Validation d'un questionnaire mesurant la consommation de boissons sucrées, jus et eau auprès d'adolescents francophones.

Purpose: To examine the temporal stability and relative validity of the adapted French version of an English self-reported questionnaire measuring the beverage intake (BEVQ) of adolescents.Methods: The French adaptation of the BEVQ (AF-BEVQ) included conversion from the imperial to the metric system and the adjustment of some formats to those available in Canada. Next, 60 adolescents from two regions in Quebec completed the AF-BEVQ and two web-based 24-hour dietary recalls (R24W) (one for a weekday and one for a weekend day) on two occasions, two weeks apart.Results: The AF-BEVQ had moderate intraclass correlation coefficients (ICC) for amounts of sugar-sweetened beverages (ICC: 0.68; 95% confidence interval [CI]: 0.46-0.81), fruit juice (ICC: 0.54; 95% CI: 0.23-0.72) and water (ICC: 0.66; 95% CI: 0.38-0.81) consumed. The amounts of sugar-sweetened beverages (rs = 0.49; p < 0.0001), fruit juice (rs = 0.38; p = 0.0024) and water (rs = 0.65; p < 0.0001) reported in the AF-BEVQ were significantly correlated with those of both R24Ws.Conclusions: For the most part, the AF-BEVQ had adequate metrological properties. It is an interesting tool to quickly measure the sugar-sweetened beverage, fruit juice and water intake of French-speaking adolescents.

Objectif : Vérifier la stabilité temporelle et validité relative de la version française adaptée d'un questionnaire auto-déclaré en anglais mesurant la consommation de diverses boissons (BEVQ) chez les adolescents.Méthodes : L'adaptation française du BEVQ (AF-BEVQ) comprenait notamment la conversion des unités impériales en unités métriques et l'ajustement de certains formats selon ceux disponibles au Canada. Ensuite, 60 adolescents provenant de deux régions du Québec ont complété l'AF-BEVQ et deux rappels de 24 heures Web (R24W) (un jour de semaine et un de fin de semaine) à deux reprises à deux semaines d'intervalle.Résultats : L'AF-BEVQ avait des coefficients intra-classe (ICC) modérés pour les quantités de boissons sucrées (ICC : 0,68; intervalle de confiance [IC] 95 % : 0,46­0,81), de jus de fruits (ICC : 0,54; IC 95 % : 0,23­0,72) et d'eau (ICC : 0,66; IC 95 % : 0,38­0,81) consommées. Les quantités de boissons sucrées (rs = 0,49; p < 0,0001), de jus de fruits (rs = 0,38; p = 0,0024) et d'eau (rs = 0,65; p < 0,0001) rapportées dans l'AF-BEVQ étaient significativement corrélées à celles des deux R24W.Conclusions : L'AF-BEVQ présentait majoritairement des propriétés métrologiques adéquates. Il est un outil d'intérêt pour mesurer rapidement la consommation de boissons sucrées, de jus de fruits et d'eau d'adolescents francophones.

Factors Associated with Eating in the Absence of Hunger among Children and Adolescents: A Systematic Review.

Eating in the absence of hunger (EAH) has been extensively studied over the past two decades and has been associated with excess body weight and the development of obesity. However, determinants of EAH remain uncertain. This systematic review aims to identify individual, familial, and environmental factors associated with EAH among children and adolescents. We included studies with a measure of EAH in participants aged 3-17 years old and including ≥1 factor associated with EAH. Our search identified 1494 articles. Of these, we included 81 studies: 53 cross-sectional, 19 longitudinal and nine intervention studies. In childhood (≤12 years old), EAH increases with age, it is greater in boys compared to girls, and it is positively associated with adiposity. Moreover, EAH development seems to be influenced by genetics. In adolescence, the number of studies is limited; yet, studies show that EAH slightly increases or remains stable with age, is not clearly different between sexes, and findings for overweight or obesity are less consistent across studies in adolescence. For familial factors, parental restrictive feeding practices are positively associated with EAH during childhood, mostly for girls. Studies assessing environmental factors are lacking and robust longitudinal studies spanning from early childhood to adolescence are needed.

