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The development and maintenance of body composition and functions require an adequate protein intake with a continuous supply of amino acids (AA) to tissues. Body pool and AA cellular concentrations are tightly controlled and maintained through AA supply (dietary intake, recycled from proteolysis and de novo synthesis), AA disposal (protein synthesis and other AA-derived molecules) and AA losses (deamination and oxidation). Different molecular regulatory pathways are involved in the control of AA sufficiency including the mechanistic target of rapamycin complex 1, the general control non-derepressible 2/activating transcription factor 4 system or the fibroblast growth factor 21. There is a tight control of protein intake, and human subjects and animals appear capable of detecting and adapting food and protein intake and metabolism in face of foods or diets with different protein contents. A severely protein deficient diet induces lean body mass losses and ingestion of sufficient dietary energy and protein is a prerequisite for body protein synthesis and maintenance of muscle, bone and other lean tissues and functions. Maintaining adequate protein intake with age may help preserve muscle mass and strength but there is an ongoing debate as to the optimal protein intake in older adults. The protein synthesis response to protein intake can also be enhanced by prior completion of resistance exercise but this effect could be somewhat reduced in older compared to young individuals and gain in muscle mass and function due to exercise require regular training over an extended period.
Health professionals consider the evaluation of eating habits to be challenging, given the potential biases of dietary questionnaires based on self-reported data. Circulating carotenoid concentrations are reliable biomarkers of dietary carotenoid intake and could be useful in the validation of dietary assessment tools. However, there is a sex difference in circulating carotenoids, with women displaying higher concentrations compared with men independent of intake. The aim of the present study was to identify the correlates of plasma carotenoid concentrations among men (n 155) and women (n 110) enrolled in six fully controlled dietary interventions with varying dietary carotenoid intakes. We looked at the associations of post-intervention fasting plasma carotenoid concentrations (α-carotene, β-carotene, β-cryptoxanthin, lutein, lycopene and zeaxanthin) with physical and metabolic characteristics. We found that increased body weight (r –0·47, P<0·0001) and waist circumference (r –0·46, P<0·0001) were associated with lower plasma total carotenoid concentrations, while elevated plasma LDL-cholesterol (r 0·49, P<0·0001) and HDL-cholesterol (r 0·50, P<0·0001) concentrations were correlated with higher total carotenoids in plasma. Women had significantly higher plasma total carotenoid concentrations compared with men, despite significantly lower dietary carotenoid intake. Adjustment of circulating carotenoid concentrations for plasma HDL-cholesterol eliminated sex difference in plasma carotenoid concentrations. Our results suggest that physical characteristics as well as plasma lipids are associated with circulating carotenoid concentrations and that these variables should be taken into account when using plasma carotenoids as biomarkers for food intake in men and women.
To assess the relative validity of a new, web-based, self-administered 24 h dietary recall, the R24W, for assessment of energy and nutrient intakes among French Canadians.
Each participant completed a 3d food record (FR) and the R24W on three occasions over a 4-week period. Intakes of energy and of twenty-four selected nutrients assessed by both methods were compared.
Québec City metropolitan area.
Fifty-seven women and fifty men (mean (sd) age: 47·2 (13·3) years).
Equivalent proportions of under-reporters were found with the R24W (15·0%) and the FR (23·4%). Mean (sd) energy intake from the R24W was 7·2% higher than that from the FR (10 857 (3184) kJ/d (2595 (761) kcal/d) v. 10 075 (2971) kJ/d (2408 (710) kcal/d); P<0·01). Significant differences in mean nutrient intakes between the R24W and the FR ranged from –54·8% (i.e. lower value with R24W) for niacin to +40·0% (i.e. higher value with R24W) for alcohol. Sex- and energy-adjusted deattenuated correlations between the two methods were significant for all nutrients except Zn (range: 0·35–0·72; P<0·01). Cross-classification demonstrated that 40·0% of participants were classified in the same quartile with both methods, while 40·0% were classified in the adjacent quartile and only 3·6% were grossly misclassified (1st v. 4th quartile). Analysis of Bland–Altman plots revealed proportional bias between the two assessment methods for 8/24 nutrients.
