学龄前儿童单纯肥胖症群体干预效果评价

【目的】探索儿童单纯肥胖症的群体干预方法,降低学龄前儿童肥胖发病率。【方法】从朝阳区和大兴区各选择2所幼儿园为研究现场,2~4岁儿童为研究对象,每区各有1所幼儿园为干预组,另1所为对照组。采用WHO身高标准体重值为肥胖判断标准。对干预组进行为期2年的群体干预,干预措施包括对儿童家长的健康教育、保证儿童运动锻炼时间、幼儿园提供平衡膳食、告知家长儿童体格测量结果等。对照组除与干预组同期体检外不接受任何干预措施。【结果】经过2年干预,干预组肥胖率从8.78%降至7.77%,对照组肥胖率从3.58%上升为6.81%;干预组血压偏高检出率从4.83%降至2.60%,对照组从1.39%上升为1.85%;干预组儿童体质指数(body mass index,BMI)下降幅度大于对照组,臂围增长值低于对照组(P<0.05)。【结论】肥胖群体干预方案在幼儿园的实施有助于学龄前儿童肥胖发病率的控制和儿童体形的改善。     

重庆市城区学龄前儿童肥胖综合干预效果评价

探索城区学龄前儿童肥胖干预综合措施的干预效果,为开展肥胖防治工作提供基础数据.方法 采用随机整群抽样的方式,在重庆市城区确定6所幼儿园,以其中3所为干预组(429人),另3所为对照组(407人).干预组采用肥胖综合干预措施,对照组不接受任何干预措施;随访1 a.结果 完成监测814人,入组时干预组儿童超重和肥胖检出率为44.1%,高于对照组(30.6%),差异有统计学意义(x2=16.0,P0.05).随访1 a后干预组儿童进食甜饮料、甜点频率较干预前降低,差异均有统计学意义(x2值分别为17.54,9.10,P值均<0.05).结论 采用综合干预措施对儿童超重和肥胖的检出率以及不良饮食行为的控制均有明显效果.     

广州市城区儿童超重肥胖影响因素分析

【目的】 探讨儿童超重肥胖的影响因素,为制定相应的防治策略和干预措施提供科学依据。 【方法】 用统一调查方法和调查表对儿童及其家长进行调查。 【结果】 在被调查的1 844名儿童中,超重、肥胖的检出率分别为11.12%、7.21%,男生超重肥胖合计检出率高于女生,差异有统计学意义(χ²=9.849,P<0.05)。超重肥胖组出生体重、父亲BMI、母亲BMI高于对照组,每餐进食时间低于对照组(P均<0.001)。性别、父母亲超重肥胖、每餐进食时间、晚上睡觉前半小时吃东西、是否认同“每天喝牛奶是个好习惯”和“活动少,容易发生肥胖”观点这7个因素是儿童超重肥胖的影响因素。 【结论】 广州市城区儿童超重肥胖较为常见,儿童超重肥胖是多因素综合作用的结果,应采取综合干预措施来控制儿童超重肥胖的发生。     

学龄前儿童肥胖的预防和干预

【目的】通过研究寻找出减少托幼机构肥胖儿童发生的有效方法。【方法】随机抽取闸北区2所托幼机构4~5岁60例超重及肥胖的学龄前儿童及相同条件的其他2所托幼机构4~5岁60例超重及肥胖的学龄前儿童分别作为干预组和对照组。干预组儿童,要求每天减少静态少动时间(30 min),增加运动量20%,用计步器作24 h运动强度记录(入园前、离园前记录两次)。在干预研究结束后,对两组儿童进行体格比较及体能测试。【结果】干预组儿童超重和肥胖程度的减轻或痊愈明显好于对照组,差异有显著性。【结论】托幼机构中开展肥胖儿童的预防和干预工作是可行并且是有效的。     

