Analysis of salt content in meals in kindergarten facilities in Novi Sad.

INTRODUCTION: Investigations have brought evidence that salt intake is positively related to systolic blood pressure and that children with higher blood pressure are more susceptible to hypertension in adulthood. In developed countries the main source of salt is processed food. OBJECTIVE: The aim of this paper was to determine total sodium chloride (NaCl) in average daily meal (breakfast, snack and dinner) and in each of three meals children receive in kindergarten. METHODS: From kindergarten, in the meal time, 88 samples of daily meals (breakfast, snacks and dinner) offered to children aged 4-6 years were taken. Standardized laboratory methods were applied to determine proteins, fats, ash and water in order to calculate energy value of meal. The titrimetric method with AgNO3, and K2CrO4 as indicator, was applied in order to determine chloride ion. Content of NaCl was calculated as %NaCl = mlAgNO3 x 0.05844 x 5 x 100/g tested portion. NaCl content in total daily meal and each meal and in 100 kcal of each meal was calculated using descriptive statistical method. Student's t-test was applied to determine statistical differences of NaCl amount among meals. RESULTS: NaCl content in average daily meal was 5.2 +/- 1.7 g (CV 31.7%), in breakfast 1.5 +/- 0.6 g (CV 37.5%), in dinner 3.5 +/- 1.6 g (CV 46.1%) and in snack 0.3 +/- 0.4 g (CV 163.3%). NaCl content per 100 kcal of breakfast was 0.4 +/- 0.1 g (CV 29.5%), dinner 0.7 +/- 0.2 g (CV 27.8%) and snack 0.13 +/- 0.19 g (CV 145.8%). The difference of NaCl content among meals was statistically significant (p < 0.01). CONCLUSION: Children in kindergarten, through three meals, received NaCl in a quantity that exceeded internationally established population nutrient goal for daily salt intake. The main source of NaCl was dinner, a meal that is cooked at place.

How a routine checking of Escherichia coli in retailed food of animal origin can protect consumers against exposition to Campylobacter spp. and Listeria monocytogenes?

BACKGROUND/AIM: According to the literature that has been published over the last two decades Campylobacter spp i Listeria monocitogens can be identified as causes of numerous diseases derived by consuming food of animal origin. The purpose of this paper was to find out how established national microbiological criteria of the Republic of Serbia on food safety in retailed food of animal origin could contribute to consumer's protection against exposition to foodborne pathogens such as Campylobacter spp. and Listeria monocytogenes. METHODS: During a routine microbiological safety control of randomly selected 60 samples of fresh poultry meat, 30 samples of other fresh meat readymade for grilling, 30 samples of sausage products, 37 samples of heat-treated meat, 39 samples of toppings for fast food of animal origin and 31 samples of dairy products a national food safety criteria (Escherichia coli, aerobic plate count, Salmonella spp., coagulasa positive Staphylococcus, Proteus spp., sulphito-reducting Clostridia) were applied and, as well as, testing to Campylobacter spp. and Listeria monocitogens. In determination of Campylobacter spp. and Listeria monocytogenes, food quality control methods of the Food and Agriculture Organization (FAO) were applied, while in determination of the other above motioned bacteria, national provisions on microbiological methods were applied who are adjusted to the FAO ones. RESULTS: Related to the national criteria on microbiological food safety, 88 (38.8%) samples, out of the total 227 tested, were rejected. When to these results, the results of laboratory tests on Listeria monocytogens were added, a terminal number of rejected samples were not changed. When to these results, the results of Campylobacter spp. testing were added, 91 (40.1%) out of the 227 samples were unsatisfied. Results of logistic regression model with occurrence of Escherichia coli as dependent variable indicated that Escherichia coli was 4.5 times likely to occur among samples with Campylobacter spp. than among samples without Campylobacter spp. (OR = 4.515, 95% CI: 1.019-20.002). Sensitivity of the fitted model (Hosmer-Lemeshowp = 0.268) was 76.8% and its specificity was 75.0%. At the same time Escherichia coli was confound in all (100%) food samples that were contaminated by Listeria monocytogenes. CONCLUSION: Statistical analysis indicated that Escherichia coli was completely sensitive to identify all samples contaminated with Listeria monocytogenas and highly sensitive to identify samples contaminated with Campylobacter spp. Nevertheless, 3 (1.3%) of the tested samples were not covered with Escherichia coli.

Patients' falls and injuries during hospitalization as quality indicators of work in hospitals.

The number of patients' falls and injuries happening during their hospital treatment is a good quality indicator of safety of in-patients. A fall is of multifactorial etiology, and its causes are usually classified into intrinsic and extrinsic factors. According to Jenise Morse there are three categories of falls among inpatients: accidental, non-anticipated physiologic and anticipated physiologic fall. Fall induced injuries in clinical and hospital settings are mostly categorized into five groups: no injury, minor injury, moderate injury, severe injury and lethal injury. The number of in-patient falls can be reduced by implementing a prevention programme in order to improve the quality of the specific health care and health care in general. The key preventive strategies aimed at safe and efficient health care include: a regular assessment of the risk for falls using predictive scales, visual identification of patients at high risk for falls, communication with patients and education of patients, their family members and staff about fall prevention interventions.

Assessment of quality of care in acute postoperative pain management.

