25,95%CI:1.04～1.52),越容易在婴儿腹泻时采取正确行为. [结论]调查地区需加强5月龄纯母乳喂养、合理时间添加辅食以及腹泻时喂养的健康宣教,并对目标人群有所侧重.     

门诊共济背景下职工医保个人账户对卫生服务利用的影响——基于广东省三市的实证研究

目的：考察门诊共济背景下,职工医保个人账户对卫生服务利用的影响,并探究不同门诊统筹模式下二者的关系。方法：利用广州、深圳、肇庆职工医保参保人问卷调查数据,使用两部模型进行统计分析。结果：1 527名参保人个人账户余额均值为3 896.04元,门诊费用均值为585.63元,个人账户支出额均值为1 022.59元。总样本中,个人账户余额对门诊服务利用概率、门诊费用无影响;亚组中,肇庆市与门诊服务利用率相关,广州市与门诊费用呈正相关,深圳市与门诊服务利用无关。总样本中,个人账户余额对个人账户利用率无影响,但与个人账户支出额呈正相关;亚组中,三市与个人账户支出额均呈正相关。结论：门诊共济的背景下,个人账户余额对门诊服务利用无影响,但对个人账户利用产生影响。不同门诊统筹模式下,个人账户余额对卫生服务利用的影响存在差异。     

不同分娩方式婴儿的气质与智力及体格发育

目的:探讨不同分娩方式对婴儿气质类型、智能和体格发育的影响。方法:采用儿童气质问卷和DST儿童智能发育量表调查364名顺产与剖宫产婴儿的气质和智能发育,并分别测量其体重、身长,观察不同分娩方式对婴儿气质类型、智能和体格发育的影响。结果:两组婴儿的气质类型、智力、体重和身长之间无统计学上的差异(P>0.05)。结论:不同分娩方式对婴儿气质、体格及智力水平无显著影响。