Health professionals' reporting of family violence against children and adolescents

Reporting family violence against children has two main benefits: it protects the child from the violence and improves epidemiological control of violence. Health professionals play an important role in this area, since they are required to report any known or even suspected case of violence. Nevertheless, when and how to report has been questioned recently. This paper discusses the problems faced by health professionals and suggests specific solutions to the Brazilian case. The authors conclude that it is necessary: (a) to clarify the legal notion of violence in Brazil, specifically the concept of suspicion; (b) to create technical manuals to guide action in this area; (c) to improve the number and quality of services to assist the population; (d) to improve studies and discussion of the consequences of reporting, mainly concerning the notion of justice transmitted to Brazilian families through this practice.     

南京市儿童青少年家长健康素养状况

了解南京市儿童青少年家长健康素养状况,为提升儿童青少年健康素养提供支持和建议.方法 2017年4-5月,采用方便抽样方法,在南京市选取6所小学的3 412名小学生家长进行中国公民健康素养问卷调查.结果 南京市儿童青少年家长健康素养的具备率为21.69%.家长健康知识储备回答率最高的是“关于对戒烟的正确认识”,为98.24%.日常行为习惯回答率最高的是“驾车的正确方法”,为98.62%.健康技能回答率最高的是“火灾发生时逃生的技能”,为99.79%.父母亲随着学历层次的不断上升,其健康素养具备率也呈现升高的趋势,差异均存在统计学意义(X2值分别为111.46,114.58,P值均<0.01);父亲职业为专业技术人员群体的健康素养比例最高(95.43%),母亲也为专业技术人员群体的健康素养比例最高(97.53%),父母不同职业类型健康素养具备率差异均有统计学意义(X2值分别为228.95,218.79,P值均<0.01).结论 应加强低文化水平儿童青少年家长群体健康素养水平教育,为儿童青少年健康发展提供支持.     

儿童青少年视觉环境卫生要求及建议

防控近视,需要治理各种视觉环境。该文全面梳理了国内相关标准,包括地方标准、团体标准,结合笔者的研究经验,重点探讨了作业本、教科书、作业台灯、考试试卷等学习用品,以及电子读物、教辅与课外读物、报纸、采光与照明等视觉环境卫生要求,探讨与视力保护有关的指标。     

Health plans' role in preventing overweight in children and adolescents

The increasing prevalence of overweight children and adolescents in the United States threatens the well-being of a vast segment of this population. This paper examines how U.S. health plans can promote evidence-based behavioral-change strategies by directly intervening in medical settings and by supporting efforts to modify the environments in which young people live, study, and play. We describe a variety of innovative initiatives launched in recent years by health plans to address overweight among children and adolescents. Despite gaps in the evidence base, enough is now known to support aggressive steps to control this important public health problem.     

Estimating the burden of road traffic injuries among children and adolescents in urban South Asia

Over a million people died from road traffic injuries (RTI) globally in the year 2000 and as many as 50 million were injured. Yet there has been little work focused on the South Asia region, let alone the vulnerable segments of population such as children and adolescents. This study aims at measuring the burden of disease caused by urban road traffic injuries among children and adolescents in South Asia. This study selected 26 studies for review and data extraction out of 1505 published articles. Data from the studies were pooled to calculate the proportion and characteristics of child and adolescent RTI, regional RTI incidence and mortality rates, and an estimate of the burden of disease caused by these injuries through the use of the healthy life years lost (HeaLY) composite measure. Our findings showed that the majority of injuries occurred in males (67-80%) and the most frequent age group injured was between ages 0 and 9 representing 40% of cases. Children and adolescents represent an average of 22% of all those with RTI whom seek care. Children and adolescents represented an average of 13% of all RTI deaths. Regional RTI incidence rate was calculated at 880 per 100,000 urban persons aged 0-19. Mortality due to RTI was at 17 deaths per 100,000 urban persons aged 0-19 in South Asia. Burden of disease was calculated 16 HeaLYs per 1000 general population from road traffic mortality alone. With disability data added, then 27.7 HeaLYs per 1000 general population are lost from road traffic injuries in South Asia. The increasing burden of RTI in young persons in South Asia is a call for considering appropriate research and effective interventions. This relatively high loss of healthy life from RTI needs to be addressed by public health systems in South Asia.     

