Obstacles to the Integrated Care of Children Aged 6 to 59 Months Suffering from Acute and Severe Malnutrition at the Chu-Me and HATC of N’Djamena/Chad

Introduction: the problem of Severe Acute Malnutrition (SAM) and its consequences concern and challenge all social actors worldwide. The objective of the study was to identify the real obstacles that actors face in the integrated management of children aged 6 - 59 months suffering from SAM at the University Hospital of Mother and Child (CHUME) and the Chad-China Friendship Hospital (HATC) of N’Djamena. Methodology: this is a cross-sectional descriptive and interpretative study conducted from January to October 2023 at the CHUME and HATC of N’Djamena. It is based on questionnaires and direct observation of two hundred and thirty-six (236) parents or guardians of malnourished children admitted to these health facilities. All 236 agreed to participate freely in this study. Results: it appears from this study that the obstacles to the integrated management of malnourished children were: poor care-care relationship (26.7%) permanent product breaks (22.9%), the direct costs of services ranged from 30,000 to 60,000 FCFA (41.53%), drugs used for the treatment of patients came from the street (66.10%), malaria and anemia occupy an important place (27.5%), 57.2% respondents had monthly income below 60,000 CFAF. Conclusion: the present study carried out has identified the real bottlenecks to the integrated management of children suffering from SAM in the therapeutic nutritional units of the city of N’Djamena. .

THE CALENDAR SYNCHRONIZATION AND INTERCALARY MONTHS IN UMMA,PUZRIS-DAGAN,NIPPUR,LAGAS AND UR DURING THE UR Ⅲ PERIOD

In my article in JAC 15,I discuss“the Mada calendar”of Puzri-Dagan of the UrⅢ period.This calendar started from the month iti-ma-d-k while its alternatecycle“the Akiti Calendar”started from the month iti-ki-ti(vi).The Akiticalendar was only used for three whole and two half years(ulgi 44’viii’-xii',45’-47’,48’i’-vii’)during the Mada years of ulgi 45/i to ulgi 48/xii.It wasonly used by the main office of Puzri-Dagan.

Introduction of a New Cycle in Replacement of Metonic: An Ideal Solution towards a Deviation Free Luni-Solar Calendar

Molad is simply an interval between two successive new moon timelines with respect to the line joining the Sun and the Earth i.e., with respect to the Sun as seen from the Earth, which in scientific terms is referred as lunation or “synodic lunar month”. Though synodic lunar month may vary by up to ±0.7 days locally, the length of mean synodic lunar month is constant over a long period of time and is a crucial value in determining the luni-solar calendar’s new months similar to Hebrew calendar’s “Rashei Hodesh”. Based on the Metonic cycle the luni-solar Hebrew calendar adds 07 intercalary months in 19 solar years. This hypothesis proposes a new cycle instead of the Metonic cycle towards eliminating the deviation of the calendar incurred in the long course of time. The research analyzed that application of the conventional Metonic cycle to luni-solar calendar is erroneous, which theoretically leads Hebrew calendar to absorb extra 11 days (approx.) by 2053 years after inception. The study pointed out that through the application of 2116 - 2053 lunar-solar years cycle instead of 235 - 228 lunar-solar months based Metonic cycle, formulation of a far better high precession luni-solar calendar is possible and also both lunar and solar sides of the luni-solar calendar became fully balanced and harmonized.

The effect of protective genital care protocol on preventing diaper dermatit development in 0 - 18 month old children using antibiotics

Diaper dermatit is among the widely seen inflamatory skin diseases in neonatals and small 0 - 18 month old children. Control of causative agents as well as providing good genital care may prevent or reduce the risk of the disease. The aim of this study is find out the effect of protective genital care on reducing the diaper dermatit development in 0 - 18 months old inpatient 0 - 18 month old children who are using antibiotic. The study was conducted as prospective half-experimetal using control-experimental groups. Our samples comprise of 0 - 18 month old children admitted at Dokuz Eylul University Practical and Research Hospital, pediatric clinic between January and May 2009, 41 0 - 18 month old children as a control group were not under protective genital care, and 42 0 - 18 month old children as an experimental group were under the protecion and using vaseline. The mothers of the experimental group 0 - 18 month old children were given education. All 0 - 18 month old children were followed-up 3 - 7 days and the collected data were evaluated in computer using Pearson’s chisquare, Fisher’s exact chi-square and Yatest-corrected chi-square tests. The diaper dermatit develop- ment ratio was 34.1% in the control group and 7.1% in the experimental group

