Impacts of colonization on Indigenous food systems in Canada and the United States: a scoping review.

BACKGROUND: Indigenous populations in Canada and the United States (US) have maintained reciprocal relationships with nature, grounded in respect for and stewardship of the environment; however, disconnection from traditional food systems has generated a plethora of physical and mental health challenges for communities. Indigenous food sovereignty including control of lands were found to be factors contributing to these concerns. Therefore, our aim was to conduct a scoping review of the peer-reviewed literature to describe Indigenous disconnection from Indigenous food systems (IFS) in Canada and the US. METHODS: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Reviews (PRISMA-SR) and Joanna Briggs Institute guidelines, we searched MEDLINE, SCOPUS, International Bibliography of the Social Sciences, Sociological Abstracts, and Bibliography of Native North Americans. Data was extracted from 41 studies and a narrative review completed based on study themes. RESULTS: The overarching theme identified in the included studies was the impact of colonization on IFS. Four sub-themes emerged as causes for Indigenous disconnection from traditional food systems, including: climate change; capitalism; legal change; and socio-cultural change. These sub-themes highlight the multiple ways in which colonization has impacted Indigenous food systems in Canada and the US and important areas for transformation. CONCLUSIONS: Efforts to reconnect Indigenous knowledge and values systems with future food systems are essential for planetary health and sustainable development. Traditional knowledge sharing must foreground authentic Indigenous inclusion within policymaking.

What's new in acne? An analysis of systematic reviews published in 2009-2010.

This review highlights clinically important findings about acne treatment identified in nine systematic reviews published or indexed in the period March 2009 to February 2010. A systematic review of dietary influences on acne suggested that a possible role of dietary factors in acne cannot be dismissed, as the studies to date have not been sufficiently large or robust. Another review looked at benzoyl peroxide, which may be enjoying a comeback because of increasing bacterial resistance to antibiotics, and suggested that there was a lack of evidence that stronger preparations were more effective than weaker ones. The same team also carried out a systematic review addressing the question of whether topical retinoids cause an initial worsening of acne. They found no evidence to suggest initial worsening of acne severity, although there was evidence of skin irritation that typically settled by 8-12 weeks. A review of oral isotretinoin and psychiatric side-effects reinforced a possible link between the two, although it pointed out that the better-quality primary studies were still inconclusive. An updated Cochrane Review confirmed the efficacy of combined oral contraceptives (COCs) in reducing acne lesion counts. It also found that the evidence to support COCs containing cyproterone acetate over others was very limited. Another Cochrane Review failed to show any benefit of spironolactone for acne, based on limited studies. Three reviews examined laser and light therapies, and found some evidence of superiority only for blue or blue/red light treatment over placebo light, but a general absence of comparisons against other acne treatments. Photodynamic therapy had consistent benefits over placebo but was associated with significant side-effects and was not shown to be better than topical adapalene.

Toward establishing a unified metric for performance and learning goal orientations.

Findings in the goal orientation literature are convoluted due to sample and scale dependent interpretations and potentially the use of inappropriate measurement models for ordinal data. The purpose of this investigation was to explore the possibility of developing a common metric in order to enhance communication among goal orientation researchers using different scales. A simultaneous calibration of four commonly used goal orientation scales was undertaken to investigate if item responses meet the unidimensionality requirement of Rasch models and hence provided a common metric. Participants were 305 third year psychology students at a large University in France. Results indicated that 30 of 36 learning goal and 28 of 33 performance goals items from the four scales defined unidimensional constructs. Correlations between person measures from the four scales and the simultaneous calibration for both learning goal and performance goals support the interpretation of unidimensional variables. Raw score to interval measure conversion tables provide goal orientation researchers using different scales a common metric for interpretation and statistical analyses. Limitations and extensions of this research are discussed.

Evidence for the reliability of measures and validity of measure interpretation: a Rasch measurement perspective.

In an era of high stakes testing and evaluation in education, psychology, and health care, there is need for rigorous methods and standards for obtaining evidence of the reliability of measures and validity of inferences. Messick (1989, 1995), the Standard for Educational and Psychological Testing (American Psychological Association, American Educational Research Association, and National Council on Measurement in Education, 1999), and the Medical Outcomes Trust (1995), among others, have described methods that may be used to gather evidence for reliability and validity, but ignored the potential role Rasch measurement may contribute to this process. This article will outline methods in Rasch measurement that are used to gather evidence for reliability and validity and attempt to articulate how these methods may be linked with the current views of reliability and validity.