Health of adolescents

Adolescents are the future adults of the world. While adolescence is typically regarded as a period of life relatively free from health problems, adolescents are actually in need of the attention of health professionals and health services, especially with regard to sexual health. A trend of decreasing age at menarche and increasing age at marriage presents adolescents with a substantial number of years in which they will experiment with their developing reproductive organs and sexuality. Substantial psychological and physical change takes place during this period. Inconsistent and suboptimal users of contraception, youths are at high risk for reproductive health problems and sexually transmitted diseases. Substance abuse, unintentional and intentional injuries and their sequelae, academic underachievement and illiteracy, and obesity may also be problematic for adolescents. Adolescents are, however, most damaged by internalized and externalized homophobia. The authors point out that adolescents may be persuaded to learn and change their behaviors more readily than adults. Appropriate messages could be conveyed through targeted information, education, and communication strategies to complement medical and health care services which are available, accessible, and acceptable.     

气候变化对水循环与水资源的影响研究综述

气候变化背景下暴雨洪涝频发,对东南亚季风区域的发展中国家影响相对较大,可能会改变细菌性痢疾的发病规律或地区差异。本综述梳理了暴雨洪涝与细菌性痢疾发病的相关研究进展,包括流行病学关联分析、影响机制路径探究、环境 – 社会因素归纳和主要研究模型汇总等。较多研究表明暴雨洪涝会显著增加人群细菌性痢疾的发病风险;相关环境 – 社会影响因素包括环境影响因素,如基础设施过载和地理景观格局等,以及社会影响因素,如经济发展水平、城乡差异和医务人员数量;不同地区、不同性别、年龄和职业类型人群的发病风险也存在差异。当前研究分析模型多为广义相加模型、分布滞后非线性模型和泊松回归模型。未来亟待开展关于暴雨洪涝导致细菌性疾病发病的环境 – 社会影响因素和机制路径的深入研究。     

International impacts of pesticides on children

Pesticide exposures among children fall into a range of regulatory concerns. A survey encompassing children's exposures in rural farming communities in Honduras illustrates the complexity and magnitude of the problem. Further study and international guidelines for prevention are recommended.     

中国九省城市化水平对儿童青少年超重肥胖影响的多水平研究

目的探讨中国城市化水平对儿童青少年体质指数(BMI)和超重肥胖的影响。方法采用分层多阶段整群随机抽样方法,选择中国健康与营养调查中1997—2011年中国九省儿童青少年作为研究对象,利用城市化指数测量方法,将城市化水平分为低、中、高三类,采用多水平模型分析城市化水平对儿童青少年BMI和超重肥胖的影响。结果在多水平随机截距线性模型中,控制年龄、总能量摄入、膳食脂肪供能比、身体活动量和静坐时间、家庭收入、父母受教育水平和父母超重肥胖情况等变量后,高城市化水平社区男孩BMI均值相对低城市化水平社区男孩增加了0.61(95%CI 0.03~1.19,P0.05),城市化水平对女孩BMI的影响无统计学意义(P=0.59);在多水平随机截距Logistic回归模型中,控制年龄、基线BMI、总能量摄入、膳食脂肪供能比、身体活动量和静坐时间、家庭收入、父母受教育水平和父母超重肥胖情况等变量后,不同城市化水平社区男、女发生超重肥胖的危险性差异均没有统计学意义(男:P=0.17,女:P=0.57)。结论高城市化水平社区男孩BMI高于低城市化水平社区男孩,城市化水平对女孩BMI没有影响,城市化水平与儿童青少年超重肥胖无显著相关性,说明社区本身城市化水平的高低可能不是影响超重肥胖的直接因素,其主要通过对儿童青少年生活方式和家庭因素的影响,间接影响儿童青少年超重和肥胖。     

