PubMed Search: National Health and Nutrition Examination Survey 
Crossed with keywords: Job, Work, Employment, Occupation, and Vocation
Conducted on: Tuesday, January 5, 2009

1. Health Econ. 2009 Dec 3. [Epub ahead of print]

The effect of education on health among US residents in relation to country of
birth.

Seo B, Senauer B.

Department of Family Medicine, University of Manitoba, Winnipeg, Canada.

This research explores the impact of education on health in relation to an
individual's country of birth using the US National Health and Nutrition
Examination Surveys for 2001-2004. We analyze health equations that relate health
to education and other variables. Health is measured in terms of self-reported
overall health, an index of biological risk factors, and body mass index. The
primary hypothesis tested is whether education has a greater impact on
immigrants' productive and allocative efficiency, because of their need to learn 
about how to remain healthy and access appropriate health care in a new
environment. The empirical results indicate that for US residents, who were
foreign-born, education is associated with a greater beneficial effect on every
health outcome compared to those born in the United States. More education is
related to an even greater positive effect on health for immigrants from Mexico, 
the origin of most immigrants, than from other countries. These results provide
additional support for the portions of the 2007 Immigration Reform Act rejected
by the US Congress, which placed a higher priority on education and job skills
than current law. Since increased education and improved health are associated,
such policy reform would help reduce the demands on the US health-care system.
Copyright (c) 2009 John Wiley & Sons, Ltd.

PMID: 19960487 [PubMed - as supplied by publisher]


2. J Nurs Manag. 2009 Nov;17(7):853-60.

Lifestyle behaviours and weight among hospital-based nurses.

Zapka JM, Lemon SC, Magner RP, Hale J.

Department of Biometry, Bioinformatics and Epidemiology, Medical University of
South Carolina, Charleston, SC, USA. zapka@musc.edu

AIMS: The purpose of this study was to (i) describe the weight, weight-related
perceptions and lifestyle behaviours of hospital-based nurses, and (ii) explore
the relationship of demographic, health, weight and job characteristics with
lifestyle behaviours. BACKGROUND: The obesity epidemic is widely documented.
Worksite initiatives have been advocated. Nurses represent an important part of
the hospital workforce and serve as role models when caring for patients.
METHODS: A sample of 194 nurses from six hospitals participated in anthropometric
measurements and self-administered surveys. RESULTS: The majority of nurses were 
overweight and obese, and some were not actively involved in weight management
behaviours. Self-reported health, diet and physical activity behaviours were low,
although variable by gender, age and shift. Reports of co-worker norms supported 
low levels of healthy behaviours. CONCLUSIONS: Findings reinforce the need to
address the hospital environment and culture as well as individual behaviours for
obesity control. IMPLICATIONS FOR NURSING MANAGEMENT: Nurse managers have an
opportunity to consider interventions that promote a climate favourable to
improved health habits by facilitating and supporting healthy lifestyle choices
(nutrition and physical activity) and environmental changes. Such efforts have
the potential to increase productivity and morale and decrease work-related
disabilities and improve quality of life.

PMCID: PMC2760042
PMID: 19793242 [PubMed - in process]


3. J Ren Nutr. 2009 Nov;19(6):450-61. Epub 2009 Jul 17.

Survey of current job functions of renal dietitians.

Thelen B, Byham-Gray L, Touger-Decker R, O'Sullivan Maillet J, Khan H.

Department of Nutritional Sciences, School of Health Related Professions,
University of Medicine and Dentistry of New Jersey, Newark, New Jersey, USA.
bonnie.thelen@gmail.com

OBJECTIVE: This cross-sectional study examined the current job functions of renal
dietitians in relation to their demographic characteristics. SETTING AND
PARTICIPANTS: Seven hundred and forty-seven dietitians of the Renal Dietitians
Dietetic Practice Group of the American Dietetic Association and Council on Renal
Nutrition of the National Kidney Foundation completed an electronic survey. Of
2566 surveys distributed, 29.1% (n=747) were returned and useable. MAIN OUTCOME
MEASURE: Descriptive and inferential statistics were used. We performed chi(2)
tests to identify relationships between reported job functions and demographic
characteristics. Fisher's exact tests were used when greater than 20% of cells
had an expected frequency of less than five. RESULTS: Dietitians' job functions
were related to demographic characteristics. Dietitians with greater than 10
years of renal-dietitian experience were more likely to evaluate urea kinetic
modeling frequently (chi(2)=32.95, P < .0005), or evaluate dialysis adequacy
(chi(2)=24.16, P < .0005), than those with less renal-dietetics experience.
Dietitians who worked in an outpatient facility were more likely to prescribe a
renal diet frequently (chi(2)=13.39, P < .0005), recommend renal vitamins
(chi(2)=9.81, P=.002), or evaluate interdialytic weight gain, or IDWG
(chi(2)=32.24, P < .0005), versus those who did not work in an outpatient
facility. CONCLUSIONS: This study documented the frequency of dietitians
performing job functions related to renal dietetics. The results of this study
document the variability in the role of renal dietitian, and suggest differing
levels of practice within renal dietetics.

PMID: 19616455 [PubMed - in process]


4. Am J Prev Med. 2009 Aug;37(2 Suppl):S126-30.

Did cigarette vouchers increase female smokers in China?

Fang H, Rizzo JA.

Department of Health Systems, Management, and Policy, Colorado School of Public
Health, University of Colorado, Denver, Colorado, USA. fanghaimail@gmail.com

BACKGROUND: From 1960 to 1980, a voucher was required to purchase cigarettes in
China. The Chinese government issued vouchers to ration cigarettes, without
informing its citizens that smoking was unhealthy. These vouchers were available 
to all adults, and allowed them to purchase specified numbers of cigarettes. As a
result, a number of nonsmokers started smoking during the voucher period.
METHODS: This study included 229 female and 1165 male smokers from the China
Health and Nutrition Survey 1989-2006, which provides the year in which each
respondent began smoking. The percentages of male and female smokers who started 
smoking during the voucher period were compared using the chi-square test.
Logistic regression analysis was used to study the relative risk of smoking
initiation by women during the voucher period, while adjusting for confounding
variables. RESULTS: During the voucher period, 46% of female smokers and 39% of
male smokers started smoking (p=0.05). Women who did not have a regular job or
were less educated were more likely to start smoking. The relative risk of female
smokers to have initiated smoking during the voucher period was 4.75, with a
p<0.01 in the logistic regression. CONCLUSIONS: China's policy of issuing
vouchers to ration tobacco consumption had the unintended consequence of
encouraging smoking, particularly among women. Issuing cigarette vouchers to
every adult, combined with the inexpensive prices of cigarettes, led more women
to initiate smoking. Women with low SES were particularly likely to initiate
smoking.

PMID: 19591751 [PubMed - indexed for MEDLINE]


5. Am J Ind Med. 2009 May;52(5):358-71.

Exposure to hazardous workplace noise and use of hearing protection devices among
US workers--NHANES, 1999-2004.

Tak S, Davis RR, Calvert GM.

Division of Surveillance, Hazard Evaluations, and Field Studies, National
Institute for Occupational Safety and Health, Centers for Disease Control and
Prevention, Cincinnati, Ohio 45226, USA. stak@cdc.gov

BACKGROUND: To estimate the prevalence of workplace noise exposure and use of
hearing protection devices (HPDs) at noisy work, NIOSH analyzed 1999-2004 data
from the National Health and Nutrition Examination Survey (NHANES). METHODS: A
total of 9,275 currently employed workers aged > or =16 years were included in
the weighted analysis. Hazardous workplace noise exposure was defined as
self-reported exposure to noise at their current job that was so loud that the
respondent had to speak in a raised voice to be heard. Industry and occupation
were determined based on the respondent's current place and type of work.
RESULTS: Twenty-two million US workers (17%) reported exposure to hazardous
workplace noise. The weighted prevalence of workplace noise exposure was highest 
for mining (76%, SE = 7.0) followed by lumber/wood product manufacturing (55%, SE
= 2.5). High-risk occupations included repair and maintenance, motor vehicle
operators, and construction trades. Overall, 34% of the estimated 22 million US
workers reporting hazardous workplace exposure reported non-use of HPDs. The
proportion of noise-exposed workers who reported non-use of HPDs was highest for 
healthcare and social services (73.7%, SE = 8.1), followed by educational
services (55.5%). DISCUSSION: Hearing loss prevention and intervention programs
should be targeted at those industries and occupations identified to have a high 
prevalence of workplace noise exposure and those industries with the highest
proportion of noise-exposed workers who reported non-use of HPDs. Published 2009 
Wiley-Liss, Inc.

PMID: 19267354 [PubMed - indexed for MEDLINE]


6. Econ Hum Biol. 2009 Mar;7(1):7-17. Epub 2009 Feb 6.

Early childhood length-for-age is associated with the work status of Filipino
young adults.

Carba DB, Tan VL, Adair LS.

University of San Carlos-Office of Population Studies Foundation, Talamban
Campus, 6000 Cebu City, Philippines. carbadel@yahoo.com

Most studies on childhood health and human capital in developing countries
examine how early childhood linear growth relates to later human productivity as 
reflected in schooling success. Work status is another important human capital
outcome related to early child health. This study examines the relationship of
linear growth restriction at 2 years of age to work status in young adults who
have, for the most part completed their schooling and further explores whether
this relationship differs by gender. The analysis sample of 1795 was drawn from
participants in the Cebu Longitudinal Health and Nutrition Survey, which followed
individuals from birth to age 20-22 years. Work status in 2005 was represented by
three categories: not working, working in an informal job, and working in a
formal job. Formal work in the Philippines, as in most countries, is associated
with regular hours, higher wages and benefits. Analyses were stratified by gender
and current school enrolment, and adjusted for socioeconomic status and attained 
years of schooling. Among males no longer in school, higher length-for-age
Z-score (LAZ) at age 2 was associated with a 40% increase in likelihood of formal
work compared to not working. In females, each 1 unit increase in LAZ was
associated with 0.2 higher likelihood of formal vs. informal work. No significant
associations were observed in the small sample of young adults still in school.
To improve job prospects of young adults, it is important to provide proper
nutrition in early childhood and adequate educational opportunities during
schooling years.

PMCID: PMC2692275 [Available on 2010/3/1]
PMID: 19261549 [PubMed - indexed for MEDLINE]


7. Soc Sci Med. 2009 Apr;68(7):1305-14. Epub 2009 Feb 18.

Why have physical activity levels declined among Chinese adults? Findings from
the 1991-2006 China Health and Nutrition Surveys.

Ng SW, Norton EC, Popkin BM.

University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-7411, USA.
shuwen@unc.edu

Between 1991 and 2006, average weekly physical activity among adults in China
fell by 32%. This paper discusses why total and occupational physical activity
levels have fallen, and models the association between the rapid decline and
various dimensions of exogenous community urbanization. We hypothesize that a)
physical activity levels are negatively associated with urbanization; b)
urbanization domains that affect job functions and opportunities will contribute 
most to changes in physical activity levels; and c) these urbanization domains
will be more strongly associated for men than for women because home activities
account for a larger proportion of physical activity for women. To test these
hypotheses, we used longitudinal data from individuals aged 18-55 in the
1991-2006 China Health and Nutrition Surveys. We find that physical activity
declines were strongly associated with greater availability of higher educational
institutions, housing infrastructure, sanitation improvements and the economic
wellbeing of the community in which people function. These urbanization factors
predict more than four-fifths of the decline in occupational physical activity
over the 1991-2006 period for men and nearly two-thirds of the decline for women.
They are also associated with 57% of the decline in total physical activity for
men and 40% of the decline for women. Intervention strategies to promote physical
activity in the workplace, at home, for transit and via exercise should be
considered a major health priority in China.

PMCID: PMC2731106 [Available on 2010/4/1]
PMID: 19232811 [PubMed - indexed for MEDLINE]


8. J Occup Environ Med. 2008 Dec;50(12):1401-13.

Examining associations between job characteristics and health: linking data from 
the Occupational Information Network (O*NET) to two U.S. national health surveys.

Alterman T, Grosch J, Chen X, Chrislip D, Petersen M, Krieg E Jr, Chung H,
Muntaner C.

Division of Surveillance, Hazard Evaluations and Field Studies, National
Institute for Occupational Safety and Health, Cincinnati, Ohio 45213, USA.
talterman@cdc.gov

OBJECTIVE: To determine whether the Occupational Information Network (O*NET)
database can be used to identify job dimensions to serve as proxy measures for
psychosocial factors and select environmental factors, and to determine whether
these factors could be linked to national health surveys to examine associations 
with health risk behaviors and outcomes. METHODS: Job characteristics were
obtained from O*NET 98. Health outcomes were obtained from two national surveys. 
Data were linked using Bureau of Census codes. Multiple logistic regression was
used to examine associations between O*NET factors and cardiovascular disease,
depression, and health risk factors. RESULTS: Seven of nine work organization or 
psychosocial factors were significantly associated with health risk behaviors in 
both the National Health and Nutrition Examination Survey III and National Health
Interview Survey. CONCLUSIONS: This study demonstrates a method for linking
independently obtained health and job characteristic data based on occupational
code.

PMID: 19092496 [PubMed - indexed for MEDLINE]


9. Am J Ind Med. 2008 Oct;51(10):748-57.

Gender, precarious work, and chronic diseases in South Korea.

Kim IH, Khang YH, Muntaner C, Chun H, Cho SI.

School of Public Health and Institute of Health and Environment, Seoul National
University, Seoul, Korea.

OBJECTIVE: In view of the growing number of nonstandard workers in South Korea,
this study examined whether nonstandard workers reported poorer health compared
to standard workers and assessed whether there were gender differences in the
association between employment status and chronic health outcomes. METHOD: Data
were taken from a representative-weighted sample of 1,563 men and 1,045 women
aged 20-64, from the 2001 National Health and Nutrition Examination Survey.
Nonstandard employment included part-time work, temporary work, and day labor.
Self-rated health and self-reported chronic disease conditions were used as
health measures. MAIN RESULTS: Nonstandard employment was significantly
associated with higher risk of self-rated health and chronic conditions after
adjusting for socioeconomic position (education, occupational class, and income) 
and health behaviors (cigarette smoking, alcohol consumption, regular exercise,
and health examinations). However, the pattern in the relation between
nonstandard work and specific health problems greatly differed by gender. Among
men, nonstandard work arrangements were significantly associated with
musculoskeletal disorders (OR 1.97, 95% CI 1.24-3.19) and liver disease (OR 2.83,
95% CI 1.27-6.32). Among women, nonstandard employment was related to mental
disorders (OR 3.25, 95% CI 1.40-7.56). CONCLUSION: The findings clearly indicate 
the need for further study of the observed associations, particularly prospective
and analytical studies. Published 2008 Wiley-Liss, Inc.

PMID: 18704916 [PubMed - indexed for MEDLINE]


10. Minerva Ginecol. 2008 Aug;60(4):299-306, 306-10.

Diet assessment and the screening for osteoporosis: a survey in a healthy
menopause population.

[Article in English, Italian]

Bianco V, Filippi F, Tassan-Simonat P, Valente I, D'Amico C, Meroni M.

