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J Moisan

Publications and source records attributed to J Moisan.

28 records · Page 2Linked to original sources

Diet and age at menarche.

Early menarche has been associated with higher risk of breast cancer. A prospective study has been conducted in Quebec City, Canada, to evaluate the relationship of dietary intake to age at menarche. On three occasions during the schoolyear 1986-87, 2,299 pre-menarche. Incidence density ratios (IDRs) adjusted for age at entry and mothers' age at menarche were computed using proportional hazards models. IDRs for quartiles of energy, nutrient and food-group intakes were not different from the null value. In this population of well-nourished girls, diet did not influence the age at onset of menarche.

Adolescent↗

A nested case-control study of the correlates of early menarche.

Age at menarche, an early determinant of breast cancer risk, shows both a downward secular trend and marked differences by socioeconomic status, both presumably the reflection of dietary variations. A cohort study is being conducted in the Quebec City, Canada, area to assess the relation between diet, physical activities, and menarche. In the fall of 1986, 3,022 fifth-grade girls (mean age, 10.7 years) agreed to participate in the study. All of the girls' parents provided information on health, familial, and socioeconomic variables. A 3-day dietary record and a 7-day physical activity recall were provided by 95.8% of the girls. All dietary information was verified with each girl by a dietician. Body weight and height and two skinfold thickness measurements were also recorded for 98% of the subjects. At the beginning of the study, 107 girls had already experienced menarche. In the fall of 1987, letters were sent to the mothers of the remaining 2,915 girls; 2,854 (97.9%) responded. In the preceding year, 352 girls had reached menarche. Of these, 333 (94.6%) had provided baseline dietary data. A case-control analysis was conducted in which these 333 girls were compared with 333 age-matched premenarcheal girls. There was a weak association between energy intake, energy expenditure, and early menarche. Weight, height, skinfold thickness, mother's age at menarche, and participation in a dance, ballet, gymnastics, or figure skating club were also associated with the early onset of menstruation.

Anthropometry↗

Dietary and physical determinants of menarche.

Age at menarche shows a downward secular trend and differs according to socioeconomic conditions, presumably the result of dietary variations. We report two studies conducted in Quebec City in which the relation between diet and menarche was evaluated. In 1978-1980, baseline information for these studies was obtained on girls aged 9 through 15 and included body weight, height, fatfold thickness at six sites, percent of body fat (derived from underwater weighing), and a 3-day dietary record. In a cross-sectional study of 207 girls aged 11 through 15, we compared dietary patterns between premenarcheal and menarcheal girls using logistic regression. In a 6-year follow-up study of 109 girls who had not experienced menarche at the baseline data collection, the relation between time of occurrence of menarche and dietary patterns was assessed using proportional hazards models. The results confirm the association between body weight and age at menarche. Body fat, however, was not strongly related to the onset of menstruation. In both studies, a higher dietary energy intake was associated with an earlier age at menarche. Dietary composition, and dietary fat in particular, was not related to menarche.

Adolescent↗

Effect of family responsibilities and job strain on ambulatory blood pressure among white-collar women.

OBJECTIVE: This study was conducted to determine whether large family responsibilities and their combination with high job strain were associated with an increase in ambulatory blood pressure (BP) among white-collar women. METHODS: A cross-sectional study was conducted in a stratified random sample of 199 white-collar women with or without children who were employed full time in jobs involving high or low strain. These women were selected from a population of 3183 women of all ages, employed in eight organizations in Quebec City, Canada. Subjects wore an ambulatory BP monitor for 24 hours during a working day. Mean BPs were calculated. Different measures of family responsibilities were used, based on the number of children and their ages, and domestic work. Job strain was measured using the Job Content Questionnaire recommended by Karasek. RESULTS: Family responsibility measures were significantly related to diurnal BP among women holding a university degree (N=69). Indeed, women having large family responsibilities had increases in systolic and diastolic BPs of 2.7 to 5.7/1.8 to 4.0 mm Hg (p< or =.05). Among women holding a university degree, increases in diurnal systolic and diastolic BPs reached 8.1 to 10.9/5.5 to 7.1 mm Hg (p< or =.01) among women having both large family responsibilities and high job strain. These results were independent of confounders. There was no significant association among women without a university degree (N=130). CONCLUSIONS: Large family responsibilities were associated with significant increases in diurnal systolic and diastolic BPs among white-collar women holding a university degree. In these women, the combined exposure of large family responsibilities and high job strain tended to have a greater effect on BP than the exposure to only one of these factors.

