计算机多指标预测胎儿体重的研究

为研究用计算机多指标预测胎儿体重 (PW)的可行性 ,应用 B超测量 1 0 0 0例胎儿的腹围 (AC)、小脑横径 (TCD)、双顶径 (BPD)及股骨长度 (FL ) ,同时临床测量孕妇的腹围 (PAC)、宫高 (FUH) ,建立胎儿体重预测模型 ,用 AHP法计算出各层、各因素的权值 ,结合评价集合形成 U×V表 ,将待评资料逐级变换后 ,得出综合评判数学模型 ,用 C语言和数据库混合编程。经 1 0 0 0例临床验证 ,符合率达 91 .5% ,相对误差 <1 0 %者占 92 .5%。说明计算机多指标预测胎儿体重准确率高 ,有较好的临床实用价值     

加权平均法在膳食评价中的应用

本文选择了与儿童营养相关的21种因素和与膳食管理有关的2个因素,通过专家评分法确定各因素的权值,利用加权平均法定量地对膳食进行综合评判。既有总体评价,又有各营养素单项评价,较好地解决了儿童营养及膳食管理各因素的关系,改变了传统的评价法,为膳食调查提供了一种新的评价方法。     

原发性高血压遗传方式的研究

采用家系分析和分离分析方法,对104个原发性高血压(EHT)家系进行了分析,结果表明,EHT患者家族中存在明显的垂直传递现象,男、女患者性比无显著性差异,(?)×(?)婚配型家庭中患病同胞与正常同胞符合1:1的分离比,第二代患者呈现早发现象。分离分析中,A×U、U×U婚配型都接受显性遗传分离比的假设,U×U婚配型中存在散发病例。所得结果均支持EHT为迟发性常染色体显性遗传,不完全外显。     

家族性Ⅱ型糖尿病核心家系的遗传方式分析

目的　对 1992～ 1998年门诊及住院的家族性Ⅱ型糖尿病 (DM)患者 177个大家系及其中 2 14个核心家系的遗传方式进行研究 ,以探讨该病的遗传学特点。方法　采用家系分析、分离分析、多基因分析和阈值模式分析的方法 ,对家族性Ⅱ型DM大家系及核心家系进行研究。结果　 177个大家系的Ⅱ型DM的遗传度为 143.0 6 %± 3 .3% ,提示在这些家系中有一个显性主基因存在。 2 14个核心家系中 ,U×U婚配型的子代分离比为 0 .470 3,U×A婚配型的分离比为 0 .483 8,A×A婚配型的分离比为 0 .6 712。多基因分析和分离分析显示 ,U×A家系不符合多基因遗传和常染色体隐性(AR)遗传 ,符合常染色体显性 (AD)遗传 ,U×U家系既不符合AD遗传 ,又不符合AR遗传。结论　家族性Ⅱ型DM的遗传方式表现遗传异质性 ,在部分家系中存在AD遗传的亚型     

五岁以下儿童营养状况横断面调查时的群体评价

了解一个地区儿童的营养状况,及时发现存在的营养问题,对于改善该地区儿童的营养,促进生长发育有着重要意义。本文就常用的儿童营养状况的衡量指标、各指标的特点和指标间的相互关系,常用的儿童营养状况的群体评价方法及各方法的优缺点等几个方面进行了综述。提示①在进行儿童营养状况群体评价时要根据研究问题、研究群体和收集资料的特点合理地选择营养状况衡量指标;②群体评价时不仅要通过界值点的判断关注那些受影响较大的儿童,而且同时要了解儿童群体的整体营养水平。Z值法是能兼顾这两方面评价的较好方法;③NCHS／WHO参考标准仍旧是较为理想的参考标准,目前应当注意的是正确合理地使用该标准。     

五岁以下儿童营养状况横断面调查时的群体评价

了解一个地区儿童的营养状况,及时发现存在的营养问题,对于改善该地区儿童的营养,促进生长发育有着重要意义.本文就常用的儿童营养状况的衡量指标、各指标的特点和指标间的相互关系,常用的儿童营养状况的群体评价方法及各方法的优缺点等几个方面进行了综述.提示①在进行儿童营养状况群体评价时要根据研究问题、研究群体和收集资料的特点合理地选择营养状况的衡量指标;②群体评价时不仅要通过界值点的判断关注那些受影响较大的儿童,而且同时要了解儿童群体的整体营养水平.Z值法是能兼顾这两方面评价的较好方法;③NCHS/WHO参考标准仍旧是较为理想的参考标准,目前应当注意的是正确合理地使用该标准.     

