Wasting

浪费
  • 文章类型: Journal Article
    从游牧到久坐的生活方式的转变带来了饮食的变化,而营养不足是定居的牧区家庭中的地方性疾病。本研究旨在探讨影响发育迟缓的潜在因素,体重不足,在马萨比特县浪费6-59个月的孩子,肯尼亚。在六个捕获牧区的病房进行了横断面家庭调查,农牧,和城市生计实践。采用多级抽样方法,394名6-59个月的儿童在得到看护者书面同意的情况下参加。在数据收集过程中使用了预先测试的问卷和人体测量法。人口特征被总结为手段和比例,而卡方和方差分析用于评估变量之间的关联。后向逻辑回归用于探索发育迟缓的预测因素,体重不足,浪费,分别。结果表明,年龄Z得分的平均身高,Z年龄体重评分,身高Z评分和体重分别为-1.51、1.54和1.02。发育迟缓的患病率,体重不足,浪费是38.1%,23.0%,和18.5%,分别。孩子的年龄,饮用水源,废物处理是影响儿童发育迟缓的主要因素。总之,与世界卫生组织建议的截止值相比,营养不良的患病率较高.水源卫生,和照顾者的收入是儿童营养不良的一些主要预测因素。发展机构需要把重点放在饮用水的供应上,使用厕所设施,除了在牧区护理人员中进行关于卫生补充喂养做法的营养教育。
    The transition from nomadism to sedentary lifestyle has introduced changes in diets and undernutrition is endemic among settled pastoral households. This study aimed to investigate the underlying factors affecting stunting, underweight, and wasting of children aged 6-59 months in Marsabit County, Kenya. A cross-sectional household survey was conducted in six wards capturing pastoral, agro-pastoral, and urban livelihood practices. Using multistage sampling method, 394 children aged 6-59 months participated with written consent from the caregivers. A pretested questionnaire and anthropometric measures were used during data collection. Population characteristics were summarized into means and proportions, while chi-square and analysis of variance were used to evaluate associations between variables. Backward logistic regressions were used to explore predictors of stunting, underweight, and wasting, respectively. The results showed that the mean Height for Age Z-score, Weight for Age Z-score, and Weight for Height Z-score were -1.51, 1.54, and 1.02, respectively. The prevalence of stunting, underweight, and wasting was 38.1%, 23.0%, and 18.5%, respectively. The age of child, source of drinking water, and waste disposal were some of the main factors influencing stunting among children. In conclusion, the prevalence of undernutrition was high compared to the World Health Organization recommended cutoffs. Water sources hygiene, and caregiver\'s income were some of the main predictors of undernutrition among children. Development agencies need to focus on the supply of potable water, access to toilet facilities, in addition to nutrition education on hygienic complementary feeding practices among pastoral caregivers.
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  • 文章类型: Journal Article
    背景不发达国家的儿童免疫计划可以改善儿童的生长和营养状况,防止生长延迟,同时保护儿童免受传染病和满足生长规范。本研究旨在评估疫苗接种状况对扩大免疫接种中心12-18个月儿童人体测量指标的影响,并比较具有完整和不完整疫苗接种状况的儿童的人体测量指标。方法这项研究是在KalaShahKaku的农村卫生中心进行的,巴基斯坦,从2023年11月到2023年12月。纳入12-18个月的儿童,并记录他们的疫苗接种情况。身高和体重使用世界卫生组织生长图测量。数据采用描述性统计、卡方检验和Fisher精确检验进行分析。P值<0.05被认为是统计学上显著的。结果本研究访问疫苗接种部位的110名儿童的平均年龄为16.36个月±2.415。有28名(25.5%)发育迟缓的儿童。在研究中,17.6(16%)参与者体重不足,和15.95(14.5%)被浪费。孩子们,79%的人接受了所有推荐的疫苗接种。在疫苗接种和营养状况之间发现统计学上显著(p<0.05)的关联。结论本研究强调了疫苗接种在促进儿童健康和营养方面的重要意义。降低发育迟缓的风险,并确保公平获得疫苗接种服务和全面的医疗保健干预措施。这有助于减轻营养不良负担,促进最佳生长。促进全球健康和发展目标。
    Background Childhood immunization programs in underdeveloped nations can improve children\'s growth and nutritional status and prevent growth delays while protecting against infectious diseases and meeting growth norms. This study aimed to assess the impact of vaccination status on the anthropometric indices of children aged 12-18 months at an Expanded Programme on Immunization vaccination center and compare the anthropometric indices of growth in children with complete and incomplete vaccination statuses. Methodology This study was conducted at the rural health center in Kala Shah Kaku, Pakistan, from November 2023 to December 2023. Children aged 12-18 months were enrolled and their vaccination status was recorded. Height and weight were measured using World Health Organization growth charts. The data were analyzed using descriptive statistics and chi-square and Fisher\'s exact tests. A p-value <0.05 was considered statistically significant. Results The mean age of the 110 children who visited the vaccination site for this study was 16.36 months ± 2.415. There were 28 (25.5%) stunted children. In the study, 17.6 (16%) participants were underweight, and 15.95 (14.5%) were wasted. Of the children, 79% had received all recommended vaccinations. A statistically significant (p < 0.05) association was found between vaccination and nutritional status. Conclusions This study emphasizes the significance of vaccination in promoting child health and nutrition, reducing stunting risk, and ensuring equitable access to vaccination services and comprehensive healthcare interventions. This can help mitigate the malnutrition burden and promote optimal growth, contributing to global health and development goals.