Second Obstetrics and Gynecological Clinic, University of Milan, and Department
of Obstetrics and Gynecology, V. Buzzi Hospital, Milan, Italy.
vanda.bianco@unimi.it

AIM: The aim of this study was to investigate about diet assessment in the
screening for osteoporosis. METHODS: In 1,441 women (group A, mean age 53.5
years, mean time from menopause 3.92(+/-4.33)] the number of daily/weekly
servings/cups of different foods has been collected. In 71 women (group B, mean
age 59 years, mean time from menopause 6 years) diet was assessed through a
detailed questionnaire. Demographic and clinical data and dietary habits were
related to bone mineral density (BMD) values, using Student t-test and the chi2
test. RESULTS: Group A: borderline/reduced BMD 40%, the percentage increasing
with age and the duration of menopause (P<0.001). BMI within normal range 56.28%.
BMD values were positively associated with Body Mass Index (BMI, P<0.001),
education level (P<0.005), job (P<0.01), oral contraceptives use (P<0.001),
negatively with family history of osteoporosis (P<0.05). BMD values showed a
positive relation with the number of eggs per week (P<0.05), positive not
significant trends were observed with dairy products, vegetables, red and white
meat intake. A low/reduced BMD was related to low calcium food intake in less
than 50% of the women. Group B: borderline/reduced BMD 55%; BMD showed positive
trends, not significant, with daily calcium intake, BMI, physical exercise.
Estimated calcium intake less than 700 mg/day was found in 33% of the sample.
CONCLUSION: Diet assessment is not useful in the screening for osteoporosis. In
women with borderline or reduced BMD, diet assessment helps to detect those at
low calcium intake who need calcium supplementation, alone or in combination with
other treatments.

PMID: 18560345 [PubMed - indexed for MEDLINE]


11. Sex Transm Dis. 2008 Nov;35(11 Suppl):S3-7.

Estimates of Chlamydia trachomatis infections among men: United States.

Satterwhite CL, Joesoef MR, Datta SD, Weinstock H.

Division of STD Prevention, CDC, Atlanta, Georgia 30333, USA. clindsey@cdc.gov

OBJECTIVE: To describe the epidemiology of genital Chlamydia trachomatis
infections among men in the United States. STUDY DESIGN: Data from the notifiable
disease case surveillance system, the National Health and Nutrition Examination
Survey (NHANES), the National Longitudinal Study of Adolescent Health
(AddHealth), the National Job Training Program, the Men Having Sex with Men (MSM)
Prevalence Monitoring Project, and adult and juvenile corrections facilities were
used to summarize national chlamydia case and prevalence rates. Data were
stratified by age and race/ethnicity. RESULTS: In 2005, 232,781 chlamydia cases
among men were reported, corresponding to a rate of 161.1 cases per 100,000 men, 
an increase of 43.5% compared with the case rate in 2001 (112.3).
Population-based chlamydia prevalence rates from NHANES (1999-2002) were highest 
among men aged 20 to 29 years (3.2%); men aged 18 to 26 years participating in
AddHealth (2001-2002) had a 3.7% prevalence rate. Rates were highest among black 
men in both NHANES (5.3%) and AddHealth (11.1%). The prevalence rate among men
(aged 16-24 years) participating in the National Job Training Program was 8.1%.
Among MSM, the 2005 median urethral chlamydia prevalence rate was 6%. Overall,
chlamydia rates were highest in adult corrections facilities; the 2005 positivity
rate among men aged 21 to 25 years was 7.8%. In juvenile corrections facilities, 
the 2005 positivity rate among men aged 15 to 17 years was 6.7%. CONCLUSIONS:
Rates of genital C. trachomatis infections among men are persistently high,
particularly among men entering the National Job Training Program and men in
corrections facilities. The burden of disease is generally highest among young
men and black men.

PMID: 18418299 [PubMed - indexed for MEDLINE]


12. J Prev Med Public Health. 2007 Nov;40(6):505-11.

[Trend of socioeconomic inequality in participation in cervical cancer screening 
among Korean women]

[Article in Korean]

Jang SN, Cho SI, Hwang SS, Jung-Choi K, Im SY, Lee JA, Kim MK.

Institute of Health and Environment, Seoul National University.

OBJECTIVES: While cervical cancer is one of the leading cancers among women
worldwide, there are a number of effective early detection tests available.
However, the participation rates in cervical cancer screening among Korean women 
remain low. After the nationwide efforts in 1988 and thereafter to encourage
participation in cervical cancer screening, few studies have investigated the
effects of socioeconomic inequality on participation in cervical cancer
screening. The purpose of this study was to investigate 1) the level of
socioeconomic disparities in receiving cervical cancer screening by age group and
2) if there was an improvement in reducing these disparities between 1995 and
2001. METHODS: Using data from the Korean National Health Status, Health Behavior
and Belief Survey in 1995, and the Korean National Health and Nutrition
Examination Surveys from 1998 and 2001 (sample sizes of 2,297, 3,738, and 3,283),
age-standardized participation rates were calculated according to education
level, equivalized household income, and job status. Odds ratios and the relative
inequality index (RII) were also calculated after controlling for age. RESULTS:
Women with lower education levels were less likely to attend the screening test, 
and the disparities by education level were most pronounced among women aged 60
years and older. The RIIs among women 60 years and older were 3.64, 4.46, and
8.64 in 1995, 1998, and 2001, respectively. Higher rates of participation were
reported among those in the highest income category, which was more notable among
the middle aged women (40s and 50s). An inconsistent trend in the rate of
participation in cervical cancer screening by occupational level was found.
CONCLUSIONS: Indicators of socioeconomic position seem to have varying impacts on
the inequalities in the rates of participation in cervical cancer screening
according to age group. These results demonstrate the need for more aggressive
and age-based interventions and policy programs to eliminate the remaining
inequalities.

PMID: 18063906 [PubMed - indexed for MEDLINE]


13. Nutrition. 2008 Feb;24(2):140-7. Epub 2007 Dec 3.

Dietary intake of folate, other B vitamins, and omega-3 polyunsaturated fatty
acids in relation to depressive symptoms in Japanese adults.

Murakami K, Mizoue T, Sasaki S, Ohta M, Sato M, Matsushita Y, Mishima N.

Department of Epidemiology and International Health, Research Institute,
International Medical Center of Japan, Tokyo, Japan. kenmrkm@nih.go.jp


OBJECTIVE: Although a favorable effect of dietary folate and omega-3
polyunsaturated fatty acids (PUFAs) on depression is suggested from epidemiologic
studies in Western countries, evidence from non-Western populations is lacking.
We examined cross-sectional associations between the intake of folate, other B
vitamins, and omega-3 PUFAs and depressive symptoms in Japanese adults. METHODS: 
Subjects were 309 Japanese men and 208 Japanese women 21-67 y of age. Dietary
intake was assessed with a validated, brief, self-administered diet history
questionnaire. Depressive symptoms were defined as present when subjects had a
Center for Epidemiologic Studies Depression scale score > or =16. Adjustment was 
made for age, body mass index, work place, marital status, occupational physical 
activity, leisure-time physical activity, current smoking, current alcohol
drinking, and job stress score. RESULTS: The prevalences of depressive symptoms
were 36% for men and 37% for women. Folate intake showed a statistically
significant, inverse, and linear association with depressive symptoms in men but 
not in women. The multivariate odds ratios (95% confidence intervals) for
depressive symptoms for men in the first, second, third, and fourth quartiles of 
folate intake were 1.00 (reference), 0.78 (0.38-1.63), 0.57 (0.27-1.18), and 0.50
(0.23-1.06), respectively (P for trend = 0.045). No statistically significant
linear association was observed for the intake of riboflavin, pyridoxine,
cobalamin, total omega-3 PUFAs, alpha-linolenic acid, eicosapentaenoic acid, or
docosahexaenoic acid in either sex. CONCLUSION: Higher dietary intake of folate
was associated with a lower prevalence of depressive symptoms in Japanese men but
not women.

PMID: 18061404 [PubMed - indexed for MEDLINE]


14. Am J Ind Med. 2008 Jan;51(1):37-46.

Analysis of the Third National Health and Nutrition Examination Survey (NHANES
III) using expert ratings of job categories.

D'Souza JC, Werner RA, Keyserling WM, Gillespie B, Rabourn R, Ulin S, Franzblau
A.

Department of Environmental Health Sciences, The University of Michigan School of
Public Health, Ann Arbor, Michigan, USA.

BACKGROUND: Few epidemiologic studies have addressed the exposure-response
relationships between work activities and symptomatic knee osteoarthritis (OA).
This analysis used data from a national survey and ergonomists' ratings to
address this issue. METHODS: Interview and knee X-ray data were obtained from the
Third National Health and Nutrition Examination Survey. Occupational ratings were
obtained using ergonomists. A weighted logistic regression was used. RESULTS:
Among men, a significant exposure-response relationship was found between
symptomatic knee OA and kneeling. In both genders, there was a significant trend 
in heavy lifting and severe symptomatic knee OA. Approximately 20.7% of knee OA
can be attributed to kneeling >14% of the workday among men. CONCLUSIONS: The
significant exposure-response relationships suggest that modest reductions in
certain occupational activities can reduce the burden of knee OA. The study was
limited by unvalidated expert ratings. Research is needed to identify hazardous
characteristics of work activities and to clarify exposure-response
relationships. 2007 Wiley-Liss, Inc

PMID: 18033730 [PubMed - indexed for MEDLINE]


15. Arch Environ Occup Health. 2006 Mar-Apr;61(2):75-86.

Investigation of job-related pesticide exposure in the third national health and 
nutrition examination survey.

Allen RH, Mage DT, Gondy G, Kodali A, Christensen C, Coble J, Stewart P.

US Environmental Protection Agency, Washington, DC, USA. allen.ruth@epa.gov

The Third National Health and Nutrition Examination Survey gathered health and
job data from a sample of the US population. Researchers collected urine samples 
from a subset of subjects and analyzed it for 12 pesticide residues or
metabolites (ie, analytes). They investigated the relationship between the
industries and jobs reported and the analytes detected in the urine samples. The 
authors found an association between several jobs and the concentration for one
or more pesticide analytes above the 90th percentile. They applied a job exposure
matrix to categorize subjects on their potential for job exposures to pesticides.
For the detected analytes, the subjects with the highest potential for
occupational exposures to insecticides were more likely to have an analyte
concentration above the 90th percentile and to have an average analyte
concentration score 30% higher than that of subjects reporting jobs with the
lowest exposure potential. These findings indicate that occupational exposure may
not be a major source of pesticide exposure among the general population.

PMID: 17649959 [PubMed - indexed for MEDLINE]


16. Public Health Nutr. 2008 Mar;11(3):258-70. Epub 2007 Jul 5.

Can working conditions explain differences in eating patterns during working
hours?

Raulio S, Roos E, Mukala K, Prättälä R.

Department of Health Promotion and Chronic Disease Prevention, National Public
Health Institute (KTL), Mannerheimintie 166, 00300, Helsinki, Finland.
susanna.raulio@ktl.fi

OBJECTIVE: The aim of this study was to examine whether there are associations
between working conditions and the use of staff canteen or packed meals among
Finnish employees. SETTING: Data were obtained from cross-sectional surveys on
working conditions, conducted triennially (1997, 2000, 2003) since 1997.
SUBJECTS: In each survey, the subjects were 25-64-year-old employed Finnish
employees: 3096 men and 3273 women. RESULTS: Employees at large workplaces used
canteens far more often than those at smaller workplaces. Working conditions
played a different role in canteen use at small and large workplaces, as well as 
among the different sexes. At small workplaces, physically demanding jobs held by
female employees and low job control encouraged employees to use the canteen. On 
the other hand, at large workplaces, low social support at work encouraged the
use of canteens among men whereas high mental strain at work meant they used the 
canteen less. Among women, eating packed meals was not related to working
conditions, but among men, low social support and high mental strain at work were
associated with more frequent use of packed meals. CONCLUSIONS: The use of a
staff canteen is largely determined by the size of the workplace and by employee 
education. The underlying factor could be the availability of canteens, a
question which must be confirmed in further studies, since well-planned mass
catering at workplaces has major effects on public health, well-being and the
nutrition education of employees.

PMID: 17610750 [PubMed - indexed for MEDLINE]


17. Am J Ind Med. 2007 Aug;50(8):608-16.

Expert consensus ratings of job categories from the Third National Health and
Nutrition Examination Survey (NHANES III).

D'Souza JC, Keyserling WM, Werner RA, Gillespie B, Franzblau A.

Department of Environmental Health Sciences, The University of Michigan School of
Public Health, Ann Arbor, USA.

BACKGROUND: A method of occupational physical exposure assessment is needed to
improve analyses using large data sets (e.g., national surveys) that provide only
job title/category information as a proxy for exposure. METHODS: Five ergonomic
experts rated and arrived at consensus ratings for job categories used in the
Third National Health and Nutrition Examination Survey. Interrater agreement was 
examined for initial (pre-consensus) ratings. Correlation between consensus
ratings and an independent source of ratings (US Department of Labor (DOL)) was
used as a basis of comparison. RESULTS: Interrater agreements for the initial
ratings were weak. Highest interrater agreement was for sitting (weighted kappa
(kappa(w)) = 0.56). Lowest agreement was for standing (kappa(w) = 0.07).
Consensus ratings were well correlated with DOL ratings (correlation coefficients
>or=0.6). CONCLUSIONS: The correlation between consensus ratings and DOL ratings 
support the use of expert consensus to assess physical exposures in national data
sets. However, validation of expert consensus ratings is required. (c) 2007
Wiley-Liss, Inc.

PMID: 17595005 [PubMed - indexed for MEDLINE]


18. Epilepsia. 2007 Oct;48(10):1926-33. Epub 2007 Jun 12.

Link between epilepsy and malnutrition in a rural area of Benin.

Crepin S, Houinato D, Nawana B, Avode GD, Preux PM, Desport JC.

Institute of Neuroepidemiology and Tropical Neurology (EA 3174), Faculty of
Medicine, Limoges, France.

PURPOSE: Epilepsy and malnutrition are both important public health problems in
sub-Saharan Africa. A relationship between epilepsy and malnutrition has been
suspected for many years. Our objective was to investigate the association
between epilepsy and malnutrition in Djidja, Benin. METHODS: A matched
population-based cross-sectional case-control survey was performed: cases
(patients with epilepsy) were matched to controls according to sex, age +/- 5
years, and village of residence. The World Health Organization's criteria for
malnutrition was used. Anthropometric measurements (weight, height, mid arm upper
circumference, triceps skinfold thickness) were taken. Bioelectrical impedance
analysis, a standardized food and social questionnaire and a clinical examination
were done. Statistical analysis (conditional logistic regression) was performed
using SAS 8.0. RESULTS: A total of 131 cases and 262 controls were included. The 
prevalence of malnutrition was higher in cases than in controls (22.1% vs. 9.2%, 
p = 0.0006). Social factors were significantly different between cases and
controls. Feeding difficulties were more frequent and health status was worse in 
cases. Seven variables were associated with epilepsy: (i) nutritional factors:
mid arm upper circumference (prevalence odds ratio (pOR) = 0.7, CI: 0.6-0.9),
cereal consumption <3 times during the 3 days before the study (pOR = 4.2, CI:
1.8-10.0), <3 meals/day (pOR = 4.2, CI: 1.6-10.9), tooth decay (pOR = 2.9, CI:
1.1-7.4), food taboos (pOR = 25.0, CI: 8.3-100.0), (ii) social factors: surrogate
respondent (pOR = 16.8, CI: 3.1-90.3) and no second job (pOR = 7.1, CI:
2.3-22.3). CONCLUSION: Epilepsy and nutritional status are linked in sub-Saharan 
Africa. Programs to improve the nutritional status of people with epilepsy are
needed.

PMID: 17565592 [PubMed - indexed for MEDLINE]


19. Asia Pac J Clin Nutr. 2007;16(2):368-74.

Household food security status measured by the US-Household Food Security/Hunger 
Survey Module (US-FSSM) is in line with coping strategy indicators found in urban
and rural Indonesia.

Usfar AA, Fahmida U, Februhartanty J.

