夏季软饮料消费对幼儿生长发育的影响

目的：了解夏季软饮料的消费对幼儿生长发育指标的影响。方法：用调查表向合肥市452名12－36月龄幼儿的家长调查其子女夏季奶类及其它软饮料的日均消费量，并以此为分组依据，比较各组生长发育指标的差异，观察各组春秋季生长发育指标的变化，以确定软饲料适宜的消费量。结果：奶类和其它软饮料的消费量不超过200ml的幼分 49．6％和55．8％；奶类消费量为400－600ml时，幼儿体重和身高的增长值最大，秋季时低体重及矮身材者最少，其它软饮料消费量为200－400ml时，幼儿体重和身高的增长和发育状况较理想；随着奶类消费量的增加，幼2儿的体型越来越结实，胸廓的发育越来越好，而其它软饮料消费量为200－400ml时，幼儿的体型和胸廓的发育较理想。结论：根据上述结果，对12－36月龄幼儿来说，夏季每天奶类的消费量在400－600ml，其它软饮料在200－400ml是适宜的。     

Community Organization in a School Health Education Program to Reduce Sodium Consumption

This paper describes the important role of community organization in providing the enabling and reinforcing factors necessary for students to adopt dietary behavior changes recommended in a school health education program for cardiovascular health. The "Hold the Salt!" program was designed to teach sixth grade students and their families about the link between high sodium diets early in life and increased risk for cardiovascular disease, and to significantly reduce pupils' intake of high-sodium snacks. The program consists of four educational components: a classroom cafeteria curriculum unit built around a board game; parent outreach; health provider reinforcement; and community support. The program was tested in an experimental group (n = 55) of urban, black, sixth grade students, whose knowledge and behavior changes were compared to a control group (n = 23) with similar demographic statistics. Data collected before and after the school program showed a 20% increase in knowledge about sodium and health (p less than .01) and a 33% decrease in reported high-sodium snack consumption (p less than .05) in the experimental group compared to no significant knowledge or reported behavior changes in the control group. The program was piloted for two years in Baltimore City elementary schools, then adopted by the Maryland State Dept. of Education for dissemination as part of the Home Economics curriculum in all of the state's middle schools.     

Impact of Sugary Food Consumption on Pregnancy: A Review

Obesity in pregnancy has been directly associated with an increased risk of almost all pregnancy complications such as gestational hypertension, preeclampsia, gestational diabetes mellitus (GDM), and premature delivery. Thereby, according to current evidence available, life-style interventions to prevent pre-pregnancy overweight and obesity in women of fertile age are necessary to reduce the negative impact of obesity on mother and child health. Unhealthy dietary patterns, together with the increased consumption of processed foods rich in simple sugar and sweeteners are some of the responsible, among others, for the increase in obesity rates during the last years. Nevertheless, how its consumption can affect pregnancy outcomes and long-term children’s health is still uncertain. This review aims to collate the available evidence about the consequences of unhealthy dietary patterns and sugary products consumption, including sweeteners, during pregnancy for obesity in childhood and mid-childhood. High simple sugar intake during gestation may contribute to an excessive gestational weight gain (GWG) as well as to develop other pregnancy complications such as GDM, preeclampsia and preterm birth. The heterogeneity of study populations, sample size, different approaches to measure GWG, GMD, preeclampsia, and birth weight, among other conditions, might explain the divergences observed among studies. Therefore, large, well-designed intervention-controlled trials with biological biomarkers to ensure dietary adherence are necessary to evaluate the effectiveness of lifestyle interventions in order to provide effective nutritional advice.     

Classroom Parties in US Elementary Schools: The Potential for Policies to Reduce Student Exposure to Sugary Foods and Beverages

ObjectiveTo examine associations among school, district, and state policies regarding classroom birthday and holiday parties.DesignSchool-level policies assessed by survey during the 2009–2011 school years, with collection of corresponding district policies and state laws.SettingUnited States public elementary schools.ParticipantsSurveys from 1,204 schools (response rate, 60.9%).Variables MeasuredPrevalence of school-wide restrictions on sugary items served during parties. Predictor variables included district policy and state law.AnalysisMultivariate logistic regressions to examine associations between school-level restrictions (outcome) and district policies and state laws, controlling for demographics and school year.ResultsApproximately one half of schools discouraged or prohibited sugary items during parties, or did not allow parties. Schools with a district policy and state law were 2.5 times more likely to restrict sweet items at parties than were schools with no corresponding policy or law. School-level limits were more common where policy and law addressed specific nutritional aspects of foods and beverages served in classroom parties (odds ratios, > 2.0; P < .001).Conclusions and ImplicationsProhibitions on sugary party fare were uncommon at all levels. Even though most policies were framed as recommendations rather than requirements, policy and law were associated with increased school-level restrictions, which demonstrates the value of policy.     

