An overview of the role of bread in the UK diet

Despite being a staple food in the UK for centuries, bread consumption has fallen steadily over the last few decades. Average consumption now equates to only around 2–3 slices of bread a day. As well as providing energy, mainly in the form of starch, bread contains dietary fibre and a range of vitamins and minerals. The National Diet and Nutrition Survey (NDNS) of adults suggests that it still contributes more than 10% of our daily intake of protein, thiamine, niacin, folate, iron, zinc, copper and magnesium; one‐fifth of our fibre and calcium intakes; and more than one‐quarter of our manganese intake. Therefore, eating bread can help consumers to meet their daily requirements for many nutrients, including micronutrients for which there is evidence of low intake in some groups in the UK, such as zinc and calcium. This paper gives an overview of the role of bread in the UK diet, its contribution to nutrient intakes and current consumption patterns in different population groups.     

An overview of the role of rice in the UK diet

Rice is a staple food for over half of the world's population. Eighty percent of the British population buy rice, predominantly white rice, with the average person consuming approximately 5.6 kg per year. Rice consumption in the UK is expected to increase slightly, as a result of the growing ethnic population and food diversification. Starchy foods such as rice, potatoes, bread and cereals are our main source of carbohydrate and play an important role in a healthy diet. As well as providing energy, rice contains other essential nutrients such as thiamine, riboflavin, niacin, vitamin E, zinc, potassium, iron and fibre. On cooking, rice swells to at least three times its original weight and therefore benefits from a low‐energy density compared to other starchy carbohydrate foods (e.g. bread), as well as a low‐sodium content (unless salt is added to rice products). It has a low allergenicity and is relatively easy to digest, making it a useful food for early weaning or during convalescence. The Department of Health encourage the selection of wholegrain versions of starchy carbohydrate foods as these are higher in fibre. Brown rice also has a higher proportion of important bioactive phytochemicals such as hemicelluloses and lignans with antioxidant and anti‐inflammatory properties that may benefit health. Despite the common perception that starchy carbohydrate foods are ‘fattening’, diets containing rice have been shown to achieve weight loss in obese subjects, although greater weight reduction has been shown with mixed rice compared with white rice. Although the reported glycaemic index (GI) of different rice varieties is inconsistent, most types of rice are classified as low or medium ‘GI’ foods but this is influenced by cooking time, the degree of gelatinisation and rice type. While there are numerous studies that have examined the link between high‐carbohydrate intakes and risk of chronic diseases such as obesity, type 2 diabetes and cardiovascular disease, relatively few have investigated the role of rice specifically, particularly in western populations. In Asian populations in whom rice is a staple food, higher white rice consumption has been associated with elevated risk of diabetes and metabolic syndrome. Some prospective cohort studies in the US have linked regular consumption of white rice with higher risk of type 2 diabetes, whereas brown rice intake was associated with lower risk. These studies were however observational in nature and so cannot determine a ‘cause and effect’ relationship, whilst their findings may be subject to residual confounding. Future studies should consider potential differences of white rice varieties, which vary in amylose content, as well as the effect of processing methods.     

Early detection of influenza outbreaks using the DC Department of Health's syndromic surveillance system

Background  

Since 2001, the District of Columbia Department of Health has been using an emergency room syndromic surveillance system to identify possible disease outbreaks. Data are received from a number of local hospital emergency rooms and analyzed daily using a variety of statistical detection algorithms. The aims of this paper are to characterize the performance of these statistical detection algorithms in rigorous yet practical terms in order to identify the optimal parameters for each and to compare the ability of two syndrome definition criteria and data from a children's hospital versus vs. other hospitals to determine the onset of seasonal influenza.     

An overview of tritium behaviour in the Severn Estuary (UK).

Measurements of tritium (3H) activity in marine species in the Severn Estuary (UK) show concentrations significantly above those predicted by standard models. Concentration factors of 10(4) between seawater and marine species are observed; standard models assume a concentration factor of 1. In addition, the vast majority of activity is present in the form of organically bound tritium (OBT). The critical group dose from tritium--to consumers of local flounder--is estimated as approximately 36 microSv per annum. The measurements are related to the authorised release of wastes, via the sewer system, from the Amersham plc plant at Cardiff. The radiochemical plant manufactures a wide range of isotopically labelled compounds for use in life science research. The elevated levels of tritium observed in marine species have led to a programme of investigative work by specialist organisations. This paper describes the various definitions, measurements and significance of the term OBT. It also outlines the environmental observations and preliminary conclusions from the investigative programme to date.     

REVIEW: An overview of the role of potatoes in the UK diet

Potatoes are widely consumed in the United Kingdom and in many other countries. They provide energy, mainly in the form of starch, as well as other nutrients including vitamin C, folate, some B vitamins, potassium, magnesium, iron and zinc. Potatoes are naturally low in energy and provided that little or no fat is used when cooking them, they can decrease the energy density of a meal. As potatoes are high in starch and as they are usually eaten as a side dish replacing other carbohydrate rich foods, they are found in the starchy food section of the UK's Eatwell plate model and do not officially count towards the recommended 5 portions of fruit and vegetables per day. However, potatoes can help consumers to meet their daily requirements for some nutrients, including micronutrients for which there is evidence of low intakes in some groups in the UK, such as potassium. This paper gives an overview on the role of potatoes in the UK diet, including their consumption and their contribution to nutrient intakes in the UK.     