SEAMEO-TROPMED, RCCN-Universitas Indonesia, Jl. Salemba Raya 6. Jakarta 10430.
ausfar@cbn.net.id

The food security assessment used by the United State's Food Security/Hunger
Survey Module (US- FSSM) was used in five studies: these were in two urban and
four rural areas in Indonesia between February 2004- August 2005. The number of
households assessed was 3,704 and consisted of 45% urban and 55% rural. All
households had children below five years. This paper aims to assess the
applicability of US-FSSM for measuring household food-insecurity in Indonesia.
Common coping-strategies discussed are to borrow money from the family, get an
additional job, to lessen portion size of food, and to sell small assets.
Although households in urban and rural areas were similar in size/number of
children and male headed; the urban households were more income-secure, educated,
and had better access to electrical appliances. A majority of the households was 
food-insecure (77% and 84% in urban and rural consecutively). More food-insecure 
households without and with hunger were found in rural areas. The number of
affirmative responses to 17 out of 18 questions in the USFSSM was more in the
rural households, showing less fortunate cases of food-insecurity. For a given
coping strategy, as food-security status becomes more severe, the higher the
percentage of households employing it. For a given food-security status,
percentage of households was higher among lower-degree and less among
higher-degree coping. Combining food-security and coping-strategy indicators may 
help to identify transient-food-secure households. Observing both indicators
throughout different time of the year continuously may further identify adaptive 
mechanism by chronic-food-insecure households. Information on household food
diversity could enrich findings on dietary intake modification, hence moving from
food-security to nutrition-security.

PMID: 17468096 [PubMed - indexed for MEDLINE]


20. Wei Sheng Yan Jiu. 2006 Nov;35(6):765-8.

[The changes of the attributable factors of child growth]

[Article in Chinese]

Chen CM, He W, Chang SY.

Chinese Center for Disease Control and Prevention, Beijing 100050, China.

OBJECTIVE: To rule out the attributable factors of child growth in China and the 
changes of the factors in the past 15 years for the planning of future nutrition 
improvement of children in China. METHOD: The datasets of 1990 - 2005 China Food 
and Nutrition Surveillance were used and the Multi-factorial Logistic Regression 
analysis was used. The AR% of these factors and the changes of the attributable
factors during the past 15 years were presented. RESULT: The main factors
attributed to the growth of children under 5 in year 2005 were low education
level of mothers (AR = 40.5%), floating out-for-job mothers (AR% = 35.5%), No egg
introduction in the past 24 hours (AR = 24.2%), No milk introduction in the past 
24 hours(18.7%) and household income below national poverty line (21.9%). Many of
the attributable factors have improved significantly during the past 15 years.
However, the increasing number of floating out-for-job mothers will have more
impact on the quality of child feeding and child care. CONCLUSION: Social
economic development is the direct factors to child growth, while other factors
such as feeding and mother care are critical factors could either accelerate or
counteract the positive effects of the favorable socioeconomic development. To
improve height growth is essential to further enhance health and fitness of
children under 5 focused nutrition and dietary intervention should be
implemented.

PMID: 17290762 [PubMed - indexed for MEDLINE]


21. J Occup Environ Med. 2006 Nov;48(11):1143-8.

Is participation in occupational physical activity associated with lifestyle
physical activity levels?

Kruger J, Yore MM, Ainsworth BE, Macera CA.

Division of Nutrition and Physical Activity, Centers for Disease Control and
Prevention, 4770 Buford Highway NE, Atlanta, GA 30341, USA. ezk0@cdc.gov

OBJECTIVE: Little is known about the prevalence of lifestyle physical activity
(PA) by occupational PA (mostly sitting, walking, or heavy labor). METHODS:
Descriptive and adjusted multivariable logistic regression analysis of lifestyle 
PA (regularly active, irregularly active, inactive) and occupational activity was
used (N = 6,360). RESULTS: The prevalence of regular lifestyle activity was 45.7%
among those who sit/stand, 49.6% among walkers, and 59.7% among heavy laborers.
The regression analysis showed that adults working in heavy labor were almost
twice as likely to be regularly active as those who sit/stand. CONCLUSION:
Contrary to expectation, adults who engage in physically demanding work appear to
be more active outside the job. Those who are sedentary at work could benefit
from having access to opportunities for PA during the workday and trying to
engage in activity outside of work hours.

PMID: 17099450 [PubMed - indexed for MEDLINE]


22. J Epidemiol. 2006 Sep;16(5):220; author reply 221.

Association between job strain and nutrient intake by diet in working population:
the role of shift work.

Marchetti G, Coppeta L, Bollea MR, Pietroiusti A, Magrini A.

Comment on:
    J Epidemiol. 2006 Mar;16(2):79-89.

PMID: 16981313 [PubMed - indexed for MEDLINE]


23. J Am Coll Nutr. 2006 Aug;25(4):354-61.

Dietary diversity within food groups: an indicator of specific nutrient adequacy 
in Tehranian women.

Mirmiran P, Azadbakht L, Azizi F.

Endocrine Research Center, Shaheed Beheshti University of Medical Sciences,
Tehran IR, Iran.

OBJECTIVE: To determine the relationship between dietary diversity within food
groups and dietary diversity score and the probability of nutrient adequacy in
Tehranian women. DESIGN: Cross-sectional study assessing food intake by two
24-hour recalls questionnaires on two different occasions. Dietary diversity was 
defined according to diet quality index revised. The mean probability of adequacy
across 14 nutrients was calculated using the Dietary Reference Intakes. SETTING: 
District 13 of Tehran, Iran. SUBJECTS: 286 females aged 18-80 years. RESULTS:
Whole grain diversity score mostly correlated with protein and vitamin B2 (r =
0.35, p < 0.05). Fruit diversity score was correlated with vitamin C (r = 0.44, p
< 0.05). Dairy diversity score was correlated with calcium intake (r = 0.54, p < 
0.05). Meat diversity score was correlated with protein intake (r = 0.34, p <
0.05). Most subjects failed to meet vitamin B6, zinc, magnesium, calcium, copper,
and vitamin B12 adequacy. Energy intake was a strong predictor of the mean
probability of adequacy in models controlled for age, BMI, education level and
job status (model R2 = 0.53). Adding the number of servings from each of the food
group to the models significantly improved the model fit (model R(2) = 0.59).
Adding the dietary diversity score improved the model fit significantly (model R2
= 0.64). Dairy diversity score had the strongest association with improved
nutrient adequacy. CONCLUSION: Dietary diversity score is a useful indicator of
specific nutrient adequacy in Tehranian women. However, to determine the adequacy
of a specific nutrient, the diversity scores of specific food groups might be
taken into account.

PMID: 16943458 [PubMed - indexed for MEDLINE]


24. Br J Nutr. 2006 Aug;96(2):393-9.

Nutrient intake among Chinese women living in Shanghai, China.

Chen Z, Shu XO, Yang G, Li H, Li Q, Gao YT, Zheng W.

Department of Medicine, Center for Health Services Research and Vanderbilt-Ingram
Cancer Center, Vanderbilt University, Nashville, TN 37232-8300, USA.

It has been increasingly recognized that dietary factors play a major role in the
development of chronic diseases, including cancers and CVD. The identification of
patterns of nutrient intake in populations with different disease incidence will 
be helpful in understanding the diet and disease association. The present report 
describes nutrient intake in 74,810 Chinese women, aged between 40 and 70 years, 
who participated in a population-based cohort study in Shanghai from 1997 to
2000. A food frequency questionnaire was used to derive estimates of nutrient
intakes. The average daily energy intake was 7027.8 kJ in the study population,
with protein, fat and carbohydrates contributing 15.9%, 15.6% and 68.5%,
respectively. Factors, including younger age, higher income, attainment of
education at the college level or above, being married or holding a professional 
job, were related to higher intake levels of most nutrients. The present results 
highlight the need for continuing to promote public health strategies aimed at
improving the diets of women from both older and lower socio-demographic
backgrounds, and in the meantime, continuing to help address the current dearth
of data on nutrient intakes for middle-aged and elderly urban Chinese women.

PMID: 16923236 [PubMed - indexed for MEDLINE]


25. Med Pr. 2006;57(1):15-9.

[Influence of shift work on the diet and gastrointestinal complains among nurses.
A pilot study]

[Article in Polish]

Bilski B.

Katedry Profilaktyki Zdrowotnej Akademii Medycznej im. K. Marcinkowskiego w
Poznaniu. bilski@amp.edu.pl

BACKGROUND: The work of nurses in hospitals is connected with shift and night
work. Numerous publications suggest that shift work is responsible for some
gastrointestinal disturbances (heartburn, dyspepsia, loss of appetite, stomach
pain). It is not yet conclusive whether shift and night work is responsible for
more frequent occurrence of chronic gastric and duodenal ulcer diseases. The aim 
of the study was to preliminary assess the quality of meals consumed at night and
nutrition habits among nurses as well as to compare the use of stimulants in the 
groups of shift and non-shift nurses. MATERIAL AND METHODS: The analysis was
carried in the population of 171 nurses working in shifts and at night and 70
non-shift nurses, aged 22-50 years (mean, 34.1 years) with job seniority from 1
to 31 years (mean, 12.5 years). RESULTS: Only 17 (9.9%) nurses consumed a warm
meal at night shift (however, mostly occasional and hard to digest). As many as
13 (7.6%) nurses consumed no meals, and 17 (9.9%) drank only coffee.
Statistically significant irregularity in defecation was observed in nurses
working in shifts. The frequency of other gastrointestinal complains was not
statistically significant, but their occurrence should probably be studied in a
larger group of subjects as the differences in the frequency of non-specific
stomach pains and constipation were observed in both groups (more frequently in
nurses working in shifts). Appetite disturbances were characteristic of nurses
after night shift. No significant differences were found in the incidence of
gastric ulcer and irritable ileum syndrome, but there was a relationship between 
more frequent incidence of irritable ileum syndrome and personal situation of
nurses. CONCLUSIONS: The nurses working at night most often consumed cold meals
and drank daily more caps of coffee. Some gastrointestinal complains were
observed more frequently, but this requires further studies in a larger group of 
nurses. It is important to analyze the socio-economic conditions of shift nurses 
in Poland.

PMID: 16780170 [PubMed - indexed for MEDLINE]


26. Soc Sci Med. 2006 Aug;63(3):566-74. Epub 2006 Mar 31.

The relationship between nonstandard working and mental health in a
representative sample of the South Korean population.

Kim IH, Muntaner C, Khang YH, Paek D, Cho SI.

School of Public Health and Institute of Health and Environment, Seoul National
University, Republic of Korea. kihsdh2003@yahoo.com

In light of escalating job insecurity due to increasing numbers of nonstandard
workers, this study examined the association between nonstandard employment and
mental health among South Korean workers. We analyzed a representative weighted
sample of 2086 men and 1194 women aged 20-64 years, using data from the 1998
Korean National Health and Nutrition Examination Survey. Nonstandard employment
included part-time work, temporary work, and daily work. Mental health was
measured with indicators of self-reported depression and suicidal ideation. Based
on age-adjusted prevalence of mental health, nonstandard employees were more
likely to be mentally ill compared to standard employees. Furthermore,
nonstandard work status was associated with poor mental health after adjusting
for socioeconomic position (education, occupational class, and income) and health
behaviors (smoking, alcohol consumption, and exercise). However, the pattern of
the relationship between nonstandard work and mental health differed by gender.
Female gender was significantly associated with poor mental health. Although
males tended to report more suicidal ideation, this difference was not
statistically significant. Considering the increasing prevalence of nonstandard
working conditions in South Korea, the results call for more longitudinal
research on the mental health effects of nonstandard work.

PMID: 16580108 [PubMed - indexed for MEDLINE]


27. J Epidemiol. 2006 Mar;16(2):79-89.

Job strain, worksite support, and nutrient intake among employed Japanese men and
women.

Kawakami N, Tsutsumi A, Haratani T, Kobayashi F, Ishizaki M, Hayashi T, Fujita O,
Aizawa Y, Miyazaki S, Hiro H, Masumoto T, Hashimoto S, Araki S.

Hygiene and Preventive Medicine, Okayama University Graduate School of Medicine, 
Dentistry & Pharmaceutical Sciences, Okayama, Japan. norito@md.okayama-u.ac.jp

Comment in:
    J Epidemiol. 2006 Sep;16(5):220; author reply 221.

BACKGROUND: The association of job strain (as defined by the job demands/control 
model) and worksite support with nutrient intake is not clear. METHODS: A
questionnaire survey was conducted of 25,104 workers employed in nine companies
in Japan. Job strain and worksite support were assessed using the Job Content
Questionnaire. Daily intake of 17 nutrients was measured using a dietary history 
questionnaire. Data from 15,295 men and 2,853 women were analyzed, controlling
for age, education, marital status, occupation, and study site. RESULTS: Among
men, job strain was positively associated with average daily intakes of fat,
vitamin E, cholesterol, poly- and mono-unsaturated fatty acids (p for
trend<0.05), and worksite support was positively associated with average daily
intakes of total energy, crude fiber, retinol, carotene, vitamins A, C, and E,
cholesterol, and saturated fatty acid (p for trend<0.05). Among women, worksite
support was positively associated with average daily intakes of total energy,
protein, vitamin E, and polyunsaturated fatty acid (p for trend<0.05). However
these differences were generally small. CONCLUSIONS: The present study showed
that job strain and worksite support were only weakly and inconsistently
associated with nutritional intakes. It does not seem that changes in nutritional
intakes explain the association between job strain or worksite support and
coronary heart disease.

PMID: 16537988 [PubMed - indexed for MEDLINE]


28. Int J Qual Health Care. 2006 Apr;18(2):134-44. Epub 2006 Jan 19.

Effect of the Integrated Management of Childhood Illness strategy on health care 
quality in Morocco.

Naimoli JF, Rowe AK, Lyaghfouri A, Larbi R, Lamrani LA.

Department of Health, Nutrition, Population, The World Bank, Washington, DC
20433, USA. jnaimoli@worldbank.org

OBJECTIVE: To evaluate an intervention to promote health workers' use of the
World Health Organization's Integrated Management of Childhood Illness clinical
guidelines and to identify other factors influencing quality of care received by 
Moroccan children. SETTING: Public outpatient health facilities. DESIGN:
Cross-sectional survey of consultations with sick children under 5 years old at
facilities in two intervention and two comparison provinces in April 2000 (6-12
months after intervention). Consultations were observed, children's caretakers
and health workers were interviewed, and children were re-examined by a 'gold
standard' study clinician. STUDY PARTICIPANTS: Probability sample of 467
consultations (97.9% participation) performed by 101 health workers in 62
facilities. INTERVENTION: Health workers received in-service training with job
aids and a follow-up visit with feedback 4-6 weeks after training. MAIN OUTCOME
MEASURES: Index of overall guideline adherence (mean percentage of recommended
tasks that were done per child) and the percentage of children requiring
antibiotics correctly prescribed antibiotics. RESULTS: Quality of care was better
in intervention provinces, according to the adherence index (79.7 versus 19.5%, P
< 0.0001), correct prescription of antibiotics (60.8 versus 31.3%, P = 0.0013),
and other indicators. Multivariate modeling revealed a variety of factors
significantly associated with quality, including health worker attributes
(pre-service training, residence in government-subsidized housing, sex, and
opinions) and child/consultation attributes (child's age and temperature, number 
of chief complaints, and caretaker type). CONCLUSIONS: Exposure to the
intervention was strongly associated with adherence to the guidelines and correct
prescribing of antibiotics 6-12 months after exposure. Many other factors may
influence health worker performance.

PMID: 16423842 [PubMed - indexed for MEDLINE]


29. J Prev Med Public Health. 2005 Aug;38(3):337-44.

[Does non-standard work affect health?]

[Article in Korean]

Kim IH, Paek DM, Cho SI.

School of Public Health and Institute of Health and Environment, Seoul National
University.