A Behavioral Intervention to Reduce Excessive Gestational Weight Gain

Objectives Excessive gestational weight gain (GWG) is a key modifiable risk factor for negative maternal and child health. We examined the efficacy of a behavioral intervention in preventing excessive GWG. Methods 230 pregnant women (87.4 % Caucasian, mean age = 29.2 years; second parity) participated in the longitudinal Glowing study (clinicaltrial.gov #NCT01131117), which included six intervention sessions focused on GWG. To determine the efficacy of the intervention in comparison to usual care, participants were compared to a matched contemporary cohort group from the Arkansas Pregnancy Risk Assessment Monitoring Survey (PRAMS). Results Participants attended 98 % of intervention sessions. Mean GWG for the Glowing participants was 12.7 ± 2.7 kg for normal weight women, 12.4 ± 4.9 kg for overweight women, and 9.0 ± 4.2 kg for class 1 obese women. Mean GWG was significantly lower for normal weight and class 1 obese Glowing participants compared to the PRAMS respondents. Similarly, among those who gained excessively, normal weight and class 1 obese Glowing participants had a significantly smaller mean weight gain above the guidelines in comparison to PRAMS participants. There was no significant difference in the overall proportion of the Glowing participants and the proportion of matched PRAMS respondents who gained in excess of the Institute of Medicine GWG guidelines. Conclusions for Practice This behavioral intervention was well-accepted and attenuated GWG among normal weight and class 1 obese women, compared to matched participants. Nevertheless, a more intensive intervention may be necessary to help women achieve GWG within the Institute of Medicine’s guidelines.     

降低早产儿死亡率的产前药物干预

目的为降低新生儿死亡率，以提高产科医疗质量。方法对2001--2004年间包钢三院新生儿死亡原因进行分析，针对主要原因，实施相应干预措施。结果早产儿死亡是新生儿死亡的主要原因，占50％，而影响早产儿存活的主要疾病是肺透明膜病变。2005年开始采取干预措施，促进胎肺成熟，取得明显效果，使早产儿死亡率由152．2‰下降到38．5‰。结论凡有先兆早产征象者或高危妊娠计划分娩提早终止妊娠者，在积极治疗原发病的同时，产前常规静脉注射地塞米松，可明显降低早产儿与新生儿的死亡率。     

Community-Based Interventions to Reduce Alcohol Consumption and Alcohol-Related Harm in Adults

Journal of Community Health - Alcohol consumption was associated with 3 million deaths worldwide in 2016. Although community action has proven to be effective and has become a priority area of the...     

当前药品价格虚高难降的问题和对策

药品价格作为关系广大人民群众身体健康和切身利益的重大问题,长期以来一直是人们议论的热门话题,很多人在感慨"看不起病、吃不起药"的同时,也在盼望药品价格下降的步伐能快些、再快些.     

The Use of a Brief Antenatal Lifestyle Education Intervention to Reduce Preterm Birth: A Retrospective Cohort Study

Preterm birth is a leading cause of neonatal and child mortality and morbidity worldwide. The aim of this study was to investigate associations between attending a brief antenatal lifestyle education seminar and preterm birth, and whether education timing modifies outcomes. A retrospective cohort study was conducted in a hospital-based antenatal care center in Beijing, China, where a free, 2 h, optional, face-to-face, midwife-led group seminar on healthy lifestyle choices during pregnancy was provided. Among the 3008 eligible women, 1107 (36.8%) attended the seminar during the first trimester, 515 (17.1%) attended during the second trimester or later, and 1386 (46.1%) did not attend. Multiparous women were more likely to not attend or to attend at a later stage. The overall prevalence of preterm birth was 8.7%, but it was higher for women who did not attend the antenatal seminar (11.5%). The risk of preterm birth for first trimester attendees decreased by 53%, and it decreased by 41% for later attendees. Estimates persisted after adjusting pre-existing and gestational covariates. Attending a brief antenatal lifestyle education seminar was associated with lower preterm birth risk, and attending during the first trimester had a better impact than later attendance. The results can inform the development of tailored preterm birth prevention strategies.     

