Gene-environment study on PON1 serum activity and methylmercury exposure among Indian Cree adults

La présente étude visait à déterminer si une augmentation des niveaux de mercure dans le sang était associée à une diminution de l'activité sérique de PON1 dans la population Crie qui est exposée au méthylmercure (MeHg) par son alimentation traditionnelle riche en poisson. Des échantillons sanguins ont été prélevés chez 881 adultes Cris vivant dans la région de la Baie James (Québec, Canada), chez lesquels nous avons mesuré la concentration et l'activité de PON1 ainsi que les niveaux de mercure et de sélénium. Dans un modèle de régression multivariée ajusté pour l'âge, les niveaux de cholestérol-HDL et les variantes génétiques de PON1, l'effet de l'exposition au mercure variait selon le polymorphisme -108C/T. L'augmentation de la concentration de mercure était associée à une diminution du niveau d'activité de PON1 pour le génotype AA (TT) du polymorphisme -108C/T et à une augmentation de l'activité enzymatique pour le génotype GG (CC) (analyse de tendance p < 0,0001). En conclusion, nos résultats suggèrent une interaction gène-environnement possible entre l'activité de PON1 et le polymorphisme -108C/T pour les individus exposés au MeHg

Assessing the feasibility, acceptability, and fidelity of a tele-retinopathy-based intervention to encourage greater attendance to diabetic retinopathy screening in immigrants living with diabetes from China and African-Caribbean countries in Ottawa, Canada: a protocol

Background: Diabetic retinopathy is a leading cause of preventable blindness in Canada. Clinical guidelines recommend annual diabetic retinopathy screening for people living with diabetes to reduce the risk and progression of vision loss. However, many Canadians with diabetes do not attend screening. Screening rates are even lower in immigrants to Canada including people from China, Africa, and the Caribbean, and these groups are also at higher risk of developing diabetes complications. We aim to assess the feasibility, acceptability, and fidelity of a co-developed, linguistically and culturally tailored tele-retinopathy screening intervention for Mandarin-speaking immigrants from China and French-speaking immigrants from African-Caribbean countries living with diabetes in Ottawa, Canada, and identify how many from each population group attend screening during the pilot period. // Methods: We will work with our health system and patient partners to conduct a 6-month feasibility pilot of a tele-retinopathy screening intervention in a Community Health Centre in Ottawa. We anticipate recruiting 50–150 patients and 5–10 health care providers involved in delivering the intervention for the pilot. Acceptability will be assessed via a Theoretical Framework of Acceptability-informed survey with patients and health care providers. To assess feasibility, we will use a Theoretical Domains Framework-informed interview guide and to assess fidelity, and we will use a survey informed by the National Institutes of Health framework from the perspective of health care providers. We will also collect patient demographics (i.e., age, gender, ethnicity, health insurance status, and immigration information), screening outcomes (i.e., patients with retinopathy identified, patients requiring specialist care), patient costs, and other intervention-related variables such as preferred language. Survey data will be descriptively analyzed and qualitative data will undergo content analysis. // Discussion: This feasibility pilot study will capture how many people living with diabetes from each group attend the diabetic retinopathy screening, costs, and implementation processes for the tele-retinopathy screening intervention. The study will indicate the practicability and suitability of the intervention in increasing screening attendance in the target population groups. The study results will inform a patient-randomized trial, provide evidence to conduct an economic evaluation of the intervention, and optimize the community-based intervention

Omega-3 polyunsaturated fatty acid profiles and relationship with cardiometabolic risk factors in Cree (Eeyouch) of Northern Québec

Background: n-3 long-chain polyunsaturated fatty acids (LC-PUFAs) from fish are known modulators of cardiometabolic risk factors. Objective: To examine fatty acids (FAs) status and the relationship between n-3 LC-PUFA and cardiometabolic risk factors in Cree participants. Design: We analyzed data from a cross-sectional study (n=829) conducted in Cree adults (aged 18–74 years) from 7 communities of the James Bay territory of Quebec (Canada) in 2005–2009. Sociodemographic, lifestyle, clinical and anthropometric data were collected. FAs were quantified in red blood cells (RBCs) under fasting conditions. Results: A total of 89% of the participants were overweight (with 69% obesity), 33% had hypertriglyceridemia, 44% had low plasma HDL-c and 77% had fasting plasma insulin ≥90 pmol/l. Total n-3 PUFAs accounted for 6% of total FAs and were higher among older participants, while n-6 PUFAs accounted for 31% of total FAs and were higher among younger participants. According to the adjusted multiple linear regression models, n-3 LC-PUFA was associated (p<0.05) with higher total cholesterol, LDL-c and apo B-100, and was also associated (p<0.05) with lower blood glucose. Conclusion: Overall, this study showed that n-3 LC-PUFA levels measured in the RBCs of the Cree adults are relatively low and tend towards lower levels among youth. These levels might be insufficient to offset the prevalence of cardiometabolic risk factors