These data suggest that the R24W presents an acceptable relative validity as compared with the FR for estimating usual dietary intakes in a cohort of French Canadians.
This issue of International Psychogeriatrics contains three papers from three continents that explore the use of sedatives–hypnotics and opioids in the treatment of older adults (Hamina et al., 2018; Machado-Duque et al., 2018; Tseng et al., 2018), and a fourth paper reporting on a qualitative study that addresses the broader question of training needs in dementia in a setting of rapid economic and demographic changes (Xu et al., 2018).
The present study aimed to develop and validate a questionnaire assessing social support for healthy eating in a French-Canadian population.
A twenty-one-item questionnaire was developed. For each item, participants were asked to rate the frequency, in the past month, with which the actions described had been done by family and friends in two different environments: (i) at home and (ii) outside of home. The content was evaluated by an expert panel. A validation study sample was recruited and completed the questionnaire twice. Exploratory factor analysis was performed on items to assess the number of subscales. Internal consistency reliability was assessed using Cronbach’s ɑ. Test–retest reliability was evaluated with intraclass correlations between scores of the two completions.
Men and women from the Québec City area (n 150).
The content validity assessment led to a few changes, resulting in a twenty-two-item questionnaire. Exploratory factor analysis revealed a two-factor structure for both environments, resulting in four subscales: supportive actions at home; non-supportive actions at home; supportive actions outside of home; and non-supportive actions outside of home. Two items were removed from the questionnaire due to low loadings. The four subscales were found to be reliable (Cronbach’s ɑ=0·82–0·94; test–retest intraclass correlation=0·51–0·70).
The Social Support for Healthy Eating Questionnaire was developed for a French-Canadian population and demonstrated good psychometric properties. This questionnaire will be useful to explore the role of social support and its interactions with other factors in predicting eating behaviours.
To develop consensus recommendations for training future clinician educators (CEs) in emergency medicine (EM).
A panel of EM education leaders was assembled from across Canada and met regularly by teleconference over the course of 1 year. Recommendations for CE training were drafted based on the panel’s experience, a literature review, and a survey of current and past EM education leaders in Canada. Feedback was sought from attendees at the Canadian Association of Emergency Physicians (CAEP) annual academic symposium. Recommendations were distributed to the society’s Academic Section for further feedback and updated by a consensus of the expert panel.
Recommendations were categorized for one of three audiences: 1) Future CEs; 2) Academic departments and divisions (AD&D) that support training to fulfill their education leadership goals; and 3) The CAEP Academic Section. Advanced medical education training is recommended for any emergency physician or resident who pursues an education leadership role. Individuals should seek out mentorship in making decisions about career opportunities and training options. AD&D should regularly perform a needs assessment of their future CE needs and identify and encourage potential individuals who fulfill education leadership roles. AD&D should develop training opportunities at their institution, provide support to complete this training, and advocate for the recognition of education scholarship in their institutional promotions process. The CAEP Academic Section should support mentorship of future CEs on a national scale.
These recommendations serve as a framework for training and supporting the next generation of Canadian EM medical educators.
The present study aimed to develop and validate a questionnaire assessing perceived food environment in a French-Canadian population.
A questionnaire, the Perceived Food Environment Questionnaire, was developed assessing perceived accessibility to healthy (nine items) and unhealthy foods (three items). A pre-test sample was recruited for a pilot testing of the questionnaire. For the validation study, another sample was recruited and completed the questionnaire twice. Exploratory factor analysis was performed on the items to assess the number of factors (subscales). Cronbach’s α was used to measure internal consistency reliability. Test–retest reliability was assessed with Pearson correlations.
Men and women from the Québec City area (n 31 in the pre-test sample; n 150 in the validation study sample).