OBJECTIVES: Job insecurity, such as non-standard work, is reported to have an
adverse impact on health, regardless of health behaviors. The aim of this study
was to examine the relationship between non-standard employment and health in
Korea. METHODS: We analyzed a representative weighted sample, which consisted of 
2,112 men and 1,237 women, aged 15-64, from the 1998 Korea National Health and
Nutrition Examination Survey. Non-standard employment included part-time
permanent, short time temporary and daily workers. Self-reported health was used 
as a health indicator. RESULTS: This study indicated that women were more likely 
to report poorer health than men with standard jobs. Of all employees, 20.3% were
female manual workers. After adjusting for potential confounders, such as age,
education, equivalent income, marital, social and self-reported economic status
and health behavior factors, nonstandard employment was found to be significantly
associated with poor health among female manual workers (OR, 1.86; 95% CI, 1.24
to 2.79). No significant association was found in other working groups
CONCLUSIONS: Among female manual workers, nonstandard employees reported
significantly poorer health compared with standard workers. This result raises
concern as there are increasing numbers of non-standard workers, particularly
females.

PMID: 16323635 [PubMed - indexed for MEDLINE]


30. Eur J Clin Nutr. 2005 Nov;59(11):1233-40.

Variety scores of food groups contribute to the specific nutrient adequacy in
Tehranian men.

Azadbakht L, Mirmiran P, Azizi F.

Endocrine Research Center, Shaheed Beheshti University of Medical Sciences,
Tehran, Iran.

OBJECTIVE: To examine the relationship between variety scores of food groups
(between and within food groups) and the probability of nutrient adequacy in
Tehranian men. DESIGN: A cross-sectional study assessing food intake by two 24-h 
recall questionnaires. Dietary diversity was defined according to diet quality
index revised, which was used by Haines et al in 1999. The mean probability of
adequacy across 14 nutrients was calculated using the Dietary Reference Intakes. 
SETTING: District 13 of Tehran, Iran. SUBJECTS: A total of 295 males, aged 18 y
and over. RESULTS: Whole grain variety mostly correlated with protein and vitamin
B2 (r=0.3, P<0.05). Fruit variety was correlated with vitamin C (r=0.4, P<0.05). 
Dairy variety was correlated with calcium intake (r=0.4, P<0.05). Meat variety
was correlated with protein intake (r=0.3, P<0.05). Most subjects failed to meet 
vitamin B6, zinc, magnesium, calcium, copper, and vitamin B12 adequacy. Energy
intake was a strong predictor of the mean probability of adequacy in models
controlled for age, body mass index, education level and job status (model
R2=0.48). Adding the number of servings from each of the food group to the models
significantly improved the model fit (model R2=0.55). Adding the dietary variety 
improved the model fit significantly (model R2=0.61). Dairy variety and meat
variety had the strongest association with improved nutrient adequacy.
CONCLUSION: Variety of different food groups is a useful indicator of specific
nutrient adequacy. Hence, to determine the adequacy of a specific nutrient, the
variety scores of specific food groups should be taken into account.

PMID: 16015253 [PubMed - indexed for MEDLINE]


31. Gastroenterol Nurs. 2005 May-Jun;28(3):228-31.

A survey of role diversity among advanced practice nurses in pediatric
gastroenterology.

McDuffie AF, Huffman S.

Children's Specialty Group, Children's Hospital of The King's Daughters, Norfolk,
Virginia 23507, USA. amcduffi@chkd.com

A survey of advanced practice nurses in the Association of Pediatric
Gastroenterology and Nutrition Nurses (APGNN) was conducted to assess role
diversity in anticipation of sharing these results with our international
colleagues at the World Congress in 2004. A single-page, 14-item survey was sent 
via e-mail or fax to 79 APGNN advanced practice nurses identified by their
credentials (MS, PNP, FNP) in the membership database. Forty surveys were
returned via e-mail or fax for an overall response rate of 51%. Most reported
working full time as nurse practitioners in an outpatient gastrointestinal
clinic, yet almost one third were hospital based. Additional job titles included 
clinical nurse specialist, researcher, and case manager or clinical coordinator. 
Slightly more than one half reported seeing any patients in their outpatient
practice, whereas 43% saw specific populations, with constipation,
gastroesophageal reflux, and abdominal pain being the most common diagnoses.
Seventy percent had prescriptive privileges. Billing practices were the most
diverse, with 30% always billing under their own number, 23% sometimes billing
under their own number, and 40% never billing under their own number (5% not
applicable). Overall, most advanced practice nurses in APGNN are pediatric nurse 
practitioners with a primary focus on outpatient care but also are involved in
patient and family teaching, nutrition support, home care, and research. Only a
few were involved with procedures, which may be surprising to our adult
counterparts.

PMID: 15976566 [PubMed - indexed for MEDLINE]


32. J Occup Environ Med. 2004 Jul;46(7):720-8.

Blood lead levels in U.S. workers, 1988-1994.

Yassin AS, Martonik JF, Davidson JL.

Office of Evaluations and Audit Analysis, Occupational Safety and Health
Administration, United States Department of Labor, Washington, DC, USA.
yassin.abdiaziz@dol.gov

Limited research has been conducted to measure the association between elevated
blood lead levels and sociodemographic factors among U.S. workers in various
industries and occupations using population-based survey data. Data from the
Third National Health and Nutrition Examination Survey ( n = 10,127) were used to
determine the blood lead levels in the U.S. workers. The prevalence of elevated
blood lead levels > or = 50 microg/dL was 0.001% (1560) among U.S. workers
compared with 0.2% (19,953) workers with elevated lead levels > or = 40
microg/dL. Regression analyses indicated that workers in the repair service
industry were correlated with higher blood lead levels than those workers in the 
construction industry. Although low blood lead levels were found for the entire
working population, the results showed that there were still high blood lead
levels in certain occupations and industries during 1988 to 1994.

PMID: 15247812 [PubMed - indexed for MEDLINE]


33. Can J Diet Pract Res. 2004 Summer;65(2):59-64.

Implementing the British Columbia Nutrition Survey: perspectives of interviewers 
and facilitators.

Wassink HL, Chapman GE, Levy-Milne R, Forster-Coull L.

Food, Nutrition & Health Program, Faculty of Agricultural Sciences, University of
British Columbia, Vancouver, BC, Canada.

The British Columbia Nutrition Survey was the last of ten provincial nutrition
surveys completed between 1988 and 1999. A qualitative process evaluation was
conducted to identify strengths and weaknesses of British Columbia Nutrition
Survey procedures, as perceived by 27 public health nurses and dietitians
directly involved in data collection. Data for the process evaluation were
collected through in-depth telephone interviews, during which interviewers and
facilitators described their experiences working for the survey. Qualitative
analysis of interview transcripts identified codes that were then organized into 
eight categories, including issues arising from interviewer and facilitator
training, challenges in recruiting survey participants, reflections on safety for
survey personnel and participants, facilitators' key role, the flexibility
required to implement the protocol, and communication within the survey research 
team. Two final categories related to rewarding aspects of the job: insights
affecting professional practice, and meeting survey participants and personnel.
Evaluation findings show the importance of establishing open communication
between research planners and those conducting surveys. This communication is
needed to ensure that workers' needs are met, the quality of the study is
maximized, and evaluations of study protocols include the perspectives of those
directly involved in data collection.

PMID: 15217523 [PubMed - indexed for MEDLINE]


34. Thorax. 2004 Mar;59(3):194-8.

Urinary cadmium levels predict lower lung function in current and former smokers:
data from the Third National Health and Nutrition Examination Survey.

Mannino DM, Holguin F, Greves HM, Savage-Brown A, Stock AL, Jones RL.

Air Pollution and Respiratory Health Branch, Division of Environmental Hazards
and Health Effects, Atlanta, Georgia 30333, USA. dmannino@cdc.gov

BACKGROUND: A study was undertaken to determine the relation between urinary
cadmium levels and lung function in a nationally representative cohort of
current, former, and never smokers in the US. Urinary cadmium levels reflect the 
total body burden of cadmium. METHODS: The following data from the Third National
Health and Nutrition Examination Survey were analysed: urinary cadmium (adjusted 
for urinary creatinine), lung function, sex, race/ethnicity, age, education
level, job category, body mass index, serum cotinine level, and smoking history. 
Linear regression models were developed to predict lung function using urinary
cadmium as the main predictor, adjusting for other covariates and stratified by
smoking status. RESULTS: Data were available on 16 024 adults. Current smokers
had higher mean (SE) urinary cadmium/creatinine levels (0.46 (0.01) micro g/g)
than former (0.32 (0.01) micro g/g) or never smokers (0.23 (0.01) micro g/g).
Higher levels of urinary cadmium were associated with significantly lower forced 
expiratory volumes in 1 second (FEV(1)) in current (-2.06%, 95% confidence
interval (CI) -2.86 to -1.26 per 1 log increase in urinary cadmium) and former
smokers (-1.95%, 95% CI -2.87 to -1.03) but not in never smokers (-0.18%, 95% CI 
-0.60 to 0.24). Similar results were obtained for forced vital capacity (FVC) and
FEV(1)/FVC. CONCLUSIONS: Cadmium, which is known to cause emphysema in
occupational settings, may also be important in the development of tobacco
related lung disease.

PMCID: PMC1746977
PMID: 14985551 [PubMed - indexed for MEDLINE]


35. Rocz Panstw Zakl Hig. 2004;55(4):347-56.

[Questionnaire studies on the vital situation and nutritional habits of students]

[Article in Polish]

Przybulewska K, Janda K.

Katedra Mikrobiologii i Biotechnologii Srodowiska, Akademia Rolnicza w
Szczecinie, 71-434 Szczecin, ul. Słowackiego 17. kprzybulewka@agro.ar.szczecin.pl

Results of questionnaire studies carried out in 2001/2002 among 230 students of
University of Agriculture in Szczecin were presented. It served for assessing
their material and living situation during studying at the University. Women and 
people originating from cities dominated in studied group of respondents.
Probably, there is a decreasing tendency referring to attending the University by
country people. Residence during studying depended on the year of education and
origin of respondents. Last-year students and country people were more often
placed in hostel. Material help in a form of social scholarship was more often
assigned to country youth, and scientific grants were more frequently given to
fifth-year students. No finance help of student's families made they undertook a 
part-time job that was made more often by final-year students. Significant
differences referring to consumption customs often depended on sex. Students
themselves most often prepared meals, including dinners. Only small per cent
(12%) of students went to canteens, milk bars or other restaurants. Almost
one-third of respondents fed irregularly. One-dish dinners consisting most often 
of purchased or earlier prepared semi-products dominated. Majority of students
declared feeding meat, poultry, and sweets at least once a week, as well as
fish--at least once a month. Every second person declared everyday consumption of
fruit and vegetables, milk and its products as well as several cups of coffee
daily; it referred more often to women. Most of respondents occasionally consumed
sprinkle, low-alcoholic beverages and snacks in a form of chips and nuts, but
they were more often men.

PMID: 19097585 [PubMed - indexed for MEDLINE]


36. Rev Panam Salud Publica. 2003 Oct;14(4):235-45.

[Factors associated with physical activity among Mexican women of childbearing
age]

[Article in Spanish]

Hernández B, de Haene J, Barquera S, Monterrubio E, Rivera J, Shamah T, Sepúlveda
J, Haas J, Campirano F.

Instituto Nacional de Salud Pública, Centro de Investigación en Salud
Poblacional, Cuernavaca, Morelos, México.

OBJECTIVE: To document the practice of light and heavy physical activities,
especially sports and exercise, among women from 12 to 49 years old in Mexico,
and to evaluate the association that that has with some sociodemographic
characteristics. METHODS: A sample of 2 367 women 12 to 49 years old living in
Mexico in 1999 was studied through secondary analysis of data from Mexico's 1999 
National Nutrition Survey (Encuesta Nacional de Nutrición). The Survey used a
clustered stratified multistage sampling scheme, with a final sample of 21 000
homes in the entire country. A questionnaire was used to evaluate the time that
the women spent on various forms of physical activity, with the activity measured
on a scoring scale in terms of metabolic equivalents (METs). The dependent
variables in the study were the time spent on heavy physical activities (those
that require an energy expenditure of at least 5 METs/hour) and the time devoted 
to light or sedentary activities (such as sitting while on the job or elsewhere; 
watching television, a video, a movie, or a theater presentation; or sleeping).
The independent variables were age, schooling, parity, region of the country,
area of residence (urban or rural), socioeconomic level (measured through an
index prepared based on housing conditions and household possessions), and
marital status. The association between the independent variables and practicing 
sports was evaluated, and gross odds ratios (ORs) were calculated, with 95%
confidence intervals (CIs). In order to identify the association between
practicing sports and the independent variables a logistic regression model was
used, adjusted for the effects of possible confounding variables. Adjustments
were also made in the probability of a woman's being selected for the sample,
using a weighting factor. In addition, adjustments were made to control for the
design effect produced by the grouping of the observations in the sample, using
the "svy" complex-samples routine of the Stata version 7.0 statistical analysis
computer software. RESULTS: The 2 367 women whose information was analyzed spent 
an average of 0.08 hours per day practicing sports and 1.25 hours per day on
heavy physical activities. Only 16% of the women reported that they regularly
practiced some sport. After adjusting for all the independent variables, the
women older than 30 years had a lower OR of practicing sports in comparison to
women who were 20 years of age or less (OR = 0.53; 95% CI: 0.33 to 0.84), as was 
also true for women 21-30 years old (OR = 0.35; 95% CI: 0.23 to 0.54). Having the
highest level of schooling and not having had children were both directly
associated with practicing a sport. While the area of residence (urban or rural),
marital status, and socioeconomic level showed differences among the groups, such
differences were not significant after adjusting for the other study variables.
In terms of physical activity measured in METs, the time spent on sports made up 
10% of the total for heavy activity and 0.7% of the overall total. In terms of
the possibility of being among the 10% of the women who expended the fewest METs 
per day, that was more likely for women under 21 years of age than it was for
women 31 or older, and it was also more likely for women who had a primary level 
of schooling than for women with a secondary education. CONCLUSIONS: This study
showed that practicing sports is not a frequent form of physical activity among
women of childbearing age in Mexico, especially those who are over 20 years of
age and those with a low level of schooling. This situation could contribute to
increases in the prevalence of obesity and chronic diseases.

PMID: 14662074 [PubMed - indexed for MEDLINE]


37. Soc Sci Med. 2003 Apr;56(7):1397-410.

Socioeconomic differences in dietary patterns among middle-aged men and women.

Martikainen P, Brunner E, Marmot M.

Department of Epidemiology, International Centre for Health and Society,
University College London Medical School, 1-19 Torrington Place, WC1E 6BT,
London, UK. pekka@public-health.ucl.ac.uk

The aim of the study is to (i) identify common dietary patterns, (ii) study
socioeconomic differences in these dietary patterns, and (iii) assess whether
they contribute to socioeconomic differences in biological risk factors. The data
come from the Whitehall II study of London civil servants, who participated in
the third phase (1991-1993) and were 39-63-years old (N=8004). Food frequency
questionnaire and socioeconomic background information was from a questionnaire, 
and biological risk factors from a medical screening. Six dietary patterns were
identified. In reference to high employment grade men, the odds ratios of low
grade men consuming the 'unhealthy' or the 'very unhealthy' diet were 1.26 and
3.34, respectively, while the odds for the 'French' diet was 0.13. Among women
the corresponding odds were 2.98, 6.19 and 0.25. Adjusting for spouse's
socioeconomic status and to a lesser extent smoking and exercise as well as job
control attenuate these grade differences somewhat. Among men and women adjusting
for dietary patterns accounted for about 25-50 per cent of grade differences in
HDL and serum triglyceride levels.

PMID: 12614692 [PubMed - indexed for MEDLINE]


38. Am J Public Health. 2003 Mar;93(3):477-81.

Why do WIC participants fail to pick up their checks? An urban study in the wake 
of welfare reform.

