Mapa de las políticas nutricionales escolares en España

ObjectiveTo systematically describe the school nutritional policies of the 17 autonomous communities of Spain.MethodThrough a search of bibliographic databases, web pages and other official information systems, 183 documents of interest were identified. Information was systematically collected with the SNIPE (school nutrition index of programme effectiveness) questionnaire, adapted to Spain, and validated by reference staff of the regional government's health and education ministries.ResultsThe main objective of the policies is to prevent obesity and improve the nutrition of schoolchildren. The 17 autonomous communities cover the school canteen service, 11 cafeteria and vending machines, and 9 the breakfast service. All communities use the Consensus Document on School Food as a reference for the content of the menu and the nutritional quality of the products offered at the school; however, only 4 of them have regulated these aspects. The evaluation of policy objectives ranges from 58.8% of the autonomous communities for food supply to 5.9% for rotation and menu quality.ConclusionAlthough all the autonomous communities have standards for the school menu, the standards for the rest of the food supply vary across them; also, evaluation of objectives is scarce and only 4 communities have approved mandatory regulations. Nutritional standards should be reviewed according to current scientific knowledge and enacted by law, in compliance with the current legislation (Act 17/2011).     

An observational study of antibody responses to a primary or subsequent pertussis booster vaccination in Australian healthcare workers

Adult pertussis vaccination is increasingly recommended to control pertussis in the community. However, there is little data on the duration and kinetics of immunity to pertussis boosters in adults. We compared IgG responses to vaccination with a tetanus, low-dose diphtheria, low-dose acellular pertussis (Tdap) booster at 1 week, 1 month and 1 year post-vaccination in whole-cell (wP)-primed Australian paediatric healthcare workers who had received an adult Tdap booster 5–12 years previously, to those who received their first Tdap booster.Tdap vaccination was well tolerated in both groups. Previously boosted adults had significantly higher pre-vaccination IgG concentrations for all vaccine-antigens, and more were seropositive for pertussis toxin (PT)-specific IgG (≥ 5 IU/mL) (69.5%; 95% confidence interval (CI) 59.5–79.5) than adults in the naïve group (45.2%; 95% CI 32.8-57.5). Tdap vaccination significantly increased IgG responses 1 month post-vaccination in both groups. This increase was more rapid in previously boosted than in naïve adults, with geometric mean fold-increases in PT-IgG at 1 week post vaccination of 3.6 (95% CI 2.9–4.3) and 2.6 (95% CI 2.2–3.2), respectively. Antibody waning between 1 month and 1 year post-vaccination was similar between groups for IgG specific to PT and filamentous haemagglutinin (FHA), but was faster for IgG against pertactin (PRN) in the naïve group (GMC ratio 0.36; 95% CI 0.31–0.42) than the previously boosted group (GMC ratio 0.45; 95% CI 0.39–0.50). At baseline, all but one adult had protective IgG titres against tetanus toxin (TT) (≥ 0.1 IU/mL), and 75.6% in the previously boosted and 61.3% in the naïve group had protective IgG titres against diphtheria toxoid (DT) of ≥ 0.1 IU/mL.This study shows that pertussis immune memory is maintained up to 12 years after Tdap vaccination in wP-primed Australian adults. There was no evidence that pertussis immune responses waned faster after a booster dose. These findings support current recommendations of repeating Tdap booster vaccination in paediatric healthcare workers at least every 10 years. Clinical trials registry: ACTRN12615001262594.     

