中国七省农村地区1～7岁儿童饮食行为及其与生长发育的关系

目的了解我国农村地区1～7岁儿童饮食行为及其与生长发育的关系,为儿童饮食行为干预提供科学依据。方法采用多阶段分层整群随机抽样选择13692名1～7岁农村儿童,对其进行问卷调查和体格测量;采用χ2检验,多因素非条件logistic回归分析等方法分析饮食行为与生长发育的关系。结果在被调查者中,53.1%偶尔或从不饮牛奶/豆奶,48.1%几乎每天吃零食,22.5%挑食,7.3%偶尔或从不吃早餐,1.9%不能按时就餐。多因素非条件logistic回归分析显示:偶尔或从不吃早餐、偶尔或从不饮牛奶/豆奶、偶尔或从不吃零食与儿童生长迟缓有关;偶尔或从不吃早餐、偶尔或从不吃零食与儿童低体重有关;消瘦和超重/肥胖与饮食行为没有关联。结论农村地区儿童不良饮食行为发生率较高,且不良饮食行为与儿童生长迟缓、低体重等有关。     

中国十二省市社区城市化水平和家庭收入对儿童青少年早餐行为的影响

目的了解中国十二省市儿童青少年早餐行为情况。方法采用分层多阶段整群随机抽样方法,选取参加2011年第九轮"中国健康与营养调查(CHNS)"并有完整个人信息的4~17岁儿童青少年作为研究对象,共纳入1984人,分析调查对象的早餐就餐情况、就餐地点、食物制作地点、制作方法、食物选择种类以及膳食结构。结果 4~17岁儿童青少年吃早餐的人群比例为96.9%;早餐就餐地点以及早餐食物制作地点选择在家的人群比例分别为82.8%和73.0%;早餐食物制作方式选择为煮以及早餐食物选择谷类的人群比例分别为81.7%和84.1%;早餐膳食结构主要为以谷类食物及蔬菜水果等为主的植物类食物,以奶类及奶制品和肉、蛋类为主的动物类食物,以方便食品为主的零食食物为主的3种膳食模式。高城市化水平社区和高收入水平家庭儿童青少年的早餐在外就餐人群比例(22.7%,19.1%),早餐中食用奶类及奶制品、豆类及其制品(40.7%,38.9%)以及肉、蛋类(47.4%,42.0%)的人群比例更高(P0.001),而低城市化水平社区和低收入水平家庭的儿童青少年在家吃早餐(91.2%,86.4%)、早餐食用谷类食物(97.8%,94.5%)及蔬菜水果类食物(41.5%,32.0%)的人群比例更高(P0.001)。结论中国十二省4~17岁儿童青少年早餐行为存在一些不合理方面,社区城市化水平和家庭收入影响4~17岁儿童青少年早餐行为,应提供有针对性的营养干预,促进儿童青少年的身体健康。     

早餐食用频率和食物种类与儿童肥胖及相关慢性病患病率的关系

目的探讨早餐的食用频率和食物种类与儿童肥胖以及相关慢性病的关系。方法用随机整群抽样法从哈尔滨等6城市抽取一至五年级6～13岁小学生7009名进行问卷调查,并按照统一的标准进行体格检查及血生化指标的测量。结果经常吃早餐且早餐食物种类多样、经常吃早餐但早餐食物种类单调、不经常吃早餐但早餐食物种类多样、不经常吃早餐且早餐食物种类单调4组儿童中肥胖患病率[比值比及其95%可信区间]依次为10.0%(参考人群)、10.3%[OR:1.03(0.87-1.22)]、12.2%[OR:1.24(0.90-1.71)]、14.7%[OR:1.51(1.14-2.01);]腹型肥胖的患病率在各组间依次为:14.5%(参考人群)、13.8%[OR:0.94(0.81-1.09)]、18.3%[OR:1.36(1.04-1.79)]、18.8%[OR:1.38(1.07-1.78);]高血压的患病率依次为:10.0%(参考人群)、12.8%[OR:1.36(1.16-1.60)]、12.4%[OR:1.29(0.93-1.79)]、13.6%[OR:1.49(1.11-1.99)]。在调整了年龄、性别、出生体重、出生4个月内喂养方式、父母文化程度、家庭人均收入等混杂因素后,肥胖、腹型肥胖、高血压的发生率在各组间仍有统计学差异,血糖升高、高甘油三酯血症、高胆固醇血症、代谢综合征发生率在各组间无统计学差异。结论不经常吃早餐或早餐食物种类单一均会增加儿童患肥胖及相关慢性病的风险,保质保量的早餐能为儿童提供更加均衡的营养素摄入,有利儿童健康成长。保障早餐食用频率及食物种类多样对儿童健康意义重大。     