学龄前儿童单纯肥胖症群体干预中期效果评价

【目的】探索儿童单纯肥胖症的群体干预方法，降低学龄前儿童肥胖发病率。【方法】从朝阳区和大兴区各选择2所幼儿园的2～4岁儿童为研究对象，每区各有1所幼儿园为干预组，另1所为对照组。采用WHO身高标准体重值为肥胖判断标准。对干预组进行为期2年的群体干预，干预措施包括对儿童家长的健康教育、保证儿童运动锻炼时间、幼儿园提供平衡膳食、告知家长儿童体格测量结果等。对照组除与干预组同期体检外不接受任何干预措施。【结果】经过1年干预（干预中期），干预组肥胖率从7．72％降至5．34％，对照组肥胖率从3．96％上升为4．62％；干预组血压偏高检出率从5．05％降至2．76％，对照组从1．61％上升为3．11％；干预组儿童骨强度平均增长值高于对照组（P〈0．05）。【结论】肥胖群体干预方案在幼儿园实施1年来对学龄前儿童肥胖发病率的控制取得了一定的效果。     

学龄前超重、肥胖儿童家庭膳食结构分析

【目的】了解学龄前超重、肥胖儿童家庭膳食情况,分析其家庭膳食结构和营养,提出合理膳食建议。【方法】以市区两所幼儿园3~6岁超重、肥胖儿童90例为对象,随机抽取同年龄正常体重儿童66例为对照组,进行4 d家庭膳食调查,使用儿童青少年营养评估软件系统进行运算,对观察组和对照组各项膳食结构进行比较和分析。【结果】超重或肥胖儿能量摄入量、蛋白质摄入量和脂肪摄入量高于体型正常儿,而碳水化合物摄入量则低于体型正常儿;超重或肥胖儿谷类提供的能量低于正常体型儿,优质蛋白质摄入量高于正常体型儿。【结论】超重及肥胖儿童家庭膳食营养配餐不合理,家庭膳食中应适当减少动物性食品,合理增加谷类、薯类、豆类食品和绿色蔬菜、水果是降低超重或肥胖儿童体重,预防儿童肥胖的重要方法。     

南京市栖霞区学龄前儿童单纯性肥胖干预效果分析

目的 分析学龄前儿童单纯性肥胖主要因素,制订有针对性的干预措施。方法 2015年5月选取3 所幼儿园4岁学龄前儿童452名开展健康问卷调查,并实施健康干预,研究干预措施对学龄前儿童超重/肥胖检出率和体质量指数(BMI)的影响。结果 实验组超重/肥胖1年后检出率(14.16%)呈减少趋势,差异无统计学意义(χ²=0.43,P＞0.05)。观察组1年后超重/肥胖检出率(16.37%)呈显著增加趋势,差异有统计学意义(χ²=4.82,P＞0.05)。调查显示母亲超重/肥胖、摄入肉类占比超30%、食量超标、进食速度过快,运动不足等是导致超重/肥胖的重要因素。干预后超重组和肥胖组儿童BMI增长趋势均放缓(t=2.30和2.27,P均<0.05),超重/肥胖儿童生长曲线趋于正常。结论 引发学龄前儿童超重/肥胖是多种因素共同作用的结果,通过有针对性的综合干预,可以有效控制儿童超重/肥胖的发展程度,干预效果的持续性有待进一步研究。     

广州市某社区2~6岁儿童超重肥胖与生命早期因素研究

分析2~6岁儿童超重肥胖与生命早期因素的关系,为预防学龄前儿童超重肥胖提供理论依据.方法 采用随机整群抽样方法,于2018年在广州市抽取1个社区的所有托幼园所922名儿童为研究对象.调查内容包括问卷调查和体格检查.采用Logistic回归分析学龄前儿童超重肥胖与生命早期因素的关系.结果 学龄前儿童超重肥胖检出率为13.4%,男童超重肥胖检出率(16.1%)高于女童(10.1%),差异有统计学意义(Z=2.69,P<0.05).学龄前儿童超重肥胖检出率在大于胎龄儿、剖宫产、出生后6月内人工喂养、母亲孕前体质量指数(BMI)超重或肥胖、母亲孕期体重增重过多组内较高(P值均<0.01).二项式Logistic回归分析显示,大于胎龄儿(OR=2.62,95%CI=1.42~4.82)、剖宫产(OR=1.59,95%CI=1.08~2.36)、出生后6月内人工喂养(OR=2.00,95%CI=1.19~3.37);母亲孕前超重或肥胖(OR=1.97,95%CI=1.08~3.58)和母亲孕期增重过多(OR=2.07,95%CI=1.26~3.39)与学龄前儿童超重肥胖呈正相关(P值均<0.05);母亲孕前消瘦(OR=0.51,95%CI=0.29~0.88)与学龄前儿童超重肥胖呈负相关(P<0.05).结论 该社区2~6岁儿童超重肥胖检出率较高,学龄前儿童超重肥胖与出生体重、分娩方式、出生后6月内喂养方式、母亲孕前BMI和母亲孕期增重等生命早期因素相关,积极有效的早期干预可预防学龄前儿童超重肥胖.     

