An enquiry into the attitudes of Muslim Asian mothers regarding infant feeding practices and dental health

Recent studies have highlighted some unfavourable dietary practices among Asian infants in the UK. A number of reasons for such nutritional patterns have been suggested. In the present study, attitudes, beliefs and expectations of 100 first-generation Muslim Asian mothers regarding infant feeding practices were explored through group discussions in their mother tongue.
It was found that mothers generally favoured breast-feeding but lacked knowledge of weaning practices. There was great emphasis on the consumption of milk. The advice from health professionals to discontinue using a feeding bottle by 12 months of age was not considered acceptable. Some mothers thought the change might cause infants to stop drinking milk and that there was little alternative suitable nourishing food available for that age group. The main requirement for infant foods was that they must be halal. Sugar was used either because it ensured that more milk would be consumed, or because it was considered to be intrinsically beneficial. Some mothers fed children on demand, some stated that children chose what they wanted to eat, and that mothers lacked firm control of dietary intake.
Against a background of conflicting advice from health professionals, pressure from in-laws, and the powerful influence of advertising, there is considerable scope for the training of health professionals and for continuing education for families and communities.     

Neonatal feeding practices in Periurban Bolivia

Early initiation of breastfeeding offers numerous benefits, but in many cultures the first suckling is delayed and the infant is instead given various prelacteal foods. Mothers residing in periurban areas of two Bolivian cities were interviewed regarding their neonatal feeding practices. Virtually all infants were breastfed, but the first breastfeed was typically delayed for more than 1–2 hours after birth; about 15% did not suckle for at least 24 hours. When asked whether they gave colostrum, three‐quarters of mothers answered affirmatively, although some who initiated breastfeeding on the first day answered negatively. Of those who did not give colostrum, many said they refrained because of concern that it would harm the infant. Advice from medical professionals was variously cited as the reason for giving or for not giving colostrum. Herbal teas were commonly fed in the first few days. Education programs should encourage mothers to begin breastfeeding immediately after birth and to not feed their newborns any other foods.     

A study of infant feeding practices in an urban Indian community

Thirty mothers, attending either a paediatric clinic at a Government hospital or a private paediatrician's surgery, both in Tirupati, Andhra Pradesh, South East India, were questioned about their infant feeding practices. A sample of milk from their child's bottle was requested and subsequently analysed for the presence of dilution. Over-dilution, defined as less than 75% of the standard concentration, was found to be common (P<.05). No significant correlations were found between the incidence of over-dilution and either family income or educational status of the mothers due to the small sample size. The study suggests the need for practical education on the reconstitution of milk feeds.     

Non-pharmaceutical interventions for pandemic influenza, international measures

Since global availability of vaccine and antiviral agents against influenza caused by novel human subtypes is insufficient, the World Health Organization (WHO) recommends non-pharmaceutical public health interventions to contain infection, delay spread, and reduce the impact of pandemic disease. Virus transmission characteristics will not be completely known in advance, but difficulties in influenza control typically include peak infectivity early in illness, a short interval between cases, and to a lesser extent, transmission from persons with incubating or asymptomatic infection. Screening and quarantining entering travelers at international borders did not substantially delay virus introduction in past pandemics, except in some island countries, and will likely be even less effective in the modern era. Instead, WHO recommends providing information to international travelers and possibly screening travelers departing countries with transmissible human infection. The principal focus of interventions against pandemic influenza spread should be at national and community levels rather than international borders.     

Non-pharmaceutical interventions for pandemic influenza, national and community measures

The World Health Organization's recommended pandemic influenza interventions, based on limited data, vary by transmission pattern, pandemic phase, and illness severity and extent. In the pandemic alert period, recommendations include isolation of patients and quarantine of contacts, accompanied by antiviral therapy. During the pandemic period, the focus shifts to delaying spread and reducing effects through population-based measures. Ill persons should remain home when they first become symptomatic, but forced isolation and quarantine are ineffective and impractical. If the pandemic is severe, social distancing measures such as school closures should be considered. Nonessential domestic travel to affected areas should be deferred. Hand and respiratory hygiene should be routine; mask use should be based on setting and risk, and contaminated household surfaces should be disinfected. Additional research and field assessments during pandemics are essential to update recommendations. Legal authority and procedures for implementing interventions should be understood in advance and should respect cultural differences and human rights.     