Intake of Energy-Dense Foods,Fast Foods,Sugary Drinks,and Breast Cancer Risk in African American and European American Women

Limiting energy-dense foods, fast foods, and sugary drinks that promote weight gain is a cancer prevention recommendation, but no studies have evaluated intake in relation to breast cancer risk in African American (AA) women. In a case-control study with 1692 AA women (803 cases and 889 controls) and 1456 European American (EA) women (755 cases and 701 controls), odds ratios (OR) and 95% confidence intervals (CI) for risk were computed, stratifying for menopausal and estrogen receptor (ER) status. Among postmenopausal EA women, breast cancer risk was associated with frequent consumption of energy-dense foods (OR = 2.95; 95% CI: 1.66–5.22), fast foods (OR = 2.35; 95% CI: 1.38–4.00), and sugary drinks (OR = 2.05; 95% CI: 1.13–3.70). Elevated risk of ER+ tumors in EA women was associated with energy-dense (OR = 1.75; 95% CI: 1.14–2.69) and fast foods (OR = 1.84; 95% CI: 1.22–2.77). Among AA women, frequent fast food consumption was related to premenopausal breast cancer risk (OR = 1.97; 95% CI: 1.13–3.43), and with ER+ tumors. Energy adjustment attenuated risk estimates in AA women, while strengthening them among EA women. Frequent consumption of energy-dense and fast foods that have poor nutritive value appeared to increase breast cancer risk in AA and EA women, with differences by menopausal status and ER status.     

Digital Promotion of Energy Drinks to Young Adults Is More Strongly Linked to Consumption Than Other Media

Objective

To examine whether digital marketing strategies are more strongly associated with energy drink use than other marketing and whether Theory of Planned Behavior (TPB) constructs mediated the effects of digital marketing on energy drink use.

Ultra-Processed Foods and Drinks Consumption Is Associated with Psychosocial Functioning in Adolescents

Adolescents show one of the highest rates of ultra-processed foods and drinks (UPF) consumption, and studies indicate an association between their consumption and internalizing problems. We aim to investigate whether UPF consumption associates with dysfunctions in other psychosocial domains, as well as sex effects. In 560 Spanish adolescents (14–17 years old), we assessed the UPF products consumed in the previous day, fruits and vegetables consumption (servings/day), and physical activity (days/week). Psychosocial functioning (total and subscales) was assessed through the Pediatric Symptom Checklist–Youth self-report. Associations between UPF and psychosocial functioning were assessed using linear regression models, adjusting for sex, age, fruits and vegetables consumption, and physical activity. Sex-specific associations were also explored. Participants reported a daily consumption of 7.72 UPF servings per day, with male adolescents showing higher consumption than female adolescents. Consumption of fruits and vegetables and physical activity levels were lower than recommended. Psychosocial impairment was present in 26.2% of the participants. Higher UPF consumption was associated with higher presence of depressive symptoms and internalizing and externalizing problems in the whole sample and in male adolescents. The present study supports previous studies suggesting that UPF consumption may interact with mental health problems and indicates that these effects may go beyond internalizing problems.     

Sweetened Soft Drinks Consumption Is Associated with Metabolic Syndrome: Cross-sectional Analysis from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil)

Objective: To estimate the association between regular consumption of sweetened soft drinks, natural fruit juice, and coconut water with metabolic syndrome (MetS).

Methods: This was a cross-sectional study including men and women aged 35–74 years from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) Study, excluding patients with type 2 diabetes. The main explanatory variables were beverage consumption and the outcome variable was metabolic syndrome (Adult Treatment Panel III).

Results: After adjustments, a daily intake of 250 ml of soft drink increased the chance of metabolic syndrome (odds ratio [OR] = 1.95; 95% confidence interval [CI], 1.60–2.38). There was no association between coconut water and MetS. Moderate consumption of fruit juices has low odds of MetS compared to no consumption.

