Anemia and Feeding Practices among Infants in Rural Shaanxi Province in China

Anemia is one of the most prevalent public health problems among infants and iron deficiency anemia has been related to many adverse consequences. The overall goal of this study is to examine the prevalence of anemia among infants in poor rural China and to identify correlates of anemia. In April 2013, we randomly sampled 948 infants aged 6–11 months living in 351 villages across 174 townships in nationally-designated poverty counties in rural areas of southern Shaanxi Province, China. Infants were administered a finger prick blood test for hemoglobin (Hb). Anthropometric measurement and household survey of demographic characteristics and feeding practices were conducted in the survey. We found that 54.3% of 6–11 month old infants in poor rural China are anemic, and 24.3% of sample infants suffer from moderate or severe anemia. We find that children still breastfed over 6 months of age had lower Hb concentrations and higher anemia prevalence than their non-breastfeeding counterparts (p < 0.01), and that children who had ever been formula-fed had significantly higher Hb concentrations and lower anemia prevalence than their non-formula-fed counterparts (p < 0.01). The results suggest the importance of iron supplementation or home fortification while breastfeeding.     

中国部分贫困地区5岁以下儿童死亡情况分析

利用卫—Ⅵ项目地区报告的1997年5岁以下儿童死亡资料,重点围绕死亡水平、死亡儿童年龄构成、死因构成及死亡地点加以分析,并对新生儿死亡率与部分服务利用指标进行了多元回归分析。结果显示,项目地区1997年报告的5岁以下儿童死亡率平均为52.0‰,各省较基线调查时均有不同程度下降,但仍远高于全国农村平均水平。5岁以下儿童死亡中,婴儿死亡占77.3％,婴儿死亡中,新生儿死亡占66.9％;儿童死于家中的构成比居第一位,死于乡卫生院居第二位。感染性疾病(肺炎和腹泻)以及与孕产期保健及产科质量密切相关的死因(新生儿窒息和早产或低出生体重)是婴儿死亡的主要原因,一半以上的1～4岁儿童死亡是由于肺炎和腹泻引起。多元回归分析显示,新生儿死亡率仅与住院分娩率有统计学关联,而与产前检查、新法接生、产后访视无统计学关联。结果提示:项目地区儿童死亡仍有很大降低的余地,在项目开展过程中,应进一步提高产前检查及产后访视的质量,促进住院分娩,增强村民识别儿童危险指征的能力与就医意识,同时加强医疗机构,特别是乡卫生院救治儿童疾病尤其是肺炎、腹泻的能力。     

中国部分贫困地区5岁以下儿童卫生服务提供状况分析

目的 了解中国部分贫困地区乡、村两级5岁以下儿童保健服务提供的质量状况。方法对卫生人员进行访谈、知识技能的考核、提供服务过程的观察及对就诊的5岁以下儿童家长进行访谈。结果 儿保人员的检查诊断以及治疗方面基本达到了项目要求；乡、村儿保人员的基本知识与技能掌握良好，服务态度令人满意。但分析也反映出，乡、村儿保人员在儿科检查的知识方面及村级儿保人员在掌握使用抗生素剂量的知识方面不能令人满意。结论 今后应继续提高贫困地区乡、村级儿童保健服务的质量，特别是要加强对乡级医生的培训。     

贫困农村地区健康风险管理中的整体社会网络分析——以贵州省某村庄为例

目的:了解农村贫困家庭所处的健康风险分担网络的结构与功能,以期为政府优化健康风险管理提供依据。方法:选取贵州省贵定县某村庄40户家庭作为样本,采用整体社会网络分析方法对其进行问卷调查,并用Ucinet6软件对数据进行分析处理。结果:将健康风险分担网络分为经济、情感和信息支持3个维度,被调查地的情感支持网络结构完整,经济支持网络的整体结构松散,联系紧密而又高效的信息支持网络结构在本次调研中并未出现。结论:以较完整的情感支持网络为基础,以在网络内传播有效的信息为手段,是政府利用社会网络进行健康风险管理的策略选择,最终农村贫困家庭的健康风险化解的主要途径仍然要依靠政府加快建立和完善正式的保障制度,非正式的健康风险分担机制作为补充,形成一个综合的健康风险管理体系。     