科普期刊创新发展的三重转向

【目的】新媒体时代的科普期刊发展创新存在多个突破口,需要探讨其创新变革的可能性。【方法】采用个案研究和综合分析结合的方式,总结科普期刊的三重转向。【结果】科普期刊应推进新媒体转向、经营语态转向和运营模式转向。【结论】在互联网+洗礼各个行业的汹涌浪潮之下,科普期刊应建设基于新媒体平台的内容生产和传播新模式;致力于提供优质的科普体验;成为科普文化产业链的主导枢纽并延循类别化发展道路。     

200--2013年某外商独资企业职业病危害因素调查及检测结果分析

目的探讨某外商独资企业作业场所职业病危害因素的特点和防护措施,为用人单位预防控制职业病提供依据。方法对该企业2005～2013年职业病危害因素检测结果进行调查,了解各年度检测的职业病危害因素,计算其合格率,并对调查期间检测的化学有害因素和物理因素进行统计分析。结果用人单位职业病危害因素的合格率为91.43%,其中粉尘和毒物的合格率分别为98.18%和95.21%,物理因素的合格率为83.80%。化学有害因素的合格率（95.88%）高于物理因素合格率（83.80%）,差异有统计学意义（P〈0.01）。除砂轮磨尘、臭氧、苯、甲苯、三氯乙烯、丙酮、紫外辐射、噪声超标外,其他职业病危害因素均符合限值要求。结论用人单位重视工艺技术的改进和防护措施的完善,职业卫生状况有了较明显的改善。但涂装车间的清洗岗位应进一步完善防护措施,使工人接触甲苯的时间加权平均浓度达到限值要求。     

电子病历受控术语结构与质量的评价简

电子病历是数字化医疗的基础。虽然我国关于电子病历文档类型和文档段标识已有相关标准和规范,但仍缺乏电子病历文档内容和术语的标准和规范,难以纠正不同级别的医疗机构同一文档段的记录内容在结构和术语使用上的巨大差异,也无法利用大数据信息挖掘、知识发现等IT新技术,对我国丰富的电子病历数据资源库进行有效的二次利用。本文介绍了电子病历中单词、术语与受控术语的相关概念、用途和重要性,列举了患者主诉与临床检查结果表达的术语结构的概念框架,通过受控医学词汇结构与质量评价的12条评价要点,强调了电子病历内容结构与受控术语结构的标准化,在我国电子病历标准化工作中的重要性和紧迫性。     

Update of a study of crude oil production workers 1946-94

OBJECTIVE—To update information on workers in the petroleum industry engaged in the production of crude oil to determine whether the patterns of mortality have changed with 14 additional years of follow up.
METHODS—All workers were employed at company production and pipeline locations sometime during 1946-94. The cohort now consists of 24 124 employees with an average of 22 years of follow up.
RESULTS—The overall mortality, and most cause specific mortalities were lower than or similar to those for the general United States population. For white men (81% of the cohort), there were 4361 observed deaths and 5945 expected, resulting in a significantly lower standardised mortality ratio (SMR) of 73. There were significant deficits for all the leading causes of death in the United States including all cancers, cancer of the lung, stroke, heart disease, respiratory disease, and accidents. Slightly increased mortality was found for cancer of the prostate, cancer of the brain and central nervous system, and cancer of other lymphatic tissue. For benign and unspecified neoplasms, the SMR was 152 (95% confidence interval (95% CI) 95 to 230). There was a significant increase for acute myelogenous leukaemia that was restricted to people who were first employed before 1940 and who were employed in production and pipeline jobs for >30 years. Overall mortality patterns for non-white men and women were similar to those for white men. Mortality patterns for white men were also examined by duration of employment, time first employed, and by job group.
CONCLUSIONS—The results of the updated study showed a favourable mortality experience for crude oil production workers compared with the United States population.