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  • 文章类型: Journal Article
    严重急性营养不良的治疗旨在使儿童迅速追赶,以降低其短期死亡风险。目前尚不清楚追赶增长在多大程度上受到所提供能量的影响。这项研究评估了入院时提供的能量是否与入院时上臂中围(MUAC)<115mm的儿童的追赶体重增长有关。我们对马里的手术队列进行了二次数据分析。儿童接受简化方案治疗,提供1000千卡/天的治疗食物,直到连续两周达到MUAC≥115mm,此后达到500千卡/天,直到连续两周以MUAC≥125mm出院。线性混合效应回归模型用于评估入院时提供的能量(千卡/千克/天)与体重增加速度(克/千克/天)(主要结果)之间的关系。MUAC年龄z评分的变化和体重年龄z评分的变化。未调整的模型和性别调整的模型,年龄,符合季节性和入院时的MUAC。两种模型都包括研究地点作为随机效应。入院时提供的能量增加10千卡/千克/天与所有结果的增量相关;对于体重增加速度,在未调整和调整的分析中,平均(95%CI)增量为0.340[0.326,0.354]g/kg/天和0.466[0.446,0.485]g/kg/天,分别。在使用简化方案治疗的MUAC<115mm的儿童中,入院时提供的能量与追赶体重增长之间存在正相关关系。确定理想的体重增加率对于评估治疗期间增加能量摄入的益处和风险仍然至关重要。
    Treatment of severe acute malnutrition aims at producing quick catch-up growth in children to decrease their short-term mortality risk. The extent to which catch-up growth is influenced by the amount of energy provided is unclear. This study assessed whether energy provided at admission is associated with catch-up ponderal growth among children with mid-upper arm circumference (MUAC) < 115 mm at admission. We conducted a secondary data analysis an operational cohort in Mali. The children were treated with a simplified protocol providing 1000 kcal/day of therapeutic food until MUAC ≥ 115 mm was achieved for two consecutive weeks and 500 kcal/day thereafter until discharge with MUAC ≥ 125 mm for two consecutive weeks. Linear mixed-effects regression models were fitted to assess the relationship between energy provided at admission (kcal/kg/day) with weight gain velocity (g/kg/day) (primary outcome), change in MUAC -for-age z-score and change in weight-for-age z-score. Unadjusted models and models adjusted for sex, age, seasonality and MUAC at admission were fitted. Both models included the study site as a random effect. A 10 kcal/kg/day increase in energy provided at admission was associated with increments in all outcomes; for weight gain velocity, the mean (95% CI) increment was 0.340 [0.326, 0.354] g/kg/day and 0.466 [0.446, 0.485] g/kg/day in the unadjusted and adjusted analysis, respectively. A positive relationship exists between energy provided at admission and catch-up ponderal growth in children with MUAC < 115 mm treated using a simplified protocol. Determining the ideal weight gain rate remains essential for assessing the benefits and risks of increased energy intake during treatment.
