Lay food and health worker involvement in community nutrition and dietetics in England: roles, responsibilities and relationship with professionals

Background Community‐based food initiatives have developed in recent years with the aim of engaging previously ‘hard to reach’ groups. Lay workers engaged in community nutrition activities are promoted as a cost‐effective mechanism for reaching underserved groups. The main objective of the study was to explore perceptions and definitions of lay food and health worker (LFHW) helping roles within the context of National Health Service (NHS) community nutrition and dietetic services in order to define the conceptual and practical elements of this new role and examine the interface with professional roles. Methods Interpretive qualitative inquiry; semi‐structured interviews with LFHW and NHS professionals employed by community‐based programmes, serving ‘hard‐to‐reach’ neighbourhoods, across England. A total sampling framework was used to capture all existing and ‘fully operational’ lay food initiatives in England at the commencement of fieldwork (January 2002). Findings In total, 29 professionals and 53 LFHWs were interviewed across 15 of the 18 projects identified. Although all 15 projects shared a universal goal, to promote healthy eating, this was achieved through a limited range of approaches, characterized by a narrow, individualistic focus. Lay roles spanned three broad areas: nutrition education; health promotion; and administration and personal development. Narratives from both professionals and LFHWs indicated that the primary role for LFHWs was to encourage dietary change by translating complex messages into credible and culturally appropriate advice. Conclusions This research confirms the emerging discipline involving lay helping within the NHS and community dietetics. The primary role of LFHWs in the 15 projects involved was to support existing NHS services to promote healthy eating amongst ‘hard to reach’ communities. The activities undertaken by LFHWs are strongly influenced by professionals and the NHS. Inherent to this is a fairly narrow interpretation of health, resulting in a limited range of practice.     

Good food in family day care: Improving nutrition and food safety in family day care

Aim:  To determine the effectiveness of a nutrition and food safety intervention in family day care schemes.
Methods:  Staff and carers from seven Sydney family day care schemes completed a nutrition and food safety knowledge questionnaire and diet history about food and drinks offered to children in care before and after attending workshops and receiving advice and resources. Participating schemes' nutrition and food safety policies were assessed before and after intervention. At baseline, 18 staff members and 104 carers were interviewed. Diet histories were collected for 20 infants and 103 one-to-five-year olds. Post intervention, 21 staff and 102 carers were interviewed and diet histories collected for 22 infants and 102 one-to-five-year olds. Baseline and post-intervention data were compared using the χ²-test for categorical data (or the Fisher's exact test when expected values were below five), and t -tests for independent samples for normally distributed means.
Results:  Nutrition and food safety knowledge and the number (from one to seven) and quality of appropriate policies improved post intervention. Changes in mean per cent nutrition scores for infants (78.2% to 83.4%) and for one-to-five-year olds (68.8% to 75.2%; P  < 0.01) indicated improvements in nutritional quality of food and drinks offered during care.
Conclusion:  Health promotion strategies can improve food and drinks offered in family day care and make a sustainable contribution to children's access to safe and nutritious food.     

Use of the Acute Care Hospital Foodservice Patient Satisfaction Questionnaire to monitor trends in patient satisfaction with foodservice at an acute care private hospital

Aim:  To demonstrate how the Acute Care Hospital Foodservice Patient Satisfaction Questionnaire can be used to monitor trends in foodservice satisfaction.
Methods:  Three one-day surveys of foodservice satisfaction were conducted in 2003–05. All adult hospital inpatients with the exception of intensive care, cardiac post-operative care, labour ward and day surgery patients were eligible. The response rate was 48% (2003), 42% (2004) and 60% (2005). This took place in an acute care 440-bed private hospital. Overall foodservice satisfaction, dimensions of foodservice satisfaction (food quality, meal service quality, staff/service issues and the physical environment) and two independent statements (temperature of the hot foods, ability to choose different sized meals); satisfaction by gender, length of stay, age, diet type and appetite for 2005. Scores were calculated for overall satisfaction, four dimensions of satisfaction and two independent statements. Chi-squared analysis was used to determine the effect of gender, age, diet type and appetite on overall satisfaction. Correlation analysis was used to assess the association between overall foodservice satisfaction and length of stay.
Results:  Ratings of overall foodservice satisfaction, four dimensions of foodservice and two independent foodservice items were high, consistent with previous findings. Of the foodservice dimensions, the staff/service issues were the most positively rated and food quality the least positively rated. Patients' expectations of the foodservice were significantly associated with overall satisfaction. Quality improvement activities focused on the lowest scoring components of the questionnaire.
Conclusion:  The Acute Care Hospital Foodservice Patient Satisfaction Questionnaire can be used to determine trends in foodservice satisfaction and identify areas to target for quality improvement initiatives.     