东莞市农村小学生早餐饮食行为与质量

了解东莞市农村小学生早餐饮食行为、早餐质量及影响因素,为指导发达地区农村小学生营养教育提供依据.方法 用随机整群抽样法,抽取东莞市某镇四~六年级小学生452名进行早餐饮食行为问卷调查.结果 81.42%的小学生每天吃早餐;选择早餐食物品种主要依据包括营养又健康(44.47%),父母安排(21.90%),口味(21.24%);多数人早餐结构不合理,优、良者仅占12.17%,只有2.21%符合营养早餐4类食物要求;对营养早餐认知正确率仅7.96%;96.24%认为有必要每天吃早餐;88.50%家长要求子女每天都吃早餐,其子女每天吃早餐率高于没要求者(x2=29.519,P<0.01);营养知识得分多者早餐质量较高(x2 =9.977,P=0.041);对营养早餐认知水平较高者早餐质量也较高(x2=70.091,P<0.01).结论 东莞市农村小学生早餐质量不高,与学生对营养早餐认知度低有关;多数学生能每天吃早餐,建议对小学生及家庭开展针对性的营养教育.     

看护人营养行为对农村留守儿童膳食摄入的影响的调查

目的了解看护人营养行为现况及其对农村留守儿童膳食摄入的影响,为农村留守儿童膳食营养干预提供科学依据。方法对随机选择的1261名2～7岁农村留守儿童及其看护人进行调查,调查方法包括问卷调查和食物摄入频率调查。结果看护人中几乎每天为儿童准备早餐者占56.4%;准备牛奶/豆浆者占14.5%;注意提供含钙丰富的食物者占1.5%;吃饭时提醒儿童不偏食、挑食者占9.9%;注意改变儿童食谱以加强营养者占2.7%。多因素Logistic回归分析结果显示:看护人的营养行为对农村留守儿童肉禽水产类、蛋类及其制品、乳类及其制品、水果类食物的摄入有一定的影响。结论看护人营养行为对农村留守儿童膳食摄入产生影响。     

上海市闵行区中小学生饮食行为及其影响因素

[目的]了解上海市闵行区中、小学生饮食行为及其影响因素,为制定营养干预措施,改善学生营养状况提供科学依据. [方法]采用随机整群抽样方法抽取小学3年级～高中3年级的中、小学生及其家长各5581名,采用问卷调查方式调查学生的早餐、午餐、零食、快餐、偏食行为及家长的文化程度、营养认知和家庭经济状况等,应用非条件logistic回归分析中、小学生饮食行为的主要影响因素. [结果]中、小学生每天吃早餐的比例为79.0％,早餐营养质量较差的占79.4％;51.9％的学生不喜欢学校午餐,主要原因是色香味欠佳;经常摄入零食和饮料的比例分别为97.6％和95.4％;每天喝牛奶的学生比例仅45.9％;过去1个月食用西式快餐和过去1周食用中式快餐的学生比例分别为62.7％和45.5％;偏食率为33.2％.多因素logistic回归分析显示,母亲文化程度和家长营养认知与每天食用早餐、早餐营养质量较好、每天喝牛奶行为相关(P＜0.01或P＜0.05);家庭经济状况与每天喝牛奶和食用西式快餐行为相关(P＜0.01);学龄段与每天食用早餐、每天喝牛奶、偏食及食用西式快餐行为相关(P＜0.01);性别与每天喝牛奶、食用西式快餐和中式快餐行为相关(P＜0.01或P＜0.05). [结论]中、小学生早餐食用率和早餐营养质量现状令人堪忧,午餐营养质量较差,不健康饮食行为较普遍,应引起学校、家庭和社会的重视.家庭的经济因素是影响中、小学生饮食行为的主要因素.     

