자연주의적 탐구조사(Naturalistic Inquiry)

Chronic obstructive pulmonary disease (COPD) remains a major public health problem. It is the fourth leading cause of chronic morbidity and mortality in the United States, and is projected to rank fifth in 2020 in burden of disease worldwide, according to a study published by the World Bank/World Health Organization. Yet, COPD remains relatively unknown or ignored by the public as well as public health and government officials. In 1998, in an effort to bring more attention to COPD, its management, and its prevention, a committed group of scientists encouraged the U.S. National Heart, Lung, and Blood Institute and the World Health Organization to form the Global Initiative for Chronic Obstructive Lung Disease (GOLD). Among the important objectives of GOLD are to increase awareness of COPD and to help the millions of people who suffer from this disease and die prematurely of it or its complications. The first step in the GOLD program was to prepare a consensus report, Global Strategy for the Diagnosis, Management, and Prevention of COPD, published in 2001. The present, newly revised document follows the same format as the original consensus report, but has been updated to reflect the many publications on COPD that have appeared. GOLD national leaders, a network of international experts, have initiated investigations of the causes and prevalence of COPD in their countries, and developed innovative approaches for the dissemination and implementation of COPD management guidelines. We appreciate the enormous amount of work the GOLD national leaders have done on behalf of their patients with COPD. Despite the achievements in the 5 years since the GOLD report was originally published, considerable additional work is ahead of us if we are to control this major public health problem. The GOLD initiative will continue to bring COPD to the attention of governments, public health officials, health care workers, and the general public, but a concerted effort by all involved in health care will be necessary.

https://www.who.int/respiratory/copd/GOLD_WR_06.pdf

Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease: GOLD executive summary.

https://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(12)62167-9.pdf

Frailty in elderly people

The adolescent brain and age-related behavioral manifestations

Statistical methods in cancer research

To investigate the association of dietary patterns with a 3-year incidence of depression among healthy older adults. Multiple logistic regression models adjusted for age, sex, marital status, smoking, education, total energy intake, physical activity, body mass index, hypertension, functional autonomy, cognitive functioning, social activities, and stressful life events. Energy and macronutrient intakes were also analyzed as potential predictors of depression. Cities of Montreal, Laval, and Sherbrooke in Quebec, CA. Community-dwelling older adults, free of depression at baseline (N=1,358, 67–84 y), followed for 3y in the Quebec Longitudinal Study on Nutrition and Aging (NuAge). Dietary patterns derived from principal components analysis of three 24 h-recalls at baseline, and depression incidence as measured by the 30-item Geriatric Depression Scale (≥11) and/or use of antidepressants at follow-up years. 170 people (63% women) became depressed over the 3 years. People in the highest tertile of adherence to the “varied diet” had lower risk of depression before adjustment (OR 0.58, 98% C.I. 0.38–0.86) but not significant once age and sex were controlled. No other dietary pattern was associated with the incidence of depression. The highest tertile of energy intake was associated with lower depression incidence after controlling for all confounders (OR 0.55, 95%CI 0.34–0.87). Among healthy older adults, dietary patterns do not appear to be related to depression. Those who eat less, however, possibly reflecting declining health, are at higher risk of becoming depressed.

Dietary patterns and incidence of depression in a cohort of community-dwelling older Canadians.

