广州某区15岁以上人群奶制品摄入及影响因素

目的了解广州市海珠区≥15岁居民奶制品摄入现况及影响因素。方法根据广州市2009年社区卫生诊断调查资料,采用横断面调查方法随机调查1749位居民。结果居民奶摄入率62.44%,每日奶或奶制品摄入量≥200 ml者占23.39%。有序Logistic回归分析示女性(OR=1.57,95%CI=1.31~1.88,P0.01)、高文化水平(OR=1.29,95%CI=1.17~1.41,P0.01)、高收入(OR=1.21,95%CI=1.11~1.33,P0.01)促进奶摄入;年龄越大(OR=0.85,95%CI=0.80~0.91,P0.01)、食物支出占年收入的比例越大(OR=0.88,95%CI=0.82~0.94,P0.01),越制约奶摄入。结论广州市海珠区≥15岁居民奶摄入较低,性别、年龄、文化、经济水平影响奶摄入,应对重点人群加强营养健康教育,提高居民意识,转变食物消费观念,形成合理膳食结构。     

广州市越秀区城区居民奶及奶制品摄入状况调查及影响因素分析

目的分析广州市越秀区居民奶及奶制品摄入情况及其影响因素,为越秀区进一步开展居民营养膳食方面的健康教育、健康干预工作提供基线数据和依据。方法分别利用分层随机整群抽样和方便抽样的方法对越秀区社区居民和娱乐场所消费人群进行问卷调查,调查内容包括个人一般情况、过去1个月里是否摄入奶及奶制品、摄入奶及奶制品类型和频率、平均每次饮用量等内容。采用描述流行病学方法对结果进行分析,并对调查对象的奶及奶制品摄入影响因素进行单、多因素分析。结果调查社区住户人群和娱乐场所消费人群共985人,男性453人(占46.0%),女性532人(占54.0%)。以30~44岁(占26.6%)、汉族(占98.4%)、人均年收入≥40 000元(占22.4%)为主。奶及奶制品摄入率为71.1%(700/985)。多因素logistic回归分析结果显示,女性(OR=2.027)、人均年收入≥40 000元人群(OR=2.019)奶及奶制品摄入可能性较高,15~29岁(OR=0.302)、30~44岁(OR=0.217)、45~59岁(OR=0.160)和60~69岁(OR=0.097)摄入的可能性较低。奶及奶制品摄入人群中,摄入频率每周≥6次者占49.0%(343/700),日均奶及奶制品摄入量不足300 g的占82.4%(577/700)。结论越秀区城区居民奶及奶制品总体摄入率较高,但老年人群摄入率低,总体摄入量不足。应加强奶及奶制品作用及摄入量等知识的健康教育,从而改善居民的饮食习惯。     

我国四城市中小学生零食消费行为及家长的影响

了解我国四城市中小学生零食消费行为及家长的影响,为开展相应的干预措施提供依据.方法 采用分层随机整群抽样方法,对沈阳市、广州市、武汉市、成都市10 313名中小学生及其家长进行问卷调查.结果 中小学生最常食用的前5种零食分别是谷类(58.5%)、新鲜水果蔬菜(53.7%)、奶及奶制品(51.0%)、糖果类(43.9%)、薯片和薯条(41.6%).学生与家长的零食消费频率正相关(r=0.119,P<0.01).家长文化程度越高,学生越倾向消费奶及奶制品.相对于小学,家长文化程度为初中、高中及以上的学生消费奶及奶制品的OR值(95%CI)分别为1.155(1.035~ 1.289)和1.162(1.055~1.279),消费薯片、薯条的OR值(95%CI)分别为0.853(0.766~0.949)和0.811(0.739~0.890).相对于家庭经济水平低者,水平为中、高的学生消费薯条、薯片的OR值(95%CI)分别为1.112(1.008~1.227)和1.500(1.215~1.852),消费新鲜水果蔬菜的OR值(95%CI)分别为0.898(0.812~0.994)和0.758(0.608~0.944).结论 我国四城市中小学生不健康的零食消费行为比较普遍,家长的零食消费行为对学生的零食行为影响很大.应针对家长的文化程度、家庭经济水平采取干预措施.     

