Dissecting Obesogenic Environments: The Development and Application of a Framework for Identifying and Prioritizing Environmental Interventions for Obesity

Background. The “obesogenicity” of modern environments is fueling the obesity pandemic. We describe a framework, known as ANGELO (analysis grid for environments linked to obesity), which is a conceptual model for understanding the obesogenicity of environments and a practical tool for prioritizing environmental elements for research and intervention.Methods: Development of the ANGELO framework. The basic framework is a 2 × 4 grid which dissects the environment into environmental size (micro and macro) by type: physical (what is available), economic (what are the costs), political (what are the “rules”), and sociocultural (what are the attitudes and beliefs). Within this grid, the elements which influence food intake and physical activity are characterized as obe sogenic or “leptogenic” (promoting leanness).Results: Application of the ANGELO framework. The ANGELO framework has been piloted at the population level (island communities) to prioritize the settings/sectors for intervention and at the setting level (fast food outlets) to prioritize research needs and interventions. Environmental elements were prioritized by rating their validity (evidence of impact), relevance (to the local context), and potential changeability.Conclusions. The ANGELO framework appears to be a flexible and robust instrument for the needs analysis and problem identification stages of reducing the obe sogenicity of modern environments.     

心血管疾病介入诊治术患者心理状态调查分析

对８６２例心血管疾病介入诊治术患者术前分别采用心理护理（ｎ＝４３１）和非心理护理（ｎ＝４３１）前后比较心理状态差别观察。结果显示：手术前所有患者均有严重焦虑心理,经采用心理宣教、心理护理后,患者焦虑程度大大降低（Ｐ＜０．００１）,处于接受手术的最佳心理状态,保证手术顺利进行,并减少了术前、中、后并发症的发生。而未行心理宣教及心理护理的患者的焦虑程度几乎没有变化（Ｐ＞０．０５）,有的甚至提高。通过对照观察、心理宣教及心理护理的有效实施,对消除患者的焦虑、恐惧心理有较满意的效果,并能达到仅靠操作技术难以获得的效果,起到良好的助手作用。     

深化人事制度改革|激活内部运行机制

全面实行岗位聘用合同制和结构薪金分配制，建立契约化管理的用人模式，全员实行内部分配办法，最大程度地实行量化考核。通过人事制度改革，有效地提高职工的工作积极性，打破分配制度上的“大锅饭”和平均主义。改革不合理的人事制度、分配制度，使医院各项制度能顺应医院改革的发展。     

Test de provocation par voie orale aux aliments chez l'enfant. Quand,pour qui et comment ? Conséquences

Whatever results are, oral food challenges (OFC) will have consequences, particularly on diet and emergency kit. Positive OFC, negative OFC and food specificities are discussed, according to the literature review. In case of positive OFC, the management and monitoring of persistent food allergy is specified. Practical recommendations are suggested.