Patients' perspectives on how to improve diabetes self-management and medical care: a qualitative study

Background: The experience of living with a chronic disease such as diabetes can provide valuable knowledge about medical care and self-management. Such knowledge may be of use to people seeking to improve diabetes self-management and to health professionals seeking to provide better patient-centered care. Objective: To identify potential areas for improvement in diabetes care from the perspectives of people living with diabetes and their caregivers. Methods: We interviewed 21 people living with diabetes (hereafter called expert patients) who were patient partners in a national Patient-Oriented Research network. Expert patients were men and women from various backgrounds, including Indigenous people and immigrants to Canada. They had significant lived experience of diabetes and were able to offer diverse patient and caregiver perspectives. Three authors independently analyzed videos using inductive framework analysis, identifying themes through discussion and consensus. Results: From expert patients’ perspective, people living with diabetes benefit from acknowledging and accepting the reality of diabetes, receiving support from their family and care team, and not letting diabetes control their lives. To improve diabetes care, health professionals should understand and acknowledge the impact of diabetes on patients and their families, and communicate with patients openly, respectfully, with empathy and cultural competency. Conclusions: From the perspectives of expert patients, there are areas for improvements in diabetes care. These improvements are actionable individually by patients or health professionals and also collectively through collaboration between both groups. Improving the quality of care in diabetes is crucial for improving health outcomes in Canada

Total cord blood Hg levels (2003) and total blood mercury levels (2010) in Bermudian mothers illustrated with two boxplots showing the minimum (bottom whisker), first quartile, median, third quartile, maximum (top whisker) and the average (diamond).

<p>Raw data also shown in figure.</p

The Influence of Age, Sex, and Socioeconomic Status on Glycemic Control Among People With Type 1 and Type 2 Diabetes in Canada: Patient-Led Longitudinal Retrospective Cross-sectional Study With Multiple Time Points of Measurement

BackgroundClinical guidelines for most adults with diabetes recommend maintaining hemoglobin A1c (HbA1c) levels ≤7% (≤53 mmol/mol) to avoid microvascular and macrovascular complications. People with diabetes of different ages, sexes, and socioeconomic statuses may differ in their ease of attaining this goal. ObjectiveAs a team of people with diabetes, researchers, and health professionals, we aimed to explore patterns in HbA1c results among people with type 1 or type 2 diabetes in Canada. Our research question was identified by people living with diabetes. MethodsIn this patient-led retrospective cross-sectional study with multiple time points of measurement, we used generalized estimating equations to analyze the associations of age, sex, and socioeconomic status with 947,543 HbA1c results collected from 2010 to 2019 among 90,770 people living with type 1 or type 2 diabetes in Canada and housed in the Canadian National Diabetes Repository. People living with diabetes reviewed and interpreted the results. ResultsHbA1c results ≤7.0% represented 30.5% (male people living with type 1 diabetes), 21% (female people living with type 1 diabetes), 55% (male people living with type 2 diabetes) and 59% (female people living with type 2 diabetes) of results in each subcategory. We observed higher HbA1c values during adolescence, and for people living with type 2 diabetes, among people living in lower income areas. Among those with type 1 diabetes, female people tended to have lower HbA1c levels than male people during childbearing years but higher HbA1c levels than male people during menopausal years. Team members living with diabetes confirmed that the patterns we observed reflected their own life courses and suggested that these results be communicated to health professionals and other stakeholders to improve the treatment for people living with diabetes. ConclusionsA substantial proportion of people with diabetes in Canada may need additional support to reach or maintain the guideline-recommended glycemic control goals. Blood sugar management goals may be particularly challenging for people going through adolescence or menopause or those living with fewer financial resources. Health professionals should be aware of the challenging nature of glycemic management, and policy makers in Canada should provide more support for people with diabetes to live healthy lives

Assessing the feasibility, acceptability, and fidelity of a tele-retinopathy-based intervention to encourage greater attendance to diabetic retinopathy screening in immigrants living with diabetes from China and African-Caribbean countries in Ottawa, Canada: a protocol