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  • 文章类型: Journal Article
    背景:儿童的营养状况是其整体健康和福祉的关键指标。公共卫生仍然面临营养不良的挑战,尤其是在全球的发展中国家。在卢旺达,约33%的五岁以下儿童患有慢性营养不良。许多因素,比如贫穷,文盲,糟糕的WASH做法,不当的儿童喂养做法,医疗保健不足,是营养不良的主要原因。这项研究旨在评估婴儿和幼儿的喂养方式,WASH,粮食安全,以及他们与卢旺达西部和南部省份五岁以下儿童营养状况的关系。
    方法:采用基于社区的横断面研究设计,研究了影响Karongi439个家庭五岁以下儿童营养状况的因素,Nyabihu,和卢旺达尼亚马加贝地区。这项研究评估了贫血,发育迟缓,体重不足,浪费指标,并使用SPSS25版对收集的数据进行分析。
    结果:研究结果表明,在接受调查的儿童中,29.2%(128)被确定为发育不良,5.9%(26)体重不足,2.3%(10)患有消瘦症,20.9%(31)有贫血。与这些情况相关的因素包括较大的家庭规模[AOR=2.108;95%CI(1.016-4.371)],与发育迟缓呈正相关。此外,来自户主60岁以上家庭的儿童更有可能表现出发育迟缓[AOR=4.809;95%CI(1.513,15.283)].此外,家庭饮食多样性评分高与体重过轻呈正相关[AOR=6.061;95%CI(1.535,23.942)].
    结论:家庭特征,如大小,饮食多样性,户主的年龄影响儿童的营养状况。改善这些条件将提高儿童的营养状况。
    BACKGROUND: The state of a child\'s nutrition is a critical indicator of their overall health and wellbeing. Public health still faces challenges from undernutrition, especially in developing nations across the globe. In Rwanda, around 33% of children aged under five years suffer from chronic undernutrition. Many factors, such as poverty, illiteracy, poor WASH practices, improper child feeding practices, and insufficient healthcare, are the leading causes of undernutrition. The study aims to assess infant and young child feeding practices, WASH, food security, and their association with the nutritional status of children under five years in Rwanda\'s Western and Southern provinces.
    METHODS: A community-based cross-sectional study design was applied to study factors affecting the nutritional status of children under five years in 439 households in the Karongi, Nyabihu, and Nyamagabe districts of Rwanda. The study assessed anemia, stunting, underweight, and wasting indicators, and collected data was analyzed using SPSS version 25.
    RESULTS: The study findings indicate that among the children surveyed, 29.2% (128) were identified as stunted, 5.9% (26) were underweight, 2.3% (10) suffered from wasting, and 20.9% (31) had anemia. Factors associated with these conditions included larger household size [AOR = 2.108; 95% CI (1.016-4.371)], positively associated with stunting. Additionally, children from households where the head was above 60 years old were more likely to exhibit stunting [AOR = 4.809; 95% CI (1.513, 15.283)]. Furthermore, a high household dietary diversity score was positively linked to being underweight [AOR = 6.061; 95% CI (1.535,23.942)].
    CONCLUSIONS: Household characteristics like size, dietary diversity, and the age of the household head affect children\'s nutritional status. Improving these conditions would enhance children\'s nutritional status.
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  • 文章类型: Journal Article
    背景:有大量研究解释了女性就业和家庭财富状况对减少营养不良的单独影响。然而,我们的研究揭示了产妇就业和家庭财富对巴基斯坦3岁以下儿童营养不良的综合影响.
    方法:使用来自2017-2018年巴基斯坦人口与健康调查的1093名三岁以下儿童的样本,采用二元逻辑模型来评估影响儿童营养不良的因素。
    结果:我们的结果表明,居住在某些地区(巴基斯坦)的特定年龄(3岁)的儿童和最近的腹泻发作增加了营养不良的风险。相反,中等和高等教育,获得改善的水源,和卫生设施降低了巴基斯坦三岁以下儿童营养不良的机会。孕产妇就业与家庭财富之间的相互作用表明,孕产妇就业显着降低了发育迟缓的风险,体重不足,在平均水平中浪费,富有,最富有的家庭;然而,它没有促进贫困家庭和贫困家庭的儿童营养。值得注意的是,不管母亲是否受雇,富有和富有的财富地位降低了发育迟缓的风险,体重不足,和浪费。
    结论:在克服营养不良方面,孕产妇就业对中等收入家庭的贡献显著。然而,在富裕和最富有的家庭中,与孕产妇就业相比,财富地位发挥了更重要的作用。这表明,虽然就业在家庭资源中起着支持作用,财富状况总体上在减少营养不良方面更具影响力。
    BACKGROUND: There is an abundance of studies explaining the separate impact of female employment and household wealth status in reducing malnutrition. However, our study has unraveled the combined impact of maternal employment and household wealth on undernutrition among children under three in Pakistan.
