中国部分农村地区2～7岁留守儿童膳食营养现况研究

目的 了解中国农村留守儿童膳食营养状况,为农村留守儿童营养干预提供科学依据.方法 采用多阶段分层整群随机抽样方法,随机选择农村2～7岁留守儿童1278名和对照儿童1273名作为调查对象.采用3日膳食称重法和食物摄人频率法进行膳食调查,并以中国营养学会推荐的膳食营养素参考摄入量(DRIs)为依据,评价农村留守儿童膳食能量和各种营养素的摄人状况.结果 农村留守儿童膳食以粮谷类和蔬菜类为主,留守儿童肉禽水产类、水果类及零食类等食物的摄入量低于对照儿童,差异有统计学意义.农村留守儿童能量、三大产热营养素及部分矿物质(钙、锌、硒、钾)和维生素(维生素A、维生素B1、维生素B2)的摄入量均低于推荐摄入量.农村留守儿童能量及主要营养素普遍摄入不足,能量摄入不足率在50%以上,蛋白质摄人不足率达80%以上,而钙、锌等矿物质和维生素B1、维生素B1等维生素的摄入不足率达90%以上.蛋白质来源中,优质蛋白质摄入量仅占总蛋白质摄入量的35%,而植物蛋白质占65%.此外植物性铁的摄入比例明显偏高,达到87%.结论 中国农村留守儿童的膳食结构不尽合理,能量和多种营养素摄入不足,能量、蛋白质及铁的来源不合理,膳食营养状况有待改善.     

学龄前儿童膳食管理现状及干预效果评价

了解学龄前儿童膳食中营养素摄入状况,探讨钙摄入量与生长发育的关系.方法 在武汉市中心城区三餐制示范性幼儿园中随机抽取16所幼儿园儿童5 664名作为研究对象,回顾性调查前3个月的膳食钙摄入量及其他重要营养素摄人量,测量儿童身高、体重,分析钙摄入量与身高、体重五级评价分布关系;采用前瞻性调查分析方法将其中4所低钙摄入量幼儿园分为实验组(113人)和对照组(121人),干预研究1 a后,比较两组膳食中钙摄人量水平以及儿童身高、体重年增长平均值.结果 16所幼儿园横断面现场调查表明,按照我国制定的推荐摄入量RNI标准,幼儿膳食中蛋白质、能量、铁、锌摄入量符合标准,钙摄入量较低(41.9%~81.0%);膳食中钙摄人量占RNI比例<50%组与≥80%组中儿童身高五级评价分布差异有统计学意义(P<0.01).干预后,实验组与对照组儿童平均身高增长值分别为(7.25±0.96),(5.69±0.85) cm,差异有统计学意义(P<0.05),实验组钙摄入水平明显提高.结论 膳食中长期严重缺钙可影响儿童体格发育,并使身高生长速率减缓.幼儿园儿童膳食中钙的摄人量应达到标准供给量80%以上.     

西安市北郊入托幼儿膳食营养状况

了解西安市北郊入托幼儿膳食营养摄入状况,为探讨学龄前儿童营养适宜摄入量提供依据.方法 采用分层随机整群抽样的方法,选取西安市北郊3所公立幼儿园共计836名入托幼儿作为研究对象,采用记账法和24h回顾法相结合进行膳食调查,并根据食物成分表计算幼儿每人每日各类营养素和能量摄人情况,依据中国营养学会2000年修订的《中国居民膳食营养素参考摄入量》标准(DRIs)进行评价.同期测量幼儿身高和体重,并对其营养状况进行评价.结果 4岁组男童每日钙、锌摄入量未达到适宜摄人量,4,5岁组女童钙、锌摄入量未达到适宜摄入量;入托儿童膳食结构中肉类、蛋类和豆类摄入量较低,肉类、豆类食物摄入量仅占2.7%和0.9%.儿童日常膳食中脂肪供能比例偏低;836名入托幼儿营养不足检出率为2.4%,营养过剩检出率为10.9%.结论 入托幼儿膳食结构有待完善,应加强家园营养教育,提高入托幼儿膳食营养水平.     

贵阳市某幼儿园学龄前儿童膳食营养状况

目的了解学龄前儿童膳食摄入能量和营养素情况,为幼儿营养教育和营养干预提供基础资料。方法采用5 d称重法记录学龄前儿童园内膳食,发放记录表给儿童监护人记录园外膳食。使用食物成分表计算平均每人每日能量及营养素的摄入量,与DR Is进行比较。结果学龄前儿童膳食中豆类、蔬菜和蛋类摄入不足,谷类、水果、肉鱼水产类和乳类摄取充足。平均钙、锌摄入均不足,分别达到DR Is的62.96%和64.50%。脂肪提供的能量占总能量百分比偏低,仅为28.13%。蛋白质提供的能量占总能量的百分比偏高,为15.86%。铁主要来源于植物性食品,血红素铁仅占31.06%。能量主要来源于植物性食品。钙磷比值严重倒置。结论学龄前儿童钙、锌摄入不足,血红素铁所占比例较低。需要增加蛋类、豆类及蔬菜的摄入量,适当选择动物性食品等含血红素铁高的食物。     