Rosenberg TJ, Alperen JK, Chiasson MA.

Medical and Health Research Association of New York City Inc., NY 10013-2988,
USA. trosenberg@mhra.org

OBJECTIVES: This study explored whether work or immigration concerns affect
women's participation in the Special Supplemental Nutrition Program for Women,
Infants, and Children (WIC). METHODS: The sample included women who had withdrawn
from the WIC program and current WIC clients from 1 center in New York City.
Logistic regression analyses were used to predict noncollection of checks;
demographic characteristics, program participation, and problems with the WIC
program were independent variables. RESULTS: Strong predictors of noncollection
of checks were job conflicts, transportation or illness problems, and WIC receipt
by the woman herself (rather than by her children). CONCLUSIONS: Employment
conflicts were related to failure to pick up WIC checks; immigration concerns
were not. As a means of enhancing WIC participation, flexibility is recommended
in terms of center hours, locations, and staffing and program check distribution 
policies.

PMCID: PMC1447767
PMID: 12604499 [PubMed - indexed for MEDLINE]


39. JPEN J Parenter Enteral Nutr. 2002 Jul-Aug;26(4):239-47.

Evaluation of board certification in nutrition support pharmacy.

Ebiasah RP, Schneider PJ, Pedersen CA, Mirtallo JM.

College of Pharmacy, The Ohio State University, Columbus 43210, USA.

BACKGROUND: Credentialing of healthcare professionals is a topic that has
received increasing attention. The Board of Pharmaceutical Specialties (BPS) has 
recognized nutrition support pharmacy as a specialty for more than 10 years.
There has recently been concern about the decline in the number of pharmacists
seeking board certification or recertification as specialists in nutrition
support and changes in the job responsibilities of nutrition support pharmacists.
These factors have resulted in a need to evaluate the current system of
certification of nutrition support pharmacists. METHODS: A national survey was
developed and sent to pharmacist members of the American Society for Parenteral
and Enteral Nutrition (A.S.P.E.N.) and members of the Home Care Section of the
American Society of Health-System Pharmacists (ASHP). The objectives of this
study were to describe the activities of nutrition support pharmacists, determine
the benefits and barriers to board certification, and assess the current system
of certification. RESULTS: Two hundred and fifty-eight of 486 surveys were
returned for an overall response rate of 53%. There has been a decrease in the
amount of professional time devoted to nutrition support activities. The most
highly ranked benefit to certification was peer recognition. The most highly
ranked barrier to certification was the examination cost. CONCLUSIONS: There is
satisfaction with the current system; however, alternative methods were supported
if the current method cannot sustain itself There is a need to evaluate the cost 
of the examination and increase marketing efforts to candidates for whom the
examination is intended.

PMID: 12090689 [PubMed - indexed for MEDLINE]


40. J Public Health Manag Pract. 2001 Jan;7(1):10-20.

The effect of employee job satisfaction on program participation rates in the
Virginia WIC Program (Special Supplemental Nutrition Program for Women, Infants, 
and Children).

Chance KG, Green CG.

Banner Pharmacaps Inc., High Point, North Carolina, USA.

Many researchers have shown a link between employee job satisfaction and customer
satisfaction in the private sector. Customer satisfaction is the end result of
whether the particular service and/or a product meet the customer's needs. The
purpose of this research project was to assess the level of employee job
satisfaction in the Virginia WIC Program and to determine whether a correlation
exists between the level of employee job satisfaction and program participation
rates. The results of this study showed that high levels of employee job
satisfaction were positively correlated to high program participation rates in
the Virginia WIC Program.

PMID: 11141619 [PubMed - indexed for MEDLINE]


41. Aust N Z J Public Health. 1999 Dec;23(6):578-84.

Prevalence and socio-demographic predictors of dietary goal attainment in an
older population.

Webb KL, Schofield WN, Lazarus R, Smith W, Mitchell P, Leeder SR.

Department of Public Health and Community Medicine, University of Sydney,
Westmead Hospital, New South Wales. karenw@cmed.wh.su.edu.au

OBJECTIVE: To describe the measured dietary intakes and anthropometry of a large,
free-living population of middle-aged and older Australians who participated in
the Australian Blue Mountains Eye Study (BMES), and to identify the
socio-demographic characteristics associated with attainment or non-attainment of
dietary goals. METHOD: Anthropometry and dietary intakes were compared with
current population dietary goals and Recommended Dietary Intakes for 2,873 people
(79% of eligible residents) aged > or = 49 years who participated in the BMES.
Nutrient intakes were measured by a validated food frequency questionnaire.
RESULTS: Nutrients for which mean intakes deviated most from nutrition goals
included: percentages of energy from total and saturated fat, carbohydrate and
alcohol (men), as well as absolute intakes of calcium, zinc and fibre. More than 
half the men (60%) and women (54%) were overweight or obese. Several
micro-nutrient goals were more likely to be met in households where the
respondents and/or their spouses were independent. Married men were more likely
to meet goals for fibre and iron, but less likely to meet the goal for
cholesterol. Several goals were more likely to be met by men and women who had
qualifications after leaving school, those with higher job status and
non-pensioners, suggesting an socio-economic status dimension. CONCLUSIONS AND
IMPLICATIONS: These results indicate that over- rather than under-nutrition is
more prevalent among community-dwelling older people, although under-nutrition
should not be overlooked. Particular sub-groups that are less likely to meet some
dietary goals may require targeting in community nutrition interventions.

PMID: 10641346 [PubMed - indexed for MEDLINE]


42. Health Care Women Int. 1999 Mar-Apr;20(2):127-36.

Reasons, health behaviors, and outcomes of no prenatal care: research that
changed practice.

Higgins PG, Woods PJ.

University of New Mexico Health Sciences Center, College of Nursing, Albuquerque,
USA.

Changes in prenatal care practices resulted from a pilot study with 12 urban New 
Mexican women who received no prenatal care. The women were interviewed regarding
their reasons for not receiving care during pregnancy, health behaviors, and
perceived neonatal outcomes. Data on actual neonatal outcomes were taken from the
medical record. Maternal reasons for no prenatal care were socio-demographic,
system-related, attitudinal, and outside forces of job and childcare. To ensure a
healthy baby, the women made changes in their nutrition, self-care activities,
substance use, sleep, and exercise activities. All of the women perceived they
had a healthy baby. Yet 61% of the neonates had complications and 45% were low
birth weight. The research findings were used to develop a care management
program that included case management and utilization management.

PMID: 10409983 [PubMed - indexed for MEDLINE]


43. J Am Diet Assoc. 1999 May;99(5):553-7.

Education and certification influence the nutrition and management knowledge of
long-term-care foodservice managers.

Stonerook AL, Wolf KN, Bartlett BJ, George RT.

Graduate Program of Allied Medicine, Ohio State University, Columbus 43210, USA.

OBJECTIVES: To describe nutrition knowledge, attitude toward nutrition, and
management knowledge of long-term-care foodservice managers and to determine the 
relationship between these variables and the foodservice managers' personal and
facility characteristics. DESIGN: Nutrition knowledge, management knowledge, and 
attitudes toward nutrition were measured using survey methodology designed for
this study by modifying an instrument developed by the Nutrition Education
Training Program for the Texas Department of Human Services. SUBJECTS/SETTING:
Surveys were mailed to a random sample of 300 long-term-care foodservice
directors from the 1,092 directors listed in the 1996 Ohio Department of Health
Directory of Nursing Homes. The participants were 123 of the 300 foodservice
directors (41%). STATISTICAL ANALYSES PERFORMED: Descriptive statistics, Spearman
rank correlations, 1-way analysis of variance, and post hoc variance were
calculated. RESULTS: Mean scores of respondents were 21.2 out of a possible 29
(73%) for the nutrition knowledge assessment, and 18.2 out of 26 (70%) for
management knowledge. Dietitians and dietetic technicians scored significantly
better than others on these tests. The mean score of attitudes toward nutrition
was 4 on a 5-point scale (where 1 = strongly disagree to 5 = strongly agree). All
participants requested more training in computers, nutrition terminology, and
preparing appealing foods. APPLICATIONS: Dietitians and dietetic technicians are 
prepared with a wide scope of knowledge in nutrition and management. Thus, they
are in an ideal position to take advantage of job opportunities in the area of
foodservice management.

PMID: 10333776 [PubMed - indexed for MEDLINE]


44. J Nutr. 1999 Feb;129(2S Suppl):517S-520S.

Economic determinants and dietary consequences of food insecurity in the United
States.

Rose D.

Department of Agricultural Economics, Michigan State University, East Lansing
48824, USA.

This paper reviews recent research on the economic determinants and dietary
consequences of food insecurity and hunger in the United States. The new Current 
Population Study (CPS) food insecurity and hunger measure shows that hunger rates
decline sharply with rising incomes. Despite this strong relationship, confirmed 
in other national datasets, a one-to-one correspondence between poverty-level
incomes and hunger does not exist. In 1995, 13.1% of those in poverty experienced
hunger and half of those experiencing hunger had incomes above the poverty level.
Panel data indicate that those who are often food insufficient are much more
likely than food-sufficient households to have experienced recent events that
stress household budgets, such as losing a job, gaining a household member or
losing food stamps. Cross-sectional work also demonstrates the importance of food
stamps because benefit levels are inversely related to food insufficiency.
Concern for the dietary consequences of domestic food insufficiency is well
placed; recent research shows that the odds of consuming intakes <50% of the
recommended dietary allowance (RDA) are higher for adult women and elderly
individuals from food-insufficient households. Preschoolers from
food-insufficient households do not consume significantly lower amounts than
those from food-sufficient households, but mean intakes for the rest of members
in those very same households are significantly lower for the food insufficient. 
This research highlights the importance of food insecurity and hunger indicators,
further validates the use of self-reported measures and points to areas of need
for future research and interventions.

PMID: 10064321 [PubMed - indexed for MEDLINE]


45. WMJ. 1998 Dec;97(11):34-8.

Stress and hypertension.

Kulkarni S, O'Farrell I, Erasi M, Kochar MS.

Medical College of Wisconsin, Milwaukee, USA.

Stress can cause hypertension through repeated blood pressure elevations as well 
as by stimulation of the nervous system to produce large amounts of
vasoconstricting hormones that increase blood pressure. Factors affecting blood
pressure through stress include white coat hypertension, job strain, race, social
environment, and emotional distress. Furthermore, when one risk factor is coupled
with other stress producing factors, the effect on blood pressure is multiplied. 
Overall, studies show that stress does not directly cause hypertension, but can
have an effect on its development. A variety of non-pharmacologic treatments to
manage stress have been found effective in reducing blood pressure and
development of hypertension, examples of which are meditation, acupressure,
biofeedback and music therapy. Recent results from the National Health and
Nutrition Examination Survey indicate that 50 million American adults have
hypertension (defined to be a systolic blood pressure of greater than 139 mm Hg
or a diastolic blood pressure of greater than 89 mm Hg). In 95% of these cases,
the cause of hypertension is unknown and they are categorized as "essential"
hypertension. Although a single cause may not be identified, the general
consensus is that various factors contribute to blood pressure elevation in
essential hypertension. In these days of 70 hour work weeks, pagers, fax
machines, and endless committee meetings, stress has become a prevalent part of
people's lives; therefore the effect of stress on blood pressure is of increasing
relevance and importance. Although stress may not directly cause hypertension, it
can lead to repeated blood pressure elevations, which eventually may lead to
hypertension. In this article we explore how stress can cause hypertension and
what can be done about it.

PMID: 9894438 [PubMed - indexed for MEDLINE]


46. Wien Klin Wochenschr. 1998 Jul 31;110(13-14):459-66.

Salt and hypertension at the close of the millenium.

Luft FC.

Franz Volhard Clinic, Max Delbrück Center for Molecular Medicine, Medizinsche
Fakultät der Charité, Humboldt University of Berlin, Federal Republic of Germany.
luft@fvk-berlin.de

"Can that which is unsavory be eaten without salt?" This question was directed at
none other than God by Job, who also had other important problems to ponder. The 
question posed in this review is the notion that essential hypertension is
induced and/or sustained by an unnecessarily high salt intake. If this is indeed 
the case, then a reduction of salt intake might prevent or effectively treat
essential hypertension. A cross-sectional epidemiological study of salt intake in
populations showed a positive association of sodium excretion with median blood
pressure and the prevalence of hypertension; however, when four disparate
populations were deleted, the associations disappeared. A Scottish report on a
similarly large population minimized the importance of dietary sodium. A recently
analysis of the National Health and Nutrition Examination Survey (NHANES) data
base does not support the idea that lower salt intake improves all-cause or
cardiovascular mortality; however, the analysis is not without weaknesses.
Salt-sensitivity is based on the idea that some persons might be more susceptible
to salt-induced effects on blood pressure than others. Indeed, several monogenic 
syndromes exhibit marked salt-sensitivity and their clarification has facilitated
our understanding of basic mechanisms. Allelic variants of several genes may be
important in salt-sensitive patients with essential hypertension. Meta-analyses
of intervention trials in patients with essential hypertension show about a 5 mm 
Hg decrease in blood pressure with salt restriction. Among the normotensive, this
decrease is less than 2 mm Hg. In terms of efficacy, salt restriction has not
been shown superior to weight loss or a "vegetable" diet. Nonpharmacological
approaches in hypertensive patients should be based on a comprehensive approach.

PMID: 9746958 [PubMed - indexed for MEDLINE]


47. Appetite. 1998 Feb;30(1):39-51.

Gender and living alone as determinants of fruit and vegetable consumption among 
the elderly living at home in urban Nottingham.

Donkin AJ, Johnson AE, Morgan K, Neale RJ, Page RM, Silburn RL.

Department of Health Care of the Elderly, University of Nottingham, UK.

Consumption of fruits and vegetables by a sample of 369 elderly people living in 
Nottingham, England, was analysed in relation to whether or not they were eating 
five portions a day. Living status was only of significance to men who, if
single, consumed 2.66 portions of fruits and vegetables per day compared with an 
overall mean of 4.1. The salient question is therefore not "Are you living
alone?" but " s there a woman in the household?". Those respondents who were
older and less educated ate less vegetables and those respondents who had a lower
income or social grade ate less fruit. Men were less likely to be able to cook a 
range of meals, to have had a job that involved cooking or to watch cookery
programmes on television. Single men were more likely than single women to say
that eating food that was easy to cook and prepare was an important influence on 
their food choice. Single women on the other hand were more influenced by body
image. Finding foods that were the right portion size and easy to open, prepare
and cook was more important to single men than married men, as was the amount of 
money left after paying the bills. Copyright 1998 Academic Press Limited.

PMID: 9500802 [PubMed - indexed for MEDLINE]


48. Stud Fam Plann. 1998 Mar;29(1):69-78.

The impact of type of employment on women's use of prenatal-care services and
family planning in urban Cebu, the Philippines.

Miles-Doan R, Brewster KL.

Center for the Study of Population, Florida State University, Tallahassee
32306-2240, USA.

This study re-evaluates the relationship of urban women's employment to their
health-service and contraceptive use, drawing on data from the Cebu Longitudinal 
Health and Nutrition Survey. Multivariate analyses reveal significant differences
across types of work for the likelihood of both obtaining timely prenatal care
and practicing contraception at one year postpartum. Wage workers in white-collar
jobs are significantly more likely than those not employed for pay to have
obtained prenatal care and are substantially more likely to have adopted a
contraceptive method in the year following childbirth. Women who are
self-employed also are significantly more likely than those not employed for pay 
to be using contraceptives. Blue-collar wage work and piecework employment have
no relationship to either dependent variable. These findings suggest that
work-related autonomy encourages women to exercise control in other areas of
their lives.