1—4岁儿童营养指数与皮褶厚度的相关分析

我国目前经常采用身高、体重指数、体重、营养指数、上臂围度、皮褶厚度等评价儿童营养状况。这些指标基本上反映了儿童的营养状况，但均不全面。本文分析小年龄组儿童营养指数与皮褶厚度的关系，以期寻找小年龄组儿童营养评价各指数间相互关系，为能准确地评价儿童营养状况提供依据。1对象与方法1．1对象选取中国医科大学第二幼儿园1～4岁213名发育正常儿童为观察对象。1．2方法1．2．1皮褶厚度测量采用Harpenden式卡钳，读表最小刻度0．1mm，钳头面积15×6mm2。压强稳定在10g／mm，测量范围0～40mm，每次使用前经过校准。1．2．2测量方法…     

某县贫困地区儿童营养改善项目营养包服用影响因素分析

目的了解云南省某县贫困地区儿童营养改善项目营养包服用情况,并分析影响因素,为下一步制定干预措施提供依据。方法通过乡村医生对儿童服用营养包的情况进行监测,调查员对家长、村妇幼医生和村妇代会主任进行访谈,采用单因素、多因素及Cox回归分析,了解影响儿童服用营养包的因素。结果全县2013年3-9月知情同意服用营养包的儿童5824名,其中5072名儿童能持续服用营养包,752名儿童提前停服。单因素分析结果表明,母亲年龄、文化程度、民族及父亲年龄、文化程度、民族,以及出生体重、儿童主要照顾者等8个因素与儿童服用营养包有关。多因素分析结果提示,母亲文化程度越高越有利于儿童持续服用营养包,低出生体重儿是促进儿童持续服用营养包的有利因素;与汉族母亲比较,母亲为少数民族是儿童持续服用营养包的不利因素。结论儿童提前停服营养包与多种因素有关,应针对相关因素采取综合干预措施,减少儿童提前停服营养包。     

集体儿童10年体格发育变化趋势分析

为了解我市集体儿童体格发育状况,进一步做好抚幼机构的营养指导及卫生保健工作,现将绍兴市区１９９０年到１９９９年集体儿童体格发育状况作以下比较分析。１资料和方法 每年“六一”前夕,对绍兴市区各抚幼园的集体儿童进行健康检查,采用苏州市东吴医用电子仪器厂生产的儿童保健电脑进行生长发育评价,（为便于比较,１９９９年仍采用ＷＥＲ－ＥＡ型保健电脑评价）身高≥－１ｓ为达标,体重＜－２ｓ为中重度营养不良,体重≥２ｓ为超重。２结果２．１逐年男女儿童身高、体重达标率比较见表１。 从表１可见,１０年间绍兴市区集体儿童身…     

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.     

Explaining school children's fruit and vegetable consumption: the contributions of availability, accessibility, exposure, parental consumption and habit in addition to psychosocial factors

We studied the contributions of parental fruit and vegetable (F&V) consumption, availability and accessibility of F&V in the home, exposure to F&V, and habit, in addition to psychosocial factors, in explaining F&V consumption in 4-12-year-old children. Furthermore, we looked for effect modification by ethnicity and gender. Children's parents (n = 1739) completed a questionnaire assessing psychosocial and additional factors regarding their children's F&V consumption. Consumption was assessed by a food-frequency questionnaire. The model explained the children's F&V consumption better when the additional factors were included (R2 = .49 and R2 = .50 for fruit consumption, and R2 = .33 and R2 = .33 for vegetable consumption). Stepwise multi-level regression analyses revealed that habit was the most influential correlate of F&V consumption. It is concluded that nutrition education interventions aimed at stimulating F&V consumption among children should take into account that the consumption of fruit and that of vegetables are clearly different behaviors, with different influencing factors for boys and girls and children of native or non-native background. Furthermore, interventions to increase F&V consumption should include strategies aimed at making these behaviors habitual.     

The effects of television advertisements for junk food versus nutritious food on children's food attitudes and preferences

The effects of television advertisements for junk food versus nutritious food on children's food attitudes and preferences .
Dixon H.G. , Scully M.L. , Wakefield M.A. , White V.M. & Crawford D.A. ( 2007 ) Social Science and Medicine , 65 , 1311 – 1323 .
DOI: 10.1016/j.socscimed.2007.05.011.     