Conclusion: Our results add evidence to potential negative effects of sweetened soft drinks on cluster metabolic abnormalities in middle-income countries.     

加强术前教育减少医疗纠纷

随着《医疗事故处理条例》的颁布和实施，为了减少医疗纠纷的发生，提高医疗服务质量，增强医护人员法律意识。本文对术前教育的必要性，术前教育的程序，术前教育的方法，术前教育，谈话的内容以及如何做好术前谈话等问题进行了探讨。     

加强健康教育 降低职业危害

改革开放后 ,工矿企业尤其是三资、乡镇及私营企业迅速发展。但是 ,职业危害防治未能同经济发展同步 ,使得本已严重的职业危害问题更加日趋突出。如何加强职业健康教育 ,降低职业危害 ,是我们迫切需要探讨的问题。在职业健康教育过程中 ,要通过进厂教育或发《职业危害对话》、《职业危害防护》等指导性读物的形式 ,让职工充分了解他们的作业环境、接触毒物的性质和种类 ,接触剂量与时间、接触方式、对健康的影响、控制措施以及自我防护技能等。职业危害的致病模式也和一般疾病一样 ,职业危害因素、个体、作用条件构成了职业病损原因的“三大…     

综合护理干预对减少产后出血与提高产妇睡眠质量的效果分析

目的分析综合护理干预对减少产后出血与提高产妇睡眠质量的效果。方法将2013年3月至2014年3月期间所收治的60例产妇纳入本研究,根据随机数字表法将其分为对照组与观察组各30例,对照组采取常规护理方案,观察组则给予综合护理干预,观察两组的护理效果。结果与对照组相比,观察组产后出血量更少,睡眠质量改善更优,SAS、SES以及SDS得分更低,组间差异具有统计学意义(P<0.05)。结论围生期采取综合护理干预方案有利于减少产后出血、改善产妇睡眠质量,从而帮助产妇早期恢复,值得产科临床予以推广使用。     

Enhancing Cultural and Contextual Intervention Strategies to Reduce HIV/AIDS Among African Americans

I describe 4 protective strategies that African Americans employ that may challenge current HIV prevention efforts: (1) an adaptive duality that protects identity, (2) personal control influenced by external factors, (3) long-established indirect communication patterns, and (4) a mistrust of “outsiders.” I propose the Sexual Health Model as a conceptual framework for HIV prevention interventions because it incorporates established adaptive coping strategies into new HIV-related protective skills. The Sexual Health Model promotes interconnectedness, sexual ownership, and body awareness, 3 concepts that represent the context of the African American historical and cultural experience and that enhance rather than contradict future prevention efforts.AS THE UNITED STATES enters the third decade of the AIDS epidemic, the rates of new HIV/AIDS cases among African Americans continue to increase compared with those of other ethnic groups.¹ Consequently, the Centers for Disease Control and Prevention has proposed a heightened national response to the HIV/AIDS crisis for African Americans.² Community advocates, including the National Black Leadership Commission on AIDS and the National Medical Association, have called for a state of emergency³ to address disparities in infection rates.Among the population as a whole, evidence-based interventions have achieved some success in reducing HIV-related risks and infection rates.^4–6 Although biomedical and behavioral issues related to the transmission of HIV/AIDS have been well-addressed in these interventions,^7,8 some of the related key culture-bound protective strategies and their historical roots are not routinely included in HIV preventions targeted for African Americans.^2,3,9In the following section, I give 4 assumptions derived from HIV intervention research^4–6 regarding how and by whom HIV prevention messages should be conveyed to those at risk and how decisions are made about behavior change. For each of these 4 assumptions, I describe a culture-bound protective strategy used by African Americans that contradicts it: (1) an adaptive duality that protects identity, (2) patterns of personal control developed in response to external factors such as oppression and gender-based socialization, (3) long-established indirect communication patterns, and (4) a mistrust of “outsiders” that limits acceptance of HIV prevention and care.Finally, I propose the Sexual Health Model—a conceptual framework that addresses these adaptive coping strategies and promotes African Americans'' protective skills. I discuss new methods to aid implementation of this model in future interventions, making HIV prevention research more historically and culturally congruent.