广州市2016年城区中小学生体育锻炼现状及影响因素

了解广州市城区中小学生体育锻炼时间不足现状及其影响因素,为促进儿童青少年体质健康提供参考.方法 依托广州市中小学生常规体检工作,纳入其中10 972名城区小学二年级、初一、高一学生作为研究对象,通过问卷调查收集体育锻炼时间等资料.采用Kruskal-WallisH秩和检验,x2检验比较不同性别、年级学生每天体育锻炼时间差异;采用二分类Logistic回归模型分析不同年级学生每天体育锻炼时间<1h的影响因素.结果 中小学生平均每天体育锻炼时间为21.4(8.6 ~ 40.0) min,85.63%的中小学生每天体育锻炼时间<1h,女生每天体育锻炼时间<1h的比例(90.51%)高于男生(80.61%)(x2=218.04,P<0.05),且年级间差异有统计学意义(x2=273.68,P<0.05).Logistic回归分析显示,不愿意参加体育锻炼(小学二年级OR=6.81,95%CI=4.38~ 10.58;初一OR=4.60,95%CI=3.79~5.59;高一OR=9.25,95%CI=5.90~14.49)和女生(初一OR=1.57,95%CI=1.35~ 1.82;高一OR=2.85,95%CI=2.07~ 3.92)是中小学生体育锻炼时间不足的主要危险因素.结论 广州市城区中小学生体育锻炼时间不足问题严峻.应以女生为重点人群,实施以增强学生体育锻炼兴趣与意愿为主的干预措施.     

上海市中小学生体力活动不足及影响因素调查

了解上海市中小学生中等到高强度体力活动(MVPA)不足1h的现状及其影响因素,为促进儿童青少年参加体力活动提供参考.方法 多层整群抽取上海市中心城区和郊区共8个行政区16所中小学,对入选学校的9 583名中小学生开展问卷调查,收集学生体力活动情况.采用二分类Logistic逐步回归分析MVPA不足1h的影响因素.结果 上海市中小学生平均每天MVPA时间为0.55(0.21~1.07)h,70.1%的中小学生每天MVPA不足1h,其中男生为67.7%,女生为72.8%,女生MVPA不足1h的比例高于男生(x2=29.7,P<0.01).Logistic逐步回归分析结果显示,女生(OR=1.272,95%CI=1.156~1.399)、年龄小(OR=0.906,95%CI=0.892~0.920)、孩子从不或很少和同学/朋友一起运动(0R=3.347,95%CI=2.303~4.864)、父母每天MVPA时间少(OR=0.793,95%CI=0.763~0.825)、家长很少给孩子留出运动时间(OR=1.412,95%CI=1.178~1.684)、学校下午没安排体育活动时间(不包括体育课时间)(OR=1.667,95%CI=1.496~1.858)是中小学生MVPA不足1h的危险因素.结论 MVPA不足1h现象在上海市中小学生中广泛存在,急需开展更多能够有效促进儿童青少年参加体力活动的工作.在开展促进活动时,需综合考虑学生自身、同伴、家长和学校等多方面因素的影响.     

广州城区中小学生早餐与睡前加餐影响因素分析

了解广州市城区中小学生早餐及睡前加餐现状及其影响因素,为制定学校儿童青少年健康促进政策提供依据.方法 依托广州市中小学生常规体检工作平台,对广州市城区小学二年级、初一和高一年级的11 464名学生及其家长进行调查,收集学生吃早餐、睡前加餐、父母营养健康知识知晓情况等资料.结果 广州市中小学生经常不吃、不规律吃和经常吃早餐的构成比分别为4.90%,15.83%,79.27%.女生经常不吃/不规律吃早餐的报告率高于男生(X2=31.44,P<0.01),初一学生常不吃/不规律吃早餐的报告率高于其他年级学生(X2=257.16,P<0.01).60.80%的学生睡前加餐,女生睡前加餐的报告率高于男生(X2=15.95,P<0.01),学生睡前加餐报告率随年级升高而增加(X2=8.19,P<0.05).多因素Logistic回归分析显示,父母学历越低(OR=1.68,95%CI=1.51 ~ 1.86)、父母营养健康知识得分越低(一般:OR=1.17,95%CI=1.04~ 1.32;不及格:OR=1.42,95%CI=1.26~ 1.60),学生吃早餐频次越少.结论 广州市仍有部分中小学生经常不吃或不规律吃早餐,而相当高比例的学生睡前有加餐.父母学历和营养健康知识知晓水平对学生早餐行为有重要影响.     

