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

Population level data on how older individuals living at high latitudes achieve optimal vitamin D status are not fully explored. Our objective was to examine the intake of vitamin D among healthy older individuals with 25-hydroxyvitamin D [25(OH)D] concentrations > or =75 nmol/L and to describe current sources of dietary vitamin D. We conducted a population-based, cross-sectional study of 404 healthy men and women aged 69 to 83 y randomly selected from the NuAge longitudinal study in Quebec, Canada. Dietary intakes were assessed by 6 24-h recalls. We examined the contribution of foods and vitamin/mineral supplements to vitamin D intake. Serum 25(OH)D was assessed by RIA. We assessed smoking status, season of 25(OH)D measurement, physical activity, and anthropometric and sociodemographic variables. Vitamin D status was distributed as follows: 7% ( or = 75 nmol/L). Vitamin D intake from supplements varied across the 3 vitamin D status groups: 0.5, 4.1, and 8.9 microg/d, respectively (P 75 nmol/L had mean intakes of 14.1 microg/d from food and supplements. Supplement use is an important contributor to achieve a minimal target of 25(OH)D concentration > or = 75 nmol/L.

/pdf/vitamin-d-supplement-consumption-is-required-to-achieve-a-1t6xnvjh0v.pdf

Vitamin D Supplement Consumption Is Required to Achieve a Minimal Target 25-Hydroxyvitamin D Concentration of ≥75 nmol/L in Older People

To understand factors influencing fruit and vegetable (FV 53% of girls and 63% of boys did not consume whole fruits daily. Each unit increase in F&V consumption in mothers was associated with a 10% to 20% increase in F&V consumption in children. Interventions to improve F&V consumption should aim to improve awareness among parents of the importance of fruits and vegetables and of the impact of their own behavior on their children's F&V consumption.

Association between Fruit and Vegetable Consumption in Mothers and Children in Low-Income, Urban Neighborhoods.

OBJECTIVES To describe the prevalence and co-occurrence of lifestyle risk factors for chronic disease by family origin. DESIGN Cross-sectional analysis. SETTING Multiethnic, low-income, urban neighborhoods in Montreal, Canada. PARTICIPANTS 2033 adults (42.2% male), mean age 39.7 (standard deviation 6.4) years OUTCOME MEASURES Smoking, level of physical activity, dietary habits, body mass index. METHODS Subjects completed self-report questionnaires on sociodemographic characteristics, height, weight, and lifestyle behaviors. We tested family origin (based on language first learned in childhood and country of birth) as an independent correlate of co-occurrence (having at least two lifestyle risk factors) in multivariate logistic regression analyses. RESULTS The prevalence of smoking and poor diet was highest among participants of French Canadian family origin. Although physical inactivity was uniformly high across family origins, it was highest among participants of Portuguese, Italian, and Haitian family origin. Obesity was highest among Europeans. The prevalence of smoking was lowest among Haitians; poor diet was lowest among South Asians; and physical inactivity was lowest among Eastern Europeans. Obesity was lowest among Asians, with the exception that 55.9% of South Asians were overweight or obese. Relative to French Canadians, adults in all other family-origin groups had a lower risk of co-occurrence of lifestyle risk factors. Adults of Asian family origin had the lowest prevalence of co-occurrence of lifestyle risk factors. CONCLUSION Variation in the distribution of lifestyle risk factors may explain in part differences in chronic disease morbidity and mortality across ethnic groups. Prevention programs should take differential distribution of lifestyle risk factors by ethnicity into account.

Lifestyle risk factors for chronic disease across family origin among adults in multiethnic, low-income, urban neighborhoods.

Fortification with calcium to increase dietary intakes of this mineral is currently under evaluation in Canada. To model the potential dietary consequences of food fortification, data from a large national survey of Canadians (n = 1543) were used. Food fortification scenarios were based on reference amounts for labeling requirements. Consumption of milk, cheese and other dairy products was associated with high calcium intakes, and there was a low prevalence of inadequacy in men < 50 y old; however, other age-sex groups had lower intakes. The aim of the fortification modeling was to determine which scenario would most effectively reduce the proportion of the population with low intakes of calcium while minimizing the proportion of individuals who exceeded the tolerable upper intake level (UL). Given the correlation between energy and calcium (r = 0.60, P < 0.01), it appeared that any fortification scenario sufficient to increase the mean intake for women to near the adequate intake led to 6-7% of the men having calcium intakes above the UL. The results suggest that fortification of widely consumed foods is not a realistic way to address the issue of low calcium intakes and illustrate the need for concern about the growing use of fortification practices.

/pdf/appropriate-calcium-fortification-of-the-food-supply-5e5me7wb9w.pdf

Appropriate Calcium Fortification of the Food Supply Presents a Challenge

Population level data on how older individuals living at high latitudes achieve optimal vitamin D status are not fully explored. Our objective was to examine the intake of vitamin D among healthy older individuals with 25-hydroxyvitamin D (25(OH)D) concentrations $75 nmol/L and to describe current sources of dietary vitamin D. We conducted a population-based, cross- sectional study of 404 healthy men and women aged 69 to 83 y randomly selected from the NuAge longitudinal study in Quebec, Canada. Dietary intakes were assessed by 6 24-h recalls. We examined the contribution of foods and vitamin/ mineral supplements to vitamin D intake. Serum 25(OH)D was assessed by RIA. We assessed smoking status, season of 25(OH)D measurement, physical activity, and anthropometric and sociodemographic variables. Vitamin D status was distributed as follows: 7% (,37.5 nmol/L), 48% (37.5-74.9 nmol/L), and 45% ($75 nmol/L). Vitamin D intake from supplements varied across the 3 vitamin D status groups: 0.5, 4.1, and 8.9 mg/d, respectively (P , 0.0001). Adding food sources, these total intakes were 4.6, 8.7, and 14.1 mg/d, respectively. In multivariate analysis, vitamin D from foods and supplements and by season was associated with vitamin D status. These healthy, community-dwelling older men and women with 25(OH)D concentrations .75 nmol/L had mean intakes of 14.1 mg/d from food and supplements. Supplement use is an important contributor to achieve a minimal target of 25(OH)D concentration $75 nmol/L. J. Nutr. 140: 551-556, 2010.

Katherine Gray-Donald

Papers

Vitamin D Supplement Consumption Is Required to Achieve a Minimal Target 25-Hydroxyvitamin D Concentration of ≥75 nmol/L in Older People

Association between Fruit and Vegetable Consumption in Mothers and Children in Low-Income, Urban Neighborhoods.

Lifestyle risk factors for chronic disease across family origin among adults in multiethnic, low-income, urban neighborhoods.

Appropriate Calcium Fortification of the Food Supply Presents a Challenge

Vitamin D Supplement Consumption Is Required to Achieve a Minimal Target 25-Hydroxyvitamin D Concentration of