The effects of television advertisements for junk food versus nutritious food on children's food attitudes and preferences

Television (TV) food advertising has attracted criticism for its potential role in promoting unhealthy dietary practices among children. Content analyses indicate junk food advertising is prevalent on Australian children's TV; healthy eating is rarely promoted. This paper presents (a) a cross-sectional survey examining associations between children's regular TV viewing habits and their food-related attitudes and behaviour; and (b) an experiment assessing the impact of varying combinations of TV advertisements (ads) for unhealthy and healthy foods on children's dietary knowledge, attitudes and intentions. The experimental conditions simulated possible models for regulating food ads on children's TV. Participants were 919 grade five and six students from schools in Melbourne, Australia. The survey showed that heavier TV use and more frequent commercial TV viewing were independently associated with more positive attitudes toward junk food; heavier TV use was also independently associated with higher reported junk food consumption. The experiment found that ads for nutritious foods promote selected positive attitudes and beliefs concerning these foods. Findings are discussed in light of methodological issues in media effects research and their implications for policy and practice. It is concluded that changing the food advertising environment on children's TV to one where nutritious foods are promoted and junk foods are relatively unrepresented would help to normalize and reinforce healthy eating.     

受艾滋病影响的儿童社区关怀干预研究进展

对受艾滋病影响儿童的关怀干预研究应遵循联合国儿童基金会和联合国艾滋病规划署提出的五项基本策略,在营养与卫生服务、教育、心理情感以及经济等方面对儿童提供支持和帮助。干预研究的评价采用参与式督导与评估的方法,鼓励儿童参与。结合中国实际情况,建议在受艾滋病影响的儿童规模、儿童健康状况的影响因素、干预模式、儿童健康状况评价指标等方面进行深入的研究。     

Commentary: facing the challenge of gene-environment interaction: the two-by-four table and beyond

As a result of the Human Genome Project, epidemiologists can study thousands of genes and their interaction with the environment. The challenge is how to best present and analyze such studies of multiple genetic and environmental factors. The authors suggest emphasizing the fundamental core of gene-environment interaction-the separate assessment of the effects of individual and joint risk factors. In the simple analysis of one genotype and an exposure (both dichotomous), such study can be summarized in a two-by-four table. The advantages of such a table for data presentation and analysis are many: The table displays the data efficiently and highlights sample size issues; it allows for evaluation of the independent and joint roles of genotype and exposure on disease risk; and it emphasizes effect estimation over model testing. Researchers can easily estimate relative risks and attributable fractions and test different models of interaction. The two-by-four table is a useful tool for presenting, analyzing, and synthesizing data on gene-environment interaction. To highlight the role of gene-environment interaction in disease causation, the authors propose that the two-by-four table is the fundamental unit of epidemiologic analysis.     

Measuring the impact of a school food programme on food sales in New Zealand

The School Food Programme of the Heart Foundation of New Zealandis a health promotion programme which aims to improve the healthof the school community by increasing children's access to foodswhich are nutritious, safe and sufficient in quantity. The programmewas introduced to New Zealand primary and secondary schoolsin 1989. Outcome evaluation undertaken in 1992 concluded thatthe programme had a positive impact in creating healthier schoolenvironments. As a result, programme implementation continued.The objective of this study was to identify whether the schoolfood service has altered, as a result of programme implementation.The main outcome measures were food service staff reports onchanges in sales of specific food items. Two hundred schoolsout of a total of 2730 schools in New Zealand were successfulin achieving Heartbeat Awards by meeting all the programme criteriabetween January 1996 and December 1997. Thirty-two schools achievedawards in successive years, and data from all 232 awards wereincluded in the analysis. Schools were categorized accordingto the number of years that they had participated in the programme.Increasing participation in the programme was found to be significantlyassociated with a reduction in the sales of doughnuts and creambuns (p = 0.01), pies and sausage rolls (p = 0.009), crisps(p = 0.0065) and sweets (p = 0.004), and an increase in salesof sandwiches and filled rolls (p = 0.0005). Other foods allshowed changes in a favourable direction, although the proportionsdid not change significantly over the years. Limitations ofthis study include self-selection bias and the use of self-reporteddata. However, the results of the evaluation indicate that theSchool Food Programme is successful in achieving its aim ofinfluencing the school environment by improving healthy foodchoices, and that improvements have continued over 7 years inthe programme.     