PIP: This article examined the relationship between women's employment and use of
prenatal care services and family planning in Cebu, the Philippines. Data were
obtained from the Cebu Longitudinal Health and Nutrition Baseline and Follow-up
Survey among a 12-month birth cohort of 2695 Filipino infants and their mothers, 
residing in a sample of 33 urban and rural barangays in 1983 and 1984. The
largest percentage of women who had early prenatal care were white collar workers
(WCWs) and professionals (57%), followed by blue collar, service, and
self-employed workers (22%), and non-wage workers (23%). The smallest percentage 
of women obtaining prenatal care were pieceworkers (15%). Modern contraceptive
use at 1 year postpartum was greatest among WCWs (34%), followed by self-employed
workers (32%) and non-wage workers (26%). The lowest proportion were pieceworkers
among modern method users, and blue collar workers and service workers among
traditional method users. Logistic models indicate that WCWs were 2.5 times more 
likely than non-wage workers to obtain care within the first 5 months of
pregnancy. Among women who received free care, WCWs still had the best prenatal
care patterns. The likelihood of prenatal care was the same for blue collar
workers, self-employed workers, and pieceworkers. Women aged 25-34 years were
more likely than older women to obtain early prenatal care. Husband's education, 
a resident grandmother, and household assets contributed to a higher likelihood
of seeking early prenatal care. The degree of autonomy on the job was more
closely related to contraceptive and health service use.

PMID: 9561670 [PubMed - indexed for MEDLINE]


49. Vital Health Stat 3. 1997 Dec;(31):1-91.

Women: work and health.

Wagener DK, Walstedt J, Jenkins L, Burnett C, Lalich N, Fingerhut M.

National Center for Health Statistics, National Institute for Occupational Safety
and Health, USA.

OBJECTIVES: This report describes the sociodemographics, household
characteristics, and health of women according to workforce status and job
conditions. The report also presents data on men for comparison. METHODS: This
report combines data from numerous data systems, including: The National Health
Interview Survey, National Health and Nutrition Examination Survey, National
Maternal and Infant Health Survey, National Hospital Ambulatory Medical Care
Survey, National Traumatic Occupational Fatalities Surveillance System, and the
National Occupational Mortality Surveillance System, which are conducted by the
U.S. Department of Health and Human Services; the Census of Fatal Occupational
Injuries and Annual Survey of Occupational injuries and illnesses conducted by
the U.S. Department of Labor; and the Current Population Survey conducted by the 
U.S. Department of Commerce. The report also presents selected tables from
publications of the Women's Bureau and the Bureau of Labor Statistics, U.S.
Department of Labor. RESULTS: The report presents summary data on physical
conditions and exposures, health conditions attributed to work, other health
conditions that impact on work, health promotion in the workplace, and
health-related benefits provided by employers. Most estimates are shown according
to sex, age, race, ethnicity, educational attainment, and major occupational
group.

PMID: 9470482 [PubMed - indexed for MEDLINE]


50. J Am Diet Assoc. 1997 Dec;97(12):1389-93.

Nephrologists' and internal medicine physicians' expectations of renal dietitians
and general clinical dietitians.

Hart JJ, Hurley RS, Garrison ME, Stombaugh I.

University Hospital of Cleveland, OH 44106-5000, USA.

OBJECTIVE: To document and compare nephrologists' and internal medicine
physicians' expectations of renal dietitians and general clinical dietitians.
DESIGN: Subjects completed a mailed survey. Respondents provided demographic
information and used a 5-point Likert scale to note whether each of 14 job
functions was appropriate for general clinical dietitians, renal dietitians, or
both. SUBJECTS: Five hundred forty-one physicians registered with the Ohio State 
Medical Board (OSMB) were surveyed. Within this group were 283 nephrologists (the
population of nephrologists registered with the OSMB) and 258 internal medicine
physicians (selected randomly by the OSMB). A total of 133 physicians (25%)
returned the survey; 119 surveys were usable: 70 from nephrologists and 49 from
internists. STATISTICAL ANALYSES PERFORMED: A composite variable was created by
coding and summing physicians' responses regarding dietitian job functions. This 
variable was averaged for both physician categories. A t test was conducted to
compare composite variable results between the two physician groups. RESULTS: At 
least 50% of nephrologists and internists agreed that both types of dietitians
should conduct nutrition assessments, determine patients' energy needs, evaluate 
medication-nutrient interactions, recommend diet and tube-feeding orders,
instruct patients about physician-ordered diets, and teach nutrition concepts to 
hospital interns. Few physicians agreed that either type of dietitian should
order diets, tube feedings, or diet instructions. APPLICATIONS/CONCLUSIONS:
Clinical dietitians can educate physicians about dietitians roles informally in
their institutions and formally by supporting programs like The American Dietetic
Association Physician Nutrition Education Program. In addition, dietetics
educators can hone their students' communication and problem-solving skills to
promote positive physician-dietitian interaction.

PMID: 9404335 [PubMed - indexed for MEDLINE]


51. J Am Diet Assoc. 1997 Nov;97(11):1255-60, 1263; quiz 1261-2.

The role of nutrition support dietitians as viewed by chief clinical and
nutrition support dietitians: implications for training.

Olree K, Skipper A.

Rush-Presbyterian-St Luke's Medical Center, Chicago, Ill., USA.

OBJECTIVES: To determine current and ideal frequencies with which nutrition
support dietitians perform each item on a list of 15 tasks and evaluate dietitian
preparation for the practice of nutrition support. DESIGN: Data were collected
using two questionnaires, one completed by the chief clinical dietitian and the
other completed by the nutrition support dietitian at each hospital surveyed.
Both versions of the questionnaires contained a list of 15 tasks that had been
validated as being related to advanced nutrition support by a panel of 20
nutrition support experts using a modified Delphi method. Follow-up telephone
calls were made to increase the number of responses. SAMPLE: Questionnaires were 
mailed to the chief clinical dietitian at 300 randomly selected, general
medical/surgical hospitals with 300 or more beds in the United States and Puerto 
Rico. A total of 134 chief clinical dietitians (45%) and 129 nutrition support
dietitians (43%) responded to the surveys; 124 (41%) and 120 (40%)
questionnaires, respectively, were usable for statistical analyses. STATISTICAL
ANALYSES: The Wilcoxon matched-pairs signed-ranks test was used to determine
differences between nutrition support dietitian actual and ideal frequencies and 
between chief clinical dietitian actual and ideal frequencies for each of the 15 
tasks. The Mann-Whitney U-Wilcoxon rank sum W test was used to determine
differences between nutrition support dietitian and chief clinical dietitian
actual frequencies and between nutrition support dietitian and chief clinical
dietitian ideal frequencies for each of the 15 tasks. Descriptive statistics were
used to analyze the questions regarding educational preparation for nutrition
support practice and demographic data. RESULTS: The ideal frequency for each of
the 15 tasks was significantly greater (P < .0001) than the actual frequency
reported by nutrition support dietitians and chief clinical dietitians. Whereas
chief clinical dietitians and nutrition support dietitians agreed on the ideal
frequency for most tasks, the nutrition support dietitian ideal frequency
indicated for the tasks "determines macronutrient composition of parenteral
nutrition" and "performs physical examinations related to nutritional status,
fluid status, and gastrointestinal function" was significantly greater (P < .001,
P < .05), respectively) than the ideal frequency indicated by chief clinical
dietitians. Of the nutrition support dietitians, 79% agreed and 16% somewhat
agreed that experiences beyond those required for becoming a registered dietitian
are needed to provide nutrition support dietitians with specialized clinical
skills. APPLICATIONS/CONCLUSIONS: Nutrition support dietitians desire increased
responsibility for delivering nutrition support to their patients and this desire
is largely supported by chief clinical dietitians. Nutrition support dietitians
appear to have a strong interest in postregistration qualifying experiences that 
would provide a foundation for expanding their roles. According to the results of
this study, programs designed to provide practical, clinical experience in
nutrition support are needed.

PMID: 9366863 [PubMed - indexed for MEDLINE]


52. J Am Coll Nutr. 1997 Oct;16(5):439-42.

Nutrition knowledge, attitude and practice among primary care physicians in
Taiwan.

Hu SP, Wu MY, Liu JF.

Department of Nutrition and Health Science, Taipei Medical College, Taiwan,
R.O.C.

OBJECTIVE: To investigate nutritional knowledge, attitude and practices among
primary care physicians in the Taiwan area. METHOD: A closed-end questionnaire
containing 26 knowledge questions, 12 attitude statements and 12 practice
statements was mailed to physicians on the mailing list of the National Health
Administration (NHA). RESULTS: The data reported are based on the responses of
27% of the total 1210 primary care physicians in the Taiwan area. Physicians
answered 59% of the total knowledge questions correctly, with a tendency to score
higher on general knowledge than clinical nutrition. The majority of physicians
tended to agree with the positive-attitude statements and disagree with the
negative-attitude statements. The performance of physicians regarding personal
practices was less than that for job-related practices. CONCLUSIONS: This
nationwide survey of nutrition-related knowledge and practices demonstrates the
need for nutrition education for physicians. The questionnaire may be a useful
instrument for future educational strategies in Taiwan.

PIP: A questionnaire completed by 331 primary health care physicians in Taiwan
revealed deficiencies in nutrition-related knowledge, attitudes, and practices.
Questionnaires were sent to all 1210 physicians on the mailing list of the
National Health Administration; the response rate was 27%. Physicians answered
59% of the 26 knowledge-related questions correctly. The highest proportion of
correct responses was obtained for questions related to nutrient functions and
nutrition during pregnancy (both 70.6%), while the lowest was recorded for the
item concerning nutritional assessment (42%). Overall, physicians considered
nutrition to be important in their personal and clinical practice. However, only 
78% expressed agreement with the statement that nutrition consultation should be 
a part of health care. Nutrition knowledge was higher among female physicians,
those under 35 years of age, and non-smokers. Finally, there was a significant
correlation between nutrition knowledge and attitudes. Although this study is
limited by the poor response rate, the results indicate a need for improvements
in the basic nutritional knowledge and practices of primary care physicians in
Taiwan.

PMID: 9322193 [PubMed - indexed for MEDLINE]


53. Br J Nutr. 1997 Jun;77(6):833-51.

Characteristics of the low-energy reporters in a longitudinal national dietary
survey.

Price GM, Paul AA, Cole TJ, Wadsworth ME.

MRC Dunn Nutrition Unit, Combridge.

The aim of the present study was to establish whether the characteristics of
members of a large national birth cohort study who submitted diet diaries with
implausibly low-energy intake differed from those whose recorded energy intake
was more plausible. Survey members (n 1898) recorded their diets in a 7 d diary
in household measures. Those whose reported energy intake (EI) as a fraction of
their estimated BMR was less than 1.10, here termed low-energy reporters (LER)
but often called under-reporters, constituted 20.6% of the study population. None
of the variables describing dietary, smoking or exercise behaviour bore a
significant relationship with low EI/BMR (< 1.10), neither did those describing
region of residence, subjective adequacy of income, current social class, social 
relations or the social environment of the subjects. Results of logistic
regression analysis showed that the only independently significant characteristic
for men was higher BMI. In women, in addition to higher BMI, having been
overweight or obese as an adult independently, but less significantly, predicted 
low EI/BMR, while membership as a child of social class III (non-manual), having 
more children in the household and having a paid job marginally but independently
decreased the probability of reporting low EI/BMR. Submission of a diary with
EI/BMR < 1.10 7 years earlier in the same survey was an even more powerful
predictor of current low EI/BMR than higher BMI in both sexes. The average
reported diet-composition of LER was more micronutrient- and protein-rich than
that of the others, indicating different dietary, or diet-recording, behaviour in
this group of subjects. LER are not a random sample of the survey population, and
their characteristics, definable to some extent, put them at risk for lower
health status. Although EI/BMR cut-off points can be used to identify LER, the
problem of how to use their data is still unresolved.

PMID: 9227182 [PubMed - indexed for MEDLINE]


54. Environ Urban. 1995 Oct;7(2):51-65.

Fighting poverty: the economic adjustment of female migrants in Dhaka.

Huq-hussain S.

PIP: Data from a field survey of slum and squatter settlements in Dhaka,
Bangladesh, are used to examine the social adjustment of poor, female migrants to
work, occupational choice, work satisfaction, income, control over income, and
women's role in the family economy. A "poor household," defined in terms of
nutritional intake, included those families receiving under 2122 cal/person/day. 
44% of the urban population in Bangladesh do not obtain the daily nutritional
requirement. Findings indicate that 61% of all female migrants expected to find
work on arrival in the city. 44% of female migrants were willing to take any kind
of work available at the time of arrival. Over 66% of all females found work in
less than 6 months. Almost 25% took 6 months to a year to find a job, and 15%
found work after a year's time. Recent migrants, who were older, found work
quicker. 16% of female migrants found their job with help from relatives and
friends (23% of recent migrants and 14% of long-term migrants). Among female
migrants who sought a job on their own, 14% found work within 6 months. 3% found 
work between 6 months and a year. The rest were engaged in family and home-based 
work or found a job much later. In Dhaka, most women migrants worked in the
service or informal sector. 40% of the sample worked as domestics, 38% worked in 
the informal sector, 16% worked in other informal work, and 5% worked in
export-based garment industries. Most female migrants lived in the British Dhaka 
zone and the post-British Dhaka zone. Those living in the Mughal Dhaka zone
tended to work in home-based informal activities. Garment industry workers tended
to have more education. Women in the informal sector did not receive cash income.
Just over 33% received income in kind, about 25% received a low income, and
another 25% received a moderate income. In 71% of cases, husbands or fathers
handled the money. 29% handled income on their own. Their own earnings went
mostly for survival needs. Over 70% changed jobs more than once. 44% were
satisfied with their work. Women were unhappy with low wages, tiring and hard
work, and long working hours.

PMID: 12291446 [PubMed - indexed for MEDLINE]


55. Urban Health Newsl. 1995 Sep;(26):20-4.

The Healthy Homes Programme Greater Johannesburg Healthy Cities Project.

Dada Y.

PIP: This article describes the strategies that were used to upgrade and maintain
hygiene and sanitation in an office building renovated for housing in
Johannesburg, South Africa. The strategies were based on surveys of this building
and a case study of a similar project in the Health Community Program in Buenos
Aires, Argentina. The project staff negotiated with the landlord about legal
liability, organized a tenants' committee, negotiated for a training program for 
transferring maintenance operations to the housing residents, developed effective
skills in negotiating among residents, and developed working groups to deal with 
problems. Over the prior year, environmental health organizations provided health
education to the residents of the building. The tenants' committee resolved to
address the waste removal problem by hiring two unemployed men for waste removal.
Tenants on each floor were assigned the responsibility of cleaning common public 
areas 1 day/week or face eviction. Tenants' proposed that vendors, who wandered
through the building selling alcohol and other items, should operate out of a
vacant ground floor space. A fair rental was determined in legal negotiations. A 
local engineering department was chosen to redesign the building at no cost. The 
Housing Department will train caretakers. The Department of Parks and Recreation 
will begin an urban gardening project. Residents volunteered to clean up a nearby
park and 20 inner city blocks on a monthly basis beginning in 1995. The Healthy
Homes Program expanded functions to include job creation, nutrition, and home
ownership.

PMID: 12178505 [PubMed - indexed for MEDLINE]


56. Alcohol Alcohol. 1995 Jan;30(1):71-86.

Dangerous jobs and heavy alcohol use in two national probability samples.

Leigh JP.

Department of Economics, San Jose State University, CA 95192-0114, USA.

