The effect of a healthy school tuck shop program on the access of students to healthy foods

The objective of this study was to evaluate the effect of a healthy school tuck shop program, developed as a way of creating a healthy and nutritional school environment, on students'' access to healthy foods. Five middle schools and four high schools (775 students) participated in the healthy school tuck shop program, and nine schools (1,282 students) were selected as the control group. The intervention program included restriction of unhealthy foods sold in tuck shops, provision of various fruits, and indirect nutritional education with promotion of healthy food products. The program evaluation involved the examination of students'' purchase and intake patterns of healthy foods, satisfaction with the available foodstuffs, and utilization of and satisfaction with nutritional educational resources. Our results indicated that among of the students who utilized the tuck shop, about 40% purchased fruit products, showing that availability of healthy foods in the tuck shop increased the accessibility of healthy foods for students. Overall food purchase and intake patterns did not significantly change during the intervention period. However, students from the intervention schools reported higher satisfaction with the healthy food products sold in the tuck shop than did those from the control schools (all P < 0.001), and they were highly satisfied with the educational resources provided to them. In conclusion, the healthy school tuck shop program had a positive effect on the accessibility of healthy food. The findings suggest that a healthy school tuck shop may be an effective environmental strategy for promoting students'' access to healthy foods.     

医院战略性绩效评价的研究概述

从战略的视角出发,以医院战略性绩效管理为研究对象,探讨在医院中设计战略绩效绩效评价体系以及其对医院战略实施的促进作用。对医院战略绩效评价进行了设计,提出了医院战略绩效管理模型,构建了战略绩效评价系统模型以及医院战略绩效评价指标体系。     

县级医院改革试点医院就医环境评价及改进策略

目的 基于新医改背景调查陕西省某市县级医院改革试点医院住院患者对就医环境的满意度,为医院医疗环境的改进提供参考建议.方法 随机对250名在某市5所试点医院就诊的患者进行当面式问卷调查,应用EpiData软件对数据进行录入,应用SPSS13.0对数据进行描述性统计、x2检验和回归分析.结果 患者对医院环境的总满意度均分为3.69分,影响患者满意度的最主要因素是病房人数,其次是收入水平和文化程度.结论 随着新医改的实施推进,患者对医院环境满意度评价尚可,但仍需改进.     

People United to Sustain Health (PUSH): A Community‐Based Participatory Research Study

The prevention of weight gain to address the obesity epidemic rather than weight loss involves promoting small changes in food choices and physical activity. People United to Sustain Health (PUSH) was designed to increase fruit and vegetable consumption, physical activity, and food security to prevent weight gain in rural adults. Forty‐nine participants were randomized into a treatment group which received access to a “Rolling Store,” nutrition education and physical activity, and a control group which received family coping classes. Forty‐one (84%) of participants completed the study. At the end of 6 months, weight for all participants was maintained from baseline to completion with no significant differences between the groups. The mean fruit consumption over 6 months for the treatment group increased and was significantly greater than change in the control group (p = 0.01). This community‐based participatory research study was considered successful because weight gain was prevented.     

Obesity Prevention in Young Schoolchildren: Results of a Pilot Study

BACKGROUND: Overweight and obesity occur in 17% of children in the United States. Complications of excess weight in Americans cause 216,000 to 300,000 deaths yearly and cost $147 billion. METHODS: A convenience sample of 14 intervention and 15 control schools in the Catholic Diocese of Pittsburgh was used. A program to improve lifestyle (Values Initiative Teaching About Lifestyle [VITAL®]), was implemented in young children to encourage healthy eating and appropriate physical activity. Students had annual evaluations of height and weight over a 2‐year period, and teachers participating in VITAL completed questionnaires regarding the program. Changes in age‐ and sex‐adjusted body mass index (BMI) percentiles in control and intervention groups were compared using linear mixed models regression. RESULTS: VITAL was highly rated by teachers and was popular with children. Over the 2‐year period, adjusted mean BMI percentiles declined from 66.1 to 65.0 in control children and from 62.8 to 58.9 in intervention children. The rates of change in the 2 groups were significantly different (p = .015). CONCLUSION: VITAL improves lifestyle of young schoolchildren, is inexpensive, easy to implement, and should be expanded to improve health and reduce healthcare's financial burden.     