有序结果变量回归及其应用

目的：介绍有序结果变量回归（Ordinal Regression）的基本原理,SPSS10．0的Ordinal Regression过程和确定“最佳”模型的方法。方法：介绍有序结果变量回归模型结构和模型评估指标,用一个实例和SPSS10．0的Ordinal Regression过程,说明有序结果变量回归的操作和结果分析。结果：列出五种连接函数两种模型的各种评估指标和总正确率,“最佳”有序结果变量回归模型的系数表。结果：有序结果变量回归适用于两个或以上分类水平的应变量和一组协变量。通过五种连接函数两种模型的各种评估指标和总正确率的比较,可挑选出“最佳”有序结果变量回归模型,并能预测某个体的分类。     

西安地区学龄儿童行为模式5年间变化规律的探讨

为了解儿童行为问题的变化规律.方法 应用CBCL量表对西安市小学儿童的行为问题进行了评估,并与5年前做了比较.结果 学龄儿行为问题的现患率高于5年前常模组,男女各组中行为因子的排列顺位发生了明显改变;揭示随着时间的推移,学龄儿行为问题的模式发生了变化,行为问题的发生有上升的趋势.结论 证实环境因素对儿童的行为问题起有一定的作用.     

早期评估及干预在高危儿随访中的临床价值分析

目的 分析早期评估及干预在高危儿随访中的临床价值,为高危儿随访及干预提供新模式。方法 选取2010年10月-2016年10月芜湖市第二人民医院儿童保健科门诊随访的160例高危儿,进行扭动阶段和不安阶段的全身运动(GMs)质量评估、月龄满3个月后运用0～6岁小儿神经心理发育检查表(简称“儿-心”)定期测试发育商(DQ),随访至12月龄以上以临床诊断与随访评估结果明确其神经发育结局。对评估结果异常的实施早期干预。采用自身对照研究观察临床效果,分析两种评估结果的相关性及早期神经运动发育异常的相关影响因素。结果 1)神经学发育结局:发育正常59例(36.8%),发育偏离58例(36.3%),发育迟缓32例(20%),脑瘫11例(6.9%);2)干预前后扭动运动阶段GMs评估结果比较,差异有统计学意义(χ²= 35.367,P<0.01);3)干预后高危儿的DQ明显高于干预前,差异有统计学意义(t=-4.593, P<0.01);4)GMs评估结果与“儿-心”量表得分均显著相关(P<0.05或<0.01);5)扭动运动阶段评估异常的高危因素为低出生体重(OR=7.650,95%CI:1.129～51.813,P=0.037)、缺氧缺血性脑病(OR=2.656,95%CI:1.158～6.089,P＝0.027)、脑损伤(OR=2.123,95%CI:1.017～4.434,P＝0.045)和早产(OR=2.405,95%CI:1.126～5.133,P＝0.023)。结论 运用全身运动质量评估结合“儿-心”量表进行早期评估,有助于预测高危儿神经学发育结局,并且对高危儿早期干预起指导作用。     

早期评估及干预在高危儿随访中的临床价值分析

目的 分析早期评估及干预在高危儿随访中的临床价值,为高危儿随访及干预提供新模式。方法 选取2010年10月-2016年10月芜湖市第二人民医院儿童保健科门诊随访的160例高危儿,进行扭动阶段和不安阶段的全身运动(GMs)质量评估、月龄满3个月后运用0～6岁小儿神经心理发育检查表(简称“儿-心”)定期测试发育商(DQ),随访至12月龄以上以临床诊断与随访评估结果明确其神经发育结局。对评估结果异常的实施早期干预。采用自身对照研究观察临床效果,分析两种评估结果的相关性及早期神经运动发育异常的相关影响因素。结果 1)神经学发育结局:发育正常59例(36.8%),发育偏离58例(36.3%),发育迟缓32例(20%),脑瘫11例(6.9%);2)干预前后扭动运动阶段GMs评估结果比较,差异有统计学意义(χ²= 35.367,P<0.01);3)干预后高危儿的DQ明显高于干预前,差异有统计学意义(t=-4.593, P<0.01);4)GMs评估结果与“儿-心”量表得分均显著相关(P<0.05或<0.01);5)扭动运动阶段评估异常的高危因素为低出生体重(OR=7.650,95%CI:1.129～51.813,P=0.037)、缺氧缺血性脑病(OR=2.656,95%CI:1.158～6.089,P＝0.027)、脑损伤(OR=2.123,95%CI:1.017～4.434,P＝0.045)和早产(OR=2.405,95%CI:1.126～5.133,P＝0.023)。结论 运用全身运动质量评估结合“儿-心”量表进行早期评估,有助于预测高危儿神经学发育结局,并且对高危儿早期干预起指导作用。