    METHODS: Using a sample of 1093 children under three years of age from the Pakistan Demographic and Health Survey 2017-2018, a binary logistic model was employed to gauge factors influencing the children\'s undernutrition.
    RESULTS: Our results indicated that children up to a certain age (three years old) with residence in certain regions (Pakistan) and recent episodes of diarrhea had an increased risk of undernutrition. Conversely, secondary and higher maternal education, access to improved water sources, and sanitation facilities lowered the chances of undernutrition in children under three in Pakistan. The interaction between maternal employment and household wealth showed that maternal employment significantly lowered the risk of stunting, being underweight, and wasting among the average, rich, and richest households; however, it did not contribute to child nutrition among the poorer and poor households. Notably, regardless of whether the mother was employed, the wealth status of being rich and richest reduced the risk of stunting, being underweight, and wasting.
    CONCLUSIONS: In overcoming undernutrition, maternal employment significantly contributed to middle-income households. However, in the richer and richest households, the wealth status played a more crucial role compared to the maternal employment. This indicates that while employment plays a supportive role in household resources, the wealth status is overall more influential in reducing undernutrition.
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  • 文章类型: Journal Article
    背景:粮食不安全严重影响儿童的健康,影响他们的认知发展,物理,和社会情感维度。这项研究探讨了6个月至5岁儿童粮食不安全的影响,关注营养摄入及其与各种形式营养不良的关系。
    方法:利用机器学习算法,本研究分析了约旦河西岸819名儿童的数据,以调查与粮食不安全相关的社会人口统计学和健康因素及其对营养状况的影响.孩子的平均年龄是33个月,52%的男孩和48%的女孩。
    结果:分析显示,18.1%的儿童面临粮食不安全,家庭教育,家庭收入,局部性,区,和年龄成为重要的决定因素。来自食物不安全环境的儿童表现出更低的平均体重,高度,与粮食安全的同行相比,上臂中周围,表明粮食不安全与营养和生长指标下降之间存在直接关联。此外,机器学习模型观察到维生素B1是所有形式营养不良的关键指标,与维生素K1,维生素A,和锌。特定营养素,如“体重不足”类别中的胆碱和“浪费”类别中的碳水化合物被确定为独特的营养优先事项。
    结论:这项研究为儿童成长问题的不同风险提供了见解,为有针对性的干预和决策提供有价值的信息。
    BACKGROUND: Food insecurity significantly impacts children\'s health, affecting their development across cognitive, physical, and socio-emotional dimensions. This study explores the impact of food insecurity among children aged 6 months to 5 years, focusing on nutrient intake and its relationship with various forms of malnutrition.
    METHODS: Utilizing machine learning algorithms, this study analyzed data from 819 children in the West Bank to investigate sociodemographic and health factors associated with food insecurity and its effects on nutritional status. The average age of the children was 33 months, with 52% boys and 48% girls.
    RESULTS: The analysis revealed that 18.1% of children faced food insecurity, with household education, family income, locality, district, and age emerging as significant determinants. Children from food-insecure environments exhibited lower average weight, height, and mid-upper arm circumference compared to their food-secure counterparts, indicating a direct correlation between food insecurity and reduced nutritional and growth metrics. Moreover, the machine learning models observed vitamin B1 as a key indicator of all forms of malnutrition, alongside vitamin K1, vitamin A, and zinc. Specific nutrients like choline in the \"underweight\" category and carbohydrates in the \"wasting\" category were identified as unique nutritional priorities.
    CONCLUSIONS: This study provides insights into the differential risks for growth issues among children, offering valuable information for targeted interventions and policymaking.
