学生营养改善计划2012-2017年学校膳食能量与宏量营养素供应变迁

目的 了解“农村义务教育学生营养改善计划”(以下简称“营养改善计划”)试点地区学校食堂食物供应中能量与宏量营养素供应变化趋势,为推进中西部贫困农村学校合理供餐、促进儿童健康成长提供基础数据.方法 从2012-2017年,对中西部22省699个国家试点县,按照不同的供餐模式抽取10％的学校进行监测,计算学校每人每天能量和...     

学生营养餐现状与发展趋势

学生营养餐关系着学生的健康和生长发育，也关系着民族的素质与国家的未来。好的学生营养餐计划可以促使学生健康成长，促进孩子养成良好的饮食习惯，增加营养知识，可以促进国家经济发展。国际上发达国家有很多年的学校供餐史，成功的国家如美国、日本基本上都通过规范化、标准化、法制化而把学校供餐发展起来。尤其是日本有93％的学生参加学生营养餐计划，其国民素质提高也非常显著。中国的学生营养餐发展时间不长，主要集中在大中城市，由于政府未给予足够的重视，没有相应的法律法规，工作执行不够规范。另一方面，由于中国人的饮食习惯，学生营养餐的营养标准与传统中餐的色香味形有矛盾。中国营养师奇缺也影响了学生营养餐发展。中国学生营养餐项目虽说从无到有、从少到多，所取得成绩是巨大的，但还处于起步阶段，要发展成正规化还要走很长的路，尤其需要法制化、标准化和规范化，需要政府部门的政策支持和长期规划。     

学生营养改善计划学校供餐配餐状况变迁

目的 分析中国2013-2017年“农村义务教育学生营养改善计划”(以下简称“营养改善计划”)监测学校电子配餐软件使用和食谱制定等情况,为提高学校供餐质量提供基础数据.方法 2013-2017年,在“营养改善计划”覆盖的中国中西部22个省699个国家试点县中,分别按照食堂供餐、企业供餐和混合供餐3种供餐方式,随机抽取不...     

学生营养改善计划地区2013年学校营养改善措施分析

分析2013年“农村义务教育学生营养改善计划”(以下简称“学生营养改善计划”)地区营养改善措施,为更好地推广农村学生营养改善工作提供依据.方法 699个实施“学生营养改善计划”的国家试点县均为常规监测县,从中分片抽取50个县(每个试点省1~3个县)作为重点监测县;按照分层随机抽样的原则,每个县分别从学校食堂供餐、企业(单位)供餐和混合供餐等3种供餐模式抽取20%~30%的小学和初中作为监测学校.采用“县基本情况调查表”和“学校调查表”收集县和学校的基本信息、补助金额、经费使用方式以及执行“营养改善计划”过程中存的困难等.结果 2013年“学生营养改善计划”供餐模式以学校食堂供餐(45.1%)和企业供餐(48.8%)为主,学校食堂供餐多采用“免费提供一顿饭”的方式(68.5%),企业供餐多采用“课间加餐”(99.9%)的方式.食品安全(70.6%)和学校食堂建设(68.5%)是“学生营养改善计划”实施的过程中各监测县面临的主要问题.除“学生营养改善计划”外,有12.1%的监测学校开展了地方营养改善,主要形式为“营养知识的宣传教育”(87.7%).绪论 “学生营养改善计划”主要为“免费供餐”或“课间加餐”;试点县面临存在食品安全、食堂建设等问题,应进一步加强对试点县科学合理供餐指导.     

我国学生营养状况及相关营养改善政策

儿童少年的营养健康水平事关国家和民族长远发展,是国家综合实力和社会文明进步程度的重要标志.许多发达国家十分重视义务教育阶段学生的营养状况.早在1790年,德国慕尼黑就在一所贫民学校中实施了教学与消除饥饿相结合的计划;全球现有近90个国家先后实施了学校供餐计划,其中也包括一些发展中国家,如泰国、巴西、加纳等.     

024学生营养餐现状与发展趋势

学生营养餐关系着学生的健康和生长发育,也关系着民族的素质与国家的未来.好的学生营养餐计划可以促使学生健康成长,促进孩子养成良好的饮食习惯,增加营养知识,可以促进国家经济发展.国际上发达国家有很多年的学校供餐史,成功的国家如美国、日本基本上都通过规范化、标准化、法制化而把学校供餐发展起来.尤其是日本有93%的学生参加学生营养餐计划,其国民素质提高也非常显著.中国的学生营养餐发展时间不长,主要集中在大中城市,由于政府未给予足够的重视,没有相应的法律法规,工作执行不够规范.另一方面,由于中国人的饮食习惯,学生营养餐的营养标准与传统中餐的色香味形有矛盾.中国营养师奇缺也影响了学生营养餐发展.中国学生营养餐项目虽说从无到有、从少到多,所取得成绩是巨大的,但还处于起步阶段,要发展成正规化还要走很长的路,尤其需要法制化、标准化和规范化,需要政府部门的政策支持和长期规划.     