The pilot testing did not lead to any change in the questionnaire. The exploratory factor analysis revealed a two-subscale structure. The first subscale is composed of six items assessing accessibility to healthy foods and the second includes three items related to accessibility to unhealthy foods. Three items were removed from the questionnaire due to low loading on the two subscales. The subscales demonstrated adequate internal consistency (Cronbach’s α=0·77 for healthy foods and 0·62 for unhealthy foods) and test–retest reliability (r=0·59 and 0·60, respectively; both P<0·0001).
The Perceived Food Environment Questionnaire was developed for a French-Canadian population and demonstrated good psychometric properties. Further validation is recommended if the questionnaire is to be used in other populations.
High fruit and vegetable (FAV) intake is associated with a lower prevalence of chronic diseases. Identifying the ideal number of FAV servings needed to reduce chronic disease risk is, however, difficult because of biases inherent to common self-report dietary assessment tools. The aim of our study was to examine the associations between daily FAV intake and plasma carotenoid concentrations in men and women enrolled in a series of fully controlled dietary interventions. We compiled and analysed data from a group of 155 men and 109 women who participated in six fully controlled dietary interventions and compared post-intervention fasting plasma carotenoid (α-carotene, β-carotene, β-cryptoxanthin, lutein, lycopene, zeaxanthin) concentrations with regard to the daily FAV servings consumed by the participants. We found that plasma β-cryptoxanthin, lutein and zeaxanthin concentrations were positively associated with daily FAV servings (P≤0·005). However, daily FAV intake was negatively associated with plasma α-carotene (P<0·0005) and lycopene (P<0·0001) concentrations, whereas no association was noted with plasma β-carotene. When men and women were analysed separately, we found that for any given number of FAV servings consumed women had higher circulating lutein concentrations compared with men (P<0·01). Significant sex×FAV (P<0·0001) and sex×dietary β-cryptoxanthin (P<0·0005) interactions were also noted favouring higher plasma β-cryptoxanthin concentrations in women than in men for a given FAV consumption. Results from these fully controlled dietary feeding studies indicate that plasma β-cryptoxanthin and lutein concentrations can be used as robust biomarkers of FAV consumption. They also suggest the existence of sex differences influencing circulating β-cryptoxanthin and lutein concentrations following FAV consumption.
Carey and Hix (2011) propose that a proportional electoral system with a moderate number of seats per district offers the best compromise between (1) accurate representation and (2) strong accountability. The argument is that there is a district magnitude (DM) level where the trade-off between proportionality and fragmentation of parties is optimal. This DM is called the sweet spot. We explore this proposition through lab experiments conducted in Brussels and Montreal. We find that the probability of achieving a “good” outcome on both proportionality and the number of parties is slightly higher at moderate DMs. We note, however, that this probability remains low.
Patients may present to Emergency Departments (ED) in shock for various reasons. Emergency medicine physicians may require the use of vasopressors or inotropes to manage these patients. The Critical Care Practice Committee of the Canadian Association of Emergency Physicians (C4) conducted an intensive literature search and guideline development process to help create an evidence based approach for use of these agents in the stabilization of shock.
In 2011 the IRSN conducted several assessments of atmospheric
radioactive releases due to the Fukushima Daiichi NPP accident (March
11, 2011) and of their impact on Japan’s terrestrial environment.
They were based on the IRSN’s emergency management tools and on
the abundant information and technical data gradually published
in Japan. According to these assessments, the main release phase
lasted from March 12 to 25, 2011 and impacted Japanese land in two
events, the first on 15 and 16 March, in which the main radioactive
deposits were formed, and the second from March 20 to 23, which
was less significant. The highest amounts of radioactive deposits were
found in an area extending upwards of several tens of kilometers
northwest of the plant. Lower amounts were discontinuously scattered
in an area extending up to over 250 km away. Initially composed
mainly of short-lived radionuclides, the deposits’ activity sharply
decreased in the subsequent weeks. Since the summer of 2011, cesium-134
and cesium-137 have become the residual deposits’ main components.
