Introducing taxes, subsidies or both: the effects of various food pricing strategies in a web-based supermarket randomized trial

Objective

Fiscal policies may form a solution in improving dietary intake. This study aimed to examine the effectiveness of varying taxing and subsiding schemes to stimulate healthier food purchases.

Methods

A randomized controlled trial with three levels of price reduction on healthy foods (no; 25%; 50%) × three levels of price increase on unhealthy foods (5%; 10%; 25%) factorial design was used. 150 participants were randomized into one of nine conditions and were asked to purchase groceries at a web-based supermarket. Data were collected in the Netherlands in January-February 2010 and analyzed using analysis of covariance.

Results

Subjects receiving 50% discount purchased significantly more healthy foods than subjects receiving no (mean difference = 6.62 items, p < 0.01) or 25% discount (mean difference = 4.87 items, p < 0.05). Moreover, these subjects purchased more vegetables (mean difference = 821 g; p < 0.05 compared to no discount). However, participants with the highest discount also purchased significantly more calories. No significant effects of the price increases on unhealthy foods were found.

Conclusion

Price decreases are effective in stimulating healthy food purchases, but the proportion of healthy foods remains unaffected. Price increases up to 25% on unhealthier products do not significantly affect food purchases. Future studies are important to validate these results in real supermarkets and across different countries.     

上海市部分地区老年人营养与健康状况调查分析

[目的]了解上海市老年人营养和健康状况。[方法]采用2002年全国营养调查上海地区资料,对老年人的营养与健康状况进行分析。[结果]老年人每人每天粮谷类、蔬菜、水果、畜禽肉类、水产类、奶类及其制品、干豆类、豆制品、食用油、盐的摄入量分别为381.36 g、394.86 g、133.24 g、140.49 g、146.65 g、114.04 g、1.75 g、28.93 g、50.17g和9.78 g,每人每天能量摄入量为2762 kcal,蛋白质、脂肪、视黄醇当量、维生素B1和维生素B2、维生素C、钙、铁的摄入量分别为101.58 g、105.21 g、794.69μg、1.23 mg、1.29 mg、100.02 mg、742.35 mg、30.76 mg;来自脂肪的能量超过了中国居民膳食营养素参考摄入量和世界卫生组织推荐的30%的上限,优质蛋白质的比例超过1/3。老年人的营养不良率、超重率、肥胖率和向心性肥胖率分别为5.09%、35.33%、5.17%和17.43%;高血压患病率、知晓率、治疗率分别为57.31%、68.13%、62.32%;血脂异常患病率为24.19%,其中低高密度脂蛋白血症、高三酰甘油血症、高胆固醇血症患病率和血胆固醇边缘升高率分别为7.23%、15.21%、7.46%、6.97%;糖尿病患病率为14.17%,空腹血糖受损率为2.18%。[结论]老年人营养缺乏和营养过剩并存,营养相关性慢性非传染性疾病的预防和控制迫在眉睫。     

Barriers to implementation of the new targeted BCG vaccination in France: a cross sectional study

The aim of the study was to assess factors influencing BCG vaccination among targeted children after the end of universal and mandatory BCG vaccination in France. A cross-sectional study was conducted in 2009 among general practitioners (GPs) of the French Sentinel Network. With the participation of 358 physician-investigators, 920 children were included. Of the 261 children (31%) identified to be at risk of tuberculosis, only 113 (44%) were vaccinated. The median number of French criteria for BCG vaccination correctly cited by the GPs was 3 of the existing 6. Of the 10 proposed, a median number of 5 regions in the world according to their level of tuberculosis risk were correctly classified by GPs. After adjustment using an alternating logistic model, 7 variables were found to be associated with the immunisation status of the target population. Six of these increased the probability of being vaccinated: children older than 6 months (OR = 3.4 (CI 95% [1.4-8.6])), residents in central Paris or its suburbs (OR = 14.7 [4.4-49.5]), children expected to travel to highly endemic regions (OR = 3.5 [1.4-8.6]), those living in unfavourable conditions (OR = 19.9 [6.2-63.9]), the GP's good knowledge of vaccination guidelines (OR = 1.4 [1.1-1.9]) and the GP's perception of tuberculosis as a common disease (OR = 2.2 [1.1-4.5]). Surprisingly, GPs with university training on infectious diseases tended to be more reluctant to follow vaccination guidelines (OR = 0.14 [0.1-0.4]). Actions targeted at these factors could contribute to improving BCG immunisation coverage.     