学生营养改善计划地区2012和2013年不同供餐模式学校能量营养素供应情况比较

评价和比较2012年和2013年我国“农村义务教育学生营养改善计划”(以下简称“农村学生营养改善计划”)不同供餐模式学生餐的营养素供应情况,为开展营养干预措施提供依据.方法 采用称重记账法对2012年3 910所和2013年5 523所实施“农村学生营养改善计划”的学校食堂食物供应情况进行调查.结果 实施“农村学生营养改善计划”1a后,食堂供餐学校的能量、蛋白质、维生素A、维生素C、钙、铁、锌均高于2012年(Z值分别为-4.059,-2.665,-6.051,-2.387,-2.660,-3.900,-3.888,P值均<0.05),企业供餐学校的蛋白质、钙和锌人均供应量均高于2012年(Z值分别为-2.797,-7.048,-6.013,P值均<0.01).采用多水平混合效应模型分析发现,食堂供餐模式学校的人均膳食能量、维生素A、维生素C和铁供应量均高于企业供餐学校,分别高196.20 kcal,84.42 μg RE,29.17 mg和3.65 mg;但企业供餐模式学校的人均钙和锌供应量高于食堂供餐学校,分别高246.56 mg和2.72 mg,差异均有统计学意义(P值均<0.05).结论 实施“农村学生营养改善计划”1a后,学校的人均能量和营养素供应情况普遍提高,且存在供餐模式间的差异.各学校应结合自身情况,因地制宜地选择供餐模式和供餐食物.     

学生营养改善计划不同供餐模式学校2012和2013年食物供应比较

评价和比较我国“农村义务教育学生营养改善计划”(以下简称“农村学生营养改善计划”)不同供餐模式学生餐的食物供应情况,为推广合理的学生营养干预措施提供依据.方法 采用记账法对2012年度3 910所和2013年度5 523所实施“农村学生营养改善计划”的学校食堂食物供应情况进行调查分析.结果 实施“农村学生营养改善计划”1年后,食堂供餐学校的粮谷、鸡蛋、豆制品和植物油(Z值分别为-5.766,-2.942,-8.182,-2.950,P值均<0.01),企业供餐学校的鸡蛋和牛奶生均供应量均有显著增长(Z值分别为-7.604,-8.018,P值均<0.01).采用多水平混合效应模型分析发现,食堂供餐模式学校的生均粮谷、蔬菜、禽畜、豆制品和植物油供应量高于企业供餐学校,企业供餐模式学校的生均鸡蛋和牛奶供应量高于食堂供餐学校,差异均有统计学意义(P值均<0.05).结论 我国实施“农村学生营养改善计划”1年后,学校的食物供应量有普遍提高,不同供餐模式变化特点有所不同.     

农村学生营养改善计划地区2016年学校食堂建设情况

评价2016年“农村义务教育学生营养改善计划”(以下简称“营养改善计划”)覆盖地区学校食堂建设情况并比较“计划”开展4年来的变化,为进一步推进农村学校食堂供餐提供基础数据.方法 从实施“营养改善计划”的699个国家试点县中,每个县按照学校食堂供餐、企业(单位)供餐和家庭(个人)托餐3种供餐模式各随机抽取20%~30%的小学和初中作为调查学校,当某种供餐模式不足2所小学或2所初中时,则抽取该供餐模式下所有学校作为调查学校,共收集8 235所学校的信息.结果 82.7%的学校有食堂,既有食堂又有餐厅的学校占70.7%,有食堂和餐厅同时配备桌椅的学校占60.2%,上述比例均呈现西部地区高于中部地区,食堂供餐模式的学校比例高于企业供餐和其他供餐模式的学校,九年一贯制学校高于小学和初中.70.3%的学校多数学生在餐厅吃饭,分别有24.4%,9.7%和4.5%的学校多数学生在教室、操场和宿舍吃饭.2013-2016年,“营养改善计划”覆盖学校配备食堂的比例由60.8%上升为82.7%,有食堂和餐厅的学校比例由42.2%上升至70.7%,学校食堂和餐厅配备桌椅的比例由31.7%上升至60.2%.结论 2013-2016年“营养改善计划”实施地区试点学校食堂建设比例和硬件配套情况普遍提高,但仍有待进一步加强和完善.     