According to IRSN estimates, in the absence of protection, the doses
due to exposure to the radioactive plume during the atmospheric
release phase may have been potentially higher for people who remained
in coastal areas up to several tens of kilometers north and south
of the damaged plant. Thereafter, people living up to 50 km northwest
of the plant, outside the 20-km emergency evacuation zone, were potentially
most vulnerable to residual radioactive deposits over time.
A SiC-based ceramic foam applied in solar thermal processes was characterized in detail in terms of its textural parameters and its radiative properties. Scanning electron microscopy and x-ray µ-tomography were first performed to investigate the 3D texture of the sample at several length scales. Infrared reflectance microscopy was also applied to probe the local optical responses on the struts constituting the foam. Based on the whole set of experimental data, a numerical tool (C++) was implemented to reconstruct virtual SiC foams. A Monte Carlo Ray Tracing code (iMorphRad, C++) was then used to compute the normal spectral emittance for the real SiC foam and for another reconstructed SiC foam with similar textural features. The two numerically determined emittances were then compared with previous infrared spectroscopy experimental measurements. This numerical procedure enables us to propose a methodology for the design of SiC foams with prescribed radiative properties.
It is expected that a dietary intervention based on the traditional Mediterranean food pattern should be associated with a reduction in fast-food consumption but this has never been tested before. We assessed the impact of a 12-week dietary intervention, promoting the adoption of a Mediterranean food pattern, on fast-food consumption among seventy-one healthy women aged between 30 and 65 years. The dietary intervention consisted of two group sessions and seven individual sessions with a dietitian. To determine the Mediterranean dietary score (MedScore) and fast-food consumption, an FFQ was administered. During the 12-week intervention, the MedScore significantly increased (from 21·1 (sd 3·6) units at baseline to 28·6 (sd 4·4) units at week 12, P < 0·0001), while the fast-food consumption significantly decreased (from 51·7 (sd 46·4) g/d at baseline to 20·5 (sd 18·2) g/d at week 12, P < 0·0001). Moreover, women who had a higher consumption of fast food at baseline decreased their fast-food consumption to the most (r − 0·50, P < 0·0001). When four subgroups were formed on the basis of median values of Medscore and fast-food consumption changes, it was found that only the subgroup of women which increased the most their MedScore and decreased the most their fast-food consumption experienced a significant decrease in BMI (P < 0·01). In conclusion, a dietary intervention promoting the Mediterranean food pattern led to a decrease in fast-food consumption among healthy women even if it was not a specific target of the intervention. Dietary strategies for increasing intake of healthy foods may be a useful approach for decreasing intake of less healthy foods.
Elevated circulating concentrations of oxidized LDL (OxLDL) and cell adhesion molecules are considered to be relevant markers of oxidative stress and endothelial activation which are implicated in the development of CVD. On the other hand, it has been suggested that dietary flavonoid consumption may be cardioprotective through possible favourable impacts on LDL particle oxidation and endothelial activation. The present study was undertaken to determine the effect of the daily consumption of low-calorie cranberry juice cocktail on plasma OxLDL, intercellular adhesion molecule-1 (ICAM-1), vascular cell adhesion molecule-1 (VCAM-1) and E-selectin concentrations in men. Thirty men (mean age 51 (sd 10) years) were recruited and asked to consume increasing daily doses of cranberry juice cocktail (125, 250 and 500 ml/d) over three successive periods of 4 weeks. Plasma OxLDL and adhesion molecule concentrations were measured by ELISA before and after each phase. We noted a significant decrease in plasma OxLDL concentrations following the intervention (P < 0·0001). We also found that plasma ICAM-1 (P < 0·0001) and VCAM-1 (P < 0·05) concentrations decreased significantly during the course of the study. In summary, the present results show that daily cranberry juice cocktail consumption is associated with decreases in plasma OxLDL, ICAM-1 and VCAM-1 concentrations in men.