上海市区高中生健康和营养状况调查

目的为了解上海市区高中学生健康和营养状况及存在主要问题，为政府制定学校卫生保健工作发展规划，促进学生健康成长提供科学依据。方法采用整群随机抽样方法进行问卷调查，收集高中学生的健康、饮食、运动、生活习惯等资料并进行分析。结果高中生健康营养状况不尽人意，存在营养过剩与营养不良并存、视力不良大于2／3、挑食偏食严重、饮食不合理、睡眠和运动严重不足。结论提高青春期身心健康，重视合理营养、加强体育锻炼、优化生活方式等改善外界环境因素是重要途径。     

健康技能在大学生健康知识及其行为间的中介／调节效应

目的　探索健康技能在大学生健康知识与健康行为间的中介效应和调节效应。方法　采用分层整群随机抽样方法,对2 181名长沙市在校大学生进行问卷调查。采用EpiData3．0软件建立数据库,SPSS 17．0软件进行相关和回归分析。结果　健康知识与健康技能显著相关（r=0．592,P<0．01）,健康知识与健康行为显著相关（r=0.647,P<0．01）,健康技能与健康行为也呈显著相关（r=0．629,P<0．01）。健康技能在健康知识和健康行为之间的部分中介效应显著（34．55％）。交互作用项“健康技能×健康知识”的回归系数在以健康行为为因变量的回归方程中达到显著性水平（β=一0.093,t=5．212,P=0.000）,且引入交互作用项后新增解释量（⊿R²）亦达到显著性水平（⊿R²=0．006,P=0．000）,对健康行为变异量的解释增加了0．6％。结论　健康技能在大学生健康知识与健康行为间起中介效应和调节效应     

杭州市超市消费者预包装食品营养标签行为流行病学调查

目的 了解杭州市超市消费者对预包装食品营养标签的认知、态度、行为的现状及其影响因素.方法 采用自行拟定的调查量表,选取杭州市某大型超市,随机抽取顾客进行面对面访谈.结果 在访谈的586(男202、女384)人中,平均年龄(41.6±17.23)岁.消费者对6种营养素的模拟购物题应答正确率依次为膳食纤维(71.84%)、脂肪(70.99%)、钙(60.75%)、盐(58.36%)、能量(50.85%)和糖(39.42%);对标识营养成分表、营养声称和希望了解相关知识的3个态度指标中,认同率分别为90.44%、87.03%和77.13%;对首次购买某食品阅读营养成分表和营养标签的2个行为指标中,阅读率分别为58.36%和80.03%.经logistic建模分析,男性、青少年、低教育人群是营养标签阅读行为的危险因素.结论 消费者营养标签阅读、理解和正确应用营养标签的能力不高,亟待改进营养标签与声称的可读性和权威性,应制定全国营养知识健康教育规划.

Abstract：

Objective To study the prevalence rates of knowledge,attitudes and use of the nutrition labeling and related influential factors in Hangzhou supermarket consumers.Methods Using a self-developed survey questionnaire,randomly selected customers were conducted a face-toface interview program in a large supermarket of Hangzhou city.Results 586 people were interviewed,including 202 males and 384 females,with the mean age as 41.6±17.23 years.The Facts Labels'were as follows:dietary fiber(71.84%),fat(70.99%),calcium(60.75%),salt (58.36%),energy(50.85%)and sugar(39.42%).The support rates of the three attitudes indicators were"support marking the Nutrition Facts Label"(90.44%)."support marking the nutrition claims"(87.03%)and"want to know more relative knowledge"(77.13%).There were 58.36% and 80.03%first-time buyers who would read the Nutrition Facts Food Labels and the Nutrition Claims.Through logistic model analysis,male,youth,low-educated people were found to be the risk factors related to the nutrition label reading behavior.Conclusion The capacity of the reading,understanding and correct application of nutrition labeling among consumers was not satisfactory.Improvement on the readability and the authority of nutrition labeling and the development of the national nutrition knowledge and health education programs were in urgent needs.     

