Overweight trends among children enrolled in the New York State special supplemental nutrition program for women, infants, and children

The objective of this study is to describe overweight trends in a large, multiethnic, low-income population of preschool children by race/ethnicity and examine cohort changes in body mass index (BMI) distribution. Cross-sectional data were collected January 1 through March 31, every year, from 1989 to 2003. Subjects were children aged 2 to 4 years participating in the Special Supplemental Nutrition Program for Women, Infants, and Children in New York State. The prevalence of overweight (BMI > or =95th age- and sex-specific percentile of the 2000 Centers for Disease Control and Prevention growth charts) was calculated for each year. Least squares regression compared trends in prevalence by race/ethnicity. Changes in BMI distribution were assessed graphically. Overweight prevalence increased 33% (12% to 16%). Prevalence was highest for Hispanics and lowest for non-Hispanic whites. Rates of increase (0.28 percentage points per year) were the same for Hispanic, non-Hispanic black, and non-Hispanic white children. The BMI distribution shifted toward higher values for all children studied; for 3- and 4-year-old children, the difference increased as BMI increased, indicating that, in 2003, the heaviest children were considerably heavier than the heaviest children were in 1989.     

Postpartum iron status in nonlactating participants and nonparticipants in the special supplemental nutrition program for women, infants, and children

BACKGROUND: Iron deficiency, a pervasive problem among low-income women of childbearing age, threatens maternal health and pregnancy outcomes. The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) was designed to alleviate health problems and provides supplemental nutritious foods, nutrition education, and health care referrals. OBJECTIVES: The aim of this study was to examine the benefits associated with participation in WIC in terms of biochemical tests of postpartum iron status in nonlactating women. DESIGN: WIC participants (n = 57) and eligible nonparticipants (n = 53), matched by race and age, were followed bimonthly over 6 mo postpartum. Finger stick blood samples (500 microL) were collected for measurement of plasma ferritin, transferrin receptor (TfR), and hemoglobin (Hb). RESULTS: The mean (+/-SE) Hb concentration of participants exceeded that of nonparticipants from months 2 through 6. At 6 mo, the mean Hb concentration of participants was significantly higher than that of nonparticipants (8.01+/-0.12 and 7.63+/-0.12 mmol/L, respectively; P< 0.05) and the prevalence of anemia was significantly lower (17% and 51%, respectively; P<0.05). TfR and ferritin concentrations (consistently within the reference ranges) and dietary iron intakes did not differ significantly between participants and nonparticipants and were not correlated with Hb concentrations. CONCLUSIONS: Our results suggest that WIC participants were significantly less likely to become anemic if uninterrupted postpartum participation lasted for 6 mo. The lack of correlation among iron status indicators suggests that the lower mean Hb concentration in nonparticipants at 6 mo may not have been related to improved iron status in participants but to other nutrient deficiencies or differences in access to health care and health and nutrition education.     

139对双生子红细胞钠、钾离子的遗传度分析

利用遗传流行病学方法调查了天津市南开区139对双胞胎,其中单卵双生(MZ)74对,双卵双生(DZ)65对。并用几种不同的遗传度估计方法分析了红细胞Na⁺、K⁺的共同基因和共同环境因素对血压的影响。结果表明遗传因素、共同环境因素及双胞胎各自的环境因素对血压影响近似的是RBC Na⁺,h²=0.32,C²=0.35,u²=0.33。环境因素为主要原因的是RBC K⁺,C²=0.97。     

Evaluation of a breastfeeding peer support program for fathers of Hispanic participants in a Texas special supplemental nutrition program for women, infants, and children