广州市2016年城区中学生饮食行为模式及其影响因素分析

了解广州市城区中学生饮食行为模式及其影响因素,为中学生营养教育和营养干预提供科学依据.方法 依托广州市中小学生常规体检工作,对城区27所学校的初一和高一学生及其家长进行问卷调查,收集饮食行为等资料.采用探索性因子分析方法 建立中学生饮食行为模式,采用多因素无序多分类Logistic回归模型分析影响因素.结果 因子分析得到3种饮食行为模式:模式Ⅰ (37.09%)属于健康饮食行为模式,模式Ⅱ(33.37%)和模式Ⅲ(29.54%)属于西式饮食行为模式.Logistic回归模型分析结果显示,住校(ORⅡ=1.57,95%CI=1.33~1.85;ORⅢ=1.28,95%CI=1.07~ 1.52)、视屏时间≥2 h/d(ORⅡ =2.89,95%CI=2.51~3.33;ORⅢ =2.14,95%CI=1.85~2.48)与模式Ⅱ和Ⅲ呈正关联;家庭人均月收入≥5000元(ORⅢ=1.31,95%CI=1.14~1.51)与模式Ⅲ呈正关联;高中生(ORⅡ =0.83,95%CI=0.73~0.95;ORⅢ =0.74,95%CI=0.64~0.85)、父母为大专及以上文化程度(父ORⅡ=0.64,95%CI=0.52 ~ 0.79;母ORⅡ=0.67,95%CI=0.54~0.82;父ORⅢ =0.72,95%CI=0.58~0.90;母ORⅢ=0.73,95%CI=0.59 ~ 0.89)与模式Ⅱ和Ⅲ呈负关联.结论 广州市城区中学生存在3种饮食行为模式,父母文化程度、视屏时间、年级、住校情况、家庭人均月收入是中学生饮食行为模式的主要影响因素.     

钙、奶及奶制品摄入量与超重肥胖的关系

目的调查成都市龙泉驿区7~15岁儿童青少年膳食钙、奶及奶制品摄入情况及超重肥胖现状,并探讨两者间的关系。方法采用分层整群随机抽样法,获1738例有效样本。利用24小时膳食问卷及食物频率问卷(FFQ)收集膳食信息,同时测量身高、体重及腰围,计算体质指数(BMI)、腰围身高比(WHtR),并进一步计算体质指数分数(BMI SDS)。根据中国肥胖问题工作组(WGOC)标准评价超重肥胖。将钙、奶及奶制品摄入量分成3组,分析超重肥胖指标与钙、奶及奶制品之间的关系。结果男生的超重率与肥胖率分别为11.92%、7.04%,女生为8.40%、6.30%。女生钙、奶及奶制品摄入量均高于男生(P0.0001)。7~9岁男生的BMI SDS与奶及奶制品摄入量成正比(P=0.01);10~12岁男生钙摄入量较低时,其超重率较高(P=0.03)。不同年龄组女生中,钙、奶及奶制品摄入情况与超重肥胖指标间的差异均无统计学意义。结论男生的钙、奶及奶制品摄入量可能与超重肥胖相关,但在不同年龄组中表现不同;女生中未发现钙、奶及奶制品与超重肥胖的关系。     