学龄前儿童身体活动和视屏时间与超重肥胖的关联

  目的  分析学龄前儿童身体活动和视屏时间与超重肥胖的关联,为学龄前儿童超重肥胖的预防和控制提供依据。  方法  采用病例对照研究设计,选取北京市朝阳区某社区4所幼儿园109名超重肥胖儿童作为病例组,在同样的幼儿园内选择体重正常的117名儿童作为对照组,对照组与病例组的年龄和性别频数匹配。用单因素分析比较两组人口学、身体活动时间、视屏时间、睡眠、饮食等特征,采用Logistic回归在调整协变量的情况下分析学龄前儿童身体活动和视屏时间与超重肥胖的关联。  结果  在调整年龄、性别、平均每日睡眠时间、儿童睡眠习惯问卷(CSHQ)总评分、中国学龄前儿童平衡膳食指数(DBI-C)正端分等因素后,每日身体活动时间 < 3 h的儿童与身体活动时间≥3 h的儿童相比超重肥胖风险增加1.55倍(OR=2.55,95%CI=1.16~5.64,P=0.02),儿童每日视屏时间每增加一个四分位数超重肥胖风险增加1.44倍(OR=2.44,95%CI=1.69~3.52,P < 0.01)。  结论  学龄前儿童身体活动时间不足和视屏时间较长都与超重肥胖相关。应采取综合干预措施有效增加身体活动时间并且减少儿童的视屏行为,降低学龄前儿童超重肥胖的发生率。     

厦门市870例0~18个月儿童肥胖早期干预效果分析

【目的】 通过调查掌握厦门市870例0~18个月儿童的肥胖及超重现状,并对其进行干预效果分析,进而为预防和控制儿童肥胖的发生和发展提供科学依据。 【方法】 在厦门市6个区随机选取10个社区卫生服务中心(或社区卫生院)所服务的婴幼儿,并且根据人数配比分为干预组(4个社区卫生服务中心)和对照组(6个社区卫生服务中心)所服务的婴幼儿各870人。 【结果】 通过BMI评价基线调查结果显示:干预组儿童均呈现较高的肥胖超重发生率,对照组的超重发生率(12.6%)较高,但是肥胖发生率极低(仅有0.5%)。而通过WFH评价显示:干预组和对照组儿童均呈现较高的超重发生率;两组儿童超重发生率呈下降趋势;肥胖发生率方面,干预组有一点下降趋势(从出生时的5.4%降到18月龄时的2.6%),对照组趋于平稳。 【结论】 监测数据显示18个月来干预组和对照组儿童之间的肥胖超重发生率无显著性差异,但是由于基线数据显示干预组的肥胖超重发生率明显高于对照组,这就从侧面反映了干预组的肥胖超重发生率得到了一定的控制,说明干预措施取得了一定的效果。     

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.     

The occurrence of antimicrobial substances in toilet,sink and shower drainpipes of clinical units: A neglected source of antibiotic residues

Antibiotics represent one of the most important drug groups used in the management of bacterial infections in humans and animals. Due to the increasing problem of antibiotic resistance, assurance of the antibacterial effectiveness of these substances has moved into the focus of public health. The reduction in antibiotic residues in wastewater and the environment may play a decisive role in the development of increasing rates of antibiotic resistance. The present study examines the wastewater of 31 patient rooms of various German clinics for possible residues of antibiotics, as well as the wastewater of five private households as a reference.To the best of our knowledge, this study shows for the first time that in hospitals with high antibiotic consumption rates, residues of these drugs can be regularly detected in toilets, sink siphons and shower drains at concentrations ranging from 0.02?μg·L^?1 to a maximum of 79?mg·L^?1. After complete flushing of the wastewater siphons, antibiotics are no longer detectable, but after temporal stagnation, the concentration of the active substances in the water phases of respective siphons increases again, suggesting that antibiotics persist through the washing process in biofilms. This study demonstrates that clinical wastewater systems offer further possibilities for the optimization of antibiotic resistance surveillance.     

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.