Polymer/ceramic nanocomposites provide a means of combining the high permittivities (εr) of metal oxide nanoparticles with the solution-processability and high dielectric strength of polymeric hosts. Simple mixing of nanoparticles and polymers generally results in poor quality nanocomposites due to the agglomeration of nanoparticles and poor miscibility of nanoparticles with host materials. We have shown that surface modification of metal oxide nanoparticles with phosphonic acid-based ligands affords robust surface modification and improves the processiblity and the quality of the resulting nanocomposites. We report on the use of phosphonic-acid modified barium titanate (BaTiO3, BT) nanoparticles in dielectric nanocomposites and their applications to high-energy-density capacitors and solution-processable high permittivity gate insulators in organic field-effect transistors (OFETs). Surface modification of BT nanoparticles enabled the formation of high quality nanocomposite thin films with ferroelectric polymer hosts such as poly(vinylidene fluoride-co-hexafluoropropylene), P(VDF-HFP), with large volume fractions (up to 50 vol. %), which are potentially useful materials for electrical energy storage. Similarly, the use of phosphonic acid-modified BT nanoparticles in cross-linked poly(4-vinylphenol) (PVP) allowed to form gate insulators for OFETs. High quality nanocomposite thin films at high nanoparticle volume fractions (up to 37 vol. %) with a large capacitance density (∼50 nF/cm2) and a low leakage current (10−8 A/cm2) were obtained. Pentacene-based p-type OFETs using these nanocomposites showed a large on/off current ratio (Ion/off 104 ∼ 106). We will also present the results from a recent experimental and theoretical study where the BT nanoparticle volume fraction was systematically varied in P(VDF-HFP) host, εr = 11, to find the optimum permittivity and dielectric strength, which provided a guideline for the optimization of the volume fraction for achieving maximum energy density.
The aim of our study was to examine psychosocial changes associated with participation in a camp for children with cardiac defects. We enrolled 29 children with cardiac defects aged from 8 to 18 years, along with their parents. Both the parents and the children completed measures of expectations for the camp and anxiety. Analyses of repeated measures indicated that levels of anxiety amongst the children decreased significantly at the end of camp when compared to its beginning. Levels of anxiety amongst the children were not statistically different at follow-up. Anxiety amongst the parents concerning the separation from their children also decreased at follow-up when compared to before the camp. Higher levels of anxiety reported by the children prior to the camp were associated with greater anxiety amongst the parents concerning the anticipated separation, more negative parental expectations of the camp, fewer experiences of separation from their children, and lower expectations by the children for the camping experience. Reductions in anxiety amongst the children following the camp were associated with negative parental expectations about the camping experience. The camping environment can provide a naturalistic exposure to new experiences for the child, and a successful separation for the parent, thereby promoting confidence amongst the parents in the ability of their children to function independently.
A low HDL-cholesterol concentration is an independent risk factor for CVD. Studies have suggested that flavonoid consumption may be cardioprotective, and a favourable impact on circulating HDL-cholesterol concentrations has been suggested to partially explain this association. The aim of the present study was to determine the effect of consuming increasing daily doses of low-calorie cranberry juice cocktail (CJC) on the plasma lipid profile of abdominally obese men. For that purpose, thirty men (mean age 51 (SD 10) years) consumed increasing doses of CJC during three successive periods of 4 weeks (125ml/d, 250ml/d, 500ml/d). Before the study and after each phase, we measured changes in physical and metabolic variables. We noted a significant increase in plasma HDL-cholesterol concentration after the consumption of 250ml CJC/d (+8·6±14·0% v. 0ml CJC/d; P<0·01), an effect that plateaued during the last phase of the study (500ml CJC/d: +8·1±10·0% v. 0ml CJC/d; P<0·0001). Multivariate analyses revealed that changes in plasma apo A-I (IR2=48%, P<0·0001) and triacylglycerol (R2=16%, P<0·005) concentrations were the only variables significantly contributing to the variation in plasma HDL-cholesterol concentration noted in response to the intervention. No variation was observed in total as well as in LDL and VLDL cholesterol. The present results show that daily CJC consumption is associated with an increase in plasma HDL-cholesterol concentrations in abdominally obese men. We hypothesise that polyphenolic compounds from cranberries may be responsible for this effect, supporting the notion that the consumption of flavonoid-rich foods can be cardioprotective.