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  • 文章类型: Journal Article
    全球,2021年有500万五岁以下儿童死亡。亚洲和非洲国家贡献了69%和27.2%的浪费,分别。在埃塞俄比亚,在901名(10.1%)五岁以下儿童中,632(8.1%)被发现是中等浪费,269人(3.0%)严重浪费。这项研究的目的是评估HabroWoreda的6至59个月儿童中消瘦的患病率及其相关因素,奥罗米亚,埃塞俄比亚东部。
    于2020年8月25日至9月20日在HabroWoreda进行了一项基于社区的横断面研究。总的来说,通过系统抽样技术将306名参与者纳入本研究。通过面对面访谈,使用预先测试的结构化问卷收集数据,进入EpiData版本3.1,并使用SPSS版本25进行分析。使用多变量逻辑回归分析模型评估预测因子,并使用具有95%置信区间(CI)的校正比值比(AOR)进行报告。统计学显著性设定为p<0.05。
    总的来说,哈布罗地区6-59个月儿童的消瘦患病率为28%,95%的置信区间[26.5,32.2%]。母亲不识字等因素[AOR=3.4;95%CI:1.14-10.47],没有厕所的家庭[AOR=2.91;95%CI:1.33-6.37],粮食不安全家庭[AOR=4.11;95%CI:1.87-9],未接受家访的家庭[AOR=4.2;95%CI:1.92-9.15],不吃各种食物[AOR=7.44;95%CI:2.58-21.45],出院后的患病儿童[AOR=6.55;95%CI:2.85-15.02],再入院儿童[AOR=3.98;95%CI:1.43-15.07],和消瘦3.42[AOR=3.42;95%CI:1.24-9.45]是与结果变量统计学相关的因素。
    这项研究指出,6-59个月儿童从门诊治疗方案出院后消瘦的患病率仍然很高。母亲的教育状况,厕所的可用性,在家里单独的厨房,家庭粮食不安全,家庭饮食多样性,家访,和入院类型与门诊治疗方案出院后儿童消瘦显著相关.因此,针对这些因素的努力应最大限度地减少门诊治疗计划出院后6-59个月儿童的消瘦发生率.
    UNASSIGNED: Globally, five million children under the age of five died in 2021. Asia and African countries contributed to 69% and 27.2% of wasting, respectively. In Ethiopia, out of 901 (10.1%) under-five children, 632 (8.1%) were found to be moderately wasted, and 269 (3.0%) were severely wasted. The purpose of this study was to assess the prevalence of wasting and its associated factors among children between the ages of 6 and 59 months in Habro Woreda, Oromia, Eastern Ethiopia.
    UNASSIGNED: A community-based cross-sectional study was conducted in Habro Woreda from 25 August to 20 September 2020. In total, 306 participants were included in this study through a systematic sampling technique. Data were collected using a pretested structured questionnaire through a face-to-face interview, entered into EpiData version 3.1, and analyzed using SPSS version 25. Predictors were assessed using a multivariate logistic regression analysis model and reported using an adjusted odds ratio (AOR) with a 95% confidence interval (CI). Statistical significance was set at p < 0.05.
    UNASSIGNED: Overall, the prevalence of wasting among children aged 6-59 months in the Habro district was 28%, with a 95% confidence interval [26.5, 32.2%]. Factors such as mothers illiterate [AOR = 3.4; 95% CI: 1.14-10.47], households without latrines [AOR = 2.91; 95% CI: 1.33-6.37], food-insecure households [AOR = 4.11; 95% CI: 1.87-9], households that did not receive home visits [AOR = 4.2; 95% CI: 1.92-9.15], did not eat a variety of food [AOR = 7.44; 95% CI: 2.58-21.45], sick children after discharge from the program [AOR = 6.55; 95% CI: 2.85-15.02], readmitted children [AOR = 3.98; 95% CI: 1.43-15.07], and wasting 3.42 [AOR = 3.42; 95% CI: 1.24-9.45] were factors statistically associated with outcome variables.
    UNASSIGNED: This study noted that the prevalence of wasting among children aged 6-59 months following discharge from the Outpatient Therapeutic Program remains high. Educational status of the mother, availability of a latrine, separate kitchen in the household, household food insecurity, household dietary diversity, home visit, and admission type were significantly associated with wasting of children after discharge from the outpatient therapeutic program. Therefore, efforts that target these factors should be maximized to reduce the occurrence of wasting among children aged 6-59 months after discharge from the outpatient therapeutic program.