中国肾综合征出血热流行特征及时空分析模型进展

肾综合征出血热（HFRS）是一种由汉坦病毒引起的以发热、出血、充血、低血压休克及肾脏损害为主要临床特征的鼠传自然疫源性疾病,人主要通过接触鼠的排泄物、分泌物等方式感染HFRS。HFRS流行特征具有显著的人群差异、地理异质和季节消长特点,这些典型特征与宿主动物栖息环境和人类活动等因素密不可分。全球每年HFRS报告发病人数约15万~20万,我国病例数占全球的70%~90%,是遭受HFRS危害最严重的国家。本文详细综述了我国HFRS流行特征、传播影响因素以及相关生态学研究的模型与方法进展,以期了解我国HFRS的三间分布特征及传播的潜在影响因素,有助于开展HFRS疾病调查监测和预防控制工作。     

Comparability of health information activities—a co-ordinated framework for health information activities on nutrition and physical activity in the EU, EEA and candidate countries

Background  Many health information activities related to nutrition and physical activity have been initiated in recent years by several institutions at the national and international level as well as by European networks. A multitude of projects with different scopes and methodologies has arisen. This variety makes it necessary to bring the results of these activities into a co-ordinated framework. Aim  The report “Nutrition and physical activity—health information sources in EU Member States, and activities in the Commission, WHO, and European networks” aims to give a structured overview of the availability of routinely repeated or repeatable data on the health determinants nutrition and physical activity in European countries. Results  The report provides a structured overview of health information activities related to nutrition and physical activity as well as a state-of-the-art investigation about available data in European countries. Conclusion  It was the intention of the report to give an overview of existing health information activities related to nutrition and physical activity covering actions in all countries belonging to the European Union up to 2006, the European Economic Area and all candidate countries and including all age groups. A multitude of health information activities related to nutrition and physical activity were considered. Common data reporting guidelines and standardised methods, which encompass public and private sector health information activities, should be developed. Regular revision and adaptation concerning developed strategies, policies and practices as needed for health and population dimensions have to be realised. In order to provide for concerted action in health policy at the European level, quality, relevant and timely data are needed.     

陕西省农村沼气建设及其综合利用卫生效果与健康需求调查研究

目的了解农户沼气综合利用知识和相关卫生知识、态度、行为,沼气综合利用对农户卫生状况、健康状况的影响及相关信息来源、需求。方法采用专题小组访谈的定性方法,对骨干人群、乡村医生进行访谈。运用现场观察和随机抽样问卷调查的定量方法对农户进行调查。同时在每县采集样本,进行虫卵实验室检测。结果已建沼气的农户卫生状况和健康状况显著好于未建的农户(P<0.05);沼气相关知识知晓率和对沼气的认可态度持有率显著好于未建的农户(P<0.05);已建户和未建户沼气综合利用知识仅限于沼气做饭、沼液种植、沼渣施肥,其余用途知晓率较低(均不足45%);被调查对象对健康相关知识需求不高;农户相关信息主要获得途径为电视、广播等大众传媒、传单等健康教育宣传品和同伴宣传;除了希望从上述途径获得信息外,还希望从讲座、健康教育课等途径获得。结论农村沼气综合利用能够有效改善农村卫生条件和农户健康状况,节约能源、增加收入;以全国亿万农民健康促进行动为平台,加强多部门合作,利用各种群众喜闻乐见、易接受的传播途径,普及沼气相关知识和健康相关知识收到满意效果。     