重庆市某主城区中小学生体型自我评价及影响因素分析

了解重庆市某主城区中小学生体型自我评价与实际体质量指数(body mass index,BMI)评价的一致性及其影响因素,为有效实施儿童青少年肥胖健康教育及心理干预,预防和控制青少年肥胖提供科学依据.方法 采用分层整群抽样的方法,抽取重庆市某主城区8所中小学共2 798名学生进行中小学生肥胖相关KAP问卷调查和体格检查.结果 该区中小学生的超重肥胖检出率为22.9%,男生超重肥胖检出率(27.6%)明显高于女生(17.8%) (X2 =24.210,P<0.01).30.5%的中小学生不能正确评价自己的体型,小学生(Kappa=0.418)和中学生(Kappa =0.403)体型自我评价与实际BMI的一致性均较差.多因素Logistic回归分析显示,男生(OR=1.497,95%CI=1.239~1.809)、父亲文化程度高(OR=2.855,95% CI=1.053 ~ 7.741)和家庭经济差(OR=1.827,95%CI=1.340~2.492)是学生低估自我体型的危险因素;中学(OR=1.932,95%CI=1.411 ~ 2.646)、女生(OR=2.558,95%CI=1.854~3.531)、家庭经济状况差(OR=1.967,95%CI=1.131~3.422)、家庭关系差(OR=2.468,95%CI=1.324~4.600)与一般(OR=1.378,95%CI=1.003~ 1.894)是学生自我体型高估的危险因素.结论 重庆市某主城区学生超重肥胖检出率较高,且学生对自我体型存在低估或高估,性别和家庭经济状况是可能导致体型评价错误的影响因素.     

我国四城市中小学生饮料消费种类及家长的影响

了解我国四城市中小学生饮料消费种类及其家长的影响,为开展相应的干预措施提供依据.方法 采用分层随机整群抽样方法,对沈阳市、广州市、武汉市、成都市9 221名中小学生及其家长进行饮料消费行为问卷调查.结果 中小学生最常饮用的饮料前5位是奶类(60.5%)、碳酸饮料(37.0%)、果蔬汁饮料(31.0%)、功能饮料(26.9%)和鲜榨果蔬汁(22.5%),不同性别和学段的学生饮用的饮料种类不同.学生与家长的饮料消费行为正相关(r=0.152,P<0.01).小学生受家长影响的因素较多,包括家长文化程度、家庭经济水平以及家长的饮料消费行为.男生主要受家庭经济水平影响,女生主要受家长文化程度影响.家长文化程度、家庭经济水平越高,学生越容易消费鲜榨果蔬汁.相对于小学,家长文化程度为初中、高中及以上的学生消费鲜榨果蔬汁的OR(95%CI)值分别为1.344(1.168 ~1.546)和1.439(1.273~1.627);相对于家庭经济水平低,水平为中、高的学生消费鲜榨果蔬汁的OR(95%CI)值分别为1.321(1.151~1.515)和2.075(1.604~2.683).结论 我国四城市中小学生饮料消费以奶类为主,饮用碳酸饮料的中学生仍占有较高比例.应制定干预策略,着重考虑学生的性别、家长的文化程度和家庭经济水平.     

Management of pregnancy and childbirth in England and Wales and in France

This paper reviews national data on obstetric and neonatal practices in England and Wales, and in France between 1970 and 1980. The data have been derived from national statistics and surveys on national samples of births in 1970, 1975 and 1980 in England and Wales, and 1972, 1976 and 1981 in France. The analysis shows that there was no major difference in pregnancy outcome, but wide variations in medical practices, and their trend over time. The main differences were: in England and Wales a higher number of antenatal visits, a higher percentage of inpatient admissions during pregnancy, a higher rate of induction, more episiotomies, a higher rate of resuscitation at birth, and admission to neonatal special care units; in France, a higher rate of caesarean sections before and during labour, some evidence of a more active management of labour, and a longer hospital post-natal stay. These differences in practice reflect differences in objectives and assessment of the effectiveness of care between the two countries: they point out the need for better monitoring and evaluation of obstetric and neonatal practices.     