Keywords: petroleum industry; occupational cancer; mortality; crude oil     

核工业部分超剂量受照人员辐射危害的细胞和分子遗传学调查

目的 了解核工业超剂量受照人员的健康状况,探求辐射危害所致早期改变指标。方法 采用现场调查与实验室细胞遗传学和体细胞基因位点突变检测相结合的方法,对核工业某厂５０名超剂量受照人员和５０名对照人员进行调查。结果 染色体畸变率（ＣＡ）、微核形成率（ＭＮ）和ＨＰＲＴ（次黄嘌呤鸟嘌呤磷酸核糖转移酶）基因位点突变频率（ＨＰＲＴ）超剂量组均高于对照组,其中ＣＡ和ＨＰＲＴ结果两组之间存在统计学显著差异。超剂量组     

我国健康服务业发展现状研究

本文在简要回顾我国健康服务业发展背景的基础上,重点梳理了社会办医、医养结合、健康管理与促进、健康保险等几个重点领域的发展现状;分析了我国健康服务业发展面临的主要问题和挑战,主要包括健康服务业的定位、内涵及边界尚不清晰,政策措施不完善;缺乏完整的产业链条与产业体系;机构核心竞争力与满足健康服务需求之间存在较大差距等。建议:进一步明确健康服务业的定位与发展思路,完善配套政策;以需求为导向,促进健康服务业结构升级和服务链的完整;深入开展相关研究,为健康服务业发展提供理论支撑。     

基于内容分析法的部分地区健康服务业政策比较研究

目的:探讨我国部分地区健康服务业政策特点与存在的主要问题,并提出相应政策建议。方法:从产业组织政策、产业结构政策、产业布局政策、产业技术政策等四方面,分析北京市、上海市、深圳市、杭州市、青岛市健康服务业相关政策内容。结果:调研地区通过转变政府职能、合理规划产业布局、提升关键技术水平、促进市场竞争和适度规模经济等多种措施,构建提供主体多元化、不同种类服务间相互补充促进的产业体系。结论:调研地区采取综合性产业政策等多种形式,提高健康服务业供给效率;积极推进以"公私合作"方式提供部分基本医疗卫生服务;依据地域垄断性进行健康服务业布局;健康服务业监管体系和管理方式有待完善。建议依据自身需求与产业基础,明确发展健康服务业的目的和重点;构建多元供给体系;进一步放宽直接行政规制,加强健康服务行业与政府的互动;结合医疗卫生服务体系规划,优化产业布局;完善产业技术政策,促进科技创新。     

深圳市服务业外来务工人员自杀意念影响因素分析

目的 了解广东省深圳市服务业外来务工人员自杀行为的现状及影响因素。方法 2014年6-8月在深圳市采用同伴推动抽样方法招募1 982名服务业外来务工人员,应用一般健康问卷（GHQ-12）、Connor-Davidson 弹性量表（CD-RISC）、广泛性焦虑量表（GAD-7）、流调中心用抑郁量表（CES-D）、领悟社会支持量表（PSSS）进行调查,建立结构方程模型初步探讨心理状况、心理弹性、焦虑抑郁、社会支持与自杀意念之间的关系。结果 有效调查1 979名深圳服务业外来务工人员,平均年龄为（39.9±12.0）岁,以女性、已婚者和初中文化程度者为主,比例分别为65.1%（1 288/1 979）、83.8%（1 658/1 979）和43.3%（856/1 979）;自杀意念、自杀计划及自杀尝试报告率分别为3.1%（62/1 979）、0.4%（8/1 979）和0.3%（6/1 979）;结构方程模型的主要指标（χ²/df=17.828,NFI=0.959,CFI=0.961,IFI=0.961,RMSEA=0.092,AIC=164.793,BCC=164.935,EVCI=0.083）显示方程模拟较好;抑郁对自杀意念直接作用大小为0.16,心理状况、心理弹性、焦虑、社会支持通过抑郁对自杀意念起间接作用;自杀意念的“负向”影响因素排序为抑郁（直接作用大小0.16,构成比46.2%）>焦虑（作用大小0.10,构成比28.9%）>心理状况（作用大小0.084,构成比24.2%）>社会支持（作用大小0.000 5,构成比0.1%）;“正向”影响因素为心理弹性（作用大小-0.002,构成比0.6%）。结论 抑郁和焦虑是深圳服务业外来务工人员自杀意念的重要危险因素之一,早期筛查抑郁和焦虑情绪是预防服务业外来务工人员自杀重要手段之一。