BACKGROUND/AIM: Managing of acute postoperative pain should be of great interest for all hospital institutions, as one of the key components of patients satisfaction, which indicates quality, as well as the outcome of treatment. The aim of this study was to assess the quality of nursing care in managing acute postoperative pain and to establish factors which influence patients assessment of the same. METHOD: The investigation was conducted on the sample of 135 patients hospitalized in surgical clinics of the Clinical Centre of Vojvodina in Novi Sad in the form of cross-sectional study, by interviewing patients during the second postoperative day and collecting sociodemographic variables, type of surgical procedure and applied analgesic therapy which were taken from their medical documentation. The modified questionnaire of the Strategic and Clinical Quality Indicators in Postoperative Pain Management (SCQIPP) was used as the instrument of the investigation. The data were processed with suitable mathematical statistics methods such as multivariate analyses of variance (MANOVA), discriminative and other parametric procedures and methods. Roy's test, Pearson's coefficient contingency (X), multiple correlation coefficient (R) were conducted amongst other univariant procedures. RESULTS: The mean score for the individual items of SCQIPP questionnaire was between 2.0 and 4.7 (scale range 1-5) and the percentage of patients answers "strongly agree" ranged from 4.4 to 77%. The smallest number of positive answers were given by the patients for the item "In order to assess pain intensity, some of the staff asked me at least once in the morning, in the afternoon and in the evening to show the number from 0-10". Most of the patients (57%) evaluated severe pain during the previous 24 hours, as moderate pain, which represents significantly greater number of patients which complain of severe pain and mild pain (p < 0.001). The analysis of patients evaluation (MANOVA p < 0.05 and discriminative p < 0.05) indicates the existence of significant difference between the assessment of nursing care quality in managing acute postoperative pain as regards to clinics as the place for pain management, patient's sex and his expectations. Evaluation from "communication" subscale gives the greatest contribution (24.9%) to the difference between the observed clinics, and the greatest contribution (25.7%) to the difference in evaluation of nursing care quality as regards to patients' sex has the evaluations from "procedure" subscale. CONCLUSION: The results of this study show a useful evidence and identify aspects of nursing care in postoperative management of acute pain which are still to be improved. According to the patients' answers the priority should be given to a regular assessment of the intensity of postoperative pain and evaluation of the effects of analgesic therapy.

[Health of the population of Vojvodina].

POPULATION CHARACTERISTICS: The Province of Vojvodina is a region with 16% of population aged 65 and over, average age of 38.1 years, and aging index 0.85%. Vital statistics show low birth rate, increased death rate and as a result - a negative population growth. MORBIDITY AND MORTALITY: The leading causes of death were cardiovascular diseases, malignant diseases and injuries, accounting for more than 2/3 of all deaths. The most common outpatient morbidity of adult population included respiratory diseases, but cardiovascular diseases were of greater public health concern, accounting for more than 1/5 of the total morbidity. The hospital morbidity data showed that malignant diseases, cardiovascular diseases and gastrointestinal diseases were the most frequent. HEALTH PROFESSIONALS: In 2005, a highly-developed network included 77 health-care institutions with 29.659 employees, out of which 20.960 were health professionals (4.577 doctors, 754 dentists and 423 pharmacists).

[Epidemiology of obesity in adult population of Vojvodina].

INTRODUCTION: The prevalence of overweight and obesity is increasing worldwide at an alarming rate and is due to changes in nutritional patterns and physical activity that adversely affect the health status. Obesity is a complex disorder with multiple interactive causes. It is associated with many chronic, debilitating diseases with important health care cost and it is basically the consequence of sedantery life style and excessive energy intake. Our objective was to measure the prevalence of obesity in adult population of Vojvodina and to describe its characteristics. MATERIAL AND METHODS: This cross-sectional study was conducted in representative sample of 2467 adults from Vojvodina (in adult population of Vojvodina aged 20 years and over). The sample size was determined based on estimated frequency, exposition to risk factors, relative risks and level of statistical significance. All those who completed household interviews attended physical examination. RESULTS: The prevalence of overweight and obesity (BMI> or =25 kg/m2) in both sexes was 58.5%. Among them, 35.5% were overweight while 23% were obese (BMIl30kg/m2). The frequency of obesity was higher among females (26%) than among males (19.6%) (p<0.01). It showed a steady increase to the age of 65, after which the number of obese decreased. The obesity rate was higher in rural (26. 7%) than urban areas (19%) (p<0.01), and among people with lower level of education and socioeconomic status. CONCLUSION: Considering the existing situation concerning the high prevalence of obesity, urgent public action is necessary. It is essential to develop preventive strategies which would affect the whole society. Healthy lifestyle, balanced diet and increased physical activity must be promoted. However, it is not the responsibility of individuals. Health services, the community, food industry, mass media etc, have a crucial role in modifying body weight. Strategies for prevention and management of obesity should be in accordance with the existing public health policy and programs for prevention of noncommunicable diseases.

[Health behavior of school children without parental care]. / Zdravstveno ponasanje skolske dece bez roditeljskog staranja.

INTRODUCTION: Life style (behavior) is one of the most significant factors affecting health. Although a number of factors participate in creating behavior, family is one the most important. The goal was to analyze the life style of children without parental care. MATERIAL AND METHODS: The research was done using cross-sectional data from "Children village" in Sremska Kamenica (N=127), and a questionnaire was especially created for this purpose. RESULTS AND DISCUSSION: It was established that 75% of elementary school children and 43% of high school children are physically active. The greatest health risk is smoking (only 50% of students reported never to smoke cigarettes, while 17.5% were daily smokers). The problem is greatest in high school children (43% polled are daily smokers). Alcohol consumption is less common than in the general population of the same age (10% polled drink beer and wine several times a month, while 5% drink spirits--brandy, whisky etc.). Attitudes to sports, smoking and alcohol are mainly positive, but at older age there is an increased number of children with negative attitudes. Knowledge regarding healthy diet is on a lower level comparing with general population, meals are more regular, but with less desirable food. CONCLUSION: From the aspect of health, life style of children without parental care is characterized by risky behavior, particularly in high school children.