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  • 文章类型: Journal Article
    儿童营养不良是世界上和埃塞俄比亚最严重和最少解决的健康问题之一。营养不良的患病率,体重不足,浪费了44%,29%,分别为10%。阿姆哈拉地区的营养不良率最高,为52%,33.4%,五岁以下儿童为9.9%。这项研究的目的是评估生活在BahirDar市贫民窟地区的5岁以下儿童的营养不良患病率及其相关因素。
    对BahirDarTown贫民窟地区的680名6-59个月的儿童进行了一项基于社区的横断面研究。使用大规模抽样技术选择研究参与者,并使用预先测试的结构化问卷和人体测量数据从2018年4月至6月收集数据。最后,收集的数据被编码,输入,清洁,记录,并存储,并使用EPIINFO对数据进行处理并导出到SPSS25.0版统计软件包中。使用双变量和多变量分析进行Logistic回归分析和解释。
    共有680名儿童参加。发育迟缓的患病率,体重不足,消瘦率为46.2%(95%CI;42.5-49.1),24.3%(95%CI;21.2-27.6),和11.3%(95%CI;CI;9.2-13.9)。收入组包括儿童[AOR=3.476(95%CI,1.959-6.167)],男性儿童[AOR=2.586(95%CI;1.532-4.365)]和母亲的教育水平[(AOR=2.600)(1.623)-4.164)]与营养不良显著相关。
    这项研究的结果表明,由于发育迟缓和消瘦而导致的营养不良的患病率在五岁以下的儿童中很高。孩子的性别,母亲的教育水平,发现家庭的月收入与营养不良显着相关。推广使用计划生育,预防腹泻病,通过营养教育计划为儿童接种疫苗是改善儿童营养状况的重要活动。
    UNASSIGNED: child malnutrition is one of the most serious and least addressed health problems in the world and in Ethiopia. The prevalence of malnutrition, underweight, and wasting was 44%, 29%, and 10% respectively. The Amhara region has the highest rates of malnutrition at 52%, 33.4%, and 9.9% for children under five. The aim of this study was to assess the prevalence of malnutrition and its associated factors among children under five living in the slum areas of Bahir Dar City.
    UNASSIGNED: a community-based cross-sectional study was conducted with 680 children aged 6-59 months in slum areas of Bahir Dar Town. Study participants were selected using a mass sampling technique and data were collected from April to June 2018 using a pre-tested structured questionnaire and anthropometric measurements. Finally, the collected data were coded, entered, cleaned, recorded, and stored, and the data were processed using EPI INFO and exported to the SPSS version 25.0 statistical package. Logistic regression analysis and interpretation were performed using bivariate and multivariate analysis.
    UNASSIGNED: a total of 680 children participated. The prevalence of stunting, underweight, and wasting was 46.2% (95% CI; 42.5-49.1), 24.3% (95% CI; 21.2-27.6), and 11.3% (95% CI; CI; 9.2-13.9). Income groups included children [AOR=3.476 (95% CI, 1.959-6.167)], male children [AOR=2.586 (95% CI; 1.532-4.365)] and mother\'s educational level [(AOR=2.600) (1.623) - 4.164)] were significantly associated with malnutrition.
    UNASSIGNED: the results of this study showed that the prevalence of malnutrition due to stunting and wasting was high among children under five years of age. The gender of the child, the educational level of the mother, and the monthly income of the family were found to be significantly related to malnutrition. Promoting the use of family planning, preventing diarrheal diseases, and vaccinating children through nutrition education programs are important activities to improve the nutritional status of children.