Attention Deficit Hyperactivity Disorder: scaling and standard setting using Rasch measurement.

This paper explores the dimensionality of responses to the Adult Behavior Checklist Revised, a screening assessment for Attention Deficit Hyperactivity Disorder (ADHD) in college students, and demonstrates a standard setting process for diagnostic rating scales. Responses from 317 undergraduate college students were used to investigate dimensionality; 8 judges were used for the standard setting procedure. A series of Rasch rating scale analyses support the interpretation of Inattention and Impulsivity/Hyperactivity variables. Principal component analyses of residuals identified the existence of secondary variables that may have clinical implications for the evaluation and treatment of ADHD. For the standard setting process, judges generally displayed less variability than expected by the model. Several judges were in disagreement as to the level of symptomatology needed to indicate potential ADHD. The derived standard for Inattention was found to be more stringent than a previously suggested standard while the derived standard for Hyperactive/Impulsive more lenient. Prevalence rates found a diagnosis of Hyperactive/Impulsive to be more common than a diagnosis of Inattention. Efficient screening assessments for ADHD in college students are needed in order to determine who may qualify for further evaluation and special services. The standard setting process attempts to identify judge disagreement regarding the level of symptomatology (the standard) needed to qualify for additional evaluation and identify judge response strings not consistent with the item difficulties. Recommendations suggesting additional work on the screening assessment and standard setting process are outlined.

Metric development and score reporting in Rasch measurement.

This article: 1) describes problems in score reporting with the True-Score Model, 2) presents a definition of the Rasch measurement unit, the logit, 3) reviews various transformations of the logit metric, and 4) provides examples of score reporting procedures. Two data sets are used. The first contains dichotomous data drawn from responses to a multiple-response statistics examination taken by Ph.D. students; the second contains polychotomous data from a self-efficacy assessment given to war veterans suffering from Post Traumatic Stress Disorder.

Development of a scale to assess concern about falling and applications to treatment programs.

This study used Rasch methodology to pursue three goals. First, we sought to demonstrate the psychometric limitations of the Falls Efficacy Scale (Tinetti, Richman, & Powell, 1990). Second, we addressed these limitations using a simultaneous calibration of the Falls Efficacy Scale and Mobility Efficacy Scale items. Third, we review previous explorations of the self-efficacy construct in relationship to health behaviors and discuss a possible treatment program based on the simultaneous calibrated items and Social Cognitive Theory. Results indicate that responses from the Falls Efficacy Scale fail to assess the higher ends of the self-efficacy continuum. Simultaneous calibration of items improved this lack of scale definition. This initial work in assessing self-efficacy perceptions provides a theoretical framework for planning treatment programs that may be more cost effective than collecting performance measures.

Underreporting of Lyme disease by Connecticut physicians, 1992.

To determine the magnitude of underreporting of Lyme disease, a random sample of Connecticut physicians was surveyed in 1993. The magnitude of underreporting was assessed by comparing physician estimates of Lyme disease diagnoses with reports of Lyme disease sent by physicians to the Connecticut Lyme disease surveillance system. Complete questionnaires were returned by 59 percent (412/698) of those surveyed. Of the 224 respondents who indicated that they had made a diagnosis of Lyme disease in 1992, only 56 (25 percent) reported a case of Lyme disease that year. Survey results suggested that, at best, only 16 percent of Lyme disease cases were reported in 1992. Physician underreporting of Lyme disease underestimates the public health impact of Lyme disease.

An NMR blood test for uveal melanoma?

In a recent article a simple nuclear magnetic resonance (NMR) blood test was suggested for the detection of the presence of cancer. The test's sensitivity to uveal melanoma of both pre- and posttreatment status has been investigated. Cases in this study were 95 patients with uveal melanoma, and controls were 70 participants in an ongoing case control study of retinal eye disease being conducted at the Massachusetts Eye and Ear Infirmary. Proton NMR evaluations at 4.7 T (200 MHz) were performed on plasma obtained from EDTA and citrated blood samples. The average line-width values were calculated from each spectrum. Statistical analysis revealed that mean proton NMR line widths were essentially equal for patients with treated (18.7 Hz) and untreated tumors (18.4 Hz) and for controls (18.5 Hz). Results based on this data set suggest that proton NMR spectroscopy has little predictive power in the detection of uveal melanoma or in the monitoring of therapy.