山东省、吉林省部分城乡妇女膳食营养水平调查

[目的 ]了解山东省和吉林省部分城乡妇女的膳食结构与营养水平。 [方法 ]应用食物复制法 ,要求调查对象收集 2 4h摄取的食物 ,以中国的食物成分表为计算依据 ,用 2 0 0 0年修订的“推荐营养素摄入量 (RNI)”为评价指标。 [结果 ]山东省济南市市区和章丘市农村妇女的膳食营养水平分别优于吉林省长春市市区和德惠县农村妇女 ;德惠县农村妇女膳食中热量和各种营养素几乎均低于RNI。 [结论 ]应及时调整膳食结构 ,改善城乡妇女的膳食营养状况     

贫困农村地区妇女的产时保健：问题与对策

本文对云南贫困农村地区产时保健存在的问题进行了分析,结果表明,贫困地区住院分娩率低,新法接生率低,且短期内难以大幅度提高;产时并发症发生率高;贫困妇女不愿意住院分娩。针对上述情况,可考虑提供住院分娩,在家由受训人员接生分娩和在家由家人接生分娩三级服务,并采取其他相应的配套措施以加强贫困地区的产时保健工作。     

居民膳食营养与健康状况研究

目的分析2009年浙江省杭州、金华地区居民膳食营养及健康状况。方法运用3天24小时回顾法对浙江省杭州、金华地区共2337名调查对象进行膳食调查,获得居民每日食物和营养素摄入量。对调查对象体检,包括身高、体重和血压测量。采集血样进行血红蛋白、血糖和血脂检测。结果浙江省两地居民成人超重患病率为29,92％,肥胖患病率为7．92％,低体重患病率为6．43％;高血压患病率为13．39％;缺铁性贫血患病率为17．42％。18-45岁育龄期妇女的贫血患病率比较高,是贫血高危人群;糖尿病检出率为3．67％;成人高胆固醇血症患病率为11．70％,高甘油三酯血症患病率为31．98％,低高密度脂蛋白血症患病率为1．39％。居民膳食谷类、蔬菜、水果、蛋类、水产摄人合理,豆类、奶类摄入不足,肉类、食用油摄入偏高。与推荐摄入量或适宜摄入量相比,脂肪、钠摄入过剩,钙摄入不足。结论两地居民膳食营养状况存在问题;肥胖、高血压、高血脂、糖尿病等问题依然需要关注。     

Emotional Eating in Adolescence: Effects of Emotion Regulation,Weight Status and Negative Body Image

Emotional eating is associated with an increased risk of binge eating, eating in the absence of hunger and obesity risk. While previous studies with children and adolescents suggest that emotion regulation may be a key predictor of this dysregulated eating behavior, little is known about what other factors may be influencing the link between emotional regulation and emotional eating in adolescence. This multi-method longitudinal study (n = 138) utilized linear regression models to examine associations between childhood emotion regulation, adolescent weight status and negative body image, and emotional eating at age 17. Emotion regulation predicted adolescent emotional eating and this link was moderated by weight status (β = 1.19, p < 0.01) and negative body image (β = −0.34, p < 0.01). Higher engagement in emotional eating was predicted by lower emotional regulation scores among normal-weight teens (β = −0.46, p < 0.001) but not among overweight/obese teens (β = 0.32, p > 0.10). Higher scores on emotion regulation were significantly associated with lower emotional eating at high (β = −1.59, p < 0.001) and low (β = −1.00, p < 0.01) levels of negative body image. Engagement in emotional eating was predicted by higher negative body image among overweight/obese teens only (β = 0.70, p < 0.001). Our findings show that while better childhood emotion regulation skills are associated with lower emotional eating, weight status and negative body image influence this link and should be considered as important foci in future interventions that aim to reduce emotional eating in adolescence.     