农村学生营养改善计划试点学校2016年食物供应情况

分析2016年“农村义务教育学生营养改善计划”(以下简称“营养改善计划”)试点学校食物供应情况并对历年数据进行纵向比较,为“营养改善计划”的下一步实施提供基础数据.方法 在“营养改善计划”试点地区按照不同供餐模式抽取10%的学校共5 356所进行监测,通过对“供餐单位供餐表”中的就餐情况和食物购买记录进行分析,计算生均谷薯类、蔬菜水果、禽畜肉、豆制品、蛋类和奶类的供应量,并与《学生餐营养指南》(WS/T 554-2017)进行比较.结果 2016年“营养改善计划”试点学校谷薯类、禽畜肉的供应较为充足(101.2%,116.1%),食堂供餐模式的禽畜肉类略高(127.7%),奶类供应最低(为0),企业供餐模式的蔬菜水果、豆制品和禽畜肉的供应不足(31.3%,0,0.4%).中部地区学校的食物供应整体好于西部,初中供应情况较差.2012-2016年,学校的食物供应整体呈增加趋势.结论 “营养改善计划”地区试点学校的食物供应情况有所改善,但还需加强配餐的合理性和科学性.西部地区和初中学校的食物供应情况更要重视.     

The role of information dissemination in sustainability of international partnerships.

The Fogarty-supported International Training Program of the Southwest Center for Occupational and Environmental Health (SWCOEH) at the University of Texas School of Public Health was initiated in 1995, with its activities focused primarily on Latin America. As this program has matured, its participants have been concerned about including elements that increase the likelihood that its trainees and projects will have a sustainable impact on occupational and environmental health in collaborating countries. The Center recently reviewed the experiences of various international organizations and national development agencies with established track records involving donor-supported projects. The authors summarize factors associated with project sustainability and describe how some of them are being incorporated into the SWCOEH program. Particular mention is made of the importance of supporting an infrastructure for broad information dissemination in the language of the intended audience. An example of a project to support a peer-reviewed Spanish-language journal devoted to occupational and environmental health, Salud de los Trabajadores, is presented.     

The Role of Information Dissemination in Sustainability of International Partnerships

Abstract

The Fogarty-supported International Training Program of the Southwest Center for Occupational and Environmental Health (SWCOEH) at the University of Texas School of Public Health was initiated in 1995, with its activities focused primarily on Latin America. Asthis program has matured, its participants have been concerned about including elements that increase the likelihood that its trainees and projects will have a sustainable impact on occupational and environmental health in collaborating countries. The Center recently reviewed the experiences of various international organizations and national development agencies with established track records involving donor-supported projects. The authors summarize factors associated with project sustainability and describe how some of them are being incorporated into the SWCOEH program. Particular mention is made of the importance of supporting an infrastructure for broad information dissemination in the language of the intended audience. An example of a project to support a peer-reviewed Spanish-language journal devoted to occupational and environmental health Salud de los Trabajadores, is presented.     

Partners in school asthma management: evaluation of a self-management program for children with asthma

The "Partners in School Asthma Management" program for inner-city elementary school children comprises (1) case finding; (2) linkage of school nurses, parents, and clinicians; (3) a computer-based tailored educational program; and (4) school environmental assessment and intervention. Case finding identified 1730 children in 60 elementary schools with probable asthma; 835 (96% Hispanic or African American) joined the study. Baseline, posttest, and follow-up measures of asthma knowledge, self-efficacy, and self-management behavior were obtained from the children, and data on symptoms, emergency department visits, and hospitalizations were obtained from their parents. The schools provided data on grades and absences. Each school had a baseline and follow-up environmental assessment. The children in the intervention group showed greater increases in knowledge, self-efficacy, and some aspects of self-management. No differences between groups were found in health status variables, school performance, attendance, or levels of environmental allergens in schools. In 15 schools, an enhanced intervention allowed children and their parents to meet with a project physician, develop an asthma action plan, and receive a 1-month supply of medication; the project physician then followed up with the child's community physician. Children participating in this enhanced intervention had better school performance and fewer absences than the comparison group. Overall, the program was effective in improving children's asthma self-management but not in improving their health status. While the case-finding, computer-based self-management training program and linkage system were successfully implemented, the program failed in creating needed changes in the medical (action plans by community physicians) and physical environments (reduced school allergen levels) of the children.     

Children walking to school: Parent perceptions of environmental and psychosocial influences

Background and Aims:  Children's declining physical activity has attracted attention from those concerned with the health and well-being of the young. The present study aims to determine if the extent of walking to and from a school with an active participation program differed from that in another school without a program.
Method and Results:  Data from 21 parents of Grade 7 children from School A, sourced from a previous study, were compared with data from parents of Grade 7 children in School B, collected using the same questionnaire. No significant difference in the mean number of days walked to ( t = 0.098, P = 0.92) or from school ( t = 0.251, P = 0.80) was identified.
Conclusions:  This small-scale project suggests that a mélange of variables has the potential to influence children's incidental activity levels.     