2020—2021年芜湖市主城区大气PM2.5中多环芳烃污染特征及健康风险评估

目的 调查芜湖市主城区大气 PM2.5中多环芳烃（PAHs）污染特征及其人群健康风险。方法 2020年6月至2021年5月，每月10至16日采集芜湖市主城区大气PM2.5样品，检测和分析其中16种优先控制PAHs浓度及组成特征，并利用特征比值法和物质结构判断PM2.5中PAHs来源，采用US EPA健康风险模型评估其人群健康风险。结果 大气PM2.5浓度均值为49.2μg/m³，范围为7~151μg/m³；16种PAHs均有不同程度检出，总浓度均值为6.85ng/m³，范围为0.13~31.62ng/m³；PM2.5与16种PAHs各月份日均浓度变化存在相关性（R=0.867，P<0.001）；16种PAHs季节变化为冬季＞秋季＞春季＞夏季，构成均以4~6 环为主；大气PM2.5中PAHs主要来源为机动车排放和燃煤。PM2.5中16种PAHs的总致癌风险值（Risk）为2.20×10^-7，低于1×10^-6，致癌风险可忽略；非致癌风险危害商值（HQ）为0.49，小于1，非致癌健康风险低。结论 芜湖市主城区大气PM2.5中PAHs污染较轻，无明显健康风险。     

2006-2014年安徽省0～14岁儿童医院伤害病监测病例变化趋势及现况特征分析

目的 了解安徽省0 ～ 14岁儿童伤害医院门/急诊病例变化趋势和现况特征,为制定相关干预措施和政策提供依据.方法 利用2006-2014年全国伤害监测系统中安徽省0～14岁儿童伤害病例数据,分析儿童伤害病例变化趋势及人口学、伤害事件和临床等现况特征.结果 2006-2014年安徽省共监测0～14岁儿童伤害病例23 374例,占全部病例的12.56％,该比例呈现下降趋势.2014年安徽省0～14岁儿童男女性别比为2.09,一天中伤害发生高峰为9:00和16:00～17:00,跌倒/坠落占66.30％,伤害发生地点构成比前三分别是家中(39.40％)、学校与公共场所(24.01％)、公路/街道(19.57％),70.18％的伤害是发生在休闲活动时,伤害部位41.44％为头部,轻度伤占90.90％,伤童中94.26％的就医结局为治疗后回家.结论 儿童伤害是重大社会和公共卫生问题,然而儿童伤害是可预防的,儿童既是伤害的弱势群体又是伤害的重点干预人群,应针对不同年龄段和性别儿童以及家长和学校老师开展伤害预防教育.     

2009-2014年无锡市手足口病聚集性疫情流行病学及病原学特征分析

目的 了解无锡市2009-2014年手足口病聚集性疫情的流行特征,为制定手足口病防控措施提供科学依据。方法 收集2009-2014年无锡市手足口病聚集性疫情信息,应用描述流行病学方法分析三间分布特征。结果 2009-2014年无锡市共报告手足口病聚集性疫情1 035起,累积报告病例4 959例,占同期总发病人数的6.2%（4 959/79 571）,其中12起符合突发公共卫生事件标准;聚集疫情每年发病高峰在4~6月和11月;聚集性疫情和病例数均集中在城乡结合部,主要发生在托幼机构77.6%（803/1 035）,且地区间托幼场所发生频次分布差异有统计学意义（χ²=128.21,P<0.001）;疫情发生后1 d内报告的占21.3%（220/1 035）,罹患率为0.02%~100.00%,中位数为1.6%,疫情持续时间1~46 d,中位数为4.0 d;疫情发生报告间隔与疫情持续时间及发病人数均呈正相关（均有P<0.001）。共采集病例标本阳性率为42.2%（1 008/2 389）,阳性标本中以EV71型（45.3%）和CoxA16（40.1%）为主。结论 无锡地区城乡结合部的托幼机构是手足口病聚集性疫情高发场所,应加大对托幼机构的监管,可以有效防控手足口病暴发疫情。     