Climatic Change in Qinghai-Tibet Plateau and the Surrounding Areas in 130 Years

[ Objective] The research aimed to study climatic change in Qinghai -Tibet Plateau and the surrounding areas from 1880 to 2011. [ Method] Based on GISS temperature grid data, by using change rules of the annual and monthly anomaly temperatures, sliding t-test and wavelet analysis, periodicity and tendency of the atmospheric temperature change in Qinghai -Tibet Plateau and the surrounding areas were analyzed. [ Re- sult] Both annual and monthly anomaly temperatures in Qinghai -Tibet Plateau in recent 130 years presented rise tendency. Since the 1990s, tem- perature rose evidently, and it presented temperature-rise tendency of winter 〉 autumn 〉 spring 〉 summer. Rise velocity of the temperature had spatial difference. Rise velocity of the temperature in west Inner Mongolia was the highest, followed by west Sichuan and east Tibet. Rise velocity of the temperature in some areas of Xinjiang was the slowest. Abrupt change of the temperature happened in the 1930s, and main period of the wavelet analysis was 10 years. [ Conclusion] The research could lay foundation for discussinq Qlobal climate change.

Epidemio-Clinical Profile and Factors Associated with Performance Indicators of Integrated Management of Severe Acute Malnutrition in Children Aged 6 - 59 Months Hospitalized at the Kalaban Coro Reference Health Center

Introduction: Malnutrition is an important reason for consultation in Mali’s health facilities and remains a major public health problem. The aim of this study was to describe the epidemioclinical profile and associated factors with performance indicators of integrated management of severe acute malnutrition in children aged 06 to 59 months. Methodology: this was a cross-sectional study with retrospective data collection (January 2021 to December 2022). All children hospitalized for severe acute malnutrition in the pediatric department and whose medical records were usable were included. Data collected using a standardized questionnaire was analyzed with SPSS Version 20 software. Results: A total of 534 children were included. The 12 to 23 months age group (49.1%) and the female sex (53.18%) were the most affected. Fully vaccinated children by age represented 49.4%. The predominant form of malnutrition was marasmus (77.7%). Diarrhea/vomiting (30.3%), fever (18.4%) and cough (15.5%) were the main reasons for consultations. Cure, discontinuation and death rates were 78.5%, 2.1% and 9.2%, respectively. On univariate analysis, the factors statistically associated with performance indicators (cure, drop-out, death) were gastroenteritis (P-value Conclusion: This study reveals that the frequency of severe acute malnutrition remains high at the Kalaban Coro reference health center. Better prevention of illnesses such as malaria, gastroenteritis, and respiratory infections, as well as timely referral, could help facilitate its management.

Evaluation of the Integrated Management Program for Acute Malnutrition in the Douentza Health District, Mopti Region, Mali

Introduction: Malnutrition is a major public health problem in Mali, despite the efforts of the government, its technical and financial partners. The aim of this study was to evaluate the integrated management program for acute malnutrition (IMPAM). Methodology: This was a descriptive cross-sectional study that took place from January to December 2020 in the Douentza health district. The study included anyone with at least one malnourished child aged 6 to 59 months in their care who agreed to take part in the study, community health center staff who had given their consent, and the URENI manager at the Douentza reference health center. Data collected via questionnaires were entered into Excel and then analyzed using Epi-Info version 7 software. Results: A total of 138 acutely malnourished children aged 6 - 59 months, including 71 girls (51.45%), 138 accompanying mothers and 11 health workers, were included in our case study. Among the malnourished, 54.34% were in the 12 - 23 months age group and 69.57% had the severe form. 93% of the mothers interviewed were satisfied with the care provided, and all the health staff interviewed stated that community conflicts had an impact on IMPAM’s activities. Cure rates were 81% in Moderate Outpatient Nutritional Recovery and Education Unit (URENAM), 84% in Severe Ambulatory Nutritional Recovery and Education Unit (URENAS) and 92% in Recovery and Intensive Nutritional Education Unit (URENI). Drop-out rates were 19% in URENAM, 16% in URENAS and 0% in URENI. The death rate was 8% in URENI and 0% in URENAM and URENAS. Conclusion: This study confirms the high prevalence of malnutrition in the district (10.54%). It also reveals that factors such as inter-community conflict and insecurity have seriously affected the IMPAM program.