中国西南贫困农村地区社会性别与卫生公平若干问题分析

在过去的二十年里,中国的经济得到了巨大的发展,中国已经在千年发展目标(MDGS)的扶贫、基础教育和降低儿童死亡等方面取得了实质性的进展。但是,在千年发展目标的一些其他方面,中国仍面临着挑战,包括性别平等和妇女赋权、妇幼保健、性病/艾滋病防治等方面。由于卫生费用增长过快,贫困人口的健康公平性也受到影响,在这种情况下,农村妇女由于社会地位较低,获得的资源较少,她们的健康情况不容轻易乐观。有证据表明,农村妇女的产前保健、安全分娩、生殖道感染防治等主要卫生服务需求没有得到充分的满足[1]。文章以笔者对中国西南贫困农村地区两县的提高性别与卫生公平试点研究为基础,利用抽样调查资料,分析贫困农村地区社会性别与卫生公平方面的若干问题,为提高政府和卫生服务提供方的责任意识、促进社区参与、改善性别公平提供参考。     

Caregiver Social Status and Health-Related Quality of Life in Neurologically Impaired Children on Home Enteral Nutrition

We aimed to investigate the association between caregiver social status and health-related quality of life (HRQoL) in children with neurological impairment (NI) on home enteral nutrition (HEN). This was an ancillary study of a multicenter, cross-sectional study which explored HRQoL in 75 NI children on HEN. All the caregivers from the original cohort were contacted, and data on education level, occupation and marital status were collected. The association between social status and HRQoL was investigated using a multiple Poisson Generalized Linear Model. In total, 93 caregivers were included, responsible for the care of 71 children. The caregivers of four children of the original cohort did not answer the questionnaire. Mothers with high-level education presented lower HRQoL in comparison to mothers with low-level (β: −5.97; 95% CI −11.51, −0.10; p = 0.027) or medium-level education (β: 4.85; 95% CI −9.87, 0.53; p = 0.044). The analysis of the subgroup of cases in which the main caregiver was represented by both parents gave similar findings, with education level of the father being negatively correlated with HRQoL. Our data showed that higher education level may negatively affect quality of life of caregivers of NI children. This could be helpful in identifying at-risk families and addressing supportive efforts.     

内蒙古贫困地区儿童营养及贫血状况调查

目的了解内蒙古自治区贫困地区<6岁儿童营养不良和贫血现状及影响因素。方法采用多阶段整群随机抽样方法,选取贫困地区628名儿童为研究对象,通过面对面询问儿童监护人的方法进行调查,用Z评分法和血红蛋白值评价儿童营养和贫血状况。结果调查儿童中早产儿占3.5%,适时添加辅食者占4.1%,近2周有11.1%和15.3%的儿童患腹泻和上呼吸道疾病;儿童家庭年食品费用支出中位数为6000元;儿童生长迟缓率、低体重率、消瘦率、贫血患病率分别为3.8%,9.4%,9.2%和5.6%;不同年龄儿童低体重率、消瘦率和贫血患病率差异有统计学意义(P<0.05);多因素分析结果表明,食品费用支出、早产、适时添加辅食是儿童生长迟缓的影响因素,出生体重、食品费用支出、早产是儿童体重不足的影响因素,汉族、年龄是儿童消瘦的影响因素,近2周患上呼吸道疾病、年龄是儿童贫血的影响因素。结论内蒙古贫困地区儿童营养不良问题仍然存在,应针对各年龄段儿童制定相应措施,改善儿童营养健康状况。     

基于社会资本理论的农村慢性病综合管理模式分析

文章认为当前我国农村慢性病综合管理过程中忽视了农民的主体参与作用,没有切实结合农村生产生活方式的独有特点,致使实际干预效果有限。但社会资本理论的引入为农村慢性病综合管理模式的建立、完善和创新提供了一个新的解释切入点和应用起点。     

Correlates of Medical Nutrition Therapy and Cardiovascular Outcomes in Youth With Type 1 Diabetes