Abstract Background Diabetic retinopathy is a leading cause of preventable blindness in Canada. Clinical guidelines recommend annual diabetic retinopathy screening for people living with diabetes to reduce the risk and progression of vision loss. However, many Canadians with diabetes do not attend screening. Screening rates are even lower in immigrants to Canada including people from China, Africa, and the Caribbean, and these groups are also at higher risk of developing diabetes complications. We aim to assess the feasibility, acceptability, and fidelity of a co-developed, linguistically and culturally tailored tele-retinopathy screening intervention for Mandarin-speaking immigrants from China and French-speaking immigrants from African-Caribbean countries living with diabetes in Ottawa, Canada, and identify how many from each population group attend screening during the pilot period. Methods We will work with our health system and patient partners to conduct a 6-month feasibility pilot of a tele-retinopathy screening intervention in a Community Health Centre in Ottawa. We anticipate recruiting 50–150 patients and 5–10 health care providers involved in delivering the intervention for the pilot. Acceptability will be assessed via a Theoretical Framework of Acceptability-informed survey with patients and health care providers. To assess feasibility, we will use a Theoretical Domains Framework-informed interview guide and to assess fidelity, and we will use a survey informed by the National Institutes of Health framework from the perspective of health care providers. We will also collect patient demographics (i.e., age, gender, ethnicity, health insurance status, and immigration information), screening outcomes (i.e., patients with retinopathy identified, patients requiring specialist care), patient costs, and other intervention-related variables such as preferred language. Survey data will be descriptively analyzed and qualitative data will undergo content analysis. Discussion This feasibility pilot study will capture how many people living with diabetes from each group attend the diabetic retinopathy screening, costs, and implementation processes for the tele-retinopathy screening intervention. The study will indicate the practicability and suitability of the intervention in increasing screening attendance in the target population groups. The study results will inform a patient-randomized trial, provide evidence to conduct an economic evaluation of the intervention, and optimize the community-based intervention

The Multifaceted Nature of “Food Diversity” as a Life-Related Legal Value

none1siInternational and Italian legal literature has dedicated considerable worthy research to food law in relation to questions such as food security, quality and typicality (along with the related topics of indication and guarantee of origin), the right to food, as well as food sovereignty. The same cannot be said, however, in the matter of food diversity as a significant value in law, with the exception of a few recent research initiatives underway. The genetic diversity of the living sources of food is a value that is certainly implicated in food diversity, but, as this paper seeks to show, the latter is a value of synthesis that, despite encompassing animal, vegetable and microbial biodiversity, is not exhausted only within it. What seems useful therefore is an endeavour to investigate the problem of food diversity from a broader perspective so as to delineate some frames of reference. Food diversity can be said to be a synthesis of multiple diversities. It is a value system where numerous legal values of primary importance under constitutional protection converge and are contained: environment/biodiversity, territorial autonomy and differentiation, landscape, cultural heritage, human health, personal and religious freedom, and the educational choices of the family. The strengths of these basic value aggregate organically, conferring to food diversity a role of absolute primary importance in law. As this paper proposes, recognizing cultural diversity as a complex, systemic and life-related legal value, that is, as a “condensation” of the normative energy originating from the combination of multiple constitutionally fundamental legal values that are bound up with the supreme value of life in its differing scales, which in their turn are inextricably interrelated, permits the attribution to food diversity of a much stronger (respecting the situation to date) “resistance” in law against purely economic interests.Library of Congress Control Number: 2018933578. The collective book reflects on the issues concerning, on the one hand, the difficulty in feeding an ever- increasing world population and, on the other hand, the need to build new productive systems able to protect the planet from overexploitation. The concept of “food diversity” is a synthesis of diversities: biodiversity of ecological sources of food supply; socio territorial diversity; and cultural diversity of food traditions. In keeping with this transdisciplinary perspective, the book collects a large number of contributions that examine, firstly the relationships between agrobiodiversity, rural sustainable systems and food diversity; and secondly, the issues concerning typicality (food specialties/food identities), rural development and territorial communities. Lastly, it explores legal questions concerning the regulations aiming to protect both the food diversity and the right to food, in the light of the political, economic and social implications related to the problem of feeding the world population, while at the same time respecting local communities’ rights, especially in the developing countries. The book collects the works of legal scholars, agroecologists, historians and sociologists from around the globe. ****** Il volume è stato segnalato dalla Netherlands Quarterly of Human Rights 2018, Vol. 36(3) 236. Esso è inoltre presente in numerose biblioteche internazionali, tra cui quella della Stanford University: https://searchworks.stanford.edu/view/12658601 .noneM. MONTEDUROMonteduro, M