十月历、十八月历与阴阳五行

彝族十月太阳历简称十月历,它的发现是20世纪天文界的一件大事。继十月历之后又在彝族地区发现了十八月历,即把一年分成18个月,每月20天的阳历。从现有的证据看,中国上古时代确实存在过十八月历,它就是尧都观测遗址显示的"二十节气"历。据《吐鲁窦吉》阐述,1年10个月,1月36天,半月18天,1年为20节气,1个节气18天也称为1个月。据此可以证明,彝族先民对十八月历并非独自创造,只是继承而已。植根于中国阴阳五行中的十月历,也可称作阴阳五行历,它与十八月历可看作是一回事,只是表述形式不同又互有联系的一种阳历,也可用简单的数学式表达:36天×10 (月)=20天×18 (月)=18天×20 (节气)=12天×30 (节气)

帝辛周祭系统的可能年代

商代晚期，商王用５种祀典周而复始地祭祀先王先妣，学者称之为周祭，有纪时功能。文章通过研究商末帝辛世的甲骨文和金文中的周祭材料在历法上的自洽性，得出帝辛元方祀到十一祀祀谱的历日特征，即帝辛二祀正月初一应为丙辰日或二月初一为丁巳日，结合其他材料，确定了帝辛元年为公元前１０７５年。

突发性聋发病与天气和天体变化的关系

目的研究分析突发性聋(突聋)发病与季节、月份、月亮盈亏、太阳黑子以及大气温度变化的关系方法回顾性分析我科2000年—2006年住院治疗的突聋患者发病的具体时间,并对近30年我院突聋住院人数占耳鼻喉科总住院人数的平均构成比与近56年西安市年平均气温进行对比分析。结果 332例突聋中,春季发病66例,夏季发病94例,秋季发病86例,冬季发病87例;9月和8月突聋发病人数最多,5月和10月突聋发病人数最少。农历初一与农历15日突聋发病人数明显多于农历28日和29日的发病人数。农历初一至十五突聋发病185例,农历十六至三十日发病147例,即月亮由新月到满月的突聋发病人数构成比多于月亮由满月到残月的突聋发病人数构成比。近30年太阳黑子爆发高发年是1989年和2000年,太阳黑子爆发低谷年为1996年,这3年我院突聋住院人数占耳鼻喉科总住院人数的构成比分别为1.99%、5.01%和4.23%。与所在年代的我院突聋住院人数占耳鼻喉科总住院人数的平均构成比无显著性差异(P>0.05)。研究发现近30年突聋住院病人占我院耳鼻喉科住院人数构成比有逐渐增多趋势,其中上世纪80年代构成比为1.69%、90年代为3.31%、2000年—2009年为4.38%,不同时期突聋住院人数的构成比在统计学上有显著性差异(P<0.01)。而近30年西安市的年平均气温明显升高,突聋发病与平均气温升高可能存在一定关系。结论突聋发病在一年四季中以夏季发病人数最多,9月和8月是突聋发病高发期。月亮圆缺变化可能对突聋发病有一定影响,太阳黑子爆发与突聋发病无明显相关。近30年突聋发病有逐渐增多趋势,可能与CO2排放增加和温室效应导致的大气平均温度升高有关。

彝族十月历新证

十月历在历史上的存在，已有彝文文献的发掘证据，并可从中窥视其演变脉络。原是１年分成阳年和阴年两半，以五行循环２次或以十兽纪月；继而改以五行代表三季，每季含阳和阴２个阳历月分；受汉族农历影响后，再把五季改造成四季，吸收十二生肖纪日纪年，改以数字纪月，为过渡到改行十二月历奠定了基础。

春秋时期鲁国历法研究的一些新观点

在阐述春秋时期鲁国历法研究的历史和现状的基础上,刍议历代春秋时期历法研究均不成功的原因;对月建、两次"日南至"、"三正"、频大月等重要议题进行重新审视;给出春秋时期鲁国244年间各年之岁首日期、JD和干支,并标出置有闰月的年。特别对春秋时期鲁国历法的建正、失闰和超闰等有争议的问题进行深入的研究,论证复原、重现春秋时期鲁国历谱的原则。最后讨论春秋时期各国历法的建正问题。