莒南县食品中单核细胞增生李斯特菌污染状况调查

目的掌握莒南县食品中单核细胞增生李斯特菌污染状况。方法按GB4789．30—2003方法分离单核细胞增生李斯特菌。结果2006年从610份食品中共分离到单核细胞增生李斯特菌39株，总污染率为6．32％，生肉类、熟肉及生食蔬菜的污染率分别为9．94％、4．48％、3．78％。结论该县存在发生李斯特菌食物中毒的潜在危险。     

高效液相色谱二级管阵列检测器测定食品中合成着色剂研究

目的研究高效液相色谱（HPLC）二级管阵列检测器，测定蜜饯、果冻中人工合成着色剂的方法，为此类检测提供依据。方法应用光谱图比对、光谱归一化等峰纯度检验技术，检测果冻、蜜饯等食品中的人工合成着色剂。结果峰纯度匹配因子适宜于配合光谱图比较进行综合分析定性，有效排除或降低了多种形式的干扰。结论采用该技术，提高了HPLC检测复杂样品定性定量的准确度和可靠性，具有一定实用价值。     

阜阳市市售食品中食源性致病菌污染情况调查

目的了解阜阳市市售食品中食源性致病菌污染状况,为有效防治食源性疾病提供科学依据。方法按照“全国食源性疾病监测网2007年度工作手册”检测技术要求提供的检测方法和GB4789-2,3,9中的国家标准方法,对食品中沙门菌、单核细胞增生性李斯特菌（L.m）、大肠杆菌O157：H7、金黄色葡萄球菌、副溶血性弧菌、空肠弯曲菌进行分离鉴定。结果9大类129份食品样中,共检出食源性致病菌32株,总检出率24.81%（32/129）。检出金黄色葡萄球菌18株,检出率90.00%（18/20）;沙门菌3株,检出率为2.32%（3/129）;检出单核细胞增生李斯特氏菌4株,检出率为3.67%（4/109）;大肠杆菌O157：H71株,检出率为1.51%（1/66）;动物性水产品检出副溶性弧菌4株,检出率为40.00%（4/10）;空肠弯曲菌检出2株,检出率为20.00%（2/10）。结论阜阳市居民主要消费食品中存在食源性致病菌污染,生奶、生肉、市售熟肉、蔬菜是主要污染食品品种。应有针对性防范和控制各类食品致病菌的污染,防止食源性疾病暴发。     

浅谈体检中心的放射防护

体检中心放射防护重点面对的是健康人群。要注意人员的科学安排,房间的合理搭配,还有最重要是严格的X射线防护措施,选配环保机型。     

高效液相测定保健食品中淫羊藿甙的含量

目的:建立保健食品中测定淫羊藿甙含量的方法。方法:用反相高效液相色谱法测定保健食中淫羊藿甙的含量。结果:方法线性范围为:1.66000~0.00415 mg/ml,最低检出限为0.06μg/ml,总分析时间:14.0 min。淫羊藿甙平均保留时间:12.6 min。平均回收率为:97.95%。精密度实验RSD,淫羊藿甙标准品为0.85,样品为1.46。结论:反相高效液相色谱法法测定定淫羊藿甙含品的含量方法稳定、可靠、简便,适用于保健食品的分析。     

象山县细菌性食物中毒流行特征及实验室检测结果分析

目的:了解象山县细菌性食物中毒发生概况尤其是流行特征及实验室检测情况,提高实验室应对食物中毒等突发事件的能力,为食物中毒的判定、治疗、控制和预防提供依据。方法:根据2005年~2007年食物中毒报表有关资料和实验室微生物检测报告,对细菌性食物中毒发生概况、实验室检测结果及部份副溶血性弧菌的血清学分型进行统计分析;病原菌检测依据GB/T4789-2003及《预防医学微生物学及检验技术》进行。结果:2005年~2007年共发生细菌性食物中毒34起,其中21起检出致病菌,13起未检出致病因子;送检样本501份,检出致病菌155株。检出的致病菌种类有:副溶血性弧菌、金黄色葡萄球菌、蜡样芽胞杆菌、嗜水气单胞菌、非O-1群霍乱弧菌及福氏志贺菌。结论:象山县细菌性食物中毒季节性分布明显,主要集中在第三季度;致病菌以副溶血性弧菌为主;副溶血性弧菌以O3:K6血清型为优势流行菌株;中毒场所以工厂食堂为主。     

灵山县部分传统食品中掺加硼砂情况的调查

目的:了解本地传统食品中掺加禁用防腐剂硼砂的情况。方法:对辖区市场上的传统食品以购买形式进行随机采样;硼砂定性试验按国家标准GB/T5009.29-2003规定进行;硼砂定量测定按北欧食品分析委员会编号1-1950方法进行。结果:在10个品种的122份样品中,硼砂定性试验呈阳性反应的有72份,总阳性率为59.0%;对呈阳性反应的鲜湿米切粉、粳米水糕、槐花糕、槐花凉粉、干榨米粉、凉粽、肉丸类、面条类及冬瓜蓉馅月饼样品进行定量测定,其结果平均值分别为4.04、11.7、6.37、8.48、2.98、1.47、14.5、3.00、0.79 g/kg。结论:本地传统食品中掺加硼砂情况严重,应引起人们的关注。