Samples of employed persons within the US were drawn from the National Health and
Nutrition Examination Survey II (n = 8477), and the Quality of Employment Survey 
(n = 1393) to test the hypothesis that a positive association existed between
alcohol use and job hazards. Heavy total alcohol use, or beer or wine or liquor
use separately, were the dependent variables. The key independent variables
included subjects' evaluations of hazardous nature of the job and fatality rates 
within occupations and industries. Models were estimated with logistic
regressions controlling for age, gender, race and other covariates. Only one
robust finding emerged: heavy beer use was found to be positively and strongly
correlated with the fatality rate within occupations. Additional correlations
between job hazards and heavy alcohol use were weak, generated large P values,
and some suggested an inverse association. The lack of robust findings for the
additional correlations may partially be explained by the associations between
job categories on the one hand and choice of beverage on the other. Blue-collar
jobs are more hazardous than white-collar jobs, on average. Persons in
blue-collar jobs were more likely to drink beer, while those in white-collar jobs
were more likely to drink wine or liquor (spirits). Separate analyses of beer,
wine and liquor appeared essential to explaining correlations between dangerous
jobs and heavy alcohol use in these data. Limitations of the study included (1)
age of the data (from the 1970s). (2) alcohol use and some job hazards were
measured by self-report, and (3) data were from only one country.

PMID: 7748279 [PubMed - indexed for MEDLINE]


57. J Am Diet Assoc. 1994 Dec;94(12):1381-4.

A survey of management tasks completed by clinical dietitians in the practice
setting.

Digh EW, Dowdy RP.

Department of Foods and Human Nutrition, University of Missouri, Columbia 65211.

OBJECTIVE: To investigate clinical dietitians' involvement in completing
management tasks in a practice setting. DESIGN: A random sample of 1,599
self-designated clinical dietitians was selected to receive the survey. The
survey instrument consisted of 54 management tasks divided into four management
categories: personnel, materials, financial, and organizations. For each task,
the respondent was to indicate frequency of task completion and setting that
contributed the most in providing competency for task completion. STATISTICAL
ANALYSIS: A 38% response rate was achieved and 526 surveys were submitted for
data analysis. Responses for number of respondents completing each task,
frequency of task completion, and training setting were generated for position
title, number of years as a registered dietitian, number of employees supervised,
and size of hospital. chi 2 Analysis was used to determine degree of association 
among variables. RESULTS: Every task listed on the survey was completed by at
least some of the respondents. Financial management tasks had the lowest
incidence of response. Clinical dietitians were found to be assuming management
responsibilities to varying degrees in the practice setting; 50% or more of the
respondents performed tasks in the personnel area. The position title of the
dietitian influenced which tasks were completed in the practice setting but was
independent of frequency of task completion. Work experience was the setting that
contributed the most to attaining skills needed for task completion. CONCLUSIONS:
Management is a viable component of clinical dietitians' responsibility.
Knowledge of activities and requirements of the workplace is essential if
dietitians are to be competitive in the professional job market. With the current
drive for cost-effective, quality patient care, clinical dietitians will be
expected to have competent management skills.

PMID: 7963187 [PubMed - indexed for MEDLINE]


58. J Am Diet Assoc. 1993 Aug;93(8):920-2.

Market research to recruit graduate students in dietetics.

Rhoades PK, Franz M.

College of Human Ecology, Louisiana Tech University, Ruston 71272.

In this study we conducted market research to develop a recruitment plan for the 
master's degree program in nutrition and dietetics at Louisiana Tech University. 
When individualized experience routes to dietetics registration were eliminated
by The American Dietetic Association's Standards of Education in 1988, graduate
student enrollment could not be predicted. The steps of the Baron graduate
recruitment model were followed to develop and implement a recruitment plan for
the master's degree program in nutrition and dietetics. The steps included (a)
assessment, (b) developing recruitment and enrollment objectives, (c) developing 
a recruitment plan and recruitment strategies to meet the objectives, (d)
implementing a recruitment program, and (e) monitoring and evaluating the
recruitment program. The assessment step involved institutional, student,
competitive, and job market analyses. Written questionnaires, telephone surveys, 
and focus group interviews completed the student analysis. Of the 92 respondents 
surveyed, 42 were interested in taking graduate classes. Career advancement,
specialization, and personal growth were cited as reasons to pursue graduate
study. The Baron model provided a useful guide for developing and implementing
the graduate recruitment plan.

PMID: 8335877 [PubMed - indexed for MEDLINE]


59. Int J Sport Nutr. 1993 Jun;3(2):232-42.

Practices and recommendations of sports nutritionists.

Grandjean AC.

International Center for Sports Nutrition, Omaha, NE 68105-1065.

A three-part questionnaire was used to identify professionals in sports nutrition
and survey their recommendations on various aspects of sports nutrition. The
majority of respondents were women. Over half of the sample reported working in
sports nutrition for 6 years or less, and 72% indicated that 40% or less of their
job is dedicated to sports nutrition. A portion of the questionnaire assessed the
subjects' opinions on various sports nutrition topics. Statements on water and
electrolytes generated the most agreement while statements on protein generated
the least agreement. There was a positive correlation (p < 0.004) between level
of education and whether or not the respondents recommended glycogen loading, and
a positive correlation (p < 0.008) between the subjects' use of dietary
supplements and the fact that they recommended supplements to the athletes they
counseled. The majority of professionals in this study worked with recreational
athletes and were more concerned about encouraging a healthy diet than improving 
athletic performance.

PMID: 8508199 [PubMed - indexed for MEDLINE]


60. Am J Health Promot. 1992 Jul-Aug;6(6):443-50, 464.

Employee advisory boards as a vehicle for organizing worksite health promotion
programs.

Sorensen G, Hsieh J, Hunt MK, Morris DH, Harris DR, Fitzgerald G.

Harvard School of Public Health, Boston, Massachusetts.

PURPOSE. The purpose of this article is to describe the "employee advisory board 
model" applied in the Treatwell program, a worksite nutrition intervention
program. DESIGN. The employee advisory boards of five of the seven intervention
worksites participating in the Treatwell program were surveyed. Results were
compared with results of employee surveys conducted in these five worksites.
SETTING. The five worksites included in this study are among 16 participating
worksites from Massachusetts and Rhode Island. SUBJECTS. Of the 95 board members 
represented in the five worksites, 88% responded to the survey. This article also
presents results from the 698 respondents of the five intervention worksites
where the board surveys were conducted. INTERVENTION. The boards in each worksite
participated in planning, promoting, and implementing this program in each
worksite. MEASURES. Respondents to the board survey were asked about their
participation on and satisfaction with the board and factors they thought
contributed to its effectiveness. A survey of all employees included information 
on demographics and program participation. RESULTS. Board members reported that
they were highly satisfied with the board's functioning. Board member hours spent
on Treatwell activities were directly related to the proportion of employees
aware of the program. (r = .82). The boards' effectiveness was limited by
conflicting priorities between the job and board responsibilities. CONCLUSION.
The employee advisory board model provides promise for increasing worker
awareness of worksite health promotion programs through enhanced worker
ownership.

PMID: 10148721 [PubMed - indexed for MEDLINE]


61. Med J Malaysia. 1992 Jun;47(2):134-8.

A survey of breast feeding practices in infants seen in general practice.

Chia SF.

This is a study of infant feeding practices of 126 mothers. Seventy-seven mothers
or 61.1% practised breast feeding. The typical breast feeding mother was more
likely to be a Malay, with lower family income and residing in the rural area.
The educational status of the mother was not an important factor in influencing
her to breast feed. Health education on breast feeding should be intensified in
schools to reinforce the implementation of the Malaysian Code of Ethics for
Infant Formula Products.

PIP: During December 1990, in Malaysia, 126 mothers accompanying a child between 
the ages of 6 months and 2 years were interviewed; only 77 (61.1%) mothers
practiced breast feeding. The breast-feeding mother was likely to be a Malay
(84.2%), from a rural area (70.7%), and with lower family income (72.7%). She was
likely to breast feed for 3 months (75.3%). By the age of 7 months, only 18.3% of
infants were still breast fed, and 81.7% of infants received some form of nonmilk
feeding. 61.8% of mothers with primary or less education breast fed, while 61.1% 
mothers with secondary or higher education did so. 58.8% of working mothers
breast fed compared with 65,1% of housewives. Of the 106 mothers who breast fed
partially or not at all, 49 complained of poor lactation for resorting to
artificial feeding. Nonmilk feeding was introduced early in 44 cases while breast
feeding. 14 out of 20 mothers who gave inconvenience as the reason for artificial
feeding were working mothers and did not breast feed at all. 16 gave no reasons
for not breast feeding. Of the 21 mothers who complained of illness, 7 were sick 
while breast feeding, whereas the rest complained of weakness for not breast
feeding at all. More than 10 years after the introduction of the Malaysian Code
of Ethics for Infant Formula Products, the 61.1% rate of breast feeding is not
encouraging. The apparent lack of impact of the Code of Ethnics on the breast
feeding practices may be because the Code has no legal backing for enforcement.
It is restricted to expectant mothers only with regard to the distribution of
samples, while providing infant formula samples to health professionals is
allowed. In addition to adequate information on breast feeding, the way society
views a woman's role as a mother ought to be changed. Incentives should be given 
to working mothers, e.g., flexi-time, job-sharing, and more home-based work. Time
is not on the side of breast feeding. As Malaysia becomes more developed,
urbanized, and the income level of the population rises, artificial feeding will 
increase.

PMID: 1494334 [PubMed - indexed for MEDLINE]


62. Bull World Health Organ. 1992;70(5):657-66.

Nutritional status of Brazilian children: trends from 1975 to 1989.

Monteiro CA, Benicio MH, Iunes R, Gouveia NC, Taddei JA, Cardoso MA.

Department of Nutrition, School of Public Health, University of São Paulo,
Brazil.

The prevalence of malnutrition among under-5-year-olds in Brazil fell by more
than 60% between 1975 and 1989. The benefits were smaller for population strata
that were more affected by malnutrition in the 1970s, i.e., children from the
North and North-east regions and those from poor families in general. Regional
and socioeconomic differentials in the prevalence of malnutrition therefore
increased between 1975 and 1989. Trends in family income indicate extraordinary
economic gains in the 1970s, some losses in the 1980s, and a modest net gain over
the period 1975-89. The availability of sanitation, health, and education
services, and the provision of preschool supplementary feeding programmes
increased markedly in the 1970s and 1980s. Demographic trends were also positive,
reducing the demand for services and programmes, increasing the economic
efficiency of families, and concentrating the population in urban areas, where
incomes, job opportunities, and social and material infrastructures are better.
The observed nutritional improvement was therefore probably due to a moderate
increase in family income associated with a substantial expansion in the
provision of services and programmes, both of which were facilitated by
favourable demographic trends. Also, the nutritional improvement was probably
concentrated during the 1970s, while little, if any, occurred after 1980;
prospects for the 1990s point to a stagnant situation. This is a reason for great
concern particularly in the North and North-east regions of the country, where
high rates of child malnutrition are still found.

PIP: Nutritionists used 2 surveys (1975 and 1989) to determine the trends in the 
nutritional status of children 5 years old in Brazil. Malnutrition rates fell by 
61.4% between 1975 and 1989 (18.4% vs. 7.1%). Improvements in child nutrition
occurred countrywide, but they were less in the North and the Northeast (56.7%
and 52.6% respectively) than in the other regions (69.2%-78.6%). In fact, the gap
between these regions and the other regions was wider in 1989 than it was in 1975
(e.g., prevalence ratio between the Northeast and the South, 2.5 in 1975 and 5 in
1989). In the Southeast and the South, nutrition improvement occurred basically
equally for rural and urban children, but the percentage of rural malnourished
children was still higher than it was for urban malnourished children (6.2% vs.
3.7% and 3% vs. 2.1% respectively). In the Northeast, rural children suffered
more relative excess malnutrition in 1989 than they did in 1975. A sizable
reduction in childhood malnutrition prevalence rates occurred in all 4 income
groups, but the poorest children benefited the least (55.6% vs. 77% for the
richest group). Since children most affected by malnutrition in the 1970s (i.e., 
children from the North and Northeast and the poor) gained the least, regional
and socioeconomic differences in the prevalence of malnutrition expanded between 
1975 and 1989. Modest increases in income linked to considerable expansion of
sanitation, health, and education services and of preschool supplementary feeding
programs were most likely responsible for nutritional improvement. In addition,
fertility rates fell (5.8-3) during this period. Improvement was largely
restricted to the 1970s, however. After 1980, little or no improvement occurred. 
Little hope for economic recovery, continued economic inequalities, and reduced
spending on social programs indicated a stagnant situation for the 1990s.

PMCID: PMC2393369
PMID: 1464153 [PubMed - indexed for MEDLINE]


63. Women Health. 1992;19(4):31-54.

Diet and activity patterns of male and female co-workers: should worksite health 
promotion programs assume homogeneity?

Teufel NI.

Department of Family and Community Medicine, University of Arizona, Tucson 85719.

Worksite health promotion programs address the health education needs of the
average employee. Anthropometric measurements and 24h diet and activity diaries
collected from co-workers reveal that lifestyle and subsequently, health
education needs of men and women working for the same employer, in the same
environment and performing similar tasks, may be different. In this study, males 
were marginally overweight and obese; females were within recommended limits.
Although job related workloads were comparable, females were more active
(24hEE/FFM) outside the work place. Females spent more time engaged in moderate
weight-bearing domestic activities than did males. These results question the
effectiveness of worksite health promotion program which ignore the different
health education needs of male and female employees.

PMID: 1295267 [PubMed - indexed for MEDLINE]


64. Child Dev. 1991 Oct;62(5):954-65.

Maternal work and child-care strategies in peri-urban Guatemala: nutritional
effects.

Engle PL.

California Polytechnic State University, San Luis Obispo.

Associations of 293 mothers' work for earnings and child-care arrangements with
the anthropometric status of their children were examined in urban Guatemala. It 
was hypothesized that during the period of life in which growth often falters (8 
through 35 months), maternal employment could be beneficial for children.
Informal workers tended to be poorer, less educated, and have more undernourished
children than formal workers or nonworkers. When poverty and mother's education
were controlled for, no effects of maternal employment on children's
anthropometric growth patterns were seen. However, the percent of the family
income the mother earned was positively associated with all anthropometric
indicators, controlling for confounds. Children taken care of by preteen siblings
had significantly lower weight for height than those in other situations, even
controlling for SES and maternal employment status. These effects were not found 
in a 36-48-month-old sample.

PIP: A child development researchers analyzed data on 239 8-35 month old children
living in 2 villages 20 km from Guatemala City, Guatemala to determine the
effects of maternal work and child care arrangements on children's nutritional
status. Women who worked flexible hours and had no defined job skills (informal
workers) were more likely to be poor (p.01), less educated (p.0001), and have
undernourished children (p.02 for height for age and p.01 for weight for age)
than those women who either owned a business, had a trade, or worked in a store
or factory (formal workers). Yet informal work was statistically related to those
socioeconomic factors than jeopardize adequate growth of children. When the
researcher controlled for poverty and maternal education, mother's work did not
affect growth, however. This suggested that mother's work may have a positive
effect on growth because if mothers did not work, the children may have actually 
experienced even poorer nutritional status. The data showed the arduous
circumstances informal workers encounter, their poverty, and inadequate income
for their labor. The children of full-time workers had a somewhat better weight
for height status than nonworkers. Percent of family income earned by the mother 
had a significant effect on all anthropometric indicators (p.01 for height for
age and weight for age; p.05 for weight for height). In both the 1-way analysis
of variance and the same analysis controlling for socioeconomic status and
mother's work, children cared for by a 13-year old sibling had a considerably
lower weight for height than those cared for by nonworking mothers (p.008 and
p.01 respectively). None of the effects existed in the 36-48 month old children
in these villages.

PMID: 1756668 [PubMed - indexed for MEDLINE]


65. J Am Diet Assoc. 1991 Aug;91(8):962-5.

Development and testing of a carbohydrate monitoring tool for athletes.