2011年温州城乡九所中小学生超重肥胖患病状况调查

【目的】 调查温州城乡中小学生超重肥胖的患病状况。 【方法】 2011年5-8月随机抽取温州城区、城乡结合部及农村中小学共9所学校进行整群调查。记录学生的一般资料,同时测量身高体重两项发育指标,计算体质指数,按照2004年中国肥胖问题工作组(WGOC)推荐的诊断标准,评价温州市中小学生的超重及肥胖患病状况。 【结果】 共9 657名在校学生参与调查,其中男生5 114 名,女生4 543名,平均年龄(14.95±4.53)岁,被调查人群中超重占7.6%,肥胖占2.6%,男生超重和肥胖患病状况均显著高于女生(9.8% vs 5.2%,5.2% vs 1.2%,P值均<0.01),各年龄段中以7岁儿童肥胖及超重状况最为严重(27.15% vs 7.955%),城区及城乡结合部超重肥胖患病状况明显高于农村(P值均<0.01)。 【结论】 温州中小学校肥胖和超重总患病约为10%,男性,尤其是城区及城乡结合部男生超重肥胖患病情况最为严重,需要引起高度重视。     

Efficacy of single and double doses of albendazole and mebendazole alone and in combination in the treatment of Trichuris trichiura in school-age children in Uganda

A randomised clinical trial was conducted in Kabale District, southwestern Uganda, to compare the efficacies of single and double doses of a combination of 400 mg albendazole (ALB) and 500 mg mebendazole (MBZ) with those of single and double doses of each drug given alone in the treatment of Trichuris trichiura. Infected pupils (n = 611) were randomised to six treatment groups. Three groups received either a single dose of ALB, MBZ or the combination (ALB+MBZ). The other three groups received either a double dose of ALB (ALB/ALB), MBZ (MBZ/MBZ) or the combination (ALB+MBZ/ALB+MBZ). All double doses were given 8 h apart. Children were followed-up weekly for 1 month. Cure rates were significantly higher using double doses compared with single doses (irrespective of drug; z = −4.02, P < 0.0005) as well as using the drug combination compared with single drugs (irrespective of doses; z = −7.64, P < 0.0005). Cure rates measured at Day 7 were significantly higher than on Days 14 and 21 after treatment (Day 14, z = 9.90, P < 0.0005; Day 21, z = 7.36, P < 0.0005). Geometric mean (GM) intensities of positives were significantly lower on Day 7 compared with all other subsequent days (P < 0.00005), and on Day 28 GM intensities reached pre-treatment levels (P = 0.096). Whilst there was no difference in egg excretion between single and double doses of the same drug or drug combination (F_(df1) = 0.28, P = 0.60), the combination treatment resulted in lower egg excretion than use of single drugs (F_(df2) = 50.90, P < 0.00005). All the tested regimens of ALB and MBZ had low cure rates against T. trichiura in Uganda, but both combination treatments showed satisfactory egg reduction rates 3 weeks after treatment. [ClinicalTrials.gov identifier: NCT01050452]     

儿童铁和锌缺乏与营养素补充

营养性铁和锌缺乏症是严重影响儿童健康的常见营养素缺乏问题,在发展中国家是导致疾病负担加重和高死亡率的重要因素.铁和锌缺乏症每年引起约数万名5岁以下儿童死亡.婴幼儿是铁和锌缺乏的高危人群,摄入不足是造成铁和锌缺乏的主要原因.6～24个月婴幼儿的铁缺乏可对其智力发育产生不可逆的损害;锌缺乏是引起2岁以下幼儿生长发育迟缓的主要原因之一.补充微量营养素以及应用微量营养素强化食品可减少儿童铁和锌缺乏的发生,并具有较高的成本效益,应作为优先推荐的干预措施.该文就铁和锌缺乏的危害和干预研究进展作以综述.     