Magnetic resonance imaging: an emerging technique for the diagnosis of ocular disorders.

With developments in proton and sodium imaging on eyes and ocular lesions, MRI has been rapidly advancing into the field of ophthalmology. Although many intraocular lesions have been T1 and T2 characterized, and MRI may aid in their diagnosis, there remain a few problems with the technique. One is the presence of motion artifacts which sometimes occur with lengthy scanning times. A patient must be imaged on the order of minutes with MRI. In addition ambiguities exist even with the T1 and T2 characterizations, although the specificity surpasses that of CT. Eventually these problems may be solved, but even now proton coupled with sodium imaging and other diagnostic techniques appear promising in the evaluation of ocular disorders.

Learning from the past, improving upon the present: traditional and western medical systems at the juncture.

Each cultural group has a reality which consists of a formal multi-centuried tested system of beliefs and practices. That system potentially inhibits or facilitate the acceptance of newly introduced technology and ideas. Among the critical beliefs and practices are those related to health and well-being. This article compares and contrasts "western" and "traditional" medical systems located both in the United States and other parts of the world. It discusses health and policy related postures concerning the "traditional medical system" taken by several countries and organizations. It, further, provides an overview of some current trends related to the recognition and acknowledged value of traditional medicine world-wide.

Low-dose acebutolol given once daily in the treatment of chronic angina pectoris.

Acebutolol, a beta-1 selective beta blocker with intrinsic sympathomimetic activity has been shown to be an effective agent in chronic angina pectoris therapy, with twice or three times daily dosing. The long-term effects of 400 mg of acebutolol given only once a day versus placebo on exercise hemodynamics, ST segment depression, and rate pressure product were studied. Eleven patients (mean age, 60 +/- 12 years) with hypertension and chronic angina pectoris were enrolled. Resting heart rate was not significantly altered after therapy, (80 vs 72 bpm). Objective measurements from exercise treadmill tests showed significant reduction in peak heart rate from 130 to 103 bpm, systolic blood pressure from 197 to 167 mm Hg, rate pressure product (from 25 to 18 bpm-mm Hg X 1000), and ST depression in patients receiving acebutolol compared with those receiving placebo. No significant adverse effects were reported. These data indicate that acebutolol may be efficacious as once daily therapy for chronic stable angina pectoris.

Clinical parameters of adolescent Hispanic male hypertensive subjects: a new subject?

We have previously reported an increased prevalence of elevated blood pressure in Hispanic adolescent males. The pressure elevation did not correlate with weight. In this study, we evaluated the response to antihypertensive therapy of eight adolescent Hispanic males found to have elevated pressure during high school screening. All patients were placed on placebo tablets b.i.d. for 2 weeks with weekly blood pressure readings. Those with persistently elevated pressures (at or above the 95th percentile) underwent laboratory testing, exercise testing, and echocardiography. An age-matched group of Hispanic adolescents with blood pressure recording below the 90th percentile were also exercised. Patients were then placed on 0.1 mg clonidine b.i.d. for 12 weeks. Pretherapy exercise testing demonstrated an abnormal systolic hypertensive response (mean 193 +/- 43 mmHg) that improved after therapy (mean 167 +/- 28 mmHg). Echocardiographic data were normal. All patients had elevated levels of VLDL and triglycerides. Five patients also had HDL levels below the 50th percentile for age and sex. We conclude that this population is similar to other hypertensive adolescent populations in exercise response pre- and posttherapy with clonidine, but they demonstrated a unique clinical feature in the elevation of the VLDL and triglyceride lipoprotein fractions.

Exporting the American (information) revolution: the international impact of the National Library of Medicine.

The National Library of Medicine has had an enormous impact on health information services all over the world. Although NLM is primarily a national institution, it has become an important international resource by responding to requests from the international community. NLM has been influential in three major ways. First, NLM has provided a model for other national and regional health information services. Second, it has been a catalyst, in that MEDLARS and other services it provides formed the nucleus of many regional networks. NLM helped such networks get started by giving advice on how to set up services and build collections and by "training the trainers" on the MEDLARS system. Third, NLM has supported national and regional operations by providing the additional training and materials needed for day-to-day service.