A mother's decision to breastfeed and the duration of breastfeeding depends on different factors; among them are the support of her husband or male partner and other social support. There have been different types of support programs for mothers and few have targeted fathers. In 2002, the Texas Special Supplemental Nutrition Program for Women, Infants, and Children introduced an innovative approach for encouraging breastfeeding among mothers and their spouses. The pilot Peer Dad Program targeted fathers to promote and support their spouse in breastfeeding. This cohort study evaluated duration of breastfeeding among Hispanic couples who enrolled in the pilot Peer Dad Program (n=101) and those who did not enroll (n=99). Structured interviews were conducted with Special Supplemental Nutrition Program for Women, Infants, and Children participants and their male partners. Unconditional logistic regression was used to estimate the likelihood of continuing breastfeeding past 6 months associated with participation in the Peer Dad Program and significant predictors. Mothers whose partner participated in the pilot Peer Dad Program were no more likely to continue breastfeeding past 6 months (odds ratio 1.44, 95% confidence interval 0.82 to 2.54) compared with mothers who received peer counseling only. The percentage of women in the intervention group (63.4%) who breastfed for 6 months or longer compared with women in the control group (54.6%) was not significant (P=0.20). Although other studies suggest that father's support lengthens breastfeeding duration, our study, which targeted Hispanic fathers, found no association due to its small sample size. Further research with larger studies is needed to establish this association.     

Medical evaluation of the special supplemental food program for women, infants, and children.

The special supplemental food program for women, infants, and children administered by the United States Department of Agriculture, was evaluated nationally. Participating infants, children under 4 years old, and pregnant and nursing women were investigated initially, and after receiving food supplements. The supplements were iron-fortified infant formula, iron-fortified infant cereals, and fruit juices for the infants, and milk, cheese, iron-fortified cereals, eggs, and fruit juices for the children and women. Initially, the average birth weight was lower and the infant mortality rate was higher than expected in a well nourished population. There was also evidence of slight growth retardation, a high anemia rate, and a high percentage of participants having saturation of transferrin values less 15%. The program had no effect on the prevalence of unsatisfactory values for saturation of transferrin. There was an increase in weight gain during pregnancy, and increase in birth weight, an acceleration of growth, and a reduction in the anemia rate in all participant categories except women in the first and second trimesters of pregnancy.     

适碘地区成人、儿童和孕妇碘营养状况调查

目的 了解自1996年全民食盐加碘政策实行以来,中国适碘地区成人、学龄儿童和孕妇的碘营养状况及特征。方法 采用横断面调查方法,选择河北省沧州市海兴县348名成人与150名学龄儿童及天津市174名孕晚期孕妇作为研究对象,测定成人、学龄儿童和孕妇空腹晨尿的尿碘水平及分布特征。结果 适碘地区成人、学龄儿童和孕妇尿碘中位数分别为185.20、123.13和217.06 μg/L,均为碘摄入适宜水平;适碘地区62.07%成人、68.67%儿童和63.22%孕妇碘营养状况处于富足水平,但仍有12.93%成人、22.00%儿童与27.59%孕妇为碘缺乏状态,不同人群尿碘水平分布差异有统计学意义（χ²=33.738,P<0.05）。结论 3种人群的碘营养状况适宜,但学龄儿童和孕妇出现了一定程度的碘缺乏,适碘地区特殊人群碘缺乏问题不容忽视。     

Supporting language and cognitive development of infants and young children living in children's homes in Turkey

Aim The purpose of the present study was to improve language and cognitive development of infant and young children residing in institutional settings in Turkey. Method In Study I, there were 12 children with a mean age of 35 months in the intervention group and 12 children with a mean age of 36 months in the control group. Results When both groups' pre‐test post‐test general development t scores and cognitive and language sub‐domain developmental gaps were compared, neither the time nor the time by group interactions were significant. Nevertheless, both groups' developmental gap appeared to decline. In Study II, children were recruited from the same institution and randomly assigned to the intervention and control groups. Results indicated that infants and children who were in the intervention group showed a decline in the language and cognitive development gaps, whereas the control group children's developmental gaps were increased. Conclusions It can be concluded that by increasing the quality of care in children's homes infants' and young children's development can be enhanced.     

妇幼保健机构质量管理体系整合的初步体会

目的为进一步健全妇幼保健机构的质量管理体系，形成标准化的管理模式，推动整体管理水平和服务质量的提高。方法在“上等达标”的创建活动中，以ISO9000：2000的技术方法为路径，以广东省妇幼保健机构等级评审细则（以下简称《细则》）为内容，设计运行体系，建立体系文件，形成统一的质量方针、质量目标和持续改进的质量管理机制。结果如期顺利完成创建任务，全员质量意识和质控技能明显提高，服务数量和质量大幅度改善。结论将ISO9000国际质量标准体系和其技术方法与《细则》结合起来进行“上等达标”的创建工作是可行的，它为多种管理体系的整合运行提供了可行性例证。     