基于价格和营养质量指数的配餐法在南宁市幼儿园膳食管理中的应用

目的 提供一种结合食物价格及营养质量指数的实用方法,以改善幼儿园不合理的膳食。方法 结合当地食物价格,计算INQ指数/食物可食部分价格比值,构建基于价格和INQ指数的食物数据库并指导南宁市3所幼儿园的膳食配餐,干预期为2个月,干预前后分别进行1次膳食调查,计算并分析干预前后幼儿园膳食结构、营养素摄入量和营养素-价格比的差异。结果 干预前,3所幼儿园的膳食结构不合理,儿童的大部分营养素摄入量低于5岁男孩的RNI标准。干预后膳食能量来源结构较干预前有所改善,儿童的营养素量摄入量较干预前均有不同程度增加,除硒和钙外,其余营养素的摄入量均超过了RNI标准,其中干预前后能量、蛋白质、脂肪、核黄素、钙等多种营养素平均摄入量存在统计学差异（P＜0.05）;除幼儿园A的硒元素、B幼儿园的能量、脂肪、碳水化合物和尼克酸及幼儿园C的脂肪外,其余营养素摄入量与食物价格的比值均较干预期有所提高,干预前后视黄醇、核黄素、维生素E、钙等多种营养素的营养素-价格比差异具有统计学意义（P＜0.05）。结论 基于价格及营养质量指数的配餐法科学准确、简单实用,可在不显著增加经费支出情况下明显改善幼儿园膳食质量。     

四川农村贫困地区儿童膳食营养状况评价

目的了解四川农村儿童膳食营养状况,为农村儿童营养干预提供依据。方法随机抽取四川省某县3个乡514名3～10岁农村儿童为研究对象,采用24h膳食回顾法和食物频率法进行膳食调查,并以中国居民膳食营养素参考摄入量（DRIs）为标准,评价膳食能量和各营养素摄入状况。结果调查对象膳食以粮谷类、蔬菜水果类为主;能量达到80%RNI者占18.5%,碳水化合物、脂肪和蛋白质的供能比分别为67.2%,20.4%和12.4%;蛋白质达到80%RNI者占11.7%,钙和铁摄入量达到80%AI值者分别为0.9%和36.2%。锌和视黄醇摄入量达到EAR值的儿童分别为12.4%和17.9%,铁和视黄醇均主要来源于植物性食物。结论四川农村儿童膳食结构不合理,能量和各种营养素摄入普遍不足。     

农村0～5岁留守儿童的膳食营养调查

目的:了解农村0～5岁留守儿童膳食营养状况,为制定科学的膳食指导方法及保健措施提供依据。方法:采用24h膳食回顾法及食物频率法连续调查留守儿童3天膳食情况,计算能量、蛋白质等营养素摄入量;测量身高、体重及血红蛋白含量,采用Z评分法进行生长发育评价并统计贫血患病率。结果:留守儿童能量、蛋白质、钙、钾、铁、锌、VitA、VitB1、VitC平均摄入量达不到RNIs的80%;生长迟缓率7.44%、低体重率4.21%、贫血患病率为15.21%。结论:留守儿童能量、蛋白质、钙等营养素摄入不足,影响正常生长发育,应对农村留守儿童进行膳食指导。     

临床医科大学生营养知识及膳食摄入状况

了解临床医科大学生营养知识掌握程度及其膳食结构与营养摄人情况,为营养宣教以及其服务于临床提供科学依据.方法 采用随机抽样方法,抽取同济医学院临床医学专业学生394名为研究对象,采用自行设计的调查问卷进行营养知识、膳食结构调查,采用24 h回顾法询问学生膳食摄人情况,利用营养计算软件计算每人每日热能及各种营养素摄人情况.结果 临床医科大学生营养知识普遍缺乏,获取营养知识的途径较单一.每天各种食物摄入量偏低,脂肪、维生素B1、维生素B2、维生素C、钙摄入量严重不足,分别仅占推荐摄入量(RNI)的69.15%,79.38%,70.05%,62.01%;能量(89.02%)和锌(86.53%)的摄入离RNI也有一定差距;三餐能量分配不合理,早餐能量摄入偏低(23.12%),晚餐能量摄入稍高(31.43%).结论 临床医科大学生膳食营养知识欠缺,膳食结构不合理.需要加强学校营养宣教,改进膳食结构,提高学生整体素质.     

农村5岁以下留守儿童膳食营养现况

目的探讨农村5岁以下留守儿童与父母抚养的儿童膳食营养状况是否存在差异。方法采用24小时膳食回顾法及食物频率法连续调查两组儿童3天膳食情况,计算能量、蛋白质等营养素摄入量;测量身高、体质量及血红蛋白含量,采用Z评分法进行生长发育评价并统计贫血患病率。结果留守儿童能量、蛋白质、脂肪、胆固醇、维生素A、尼克酸、维生素E、镁、锌、硒平均摄入量显著少于对照组儿童,低体质量率、生长迟缓率明显高于对照组儿童;两组儿童贫血患病率差异无统计学意义。结论留守儿童膳食营养状况与对照组儿童存在差异,应对农村留守儿童进行膳食指导,改善其营养状况。     

唐山市学龄儿童膳食营养状况评价

目的 探讨DRIs在评价学龄儿童膳食营养现状中的应用,为进一步采取膳食干预措施提供依据.方法 采用分层整群抽样的方法,在唐山市2所小学选取各年级小学生634名,采用5 d膳食调查和食物摄取频率调查结合的方法进行调查.对结果用DRIs进行评价.结果 学龄儿童脂肪能量来源较高,碳水化合物能量来源偏低;晚餐能量偏低,零食供能约占20%.烟酸、硒摄入充足的占85%以上;蛋白质摄人充足的占50%,但来源较好.视黄醇、核黄素、抗坏血酸、硫胺素和锌摄入不足的分别占34%,31%,21%,15%和59%.处于不足和充足之间的分别占14%,15%,27%,28%和56%.钙平均摄入量远低于AI,有30.9%的儿童钙摄人量低于AI的半数;79.7%的儿童总铁摄入量达到了AI,但来源较差.结论 应合理解释膳食摄人资料,积极改善学龄儿童的膳食结构.     

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.     

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.     

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.     

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.     

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.     

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.     

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.