Moses K, Manore MM.

Department of Family Resources and Human Development, Arizona State University,
Tempe 85287-2502.

Improving carbohydrate intake in athletes will increase muscle glycogen storage. 
This in turn can improve exercise time and performance by delaying fatigue.
However, planning and consuming a diet that contains 60% to 70% carbohydrate is
difficult for most athletes. To develop a simple carbohydrate monitoring tool for
athletes, we analyzed three sets of 3-day diet records from 17 male endurance
runners over a 10-week competitive period and 9 female endurance runners over a
9-week training period. We then developed a simple carbohydrate monitoring tool. 
To validate the instrument, we compared each athlete's carbohydrate intake as
estimated using the instrument with the athlete's actual carbohydrate intake from
the 3-day diet records. Mean estimated percents of energy from carbohydrate using
the carbohydrate monitoring tool were not significantly different from the actual
mean carbohydrate intakes. Examination of individual diets showed that the
estimated carbohydrate was always within 2% of the actual carbohydrate.
Therefore, the instrument did a good job of estimating the percent of energy from
carbohydrate in the diets of endurance runners. This instrument will provide a
quick method by which the athlete can assess and improve carbohydrate intake on a
daily basis without the use of daily diet records.

PMID: 1894906 [PubMed - indexed for MEDLINE]


66. Indian Pediatr. 1991 Aug;28(8):895-9.

Assessment of knowledge and skills about growth monitoring amongst multipurpose
workers in an ICDS project.

Kapil U, Sood AK, Gaur DR, Bhasin S.

Nutrition Unit, All India Institute of Medical Sciences, New Delhi.

Knowledge and skills amongst 34 multipurpose workers working in an ICDS project
about growth monitoring was assessed using interview technique. All workers had
correct knowledge about rationale of growth monitoring. A total of 73.5% and
94.1% had knowledge that flattened growth curve indicates no weight gain and
descending growth indicates decrease in weight, respectively.

PIP: Researchers interviewed 34 multipurpose workers (MPWs) from a rural
Integrated Child Development Services (ICDS) block of District Rohtak in Haryana 
State, India to examine their knowledge and skills concerning growth monitoring
(GM) and to identify knowledge gaps so ICDS can design an active on-the-job
training in GM. MPWs received 18 months of training before working for ICDS. Most
of the MPWs (70%) had worked in this ICDS area for 10 years. All MPWs knew that a
rising growth curve means improved nutritional status, the direction of the curve
allows early detection of growth retardation, and a flattened growth curve after 
a bout of measles means growth stagnation due to infection. Many MPWs were aware 
that an ascending growth curve indicates a healthy child (76.5%), a flattening of
the growth curve indicates the child is not gaining weight (73.5%), and a falling
curve indicates a reduced nutritional status (94.1%). All MPWs agreed that the
best method to monitor growth is serial periodic weighing of children. Yet only
29.4% knew that health workers should weigh children =or3 years old every 3
months. Further most MPWs were familiar with 2.5kg being the cut-off point for
low birth weight (82.3%), with 15kg the optimum weight of a 1 year old (76.5%),
and with 20kg the optimum weight of a 3 year old (70.6%). All MPWs agreed to
teach mothers how to interpret the growth curve and that mothers should take
active part in weighing and plotting of weight on growth chart. These results
indicated high MPW knowledge about anthropometry in determining nutritional
status. This may have occurred because they underwent intense, repeated, and
action oriented inservice training on a regular basis. These results indicated
that inservice training on GM should emphasize GM's importance as a tool to
detect early growth retardation and to intervene early to prevent continual
growth retardation.

PMID: 1808077 [PubMed - indexed for MEDLINE]


67. J Hypertens. 1990 Jul;8(7):679-85.

The effect of work environments on blood pressure: evidence from seven New York
organizations.

Schlussel YR, Schnall PL, Zimbler M, Warren K, Pickering TG.

Cardiovascular Center, New York Hospital-Cornell University Medical Center, NY
10021.

The prevalence of hypertension defined according to National Health and Nutrition
Examination Survey II (NHANES II) criteria (140/90 mmHg and/or taking
antihypertensive medication) was analyzed cross-sectionally at seven worksites in
New York City (n = 4274; 2616 men and 1648 women), in order to assess whether
exposure to different work environments and occupations contributes to blood
pressure variation. The prevalence of hypertension across worksites was 26% among
men and 12% among women. Blood pressure was significantly different across
worksites even after controlling for known risk factors using analysis of
covariance. Of the variation in systolic pressure, 34% was predicted
significantly by eight variables; after adjusting for upper-arm circumference,
age and body mass index, higher pressures were associated with worksite
differences (9.0 mmHg), being male (7.2 mmHg), lacking a high-school education
(4.3 mmHg), having a clerical occupation (2.9 mmHg) and being unmarried (1.8
mmHg). Similar results for diastolic pressure suggest that researchers should
consider worksite and job characteristics as important predictors of blood
pressure differences in working populations.

PMID: 2168459 [PubMed - indexed for MEDLINE]


68. Am J Epidemiol. 1989 Mar;129(3):483-94.

The relation of psychosocial dimensions of work with coronary heart disease risk 
factors: a meta-analysis of five United States data bases.

Pieper C, LaCroix AZ, Karasek RA.

Div. of Biostatistics, Columbia U. School of Public Health, New York, NY 10032.

The relation of job psychologic demands and decision latitude to four coronary
heart disease risk factors (cholesterol, smoking, and systolic and diastolic
blood pressures) was tested among 12,555 men in five investigations conducted in 
the United States during the period 1959-1980 (National Health and Nutrition
Examination Surveys I and II, National Health Examination Survey, Western
Collaborative Group Study, and Exercise Heart Survey). Using an imputation
strategy, the authors attached measures of the two job characteristics above to
persons in each data base by occupation. In 19 possible tests, decision latitude 
was related (p less than 0.05) to cholesterol and smoking in two instances in the
predicted direction in the Exercise Heart Survey, when controlling for Type I
error rate. Psychologic demands were not related to any of the risk factors. When
a meta-analysis was performed across data bases, all relations were in the
predicted direction except for the relation of psychologic demands to systolic
pressure, and two of these were statistically significant (p less than 0.05): the
relation of job decision latitude to smoking and to systolic pressure. The
interaction of psychologic demands and decision latitude was not related to any
of the risk factors when two common forms of an interaction were tested. These
results indicate that psychosocial aspects of work, in particular the decision
latitude of the job, may be related to some cardiovascular risk factors.

PMID: 2916541 [PubMed - indexed for MEDLINE]


69. Am J Public Health. 1988 Aug;78(8):910-8.

Job characteristics in relation to the prevalence of myocardial infarction in the
US Health Examination Survey (HES) and the Health and Nutrition Examination
Survey (HANES).

Karasek RA, Theorell T, Schwartz JE, Schnall PL, Pieper CF, Michela JL.

Department of Industrial and Systems Engineering, University of Southern
California, Los Angeles 90089-0193.

Associations between psychosocial job characteristics and past myocardial
infarction (MI) prevalence for employed males were tested with the Health
Examination Survey (HES) 1960-61, N = 2,409, and the Health and Nutrition
Examination Survey (HANES) 1971-75, N = 2,424. A new estimation method is used
which imputes to census occupation codes, job characteristic information from
national surveys of job characteristics (US Department of Labor, Quality of
Employment Surveys). Controlling for age, we find that employed males with jobs
which are simultaneously low in decision latitude and high in psychological work 
load (a multiplicative product term isolating 20 per cent of the population) have
a higher prevalence of myocardial infarction in both data bases. In a logistic
regression analysis, using job measures adjusted for demographic factors and
controlling for age, race, education, systolic blood pressure, serum cholesterol,
smoking (HANES only), and physical exertion, we find a low decision latitude/high
psychological demand multiplicative product term associated with MI in both data 
bases. Additional multiple logistic regressions show that low decision latitude
is associated with increased prevalence of MI in both the HES and the HANES.
Psychological workload and physical exertion are significant only in the HANES.

PMCID: PMC1349850
PMID: 3389427 [PubMed - indexed for MEDLINE]


70. World Health Forum. 1988;9(4):612-4.

Better education for better health care.

Mohapatra B, Ramadasmurthy V, Ramnath T, Mohanram M.

PIP: In India, all national nutrition programs and activities are carried out by 
staff at the primary health centers under the leadership of medical officers. A
study of 114 of these officers from 80 primary health centers in rural districts 
of Andhra Pradesh State was undertaken to assess their knowledge and performance,
particularly with regard to nutrition and related matters. Scores were expressed 
in percentages, with under 50% considered poor, 50-75% satisfactory, and over 75%
good. The highest score 67.7% was obtained on knowledge of nutrition and related 
areas, and the lowest, 19.7% was for the participant's awareness of their own job
responsibilities. Although overall theoretical knowledge on nutrition and related
matters was satisfactory, significant gaps existed. A majority were ignorant as
to how many people were covered by their centers and the numbers of staff in
different categories, suggesting little attention was being given to planning and
implementation of various services. Only 23% were aware of their own
responsibilities regarding nutrition, and only 16% mentioned teaching nutrition
during their training programs. The conclusion is that the medical education
system must be better coordinated with the health care delivery infrastructure.
Medical undergraduates need more exposure to Practical aspects of health care in 
rural communities, managerial aspects of work in primary health centers, and
programs with a stronger nutrition component. In addition, refresher courses must
be offered, and the problem of overburdening the medical officers must be dealt
with.

PMID: 3252872 [PubMed - indexed for MEDLINE]


71. Am J Public Health. 1984 Feb;74(2):147-9.

Health promotion for educators: impact on health behaviors, satisfaction, and
general well-being.

Blair SN, Collingwood TR, Reynolds R, Smith M, Hagan RD, Sterling CL.

A random sample of 117 teachers in three treatment schools and one control school
participated in a health survey at the beginning and end of the spring semester. 
Teachers in the treatment schools participated in a 10-week health promotion
program which emphasized exercise, stress management, and nutrition. Comparison
of pre- and post-survey data indicated that teachers in the treatment schools
increased their participation in vigorous exercise, improved their physical
fitness, lost weight, lowered their blood pressure, reported a higher level of
general well-being, and were better able to handle job stress.

PMCID: PMC1651402
PMID: 6691526 [PubMed - indexed for MEDLINE]


72. Psychother Psychosom. 1984;41(4):200-6.

Psychosocial stress and its relation to obstetrical complications.

Georgas J, Giakoumaki E, Georgoulias N, Koumandakis E, Kaskarelis D.

A Greek adaptation of the Schedule of Recent Experience of Holmes and Rahe was
employed to study the relationship of psychosocial stress to symptoms during
pregnancy, obstetric complications, family planning and breast feeding. An
initial experiment with 130 pregnant women in the third trimester indicated that 
psychosocial stress was not related to education, whether they were from Athens
or the provinces, nor age. The second experiment with 103 mothers 3 or 4 days
after delivery indicated that high psychosocial stress is related to increased
symptom scores during pregnancy and to obstetric complications. Symptoms were not
related to obstetric complications, nor were family planning nor breast feeding. 
Psychosocial stress was also related to family planning and also to whether or
not the mother breast fed.

PIP: The relationship between psychosocial stress, the occurrence of various
symptoms during pregnancy, the occurrence of obstetric complications, family
planning, and breast feeding intentions was assessed for 103 maternity patients
at the Alexandra Maternity Hospital in Athens, Greece. A modified version of the 
Holmes and Rake Schedule of Recent Experience was used to measure the level of
psychosocial stress. The modified instrument consisted of 48 stressogenic life
events. Respondents were asked to identify the events they had experienced, to
rate the level of stress induced by the event on a 0-100 scale, and to specify if
the event occurred 0-6 months, 7-12 months, or 13-25 months prior to delivery.
Respondents were also presented with a list of symptoms and asked to identify
those they experienced during pregnancy, to rate the severity of the symptoms,
and to identify the trimester in which they occurred. Subjective psychosocial
stress scores and symptom scores were then calculated for each respondent. A
gynecologist reviewed the delivery records of each woman and classified the
delivery in respect to obstetric complications as either normal or abnormal.
Respondents were also asked if the birth was the result of an unplanned or
planned pregnancy and if they intended to breast feed their infant.
Questionnaires were administered 3-4 days following delivery. Pearson
product-moment correlation, analysis of variance, and chi-square techniques were 
used to analyze the data. The level of psychosocial stress experienced during the
6-month period prior to delivery was positively associated with the occurrence of
obstetric complications; however, the level of stress experienced more than 6
months prior to delivery was not. The most common stressogenic events reported by
women who had obstetric complications were 1) high anxiety about the health
status of the fetus, 2) death of a loved one, 3) arguments with parents or
spouse, 4) a sharp decline in income, and 5) job-related problems of spouse. The 
level of psychosocial stress was also positively related to occurrence of
symptoms during pregnancy, and 25% of the variation in symptom scores was
explained by differences in psychosocial stress levels. Symptom scores increased 
with each trimester of pregnancy, but were not associated with the occurrence of 
obstetric complications. Women who planned their pregnancies, in contrast to
those who did not, had significantly lower psychosocial stress and symptom
scores; however, the occurrence of obstetric complications was not significantly 
related to either planned or unplanned pregnancy. Similarly, women who intended
to breast feed, compared with those who did not, had significantly lower
psychoosocial stress and symptom scores, but breast feeding intention was not
significantly related to the occurrence of obstetric complications. Women who
planned to breast feed and women who planned their pregnancy tended to be younger
than women who did not plan to breast feed and women who did not plan their
pregnancy.

PMID: 6463187 [PubMed - indexed for MEDLINE]


73. Int J Nurs Stud. 1983;20(2):63-74.

Infant feeding practices among clinical nursing staff in urban Papua New Guinea.

Marshall LB.

PIP: To determine the personal attitudes of urban public nursing staff toward
infant feeding practices, 97 nurses and aides who were mothers and also full-time
staff at public health care facilities in Port Moresby were interviewed in 1981. 
In 1977, Papua New Guinea passed legislation making infant feeding bottles and
teats available only through prescription by an authorized health professional.
This legislation was supplemented by an educational campaign advocating
breastfeeding. The nursing staff is important to this campaign, since those
charged with administrative duties can prescribe bottles; moreover, as a result
of their close contact with patients, nursing staff influence mothers' attitudes 
toward infant feeding. The nurses and aides interviewed ranged in age from 21-50 
years; 75 had at least 1 child under age 5. Each child was classified as
breastfed, mixed-fed (use of supplementary bottle 1 or more times a week), or
bottlefed. 185 (71%) of the 260 babies included in the study were exclusively
breastfed, while 72 (28%) received milk from both breast and bottle. No
significant difference in feeding practices occurred after the 1977 legislation. 
Attitudes were strongly in favor of breastfeeding, with bottle feeding considered
appropriate only under highly specific conditions. There was a significant
difference (p0.001) between children of mothers who returned to work within the
1st 6 months postpartum and those of mothers who returned later in the proportion
that were bottlefed at least occasionally. More detailed information was elicited
on the mothers' youngest child. The mean age of weaning from the breast among the
44 youngest children who were under age 5 1/2 at the time of the interview was 21
months. The mean age for bottle introduction and bottle termination was 2 months 
and 12 months, respectively. 67 (80%) of mothers in this group returned to work
within the 1st 3 months postpartum; however, 41 continued to exclusively
breastfeed. This was possible because a creche was provided at the job, or the
place of work was close enough for the childminder to bring the infant to the
mother for feeding at the 2 1/2 hour breaks provided to all wage-employed
mothers. This survey suggests that promotion of breastfeeding must be
complemented by the provision of adequate opportunities in the work place for
infant feeding.

PMID: 6553569 [PubMed - indexed for MEDLINE]