Providing health care to low-income women: a matter of trust

BACKGROUND: Trust is an important indicator of quality in patient-provider relationships and predicts adherence to certain protective health behaviours. It has been relatively unexplored among low-income or minority women. OBJECTIVES: We explored health care experiences that influence patient trust among low-income women in the USA with respect to professionals and lay health workers (LHWs). METHODS: Focus groups were conducted with 33 prenatal and postpartum women, aged 18-45 years, recruited from community-based public prenatal care programmes. Focus groups were audio-recorded, transcribed, and independently coded by readers. A model of factors associated with trust was developed based on the major thematic categories. RESULTS: Most women were Black (67%) and had completed high school (85%). Factors related to greater trust specific to patient-provider relationships were: continuity of the patient-provider relationship, effective communication, demonstration of caring and perceived competence. Women with less trust in their physicians reported an unwillingness to follow his/her advice. Most women reported having more trusting relationships with LHWs and nurses than with physicians, probably due to greater contact with these staff. Several women with a low level of trust reported experiences of discrimination due to lack of insurance. CONCLUSIONS: Prenatal care presents a unique opportunity for providers to contribute to the elimination of health disparities among low-income women. Improving continuity with public health prenatal care providers and building strong relationships with LHWs may enhance quality of care and contribute to achieving this goal. Better patient-provider communication is also a practical area of focus towards improving patient trust.     

湖南省四县市774名农村留守儿童照顾与营养问题的现况研究

目的 了解农村留守儿童照顾与营养现况,为留守儿童营养干预工程提供科学依据.方法 采用横断面调查方法,对随机选择的7岁以下留守儿童和对照儿童各774名进行调查.调查方法主要包括问卷、食物摄入频率调查、体格测量和实验室检查.结果留守儿童一日三餐保障、日常饮食与营养专人照顾均不及对照儿童(X2=6.671,P=0.036;X2=15.053,P=0.001);留守儿童母乳喂养率与母乳喂养持续时间均低于对照儿童(X2=5.051,P=0.031;t=-7.201,P=0.001);留守儿童＜2岁组奶豆类摄人量和2～4岁组粮谷类摄入量均低于对照儿童(t=-2.150,P=0.032;t=-2.054,P=0.040);留守儿童贫血患病率(31.1%)高于对照儿童(26.2%)(X2=4.560,P=0.033).结论留守儿童一日三餐保障和营养与饮食专人照顾有待改善,营养相关的健康状况不容乐观,应引起社会广泛关注,并采取有效措施,提高农村留守儿童生活质量.     

HIV阳性妇女和儿童及家庭社区关怀与支持模式

目的分析艾滋病病毒(HIV)阳性妇女和儿童及家庭社区关怀与支持服务模式,为进一步落实国家"四免一关怀"政策提供经验。方法组建HIV阳性妇女自救互助小组,经过培训的同伴教育员或骨干依托小组,对HIV阳性妇女及其家庭进行需求评估,根据需求评估结果,为HIV阳性妇女提供健康及心理咨询、随访、生产自救等在内的全方位综合性关怀与支持服务。在关怀与支持活动开始前和结束时分别对101、172名HIV阳性妇女进行了基线与评估调查。结果有70.0%接受调查的HIV阳性妇女参加了自救互助小组,4.2%的HIV阳性妇女成为小组活动的组织者和骨干;HIV阳性妇女接受心理支持的比例从基线的36.6%上升至79.7%,其中有63.9%的HIV阳性妇女接受过阳性同伴的随访,86.6%的HIV阳性妇女认为咨询、随访等心理支持活动有较好的效果,能够帮助她们减轻心理压力。探索了依托自救互助小组为HIV阳性妇女提供"咨询—随访—生产自救—技能培训—健康护理知识宣传"等活动的社区关怀与支持模式。结论依托自救互助小组开展社区关怀与支持活动,HIV阳性妇女及其家庭的各方面情况有了较大的变化,信心、情绪和对生活的态度有了较大的改善,此模式值得借鉴,但需要加强对同伴教育员的培训,提高关怀与支持覆盖面,消除社区歧视。     