铁矿工人尘肺发病及影响因素分析

目的 分析铁矿接尘工人尘肺的发病规律及影响因素,为铁矿工人尘肺防制提供依据.方法 以某铁矿1960年至1974年在册且工作1年以上的所有接尘工人建立队列,随访至2003年底.尘肺诊断由职业病诊断小组确定.采用Cox比例风险模型分析危险因素.结果 队列接尘工人3647名,累积接尘132 574.4人年.诊断尘肺316例,人年发病率为0.24％.1960年前开始接尘者中发现尘肺274例(86.7％),人年发病率为0.40％,明显高于1960年后开始接尘工人尘肺人年发病率(43例,0.07‰).尘肺发病平均潜伏期是(26.0±7.3)年.尘肺晋级年限分别为0+晋Ⅰ期(5.3士3.2)年,Ⅰ晋Ⅱ期为(6.6±5.2)年,Ⅱ晋Ⅲ期为(1 1.3±5.0)年,随诊断年代的推后,各期晋级年限均有延长趋势.164例尘肺为脱尘后诊断,平均脱尘8.3年.铁矿工尘肺发病危险度随累积接尘量增加而上升,呈明显的接触剂量-反应关系.尘肺患者年平均累积接尘量为(173.7±91.6)mg/m3,远高于非尘肺接尘工人(112.1±64.8)mg/m3.除累积接尘量外,影响尘肺发病风险因素包括肺结核(HR=5.9,P＜0.01)、吸烟(HR=1.7,P＜0.01).结论 累积接尘量与尘肺发病之间存在明显的剂量-反应关系,并发结核、吸烟是影响尘肺发病的危险因素.     

一起人畜炭疽疫情的现场处置及消毒效果评价

2010年11月4日贵州省望漠县某村发生人间皮肤炭疽流行。为查找流行原因,分析感染途径及来源并检查防控措施落实情况及评价疫源地消毒效果,于11月5-7日开展本次调查。     

Competition in the NHS internal market: an overview of its effects on hospital prices and costs

The 1989 reforms of the UK National Health Service (NHS) introduced competition in the supply of hospital services. This paper synthesizes both the theory underlying the introduction of competition into the NHS, and the limited existing evidence on whether competition affects the prices posted by sellers of medical services, and the costs of producing these services. The results indicate high levels of price variability, widespread disregard for average cost pricing rules and some indication that competition had some effect on prices. It appears that lower prices may be offered to smaller purchasers, such as General Practice Fund Holders (GPFH). This effect of competition on price was mirrored, with a delay, in hospital costs. © 1998 John Wiley & Sons, Ltd.     

Modelling the effects of intimate partner violence and access to resources on women's health in the early years after leaving an abusive partner

Although the negative health effects of intimate partner violence (IPV) are well documented, little is known about the mechanisms or determinants of health outcomes for women who had left their abusive partners. Using data collected from a community sample of 309 Canadian women who left an abusive partner, we examined whether women's personal, social and economic resources mediate the relationships between the severity of past IPV and current health using structural equation modelling. A good fit was found between the model and data for hypothesized models of mental and physical health. In the mental health model, both the direct and total indirect effects of IPV were significant. In the physical health model, the direct effect of IPV on physical health was about four times as large as the total indirect effects. In both models, more severe past IPV was associated with lower health and women's personal, social, and economic resources, when combined, mediated the relationship between IPV and health. These findings demonstrate that the health outcomes of IPV for women who have left an abusive partner must be understood in context of women's resources.     

A pilot study to examine the effects of a nutrition intervention on nutrition knowledge, behaviors, and efficacy expectations in middle school children

BACKGROUND: This was a pilot study to determine the impact of the Michigan Model (MM) Nutrition Curriculum on nutrition knowledge, efficacy expectations, and eating behaviors in middle school students. METHODS: The study was conducted in a large metropolitan setting and approved by the Institutional Review Board. The participants for this study were divided into an intervention group (n = 407) and a control group (n = 169). An MM instructor trained health teachers in the use of the curriculum, and the teacher subsequently taught the curriculum to students in the intervention group. A valid and reliable questionnaire was used to determine pre-post differences. It consisted of 3 subscales assessing eating habits, nutrition knowledge, and efficacy expectations toward healthy eating. Subscale scores were analyzed using a 2 groups (intervention vs control) x 2 times (pre vs post) analysis of variance. RESULTS: The intervention group increased their nutrition knowledge at post. There was also a significant main effect for groups in the subscales "Eating Behaviors" and "Efficacy Expectations Regarding Healthy Eating." Subsequent post hoc analysis revealed that the intervention group was significantly more likely to eat fruits and vegetables and less likely to eat junk food than the control group. Students in the intervention group also felt more confident that they could eat healthy. CONCLUSIONS: The results of this pilot study suggest that the MM Nutrition Curriculum delivered by trained professionals resulted in significant positive changes in both nutrition knowledge and behaviors in middle school children. Further research needs to be conducted to determine the long-term impact.     