2010—2012年中国6～17岁学龄儿童早餐食物种类调查

目的分析中国6～17岁学龄儿童早餐的食物种类,为改善儿童膳食营养提供理论依据。方法数据来自2010—2012年中国居民营养与健康状况监测。采用多阶段分层与人口成比例的整群随机抽样方法进行抽样,在全国31个省150个县/区共选取6～17岁儿童5822名作为研究对象。采用3天24小时膳食调查问卷调查儿童连续3天进食情况。比较不同年龄、性别、地区儿童早餐食物种类情况。结果中国分别有88.1%、47.8%、49.5%和33.1%的6～17岁学龄儿童调查期间早餐吃谷薯杂豆、蔬菜水果、禽畜肉蛋鱼和奶大豆坚果。早餐食物种类达到3类及以上的比例为41.7%,其中15～17岁儿童和贫困农村儿童早餐食物种类达到3类及以上的比例(37.7%和29.6%)均低于其他组儿童(P<0.05);不同性别的学龄儿童早餐食物种类的差异无统计学意义。结论学龄儿童早餐食物种类不能达到3类及以上的情况普遍存在,尤其是高年龄组和贫困农村儿童早餐状况更差,应重点关注。     

京沪两地小学生早餐行为及影响因素分析

目的　了解京沪两地小学生早餐现状及影响早餐的行为因素 ,为深入研究小学生早餐问题 ,制定和开展“学生营养早餐计划”提供科学依据。方法　采用分层整群抽样方法 ,对北京、上海两个城市 86 88名 6～ 1 1岁学生的早餐行为进行问卷调查。调查内容包括家庭一般情况、饮食喜好、早餐食物选择、奶类摄入等情况。结果　小学生不能保证每天吃早餐的比例北京男生为 2 5.8% ,女生为 2 1 .6 % ;上海男生为 1 1 .4 % ,女生为 1 3.3%。学生不吃早餐的原因主要是没有食欲、没有时间吃和家长没时间做。学生早餐食物品种单调 ,质量较差。学生早餐 55%以上由母亲准备 ,食用早餐的地点以家里为主 ,其次为上学路上和饭馆或小摊。早餐费用在 2～ 3元之间。学生吃早餐的行为与其母亲的吃早餐行为密切相关 (P <0 .0 1 )。结论　京沪两地小学生的早餐质量均有待改善。应加强家长的营养知识教育 ,重视早餐 ,倡导合理营养。     

中国部分地区农村≤7岁留守儿童的看护人 看护意愿及其影响因素研究

目的 探讨中国部分地区农村≤7岁留守儿童看护人看护意愿及其影响因素.方法 采用多阶段整群随机抽样方法,对随机选择的7585名≤7岁农村留守儿童看护人进行问卷调查,并采用多因素有序多分类logistic回归分析筛选看护意愿的影响因素.结果 单亲外出组看护人看护意愿为非常愿意、愿意、不愿意的比例分别为41.1%、55.4%和3.5%,双亲外出组分别为19.5%、71.4%和9.1%.多因素有序多分类logistic回归分析表明:看护人年龄、家庭年人均收入、社会关系和母亲外出务工时间、抚养费以及留守儿童年龄、生活方式、是否为独生子女、父母外出务工时留守儿童年龄等与看护意愿有关.结论 留守儿童看护人看护意愿有待提高,应关注其影响因素,必要时进行干预.     

我国4城市儿童少年食用早餐频度和肥胖率关系分析

目的分析我国城市儿童少年食用早餐频度与肥胖率之间的关系，为制定肥胖干预措施提供理论依据。方法采用分层整群随机抽样的方法，从广州、上海、济南、哈尔滨等4城市的城区及近郊区抽取4～16岁的儿童少年及家长进行问卷调查，共调查9356名儿童及其家长，同时收集儿童少年的身高、体重资料。结果4城市儿童少年中每周食用早餐7次，5～6次，3．4次，1．2次和0次的比例分别为83．1％，10．6％，3．6％，1．6％和1．1％，其肥胖率依次为11．5％，13．7％，13．7％，13．1％和17．8％。每天食用早餐的儿童少年的肥胖率显著低于每天不吃早餐的儿童少年，不吃早餐的儿童少年发生肥胖的危险是每天食用早餐儿童少年的1．656倍。结论不吃早餐的儿童少年发生肥胖的危险性大于每天食用早餐的儿童少年。不吃早餐是影响儿童肥胖的一个独立危险因素。     