Ensuring quality preventive care: the Texas Department of Health's Put Prevention into Practice initiative.

In the current public health arena, assurance of quality clinical preventive services to all populations will be possible only if collaborations are nurtured between public health and the private sector health care delivery systems. This article explores key preventive health programs that serve as the historical context for the evolution of the Texas Department of Health-Put Prevention Into Practice (TDH-PPIP) initiative, outlines documented barriers to implementation of preventive services in primary care, and reviews national public health programs launched to reduce these barriers. Lastly, a discussion regarding the joint responsibilities of the public health and the private sector professionals in assuring quality preventive services to all populations is initiated. Collaborative efforts, such as the TDH-PPIP, initiative improve the availability and quality of clinical preventive services and, thus, result in significant advances in the public health goal of ensuring conditions in which people can be healthy.     

Critical overview of the management of neonatal jaundice in the UK

AIM: To determine the current management of early neonatal jaundice in the UK and to evaluate whether the current practices are evidence based. METHODS: A questionnaire survey was carried out among identified lead paediatricians of neonatal intensive care units. RESULTS: The survey found markedly differing practices for the recognition, investigation and treatment of neonatal jaundice. This applies particularly to confirmation of the clinical suspicion of jaundice; use of invasive and non-invasive technologies for diagnosis; preferred wavelength and intensity of light used for treatment; and whether birth weight, gestational age and postnatal age should influence treatment. CONCLUSION: The study found a lack of consistency in the management of jaundiced infants in the UK. The evidence-based practice currently available does not appear to have been incorporated into treatment protocols.     

Who needs what from a national health research system: lessons from reforms to the English Department of Health's R&D system

Health research systems consist of diverse groups who have some role in health research, but the boundaries around such a system are not clear-cut. To explore what various stakeholders need we reviewed the literature including that on the history of English health R&D reforms, and we also applied some relevant conceptual frameworks.     

An overview of the SATIN project

SATIN, or SATiety INnovation, is a 5‐year European‐funded research project to develop and test new food products with satiating qualities to help control appetite, manage weight and combat obesity. It is a €6 million Framework 7 project funded by the European Commission, designed to develop foods that regulate appetite by reducing hunger, accelerating within‐meal satiation and enhancing between meal satiety. The SATIN project employs novel food processing methods to modify food structure to produce functional foods for weight management. This article provides a useful summary of the work plans and describes how industry and academia will work together to produce products ready to commercialise and with proven consumer benefits. The SATIN project involves seven small‐ to medium‐sized enterprises, four industry and seven academic partners. SATIN will also seek to educate consumers and other stakeholders about satiety to optimise the impact of weight management outcomes.     

An overview of the NUTRIMENTHE project

The NUTRIMENTHE project is in receipt of €5.9 million from the European Commission's Seventh Framework Programme to study the effect of diet on the mental performance of children. The project is especially interested in the effect of B‐vitamins, protein (in breast and formula milk), minerals and long‐chain polyunsaturated fatty acids on the six main domains of mental performance. NUTRIMENTHE is also researching consumer perceptions of how diet affects mental performance and the economic consequence of improving mental performance. This article provides an insight into the results and progress made to date by the project.     

The Department of Health's research governance framework remains an impediment to multi-centre studies: findings from a national descriptive study

OBJECTIVE: We describe our experience of using the standard application form, designed to streamline applications for multi-centre research, to seek approval from all primary care organizations (PCOs) in England and Wales to undertake a single telephone interview with a health service manager. DESIGN: We sent applications (n=316), by email to each PCO, or consortium of PCOs, attaching a completed standard application form, the 15 required documents, and the approval we had been granted by the lead NHS organization. We maintained detailed records of the responses to our application, subsequent correspondence, additional paperwork requested, and time spent on the approval process. SETTING: The UK Research Governance Framework, which regulates all research conducted in health and social care settings. PARTICIPANTS: All PCOs in England and Wales. INTERVENTIONS: None. MAIN OUTCOME MEASURES: Time taken to obtain approval to undertake a telephone interview with a health service manager. RESULTS: We were unable to establish contact with 13 (4%) PCOs. Six months after submitting our application we had received approval from 259/316 (82%) PCOs and were still awaiting a verdict from 41 (13%). The median time to approval was 56 days (IQR 42-72). Overall, an estimated 318 staff-hours were spent completing supplementary forms, providing additional information and chasing up dormant applications. CONCLUSIONS: Recent initiatives to 'streamline' research governance approval have failed to address the problems that face researchers undertaking multi-centre studies. There is an urgent need to develop a simpler process that allows low risk research to take place without threatening staff morale and endangering the quality of the research outputs. In the meantime, we advise researchers to allow far greater time than might reasonably be envisioned to obtain research governance approval.     

布尼亚病毒科概述

布尼亚病毒科是媒传疾病中重要的病毒科之一,传播媒介囊括了医学节肢动物和啮齿动物,如蚊虫、白蛉、蠓、鼠等,宿主动物为哺乳动物,如人类等。2010年在河南、山东等地出现的"蜱虫叮咬事件"是由蜱作为传播媒介,病原体为新型布尼亚病毒的传染疾病,该病严重者可致多脏器功能衰竭、弥漫性血管内凝血,甚至死亡,病死率高达10%。为给布尼亚病毒所致疾病的检测和防治提供理论依据,现就布尼亚病毒科病毒病原学、所致疾病及感染和免疫应答方面的国内外研究做一综述。