An overview of findings from a six-country European survey on consumer attitudes to the metabolic syndrome, genetics in nutrition, and potential agro-food technologies

Summary Metabolic syndrome, a cluster of cardiovascular risk factors that can lead to type 2 diabetes and/or heart disease, is at the centre of LIPGENE. This European Union (EU)‐funded project integrates human nutrition, genomics, agro‐food, social and economic analysis. In the social science module of the project, a six‐country survey was carried out to provide data on consumers’ attitudes towards the metabolic syndrome, potential agro‐food technologies and nutrigenomics. A total of 5967 participants aged 15 years plus from six European countries were interviewed. Heart disease, obesity, bulimia, anorexia and type 2 diabetes were the most frequently identified diet‐related diseases. Nearly 30% of participants self‐reported suffering from stress, and one in five reported having central obesity. High blood pressure was identified as an extremely high/high‐risk condition for almost half of the sample, followed by high cholesterol. Respondents reported the three most important ways of reducing personal risk of type 2 diabetes or heart disease to be increasing physical activity, eating more fruit and vegetables, and decreasing intake of fatty foods. However, lack of motivation, lack of information and lack of knowledge were identified as barriers to healthy actions. Participants associated the concept of ‘functional foods’ with fruit and vegetables, which were consumed at least once a week by most of them, but they also reported consuming high‐fibre products, probiotic yogurt drinks, foods with added vitamins and/or minerals, and cholesterol‐lowering spreads/drinks. However, the most commonly desired health benefits from foods to reduce the risk of type 2 diabetes and heart disease were a cholesterol‐lowering effect, blood sugar control and weight reduction. The preferred foods to decrease metabolic syndrome were fish, cheese and yogurt ‘with healthy fat’, but these foods were less acceptable to respondents if developed through genetic modification (GM) technology, and more than 30% of the sample would not eat GM foods at all. However, participants said that they would be more willing to consume GM foods if these foods provided health benefits. The survey also showed that many people would be willing to undergo a genetic test for general interest or in order for a diet to be tailored to their needs.     

2014 - 2017年新余市结核病耐药特征及影响因素分析

目的 了解新余市耐药结核病的流行特征及其影响因素,为耐药结核病防治和管理提供科学依据。方法 2014 - 2017年新余市所有涂阳肺结核病人痰标本进行培养,用比例法进行药敏试验,用SPSS 19.0进行数据分析。结果 新余市2014 - 2017年涂阳结核病标本340例,其中6.47%（22例）为非结核分枝杆菌,93.53%（318例）为结核分枝杆菌。结核分枝杆菌的总耐药率20.44%（65例）,单耐药率6.60%（21例）,多耐药率4.09%（13例）,耐多药率9.75%（31例）。初治病人耐药率15.44%（42/272）,复治病人耐药率50.00%（23/46）。年龄(OR = 1.023,95%CI = 1.006～1.040) 、吸烟史(OR = 2.126,95%CI = 1.111～4.067)、居住农村(OR = 0.468,95%CI = 0.233～0.938)和抗结核病治疗史(OR = 4.580,95%CI = 2.291～9.158)是新余市结核病发生耐药的主要影响因素。结论 新余市结核病耐药形势严峻,结核病耐药率和耐多药率均显著高于世界平均水平,耐多药结核菌株中以同时耐6种药物为主。应提高初治病人的治愈率和加强耐药结核病防控工作。