Calcium intake in the elderly: validation of a dietary questionnaire

Epidemiological studies of calcium and osteoporosis have been hampered by the lack of a suitable tool for assessing calcium intake. This report describes a new frequency and amount questionnaire for measuring present and past calcium intake in the elderly. The validity of the questionnaire was tested against two commonly used standards of dietary assessment, five-day duplicate diets and seven-day weighed dietary inventories. The resulting correlation coefficients were, respectively, r = 0.76 and r = 0.69, while that for repeatability was r = 0.84. Furthermore, the questionnaire categorized subjects into thirds of the distribution of intake with almost no gross misclassification. It is suggested that the present findings may be extended to the majority of normal, healthy elderly subjects, implying wide application for the questionnaire in the assessment of calcium intake in the elderly.     

The occurrence of antimicrobial substances in toilet,sink and shower drainpipes of clinical units: A neglected source of antibiotic residues

Antibiotics represent one of the most important drug groups used in the management of bacterial infections in humans and animals. Due to the increasing problem of antibiotic resistance, assurance of the antibacterial effectiveness of these substances has moved into the focus of public health. The reduction in antibiotic residues in wastewater and the environment may play a decisive role in the development of increasing rates of antibiotic resistance. The present study examines the wastewater of 31 patient rooms of various German clinics for possible residues of antibiotics, as well as the wastewater of five private households as a reference.To the best of our knowledge, this study shows for the first time that in hospitals with high antibiotic consumption rates, residues of these drugs can be regularly detected in toilets, sink siphons and shower drains at concentrations ranging from 0.02?μg·L^?1 to a maximum of 79?mg·L^?1. After complete flushing of the wastewater siphons, antibiotics are no longer detectable, but after temporal stagnation, the concentration of the active substances in the water phases of respective siphons increases again, suggesting that antibiotics persist through the washing process in biofilms. This study demonstrates that clinical wastewater systems offer further possibilities for the optimization of antibiotic resistance surveillance.     

Self-reported health problems among Swedish miners one year after unemployment

Unemployment is considered to be a public health concern sincedeterioration in the health of the unemployed is often anticipated.However, for some groups, such as miners, unemployment mightimprove health due to a cessation of potentially harmful occupationalexposures. This study evaluates the health of 79 miners in oneSwedish iron-ore mine, and 226 age-matched controls from thegeneral population, during one year after the closure of themine. The participants received a questionnaire regarding medicalhistory and subjective symptoms at the beginning of the studyperiod, and after one year. Statistically significant negativeeffects on self-reported health attributable to unemploymentwere not found, although neuropsychiatric symptoms were morecommon among the unemployed miners. The miners reported a statisticallysignificant improvement in grip force (p=0.031). They had asignificantly higher prevalence of symptoms associated withmining related exposures when compared with the population controls;pain in the upper extremities [relative risk (RR)=2.27, 95%confidence interval (Cl)=1.44–3.59), back pain (RR=1.84;Cl=1.237–2.75), vasospastic disease of the fingers (RR=2.05;Cl=1.18–3.57) and obstructive respiratory symptoms (attacksof dyspnea and wheezing: RR=3.67; Cl=1.167–11.6).     

Excès de cas humains et animaux de tularémie en France au cours de l’hiver 2007–2008 : émergence ou phénomène isolé ?

Context

Tularemia is a zoonosis affecting humans and hares in France. We describe the results of surveillance in both species, in 2007 and 2008.

Methods

Human tularemia cases are mandatorily notifiable in France since 2003. In hares, surveillance relies on volunteer hunter associations in all districts of the country. Data from mandatory reports and volunteer surveillance in 2007/2008 were analyzed and compared with previous results.

Results

In 2007/2008, 144 cases were reported in humans and 117 cases in hares. This was a 100% increase compared to previous years. Human cases differed from those of previous years only by the frequency of contact with breeding animals. Human cases without any documented risk exposure were also more frequent.