Background: Anemia is common among First Nation infants in Canada, often as a result of iron deficiency, which places them at risk for psychomotor impairment. Prevalence data are unavailable, and the risk factors are unknown. This study assessed the prevalence of anemia and associated risk factors among 9month-old Cree infants in northern Quebec. Methods: Between January 1995 and October 1998, 6 of 9 Cree villages in the James Bay region adopted a screening protocol for anemia in 9-month-old infants. Cross-sectional data were obtained from medical charts. The data for babies of very low birth weight and those with fever or infection were excluded. Among the 386 babies whose hemoglobin concentration was known, the type of milk consumed at the time of screening was known for 354. Associations between hemoglobin concentration and mean cell volume at 9 months, and milk type and weight gain since birth were analysed. Results: The mean hemoglobin concentration of the 386 infants was 114.1 (standard deviation [SD] 10.6) g/L. The prevalence of anemia was 31.9% (95% confidence interval [CI] 27.2%‐36.7%) with a hemoglobin cutoff value of 110 g/L, 17.6% (95% CI 13.9%‐21.7%) with a cutoff value of 105 g/L, and 7.8% (95% CI 5.3%‐10.9%) with a cutoff value of 100 g/L. Babies exclusively fed formula at 9 months had a higher mean hemoglobin concentration (118.5 [SD 9.9] g/L) than those exclusively fed breast milk (109.9 [SD 10.0] g/L), cow’s milk (112.5 [SD 10.1] g/L) or more than one type of milk (112.0 [SD 10.8] g/L) (p < 0.05). Compared with formula, the odds ratio (OR) for anemia was 7.9 (95% CI 3.4‐18.2) for breast milk, 5.0 (95% CI 2.0‐12.7) for cow’s milk and 5.2 (95% CI 1.9‐14.6) for mixed milks. Infants fed formula and those fed cow’s milk had significantly greater weight gains since birth, by 724 g and 624 g respectively, than breast-fed infants (p < 0.05). When milk type was controlled for, weight gain since birth was significantly associated with the presence of microcytic erythrocytes (OR comparing highest tertile of weight gain to lowest tertile 2.9, 95% CI 1.2‐6.6). Interpretation: Iron-deficiency anemia is highly prevalent among James Bay Cree infants. Measures to increase iron intake are required.

/pdf/prevalence-of-anemia-among-james-bay-cree-infants-of-27ksfbaj19.pdf

Prevalence of anemia among James Bay Cree infants of northern Quebec.

Objective: To assess serum zinc and copper concentrations of elderly hospitalized patients with a broad range of diseases and compare their levels to those of healthy community dwelling controls of similar age.Methods: This case-control study compared serum zinc and copper levels of 668 hospitalized subjects, aged 70 or over, with 104 healthy controls of the same age and from the same geographical area. The study protocol, conducted by one physician on the day after the admission to the hospital, included a questionnaire on sociodemographic characteristics, a medical examination, and serum zinc and copper measured with flame atomic absorption spectrophotometry. Data were analysed using analysis of covariance, controlling for age and sex.Results: The diseased subjects had markedly lower zinc concentrations than the control group. The frequency of low values (<0.70 mg/L) was high (20.2% vs. zero in controls, p < 0.001), and it differed among various disease categories: 35.7% for respiratory disease, 20%- 27...

Serum zinc and copper status in hospitalized vs. healthy elderly subjects.

Objective: To quantify patterns of Natural Health Product (NHP) use in Canada. Methods: The Food Habits of Canadians surveyed 1,543 Canadian adults using a 24-hour recall to record dietary supplements. Prevalence of use by user profile was examined. Results: Forty-six percent of women and 33% of men reported taking at least one Natural Health Product with a mean of 2.3 among users. The highest prevalence of supplement use, 57%, occurred among women aged 50–65. Supplement users were older, less likely to smoke and perceived their health as better than non-users. Among supplement users, men had higher rates of use of garlic and vitamin C while women used iron, calcium, B complex, evening primrose oil and glucosamine sulfate. Discussion: Supplement use by Canadians, at 38% for nutrients and 15% for herbal products, was similar to the rate of uses in the U.S., although differences in the reporting of types of supplements underline aspects of consumer behaviour as well as methodological issues specific to NHPs. Investigation of the use of NHPs in the healthcare setting is important given the widespread use and the potential health care consequences associated with supplement use.

/pdf/natural-health-product-use-in-canada-5c4qz00sb9.pdf

Natural health product use in Canada.

Objectives
To describe the relationship between screen time and dietary intake among children, and to examine this association in relation to body weight.

Katherine Gray-Donald

Papers

Dietary patterns and incidence of depression in a cohort of community-dwelling older Canadians.

Prevalence of anemia among James Bay Cree infants of northern Quebec.

Serum zinc and copper status in hospitalized vs. healthy elderly subjects.

Natural health product use in Canada.

Screen time is associated with dietary intake in overweight Canadian children.