Dissipation and Residues of Difenoconazole and Azoxystrobin in Bananas and Soil in Two Agro-Climatic Zones of China

Residues of a fungicide suspension (12 % difenoconazole, 18 % azoxystrobin) in bananas and soil were studied under tropical and subtropical monsoon climates, in Hainan and Yunnan provinces, respectively. The half-lives in bananas were shorter in Hainan (difenoconazole: 8.4–10.7 days; azoxystrobin: 7.8–8.4 days) than Yunnan (difenoconazole: 11.3–13.0 days; azoxystrobin: 10.4–11.6 days), possibly because of the higher temperatures and solar radiation levels in Hainan. The half-lives in soil were shorter in Yunnan (difenoconazole: 15.5–16.7; azoxystrobin: 11.9–13.9 days) than Hainan (difenoconazole: 23.1–23.2 days; azoxystrobin: 16.0–16.1 days), possibly because the organic carbon content was higher and rainfall lower in Yunnan than Hainan. Their physico-chemical properties suggest difenoconazole and azoxystrobin should be stable in bananas and soil, but both decreased to safe concentrations by the minimum harvest time after spraying the mixture at the recommended dosage and 1.5 times that dosage, through physical, chemical, and biological processes.     

Concentrations of tetrachloroethene in blood and trichloroacetic acid in urine in workers and neighbours of dry-cleaning shops

Summary Tetrachloroethene concentrations in blood and trichloroacetic acid concentrations in urine were determined — primarily over the course of a week — for 29 persons living in the vicinity of dry-cleaning shops. The mean levels of tetrachloroethene increased during the week. In some neighbours concentrations were exceeding the German biological threshold limit value for tetrachloroethene (1000 g/l blood), persisting over the whole week in one case. The concentrations of tetrachloroethene in blood depended on the floor and the construction type of the building where these people were living, but not of the type of system used in the dry-cleaning shops. 5 of 12 drycleaners were found to have tetrachloroethene levels exceeding the German biological threshold limit value, some of them by a considerable amount.     

Toxicity and uptake of TRI- and dibutyltin in Daphnia magna in the absence and presence of nano-charcoal

Butyltins (BTs), such as tributyltin (TBT) and dibutyltin (DBT), are toxic to aquatic organisms, but the presence of the strong adsorbent, black carbon (BC), can markedly influence BT toxicity and uptake in organisms. In the present study, the acute toxicity and uptake of TBT and DBT in the crustacean, Daphnia magna, were investigated with and without addition of nano-charcoal at different pHs and water hardnesses. The results showed that the toxicity of TBT and DBT increased by lowering the pH from 8 to 6. This reflects a relatively higher toxicity of cationic BT species than of the neutral species. At pH 6, by enhancing the water hardness of the media from 0.6 to 2.5?mM, the toxicity of TBT and DBT consistently decreased due to competitive binding of bivalent cations (Mg2?, Ca2?) to biotic ligands of D. magna. Furthermore, the toxicity of TBT to D. magna significantly decreased in the presence of nano-charcoal compared with experiments without nano-charcoal at pH 6 and 8, while no significant decrease in toxicity of DBT was observed in the presence of nano-charcoal. This can be attributed to the insignificant decrease of free DBT concentration in the presence of nano-charcoal compared with that for TBT. Conversely, it was observed that more TBT and DBT were taken up in D. magna in the presence of nano-charcoal due to the uptake of TBT or DBT associated with nano-charcoal by Daphnia in gut systems, as seen by light microscopy. This indicated that only free nonadsorbed BTs were toxic to D. magna, at least during short periods of exposure.     

Relationships between distribution of lead in erythrocytes in vivo and in vitro and inhibition of ALA-D.

Proteins in the ALA-D (delta-aminolaevulinic acid dehydratase) fraction from gel filtration of erythrocyte supernatant (ES) have the highest affinity for lead among erythrocyte constituents in vivo and in vitro. It takes 20-40 hours for erythrocyte components to be equilibrated with lead added in vitro. AT low lead concentrations, under 60 micrograms/100 ml ES, the extent of decrease in ALA-D activity indicates the extent of lead saturation of ALA-D fraction proteins. The saturation is attained at 80-110 micrograms/100 ml ES. Although an appreciable amount of lead is also found in the haemoglobin fraction that contains certain factors concerned in ALA-D inhibition, lead responsible for inducing the inhibition is not bound to haemoglobin fraction proteins but to ALA-D fraction proteins. Of three treatments or agents recovering the enzyme from lead effects, zinc is the only one that can fully restore the inhibition.