ObjectivesTo examine whether the types of medical nutrition therapies (MNTs) taught to and used by youth with type 1 diabetes (T1D) vary by sociodemographic characteristics and cardiovascular (CVD) risk factors.DesignCross-sectional study.SettingThe SEARCH for Diabetes in Youth study is a population-based cohort of individuals with clinical diagnosed diabetes.ParticipantsA total of 1,191 individuals with T1D.Main Outcome MeasuresTypes of MNTs and frequency of use.AnalysisBivariate analysis and multivariate linear regression (P < .05)ResultsMore race/ethnic minorities (vs whites), individuals with parents with less than a high school education (vs high school or higher education), and overweight/obese (vs underweight/normal weight) were taught additional MNTs. For underweight/normal weight individuals exclusively taught carbohydrate counting, those who used this approach “often” had lower hemoglobin A1c (8.6% vs 8.9%) and triglycerides (73.5 vs 84.1 mg/dL) than those who used it “sometimes/never.” “Often” use of additional MNTs beyond carbohydrate counting was not associated with better mean values for CVD risk factors.Conclusions and ImplicationsIn individuals with T1D, race/ethnic minorities, individuals with parents with less than a high school education, and overweight/obese individuals are taught more MNTs. Further research is needed to understand the effectiveness of the various MNTs on CVD risk factors, and to identify how to translate nutrition knowledge to behavior and metabolic status.     

Religion,Social Support,Food-Related Social Support,Diet, Nutrition,and Anthropometrics in Older Adults

Religion is an important aspect of many people's lives, especially for older adults. However, very little data exists about the relationships between religion, food-related social support, diet, nutrition, and anthropometrics in older U.S. adults. Social support may be a possible mechanism for religion-diet/nutrition relationships. This analysis examined these relationships in a sample of 424 older individuals. Religion was related to some dietary behaviors in men, and in dietary behaviors and anthropometrics in women. Religion's relationship with anthropometrics as well as diet in women may have been due to women's greater religiousness and involvement in food acquisition, preparation, and distribution in religious gatherings.     

Assets, Challenges, and the Potential of Technology for Nutrition Education in Rural Communities

ObjectiveTo examine assets of and challenges to getting adequate nutrition and physical activity among low-income rural residents, and the potential for technology to provide health education.MethodsEnvironmental scans and community stakeholder interviews were conducted in 5 rural counties in Maryland. During environmental scans, stakeholders guided tours around each county to explore community services and resources for nutrition, physical activity and technology. In-depth interviews with stakeholders (n = 58) focused on nutrition, physical activity, and technology issues.ResultsLow-income residents both benefit from and face challenges in rural settings. Besides attitude and knowledge barriers, lack of affordable resources and public transportation contributed to inattention to nutrition and physical activity. Stakeholders' reactions to a proposed Internet-based intervention were mostly favorable, but questions emerged about providing computers and Internet to individual families.Conclusions and ImplicationsInternet-based education may be a viable option to help low-income rural residents overcome barriers to nutrition and physical activity.     

中国部分贫困地区孕产妇保健服务提供质量状况分析

利用卫Ⅵ项目终末现场调查资料，重点围绕乡村级孕产妇保健服务提供的内容，数量，拥有相关的知识技能情况进行了分析。分析显示：产前检查，住院分娩，产后访视服务提供的数量及内容基本达到了项目要求，乡村妇保人员的基本知识与技能掌握良好，服务态度令被访妇女满意，但分析也反映出，乡村妇保人员对于产后血的紧急处理和护送转诊处理，妊高征（尤其是先兆子痫）的处理等相关知识还存在不足，分析结果提示，今后应加强贫困地区乡村级孕产妇保健服务质量的提高。     

全民普食碘盐后城乡居民碘营养状况调查

「目的」了解湖南省城镇和农村居民碘营养状况。「方法」按人口比例概率抽样确定３０个抽样单位,每个抽样单位分别对城镇和农村各抽一所小学,检测８～１０岁学生甲肿率、盐碘、尿碘。「结果」城镇和农村居民碘营养状况基本一致。「结论」盐碘、尿碘和甲肿率已达到碘缺乏病消除标准。但应重视孕产妇和０～２岁婴幼儿碘营养问题。