Cannabis use in patients with Autosomal Recessive Spastic Ataxia of Charlevoix-Saguenay.

Autosomal Recessive Spastic Ataxia of Charlevoix-Saguenay (ARSACS) is an early-onset cerebellar ataxia with often presence of peripheral sensorimotor neuropathy and lower limb spasticity. Recently, the presence of pain has been associated with ARSACS in a quarter of the population in relation to spasms and neuropathic pain. However, limited therapeutic options available to patients and the occurrence of persistent symptoms despite treatment with the usual pharmacologic agents have led to exploring cannabis as a potential alternative. The aim of this study was to characterize the profile of cannabis use among patients with ARSACS. Phone interviews were conducted to document current or former cannabis use. Reasons of cannabis use and the characteristics of use were also investigated. Among the 50 study participants, 18% currently used cannabis, 40% reported at least one occurrence of cannabis use and 42% reported having never used cannabis. A greater proportion of patients with regular cannabis use reported chronic pain in comparison to those who never used. Although less frequent than ataxia, spasticity, muscle cramps or muscle spasms, which were independently reported by more than half of the studied sample, chronic pain was notably present in 30% of participants. While our study did not assess the therapeutic effects of cannabis, our results highlight that there is a potential role for cannabis and cannabinoids in the management of multiple ARSACS-associated symptoms and that agents modulating the endocannabinoid system need to be properly investigated.

Canadian guidelines for clinical practice: an analysis of their quality and relevance to the care of adults with comorbidity.

BACKGROUND: Clinical guidelines have been the subject of much criticism in primary care literature partly due to potential conflicts in their implementation among patients with multiple chronic conditions. We assessed the relevance of selected Canadian clinical guidelines on chronic diseases for patients with comorbidity and examined their quality. METHODS: We selected 16 chronic medical conditions according to their frequency of occurrence, complexity of treatment, and pertinence to primary care. Recent Canadian clinical guidelines (2004 - 2009) on these conditions, published in English or French, were retrieved. We assessed guideline relevance to the care of patients with comorbidity with a tool developed by Boyd and colleagues. Quality was assessed using the Appraisal of Guidelines Research and Evaluation (AGREE) instrument. RESULTS: Regarding relevance, 56.2% of guidelines addressed treatment for patients with multiple chronic conditions and 18.8% addressed the issue for older patients. Fifteen guidelines (93.8%) included specific recommendations for patients with one concurrent condition; only three guidelines (18.8%) addressed specific recommendations for patients with two comorbid conditions and one for more than two concurrent comorbid conditions. Quality of the evaluated guidelines was good to very good in four out of the six domains measured using the AGREE instrument. The domains with lower mean scores were Stakeholder Involvement and Applicability. CONCLUSIONS: The quality of the Canadian guidelines examined is generally good, yet their relevance for patients with two or more chronic conditions is very limited and there is room for improvement in this respect.

Characterization of cannabis use by patients with myotonic dystrophy type 1: A pilot study.

The treatment of myotonic dystrophy type 1 (DM1) focuses on reducing symptom burden. However, since medication often fails to produce satisfying symptom relief, some patients seek alternatives, such as cannabis, to help reduce some of these symptoms. The aim of this study was to provide an accurate profile of cannabis use among DM1 patients. Phone interviews were conducted to identify current and former users, and to assess reasons for cannabis use. Characteristics of cannabis use were also investigated. Briefly, among the 72 study participants, 22.2% currently used cannabis and a majority of them (56.9%) reported using it to relieve symptoms associated with DM1. These users, classified as therapeutic users, reported poorer health status (EQ-5D index scores: 0.532±0.230 vs. 0.823±0.208, p = 0.020; EQ-VAS scale 50.56±10.74 vs. 75.57±21.50, p = 0.009) than non-therapeutic users. Finally, differences among sex were also highlighted. While the therapeutic effects of cannabis were not explored in our study, our results support the potential role of cannabis and cannabinoids in the treatment of DM1-associated symptoms which will need to be thoroughly investigated.