Proximity of schools in Detroit, Michigan to automobile and truck traffic

Exposure to traffic-related air pollutants, which has been associated with a range of adverse health effects, often is represented using indirect proxies or surrogate exposure measures, most commonly, the proximity to busy roads. This study examines the proximity of grade K-12 schools to high traffic roads in Wayne County, Michigan, an area including the industrialized city of Detroit as well as outlying urban and suburban communities. Unlike earlier studies, commercial and non-commercial traffic is distinguished, and effects of school type (public, charter, private), socio-economic variables, demographic factors, and mapping errors are evaluated. We find that total traffic flow, as measured by annual average daily traffic (AADT), does not reflect the substantial differences between trucking and commuting routes. Thus, AADT alone may inadequately capture traffic-related exposures, especially given the large differences between diesel and gasoline emissions. Based on close proximity (school-road distance < or = 150 m) to heavy traffic (AADT > or = 50,000), 4.9% of the 845 Wayne County schools are traffic exposed at school. In the urban core area, 7.2% of schools and 7.6% of students are traffic exposed at school. A larger proportion of grade 7-12 students in public schools are exposed than K-6 students. Considering truck emissions, 2.8% of the schools are within 150 m of roads with 5000 or more trucks per day. In Wayne County, students attending schools near high traffic roads are more likely to be Black or Hispanic, to be enrolled in a meal program, and to reside in a poor area. Many of these results are driven by the large minority population in the densely populated core area of Detroit. The findings show that a large fraction of children have high exposures to traffic-related pollutants, especially in Detroit, and the need for exposure measures that account for both the composition and volume of traffic.     

Health impacts of family planning

Among the many effects of family planning is the influence ithas on mortality and morbidity in women and children throughthe mechanism of changing the number and spacing of children.There is a complex set of relationships between mother's age,parity, birth spacing and infant and child mortality and morbidity.Much effort has been put into untangling this web in the hopeof identifying clear causal connections, but for the most parton the basis of inadequate data. Rather than attempt to establishthe relative importance of child spacing as a cause of decreasesin mortality, this paper takes as its starting point that thereis a connection, and presents some possible causal mechanismswhich explain how short birth intervals and child mortalitycould be related. In addition the most frequently cited hypotheses-maternaldepletion and sibling competition-a third is examined-birthcrowding which, it is suggested, influences the pattern of thetransmission of infectious diseases and, in turn, mortality. In the field of maternal mortality, the data which could beused to quantify the benefits of family planning are in evenshorter supply; however, the causal connections are rather moreeasily identified. The final section combines parity-specificdata on maternal mortality with evidence of changes in fertilitypatterns brought about by family planning to assess how successfulwe can hope to be in reducing through birth control the numberof women who die in childbirth.     

Dietary patterns of children and adolescents analyzed from 2001 Korea National Health and Nutrition Survey

The purpose of this study was to identify dietary patterns among children and adolescents in Korea and to examine their associations with obesity and some blood profiles. One day food consumption data measured by 24-hour recalls on 2704 subjects aged 1 to 19 were used from 2001 Korea National Health and Nutrition Survey. The data of blood profiles available in the ages of 10 or older was also used. After categorizing each food consumed into 29 food or food groups, five dietary patterns were derived through a factor analysis and subjects were classified into three major dietary patterns via a cluster analysis using the factor scores. Three dietary patterns were identified as ''traditional diet'' (25.6%), ''westernized-fast food'' (6.2%), and ''mixed diet'' (68.2%). The ''traditional diet'' pattern had a higher percentage in boys. Both the ''traditional diet'' and the ''westernized-fast food'' had higher proportions of adolescents (12-19 y) than younger children, while the ''mixed diet'' had a higher percentage of preschool children (1-5 y). Obesity rate analyzed within each age group showed no differences among 3 dietary pattern clusters. Blood pressure and all plasma profiles were not different among dietary patterns when adjusted with age and gender. Conclusively, children and adolescents in Korea had three distinct dietary patterns, which were associated with gender and age. These patterns could be useful to plan nutrition interventions for teenager health promotion.     

Health status of children and adolescents and risk factors in a geographic endemic area]

The health status of children and adolescents residing in geographic endemic area of the Republic of Tatarstan was studied. Medical examinations of 5078 children and adolescents were performed. They showed a significant increase in the incidence of thyroid hyperplasia caused by iodine deficiency. The successively significant risk factors are biological, naturally ecological, and social.