八省城乡0～5岁婴幼儿生长发育与家长喂养行为的调查分析

目的调查分析我国八省城乡0～5岁婴幼儿的营养和喂养现状。了解其中婴幼儿生长发育中存在的主要问题,为进一步制定营养改善措施提供依据。方法利用卫生部社妇司2004年在八省城乡开展的“0～5岁婴幼儿营养状况调查”,对我国八省城乡17081名0～5岁婴幼儿进行身高、体重的测量,并以问卷的形式对以上婴幼儿的家长进行了喂养行为的调查。结果城乡婴幼儿生长发育出现差异是从4月开始;农村1～2岁为营养不良的高发期,并以长期慢性营养不良为主;八省西部农村营养不良率高达20%以上,高于中、东部地区。结论在婴儿辅食添加中农村明显存在着添加时间、添加辅食在质量和数量上不科学合理的问题。分析原因除了经济的因素外,还与婴幼儿家长缺乏营养和保健知识关系。     

Randomized controlled trial to determine the effectiveness of an interactive multimedia food safety education program for clients of the special supplemental nutrition program for women, infants, and children

BACKGROUND: Pregnant women and the very young are among those most susceptible to foodborne infections and at high risk of a severe outcome from foodborne infections. OBJECTIVE: To determine if interactive multimedia is a more effective method than pamphlets for delivering food safety education to Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) clients. DESIGN: A randomized controlled trial of WIC clients was conducted. Self-reported food safety practices were compared between pre- and postintervention questionnaires completed >or=2 months after the intervention. SUBJECTS/SETTING: Pregnant WIC clients or female caregivers (usually mothers) of WIC clients who were 18 years of age or older and able to speak and read English were recruited from an inner-city WIC clinic. INTERVENTION: Participants were randomized to receive food safety pamphlets or complete an interactive multimedia food safety education program on a computer kiosk. MAIN OUTCOME MEASURES: Change from pre- to postintervention food safety scores. STATISTICAL ANALYSES PERFORMED: A mean food safety score was determined for each participant for the pre- and postintervention questionnaires. The scores were used in a two-group repeated measures analysis of variance. RESULTS: Of the 394 participants, 255 (64.7%) completed the postintervention questionnaire. Satisfaction with the program was high especially among those with no education beyond high school. When considering a repeated measures analysis of variance model with the two fixed between-subject effects of group and age, a larger improvement in score in the interactive multimedia group than in the pamphlet group (P=0.005) was found, but the size of the group effect was small (partial eta(2)=0.033). Women aged 35 years or older in the interactive multimedia group had the largest increase in score. CONCLUSIONS: The interactive multimedia was well-accepted and resulted in improved self-reported food safety practices, suggesting that interactive multimedia is an effective option for food safety education in WIC clinics.     

中国部分地区7岁及以下农村留守儿童看护人营养知识、态度和行为及其影响因素调查

目的 了解中国7岁及以下农村留守儿童看护人营养知识、态度和行为(KAP)及影响因素,为开展营养知识健康教育提供科学依据.方法 采用询问调查方法,对随机选择的1691名留守儿童看护人进行问卷调查;采用logistic回归分析方法筛选营养KAP的影响因素.结果 单亲外出留守儿童看护人的营养知识知晓率、积极态度持有率和正确行为形成率均较低,分别为59.9%、59.5%和41.8%,而双亲外出留守儿童看护人更低,分别为47.8%、55.4%和38.0%;多因素logistic回归分析结果显示:留守儿童看护人营养KAP与看护人的年龄、文化程度、家庭人均收入、看护意愿及儿童年龄等因素有关.结论 农村留守儿童看护人营养KAP水平较低,应开展留守儿童看护人营养KAP健康教育.     

Beliefs about whole-grain foods by food and nutrition professionals, health club members, and special supplemental nutrition program for women, infants, and children participants/State fair attendees

Whole-grain foods are important components of healthful diets that may help prevent chronic diseases. Consumer beliefs that influence consumption of whole grains are poorly understood. This analysis surveyed three groups regarding their beliefs about whole-grain foods. The groups were food and nutrition professionals (n=103), health club members (n=103), and individuals representing various consumer segments of the general population, including participants in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) and state fair attendees (n=68). Most respondents were aware of the term whole-grain foods, but less often reported that they use the term. Bread and cereal were most often named as examples of whole-grain foods. Lack of processing and use of the entire grain were the major reasons a food was perceived as being a whole-grain food. The major benefit of eating whole grains was reported to be fiber intake. Food and nutrition professionals provided more differentiated responses, whereas WIC/state fair participants had fewer and less elaborate responses. Assessing beliefs about whole grains offers insights to nutrition professionals for encouraging healthful food consumption.     