2000年世界卫生报告:拓展卫生系统绩效的视野

2000年世界卫生组织报告的10周年纪念,为我们提供了一个绝佳的机会,去重新审视报告的发布和随后引发的讨论,这种审视有利于客观地认识和理解各种争议、达成新的共识,并使讨论更有价值和更深入。     

人口老龄化进程中的医疗卫生支出:WHO成员国的经验分析

基于世界卫生组织(WHO)成员国的经验,本文探讨了人口老龄化进程中医疗卫生支出的基本特征和一般规律。研究表明:世界各国医疗卫生水平存在极大的不平衡。随着人口老龄化的加深,医疗卫生支出中政府支出比例趋于上升,而私人卫生支出比例趋于下降。医疗卫生支出占GDP的比例逐步提高,而政府卫生支出占政府总支出比例也趋于提高,人口老龄化进程中政府在医疗卫生支出中将承担更重要的责任。而且,在政府卫生支出中,医疗保障支出比例趋于提高,并将成为政府卫生支出越来越重要的部分。当一国进入老龄化社会后,医疗卫生支出速度将会递增,经济发展和政府财政将承受越来越重的医疗支出负担。"未富先老"的中国面临着医疗卫生支出急剧增长的严峻挑战,这应该成为医疗卫生体制改革关注的议题。     

HOSPITAL INFLUENCES ON EARLY INFANT FEEDING PRACTICES

Most mothers who stated an initial preference for breast-feeding nevertheless began supplementary or exclusive bottle-feeding during the immediate postpartum period. Hospital "modeling" appeared to be a factor in this decision.     

世界卫生组织绩效管理制度改革与启示

一直以来,世界卫生组织将绩效管理作为完善管理体制、提升全球卫生治理能力的核心内容之一。为应对全球卫生新形势,世界卫生组织紧密围绕组织目标,以具体问题为导向,从绩效计划、管理绩效、绩效考核、奖励绩效等四个环节开展绩效管理改革,改革具有合理把控改革力度、坚持全员参与、注重沟通与反馈、强化过程管理等特点。我国公共部门应充分认识绩效管理的重要作用,融入现代治理理念,科学设定并适时调整绩效管理框架和路径,基于更加完备的信息系统,建立科学合理的绩效考核标准体系和奖惩机制。     

婴幼儿喂养问题情况调查

目的了解婴幼儿哺乳及乳类以外食物添加情况。方法选取2004年3月-2008年2月首都儿科研究所附属儿童医院儿童保健门诊收治的主诉有喂养困难或睡眠不实、哭闹、排便紊乱等症状与喂养相关的婴幼儿为调查对象,将中华医学会儿科学分会儿童保健学组婴幼儿喂养建议及美国儿科学会儿科护理教材作为喂养适宜的判定标准,采用医生与家长一对一访谈及统一调查问卷形式,详细询问家长就诊时哺乳和乳类以外食物添加情况。结果基本符合婴幼儿适宜推荐哺乳次数者仅占10．9％（97／886）;多于推荐次数占82．6％（732／886）,有6．4％（57／886）哺乳少于推荐次数。〈4月龄、4～6月龄和〉6月龄超过适宜推荐次数分别占各自月龄组的40．4％（19／47）、53．0％（87／164）、92．7％（626／675）,随月龄增加超过适宜推荐频次者增多（Х2=104．137,P〈O．001）。〉4月龄婴幼儿有夜间哺乳行为者达86．5％（726／839）,其中2次者占39．9％（355／839）,〉3次者占25．6％（214／839）,夜间哺乳频次并没有随月龄增加而减少（Х2=28．869,P=O．017）。在〈4月龄婴儿中,有12．8％（6／47）已经开始添加乳类以外食物;4-,6月龄时添加者占67．7％（111／164）;但6-9月龄、9～12月龄、12-36月龄尚未添加者分别占43．6％（144／330）、17．4％（32／184）、11．2％（18／161）。结论喂养问题婴幼儿哺乳频次和夜间哺乳偏多,乳类以外食物添加出现偏晚与偏早现象。     