Strategic analysis for health care organizations: the suitability of the SWOT‐analysis

Because of the introduction of (regulated) market competition and self‐regulation, strategy is becoming an important management field for health care organizations in many European countries. That is why health managers are introducing more and more strategic principles and tools. Especially the SWOT (strengths, weaknesses, opportunities, threats)‐analysis seems to be popular. However, hardly any empirical research has been done on the use and suitability of this instrument for the health care sector. In this paper four case studies are presented on the use of the SWOT‐analysis in different parts of the health care sector in the Netherlands. By comparing these results with the premises of the SWOT and academic critique, it will be argued that the SWOT in its current form is not suitable as a tool for strategic analysis in health care in many European countries. Based on these findings an alternative SWOT‐model is presented, in which expectations and learning of stakeholder are incorporated. Copyright © 2010 John Wiley & Sons, Ltd.     

Slaying sacred cows: is it time to pull the plug on water fluoridation?

Water fluoridation continues to be a contentious public health policy. Recent moves to introduce schemes in England raise important questions about the use of evidence in public policy. Of particular concern is how evidence is used for public health policy-making purposes. This article reviews some of the key debates about water fluoridation and examines the way evidence has been promoted and used. The background to water fluoridation is discussed and also key ideas about how evidence influences policy. While traditionally the problem of evidence is characterised as one where policy makers either accept or ignore evidence, a central concern of this article is where poor evidence is promoted by professionals and accepted by policy makers. The article then examines the evidence on the effects of water fluoridation. Drawing on the idea of the ‘Gold Effect’, the article shows how deeply held beliefs about public health actions shape not just policy but also the application of evidence itself by professionals and researchers.     

基于服务营销理论的医院价格策略探讨

随着医疗服务行业竞争日渐激烈,公立医院必须树立市场观念,制定营销战略,实施服务营销策略组合(7PS)。价格策略是服务营销策略组成的重要组成部分,文章以作者所在的地市级三甲医院为例,分析了医院当前的定价方式,运用服务营销理论确定了定价目标,并阐述了在实践中如何具体实施医院的价格策略。     

石家庄市2001-2010年流行性乙型脑炎流行特征分析

目的通过分析石家庄市2001-2010年发生的流行性乙型脑炎(乙脑)个案,探索其流行特征、发病强度与蚊虫间的关系,为科学防控乙脑疫情提供依据。方法 2001-2010年,采取专病被动监测、疑似脑炎/脑膜炎症状主动监测相结合的方法监测乙脑疫情,回顾分析河北省、石家庄市疾病预防控制中心实验室共同确认的ELISA检测乙脑IgM阳性病例;使用捕蚊管或电动捕蚊器捕获蚊虫等方法于5-10月对媒介蚊虫种类与密度进行监测。结果累计报告乙脑病例75例,死亡2例,年平均发病率、病死率分别为0.08/10万和0.26%。男女性别之比为1.78:1,有5～15岁和≥40岁年龄组2个发病高峰,常住居民与流动人口比为2.57:1。一年四季均有病例发生,但以8-10月为主。淡色库蚊和三带喙库蚊是石家庄市的主要传播媒介,分别占当地蚊虫种类的54.07%和32.83%,乙脑疫情与同期媒介蚊虫密度有相关性(rs=0.5506,P=0.000)。24h内诊断为乙脑的比例为28.95%。结论石家庄市乙脑疫情呈现波动性缓慢上升,流动人口病例逐年增加的趋势;加强疑似脑炎、脑膜炎患者的流行病学、病原学监测对乙脑防治有重要意义;加强疫苗接种为主的综合措施是乙脑的防控策略。     

社区艾滋病综合防治模式探讨

[目的]探讨在城市社区采取综合防治"1+4"模式,推动城市社区艾滋病防治工作有效进行。[方法]自2005～2010年,CHARTS项目实施过程中,根据本研究提出的以民生为核心的艾滋病防治社会发展理论,采用"艾滋病综合防治1+4模式"覆盖了政府机构和大众群体,也为艾滋病防治工作提供了必要的理论支持和依据。[结果]"艾滋病综合防治1+4模式"包括组织管理1+4、防治策略1+4、环境营造1+4、资源动员1+4、能力建设1+4、大众宣传1+4和干预工作1+4进行艾滋病防治工作。[结论]通过实施和推广"城市社区综合防治模式",促进艾滋病防治工作下沉到社区,提高了社区艾滋病综合防治的能力。