Conclusion

An increase of tularemia cases occurred in 2007/2008 in both species. Complementary studies are needed to identify the species reservoir in France to understand the causes of this peak of cases.     

深圳公立医院管理体制改革制度设计

深圳公立医院管理体制改革实行政事分开、管办分开,在理事会架构下按法定机构模式组建市医管中心,落实公立医院运营管理自主权.作者从当前公立医院管理体制的弊端入手,介绍了深圳市进行公立医院管理体制改革的基本思路及改革方案设计的主要举措,深入剖析了的改革方案的特点,并对改革效果进行了预测.     

Occupational health hazards in mining: an overview

This review article outlines the physical, chemical, biological, ergonomic and psychosocial occupational health hazards of mining and associated metallurgical processes. Mining remains an important industrial sector in many parts of the world and although substantial progress has been made in the control of occupational health hazards, there remains room for further risk reduction. This applies particularly to traumatic injury hazards, ergonomic hazards and noise. Vigilance is also required to ensure exposures to coal dust and crystalline silica remain effectively controlled.     

Effects of nitrogen dioxide on red blood cells of rats: Changes in components of red cell membranes during in vivo exposure to NO2

Red cell membranes, prepared from red blood cells of rats exposed to 4, 10, or 20 ppm nitrogen dioxide (NO₂) for 1 to 10 days, were examined for evidence of changes in membrane components. Appreciable changes were not found in contents of phospholipid and cholesterol during exposure to 10 ppm NO₂. By contrast, protein content altered with the time of exposure. Moreover, changes in protein composition were observed by employing sodium dodecyl sulfate — polyacrylamide gel electrophoresis. Twenty-four-hour exposure to NO₂ at the concentration above 10 ppm resulted in a marked increase in the percentage of lysophosphatidylethanolamine (LysoPE) to the total phospholipids. The prolonged exposure to 10 ppm NO₂ gave rise to a further increase in LysoPE, whereas the percentage of phosphatidylethanolamine (PE) showed a gradual decrease. A 1-day exposure to 4.0 ppm NO₂ also caused an increase in sialic acid content and decreases in those of PE and hexose. In addition to contents of these components the percentage of LysoPE increased 5 days after exposure and the elevated values were maintained up to the end of exposure period. These results demonstrate that red blood cells in circulation exhibit different membrane properties in terms of lipid and carbohydrate composition during 10 days of exposure to 4.0 ppm NO₂.     

Manufacture and use of nanomaterials: current status in the UK and global trends

This paper provides an overview of the production and use of nanomaterials (NMs), particularly in the UK. Currently, relatively few companies in the UK are identifiable as NM manufacturers, the main emphasis being the bulk markets in metals and metal oxides, and some niche markets such as carbon nanotubes and quantum dots. NM manufacturing in the UK does not reflect the global emphasis on fullerenes, nanotubes and fibres. Some assumptions have been made about the types of NM that are likely to be imported into the UK, which currently include fullerenes, modified fullerenes and other carbon-based NMs including nanotubes. Many university departments, spin-offs and private companies have developed processes for the manufacture of NMs but may only be producing small quantities for research and development (R&D) purposes. However, some have the potential to scale up to produce large quantities. The nanotechnology industry in the UK has strong R&D backup from universities and related institutions. This review has covered R&D trends at such institutions, and appropriate information has been added to a searchable database. While several companies are including NMs in their products, only a few (e.g. manufacturers of paints, coatings, cosmetics, catalysts, polymer composites) are using nanoparticles (NPs) in any significant quantities. However, this situation is likely to change rapidly. There is a need to collect more information about exposure to NPs in both manufacturing and user scenarios. As the market grows, and as manufacturers switch from the micro- to the nanoscale, the potential for exposure will increase. More research is required to quantify any risks to workers and consumers.     

Investigating clusters in the workplace and beyond

Clusters of disease are common and occur in the workplace and in the general community. They often arouse considerable concern among the population. Investigations have sometimes lead to exciting new knowledge, but in general the investigation of clusters is difficult and often unrewarding, especially for community clusters. In the workplace, investigations are more likely to find associations and even new causes, but still many clusters remain enigmatic. Despite this, there are many reasons for investigating clusters, including allaying community concern and identifying uncontrolled exposures. A structure for investigating clusters in the workplace is suggested.