Identification of community leadership in the development of public health education programs

This paper deals with the identification of community leadership within the context of a community cancer prevention education program. An unusually high age-adjusted black/white mortality ratio exists for cervical cancer in Forsyth County, North Carolina. In response to this problem, a comprehensive public education program dealing with cervical cancer prevention was developed and currently is being implemented. Black community leaders have played an important role in planning for the program and in providing assistance for program implementation. Leaders were identified by means of a modified snowball technique in which ten recognized leaders in the black community initially were contacted and asked to name at least five other leaders in areas of leadership that included social/civic, political, religious, business, and less visible leaders. This process continued until no new names were generated. Interviews were conducted with 103 persons, and 589 leaders were identified. A cohort of 54 top-ranked leaders were identified, and the characteristics of these leaders are presented. The value of the leadership identification process is discussed in terms of (a) the identification process itself, (b) the generation of a list of key individuals who can serve as sources of advice for development and implementation of the program and as the beginning point for dissemination of new information on the project, and (c) a mechanism for development of a sense of community ownership of the project.Robert Michielutte, PhD is Research Associate Professor Department of Family and Community Medicine, Bowman Gray School of Medicine, Winston-Salem, NC 27103; Pheon Beal, MPH is Direct Education Coordinator, Forsyth County Cervical Cancer Prevention Project, Department of Family and Community Medicine, Bowman Gray School of Medicine, Winston-Salem, NC 27103.This research was supported by contract No. NCI-N01-CN-65034 from the National Cancer Institute.     

Position of the American Dietetic Association: local support for nutrition integrity in schools

It is the position of the American Dietetic Association that the schools and the community have a shared responsibility to provide all students with access to high-quality foods and school-based nutrition services as an integral part of the total education program. Educational goals, including the nutrition goals of the National School Lunch Program and the School Breakfast Program, should be supported and extended through school district wellness policies that create overall school environments that promote access to healthful school meals and physical activity and provide learning experiences that enable students to develop lifelong healthful eating habits. The National School Lunch and School Breakfast Programs are an important source of nutrients for school-age children, and especially for those of low-income status. The American Dietetic Association was actively involved in the 2004 reauthorization of these programs, ensuring access through continued funding, promoting nutrition education and physical activity to combat overweight and prevent chronic disease, and promoting local wellness policies. The standards established for school meal programs result in school meals that provide nutrients that meet dietary guidelines, but standards do not apply to foods and beverages served and sold outside of the school meal. Labeled as competitive foods by the US Department of Agriculture, there is a growing concern that standards should be applied to food in the entire school environment. Legislation has mandated that all school districts that participate in the US Department of Agriculture's Child Nutrition Program develop and implement a local wellness policy by the school year 2006-2007. Resources are available to assist in the development of wellness policies, and dietetics professionals can assist schools in developing policies that meet nutrition integrity standards.     

Henry B. Favill and the School of Occupations: Origins of Occupational Therapy Practice and Education

The Henry B. Favill School of Occupations, a pioneer program in the history of occupational therapy, was named for the visionary physician Henry Baird Favill, M.D. who practiced in Chicago, Illinois. The School had two types of classes or programs. One was a curative workshop for disabled clients in need of occupational training and the other was a teaching program designed to train people to work with clients. The curative workshop, called the Occupational Center, began in 1915 at the Illinois Society for Mental Hygiene under the guidance of Dr. Favill and the direction of Eleanor Clarke Slagle, a founder and leader in the profession of occupational therapy. The teaching program began in 1917 initially in cooperation with the American Red Cross, Chicago Chapter, and later with the Chicago School of Civics and Philanthropy and the Illinois Department of Public Welfare. This article traces the development and history of the workshop to treat clients and the training programs to educate teachers of occupation who would become known as occupational therapists.     

Anthropological involvement in the Central American diarrheal disease control project

The process of conducting applied anthropological work leading to health program development and evaluation is seldom described in the literature. This paper discusses the combination of factors which led to the involvement of anthropologists in the Central American Child Survival Project and how anthropological approaches are being used in the project. Ethnoclassification was used to illustrate the discrepancy between the proposed approach to treatment for dehydration produced by diarrheal disease and the actual beliefs and practices in 4 Central American communities. Techniques such as rapid, focused assessment using anthropological methods of data collection and presentation are discussed, as are strategies for presenting this information to health program planners and administrators.     

绵竹县儿童计划免疫保偿制影响入保因素的研究

本文通过对开展儿童计划免疫保偿制的绵竹县,1500名7周岁内儿童的抽样调查,初步探讨了投保者方面影响儿童入保的因素。结果提示:年龄较大儿童入保率较低(P<0.01),家长文化程度较低者入保率较低(P<0.05),家庭经济收入水平较低者入保率较低(P<0.001),家长对计划免疫及其保偿制的认识水平(综合评分)较低者入保率较低(P<0.001),并讨论了其意义。