世界卫生组织推动学龄儿童健康饮食的经验及启示

为促进学校膳食高质量发展,文章系统分析了世界卫生组织(WHO)颁布的《推动学校健康膳食的政策报告》,介绍了通过改变膳食的物理环境与调整膳食信息提供的手段,明确了基础调研—确定目标—确立方案—实施轻推—评估效果的五级实施步骤,指出了中国学校膳食发展正面临学校营养结构不合理、营养供给不平衡、学生营养意识较低、双重营养不良负担严重等现实困境。提出了合理使用轻推手段来帮助学生养成科学饮食习惯、加强学校健康教育、降低学生双重营养不良负担的经验启示。     

WHO Working Group on Technical Specifications for Manufacture and Evaluation of Yellow Fever Vaccines, Geneva, Switzerland, 13-14 May 2009

In May 2009, WHO convened a meeting of Working Group on Technical Specifications for Manufacturing and Evaluating Yellow Fever (YF) Vaccines, Geneva, Switzerland to initiate revision of the WHO Recommendations (formerly, Requirements) for YF vaccine published in WHO Technical Report Series number 872 (1998). The Working Group, consisting of experts from academia, industry, national regulatory authorities and national control laboratories, reviewed the latest issues of safety, efficacy and quality of YF vaccines and agreed that (i) the revision should focus on live attenuated YF vaccine virus 17D lineage; and that (ii) nonclinical and clinical guidelines for new vaccines prepared from 17D lineage be developed.     

世界卫生组织政策的挑战及应对策略研究

本研究概述了目前世界卫生组织政策面临的挑战,主要表现在政策过于技术化、宏观战略性政策不够,政策约束力低、执行力弱,政策重点受预算方式和投入机制限制,政策制定过程中协调能力不强以及政策针对性不强等方面。从技术、资源、规则和思想理念等方面分析了如何提升世界卫生组织政策的影响力,提出了保持技术领先优势、提高获取资源能力、建立更多有约束力的规则、不断创新理念、成为健康引领者等政策建议,为世界卫生组织加强政策建设提供借鉴。     

不同时期世界卫生组织主要政策及其变化趋势研究

世界卫生组织政策是一种在世界范围内的公共政策,包括法律、公约、条例以及指南等多种形式。本文概括了六个时期世界卫生组织政策的环境和重要内容,并提出世界卫生组织政策从援助到合作,从治愈疾病到安全和发展的两个重要变化。文章还探讨了世界卫生组织政策变化趋势及其对我国卫生政策发展和国际卫生合作方面的启示,对系统了解国际卫生政策的发展历程、地位作用,加强我国的国际卫生合作具有一定参考价值。     

What would the Ottawa Charter look like if it were written today?

The Ottawa Charter has been a phenomenal influence guiding the development of the concept of health promotion, and in shaping public health practice in the past 20 years. The world has changed somewhat since 1986 in many ways that could not have been anticipated by those drafting the Charter. Substantial social and economic changes have occurred, and continue to occur. These include the globalization of trade, the invention and development of the internet and mobile communications, as well as the emergence of new threats to health such as HIV/AIDS. Such profound changes require adaptations to established health promotion strategies and the development of new strategies. This paper considers the origins, describes changes and suggests adaptations to the five strategies of the Ottawa Charter - build healthy public policy; create supportive environments for health; strengthen community actions; develop personal skills; and reorient health services - that now routinely provide the framework for consideration of any major public health challenge.     