Adolescent↗

Inter-provincial variation in government drug formularies.

In Canada, coverage for ambulatory prescription drug expenditures is provided to some groups by provincial drug plans through a provincial formulary. Little is known about the drugs provincial formularies give access to. We report the variation in availability of new drug molecules (NDM) across provincial formularies. We identified 108 NDM approved in Canada between 1991 and 1998. From each drug plan bulletin or formulary, we abstracted names of NDM listed as per 15 January 1999. We compared the level of listing across provinces using kappa coefficients. In the Quebec, BC, Manitoba and Saskatchewan formularies, more than 70% of the NDM were listed. In four provinces, this proportion was lower than 50%. In general, the agreement between formularies was poor. There is a wide variation across provinces in terms of NDM listed in the formularies. This variation reflects inter-provincial differences in the way drugs are selected for coverage.

Canada↗

[Evaluation of the prescription quality: hospital databases].

Hospital databases can be used to evaluate drug prescription quality with the help of drug utilization review (DUR). A DUR appraises the appropriateness of prescribing by means of explicit criteria established in accordance with evidence-based data, and then suggests interventions designed to modify prescriber's practice. On the one hand, the capacity of the review to show the variations, and, on the other hand, the assessment of the impact of interventions implemented to correct those variations, depend on the quality of hospital databases. This article has two objectives: to identify the required data, both to carry out a DUR and to evaluate its outcomes, and to define the essential qualities of hospital databases.

Canada↗

[Evaluation of a project for nutritional rehabilitation at home in Benin].

Childhood malnutrition is a public health problem in most developing countries and the rehabilitation of malnourished children is a real challenge for health services. The main aim of this study was to evaluate the implementation of a community-based strategy for nutritional rehabilitation at home (NRH). This strategy was assessed in two districts of Benin. We also evaluated its effects on the nutrition status of the children involved in the study. Screening and rehabilitation protocols were developed for the project and were defined before the study began. The implementation process was evaluated by checking whether the children registered for NRH had received adequate treatment from the health agencies. Intervention was judged to be adequate if it was consistent with that previously set out in the rehabilitation protocol. The variables studied concerned whether the health workers had adequately implemented NRH and had applied UNICEF's three. "A" (Assessment, Analysis and Action). The results of the rehabilitation process were recorded. The weight and age of the children were determined to evaluate changes in their nutrition status. The study population was a group of 452 children aged 0 to 35 months old. The frequency of NRH sessions was adequate in 259 cases (57.9%), the quality of observations and advice was adequate in 284 cases (63.1%) and the protocol was followed properly in 151 cases (34.1%). At inclusion, 191 children (42.3%) were suffering from mild malnutrition and 146 (32.3%) were suffering from severe malnutrition. Seventy children (15.5%) were rehabilitated as defined in the protocol standards. One hundred and fifty nine children (35.2%) were lost to follow-up, 83 (18.4%) stopped the treatment and 83 (18.4%) were declared rehabilitated when they were not. The nutrition status of 69 of the 70 children who completed NRH had improved. Thus, there are flaws in the implementation process, with the three "A" not being reliably applied by health workers, particularly in terms of analysis and action. However, NRH does seem to be effective for the rehabilitation of children suffering from malnutrition, improving their nutrition status at least.

Benin↗