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  • 文章类型: Journal Article
    骨骼肌萎缩是对卸载或废弃的标志性病理生理适应,证明了对频繁机械刺激(例如肌肉激活和随后的负荷)的依赖性,以维持正常负荷肌肉的稳态。在缺乏缓解策略的情况下,没有哺乳动物对卸载引起的肌肉萎缩有抵抗力。鉴于卸载引起的肌肉萎缩对身体能力的深远影响,代谢健康和免疫功能;恢复期间卸载和/或增强方法期间的缓解策略在卧床住院中具有广泛的医疗保健意义。铸造固定和太空飞行。这篇专题综述旨在:(1)提供一个简洁的,关于卸载引起的骨骼肌萎缩机制的开创性和最新发现的现场状态总结;(2)讨论不成功与有希望的缓解和恢复增强策略;(3)确定知识差距,为未来的研究做好准备。我们专注于由相对短期的机械卸载/废弃驱动的快速肌肉萎缩,这在许多方面与高代谢肌肉萎缩和去神经支配引起的肌肉萎缩在机械上是不同的。通过将此讨论限于机械卸载,在此期间神经系统的所有组件保持完整(例如,没有去神经模型),需要肌肉运动神经和感觉神经回路的机械负荷仍然是缓解和增强恢复的可行目标。我们通过对啮齿动物研究的比较讨论来强调人类的发现,这些研究可以详细说明关键机制。我们还讨论了目前已知的年龄和性别作为生物学因素的影响,由于有限的研究,两者都被强调为知识差距和新的未来方向。
    Skeletal muscle wasting is the hallmark pathophysiological adaptation to unloading or disuse that demonstrates the dependency on frequent mechanical stimulation (e.g. muscle activation and subsequent loading) for homeostasis of normally load-bearing muscles. In the absence of mitigation strategies, no mammalian organism is resistant to muscle atrophy driven by unloading. Given the profound impact of unloading-induced muscle wasting on physical capacity, metabolic health and immune function; mitigation strategies during unloading and/or augmentation approaches during recovery have broad healthcare implications in settings of bed-bound hospitalization, cast immobilization and spaceflight. This topical review aims to: (1) provide a succinct, state-of-the-field summary of seminal and recent findings regarding the mechanisms of unloading-induced skeletal muscle wasting; (2) discuss unsuccessful vs. promising mitigation and recovery augmentation strategies; and (3) identify knowledge gaps ripe for future research. We focus on the rapid muscle atrophy driven by relatively short-term mechanical unloading/disuse, which is in many ways mechanistically distinct from both hypermetabolic muscle wasting and denervation-induced muscle atrophy. By restricting this discussion to mechanical unloading during which all components of the nervous system remain intact (e.g. without denervation models), mechanical loading requiring motor and sensory neural circuits in muscle remain viable targets for both mitigation and recovery augmentation. We emphasize findings in humans with comparative discussions of studies in rodents which enable elaboration of key mechanisms. We also discuss what is currently known about the effects of age and sex as biological factors, and both are highlighted as knowledge gaps and novel future directions due to limited research.
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  • 文章类型: Journal Article
    尽管全球贫困和饥荒显著减少,严重的儿童营养不良继续存在。2017年,超过5000万和1.5亿幼儿患有急性营养不良(消瘦)和慢性营养不良(发育迟缓)。分别。然而,决定因素的可衡量影响是模糊的。我们评估了肯尼亚和尼日利亚的发育迟缓和消瘦的社会环境相关决定因素,并量化了它们的有效性。我们将肯尼亚和尼日利亚人口健康调查(2003年,2008年-2009年,2013年,2014年)的健康和人口统计数据与空间明确的降水相结合,温度,和植被数据。地理空间和分类数据有助于更好地了解谁处于危险之中,以及在哪里开展缓解工作。我们使用四级随机截距分层广义Logit模型评估营养不良指标的反应性。我们发现空间和等级关系解释了28%至36%的营养不良结果变化。降水的时间变化,温度,植被的营养不良率变化超过50%。浪费受母亲教育的影响最大,家庭财富,临床分娩,和疫苗接种。发育迟缓受家庭财富的影响最大,母亲的教育,临床分娩,疫苗接种,和没有发烧症状的儿童,咳嗽,或腹泻。远程监测的气候变量是强大的决定因素,然而,它们的影响在不同的指标和地点是不一致的。
    Despite a remarkable reduction in global poverty and famines, substantial childhood malnutrition continues to persist. In 2017, over 50 million and 150 million young children suffered from acute malnutrition (wasting) and chronic malnutrition (stunting), respectively. Yet, the measurable impact of determinants is obscure. We evaluate proposed socio-environmental related determinants of stunting and wasting across Kenya and Nigeria and quantify their effectiveness. We combine health and demographic data from Kenya and Nigeria Demographic Health Surveys (2003, 2008-2009, 2013, 2014) with spatially explicit precipitation, temperature, and vegetation data. Geospatial and disaggregated data help to understand better who is at risk and where to target mitigation efforts. We evaluate the responsiveness of malnutrition indicators using a four-level random intercept hierarchical generalized logit model. We find that spatial and hierarchical relationships explain 28% to 36% of malnutrition outcome variation. Temporal variation in precipitation, temperature, and vegetation corresponds with more than a 50% change in malnutrition rates. Wasting is most impacted by mother\'s education, family wealth, clinical delivery, and vaccinations. Stunting is most impacted by family wealth, mother\'s education, clinical delivery, vaccinations, and children asymptomatic of fever, cough, or diarrhea. Remotely monitored climatic variables are powerful determinants, however, their effects are inconsistent across different indicators and locations.
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