WHO: retirement or reinvention?

WHO reform has become a perennial subject of debate that has seen familiar issues raised time and again by incumbent director-generals and member states. This paper begins by reflecting on the distinct nature of WHO reform debates since the 1990s and the global factors behind the pressures to change. It then argues for a shift in focus, from fixing a single UN organization, to the collective health needs of a rapidly globalizing world. The achievement of effective global health governance will require more fundamental changes, beginning with recognition of the shared responsibility for reform. The challenge in the twenty first century will require an even greater willingness to delegate authority and resources to a supranational entity. The compromise may be that the mandate and powers of a global health organization may need to be more carefully circumscribed, but more meaningful in terms of effectively delivering the essential functions needed to protect and promote health in a globalized world.     

广州市2005年城郊2岁以下儿童喂养结构分析

目的 分析2岁以下城郊儿童喂养结构特点及相关影响因素,为制定不同社区喂养指导重点提供依据.方法 采用整·群抽样调查.对11 243例0～2岁儿童进行家庭情况及喂养结构调查及城郊差异分析.结果 本地区2005年1～4个月婴儿母乳喂养率为78.60%(城区为75.90%、郊区为81.20%),纯母乳喂养率为46.20%,郊区0～4月婴儿母乳喂养率显著高于城区,差异有显著性意义(P＜0.001);城区家庭断母乳时间早于郊区,差异有非常显著性意义(P＜0.001);母亲学历越低,父亲职业越偏向体力劳动、家庭年收入越低及生育次数越多者,断母乳时间越晚;辅食添加城区比郊区更合理.讨论应加强母乳喂养宣教,进一步提高纯母乳喂养率,并根据不同地区的特点,有针对性地对家长进行耍幼儿喂养指导. 及城郊差异分析.结果 本地区2005年1～4个月婴儿母乳喂养率为78.60%(城区为75.90%、郊区为81.20%),纯母乳喂养率为46.20%,郊区0～4月耍儿母乳喂养率显著高于城区,差异有显著性意义(P＜0.001);城区家庭断母乳时间早于郊区,差异有非常显著性意义(P＜0.001);母亲学历越低,父亲职业越偏向体力劳动、家庭年收入越 及生育次数越多者,断母乳时间越晚;辅食添加城区比郊区更合理.讨论应加强母乳喂养宣教,进一步提高纯母乳喂养率,并根据不同地区的特点,有针对性地对家长进行耍幼儿喂养指导. 及城郊     

Introducing Complementary Foods to Infants: Does Age Really Matter? A Look at Feeding Practices in Two European Communities: British and Italian

ABSTRACT

Advice about the age for introducing complementary food to infants varies across European countries. Little is known about the actual practice of complementary feeding (CF) in the face of different advice from health professionals within Europe, nor about the impact of different ages of onset of CF on infant food acceptance. This longitudinal study aimed to explore CF in two European communities, British and Italian and to investigate whether infant age of CF influenced infant food acceptance. Forty-six mothers were interviewed before the onset of CF (Visit 1), one week after CF (Visit 2), and at 7 months of infant age (Visit 3), and infant mealtimes were video-recorded at Visits 2 and 3. CF occurred in both groups at a similar range of ages. CF age did not affect infant food acceptance at either Visit. Advice on CF should be based on cultural and individual differences.     

世界卫生组织国家药品报告监测指标的制定和评价

1999年以来,世界卫生组织每4年开展一次全球药品部门调查,并计划改进监测指标后于2011年开展全球第4次调查,中国是全球13个试点监测国家之一。此项工作对推动我国基本药物政策的实施、做好改革的定期监测和评价工作具有深远意义,可为科学决策提供循证依据。本文主要介绍了世界卫生组织三个层次水平的监测指标、全球和欧盟国家的监测进展情况以及国家药品报告的具体做法等。