《肩水金关汉简(贰)》历简年代考释

2012年《肩水金关汉简(贰)》出版,本文考释17枚历谱散简、9枚纪年残简和8枚月朔简的年代。将11片断简仔细缀合成5枚,连同原有6枚全简,认为属于居摄元年(6)同册历谱。指出:T24:208号简的"延和三年"就是征和三年(前90);T23:103号简应考为鸿嘉三年(前18)闰八月庚午朔,为特殊置闰,《二十史朔闰表》等今用历谱闰九月庚子朔有误。

中国古代的置闰法:一个概率问题

概述了中国传统历法中置闰算法的沿革 ,特别是比较了早期历法中置闰算法的异同。指出在推算闰月可能发生的位置时 ,《三统历》(公元前 1 0 4年 )采用以中气推闰 ,《后汉四分历》(85年 )选择以经朔推闰 ,而《大衍历》(72 4年 )则设计出以气盈朔虚推闰 ,并推导出按照平气平朔置闰时 ,闰月出现位置的概率计算公式。对于大闰周或无闰周的历法而言 ,按推算结果得本月置闰的概率为0 .4535,前一个月置闰的概率为 0 .541 3,前两个月置闰的概率为 0 .0 0

《左传》之“荆尸”再辨证

清代阮元校刻的《十三经注疏》与杨伯峻的《春秋左传注》庄公四年：＂四年,春,王正（三）月。楚武王荆尸,授师孑焉,以伐随＂有＂王正月＂与＂王三月＂两种版本。有学者根据这两种不同的版本得出了《左传》中的＂荆尸＂是楚月名,且都为＂正月＂的相同结论。实际上,把＂荆尸＂释为楚月名不是与《传》文矛盾,就是与文意不合。所以还应遵循旧注,将其释为＂楚国的一种军阵＂较妥。

《周易》复卦卦辞“七日来复”新诠

考察历代易家关于复卦"七日来复"的各种解释,可以发现诸家之说虽然各皆有理,但是都未能切合上古社会的历史实际。本文通过探讨上古"十日并出"、"以火纪时"以及汉儒"十二辟卦"等说法,认为"七日来复"实际蕴含着一段人类认识自然、模拟自然的历史记忆,其中依稀保留着中国古代历法史上久被遗忘的"十日历"("十月历")的事实,所谓"七日"者正是"七月"的古称,与临卦"八月有凶"正好前后呼应。

彝族毕摩文献中的十月太阳历研究

彝族十月太阳历作为古老悠久的历法,有着显著的特点和广泛的影响。彝族毕摩文献中,十月太阳历的"年、季、月、日、时"有其自身的命名方式和内在蕴涵,并能有机地融为一体,形成独特的认知结构和思维方法,十个"库久"、十个"肯肯"、十个"吉禄"和十个方位更是凸显出其深邃的文化意蕴。

中国股票市场异常下跌时期的日历效应分析

利用Var方法界定出股票市场的异常时期后,可对股票市场异常下跌时期的日历效应进行分析。实证表明我国股票市场在异常下跌时期具有明显的"五月份效应"、"周初效应"和"周末效应"。"五月份效应"的产生与我国上市公司的会计信息披露时间以及经济政策的调整和公布时间有关,而"周初效应"和"周末效应"与大多数学者已证实的股票市场正常时期的周内效应是一致的。

《肩水金关汉简(叁)》历简年代考释

2013年《肩水金关汉简(叁)》出版,本文考释纪年简6枚、历谱散简13枚和月朔简13枚的年代。认为T26:178和T26:218号属于元凤六年(前75),为同册历谱;T30:1,2和218号属于元康元年(前65),为同人所书;指出T26:87号简"河平元年"(前28)错释为"河平五年"。重点考释T29:117A号特殊的矩形年历简(前55),讨论汉代"伏天"的划分。这批月朔简半数可考出唯一年代。

十杆测日影的一种方法

彝文文献《滇彝天文》记述,十月太阳历的创立是以观测天象为基础,其中一种方法是立10颗杆子测日影和斗柄,确定年长度、两至点及两分点。本文对10颗杆子相对位置及作用进行讨论,并采用现代实测的有关数据,定量计算出3个观测点必备的条件。