28所省级妇幼保健机构资源配置与产出现状分析及综合评价

目的:通过对省级妇幼保健机构资源配置状况的调查,掌握省级妇幼保健机构的资源配置现状及产出发展趋势,并对省级妇幼保健机构的资源配置与产出进行综合评价。方法:基于现代化的网络传输系统开发《全国妇幼卫生机构管理信息网络报告系统》,实现妇幼保健机构资源与运营信息网络实时直报。结果:①截至2005年底,28个省级妇幼保健机构平均拥有卫生技术人员281.4人。卫生技术人员高级职称者占16.5%,本科及以上学历者占41.3%。省级妇幼保健机构平均拥有固定资产8 903.18万元,专业设备固定资产3 470.09万元,业务用房面积16 482.8平方米,床位227.0张。人均年业务收入15.63万元,人均年诊疗714.2人次,保健人员下基层525.9人天、为基层人员举办培训班11.3期,开展群众性健康教育活动37.2次。②与2002年相比,2005年卫生技术人员、固定资产、业务用房、财政补助收分别增长了1.6%、117.6%、48.4%、10.6%。③妇幼保健机构的资源产出,保健人员下基层天数、举办培训班期数、开展健康教育活动次数、人均年业务收入、人均诊疗人次逐年上升。④资源配置与产出综合评价结果显示,7个较好的省级妇幼保健院,均为开展了临床服务的独立机构,主要集中在中东部地区。结论:省级妇幼保健机构的现有资源与其承担的职责和工作任务不匹配,主要表现在,省级妇幼保健机构人力资源欠缺,政府对省级妇幼保健机构的投入不足。另外,省级妇幼保健机构之间发展极不平衡,有临床服务独立机构的资源配置与产出情况明显好于没有临床服务或者隶属于疾病预防控制中心的机构。     

Characteristics of human CD34+ cells exposed to ionizing radiation under cytokine-free conditions

To clarify the mechanisms underlying radiation-induced hematopoietic stem cell death, we investigated the effects of excessive ionizing radiation on the clonogenic potential of CD34⁺ cells obtained from human umbilical cord blood under cytokine-free conditions. The CD34⁺ cells were X-ray–irradiated (up to 2 Gy) and were cultured for 0–48 h under cytokine-free conditions. At various time-points, the CD34⁺ cells were investigated for survival, clonogenic potential and the generation of mitochondrial superoxide. At 12 h after X-ray irradiation, the number of viable cells had decreased to ∼70–80% compared with the 0-h non-irradiated control, whereas the clonogenic potential in the X-ray–irradiated cells had decreased to ∼50%–60% compared with the 0-h non-irradiated control. Furthermore, significant generation of mitochondrial superoxide was observed at 6 h, and reached a maximum value between 12 and 24 h after X-ray irradiation. However, no significant differences were observed between non-irradiated and X-ray–irradiated cells in terms of the generation of reactive oxygen species or in the intracellular mitochondrial contents. In addition, a cDNA microarray analysis showed that the majority of the altered genes in the CD34⁺ cells at 6 h after X-ray irradiation were apoptosis-related genes. These results suggest the possibility that the elimination of the clonogenic potentials of CD34⁺ cells involves the generation of mitochondrial superoxide induced by ionizing radiation.     

Synthesis and Na+/H+ exchanger inhibitory activity of benzoylguanidine derivatives

Twenty-two compounds of substituted benzoylguanidine derivatives were designed and synthesized as potent NHE1 inhibitors. Twelve compounds showed more potent NHE1 inhibitory activity than cariporide. The activities of compounds 7e, 7h and 7j (IC₅₀ = 0.073 ± 0.021, 0.084 ± 0.012 and 0.068 ± 0.021 nmol/L, respectively) were two orders of magnitude higher than that of cariporide (30.7 ± 2.5 nmol/L). Myocardial cells in vitro screening showed 7j had highlighted protective effect on cardiomyocytes subjected to hypoxia/reoxygenation. Thus it is valuable for further investigation.