Notice bibliographique
Résumé
Dr Chan-Yip is a member of the Caring for Kids New to Canada Editorial Board To the Editor; In their recent article, Caring for Kids New to Canada (1), Drs Charles Hui and Tony Barozzino call on us to better understand the distinctive needs of immigrant and refugee children in our care. I would like to draw attention to iron deficiency anemia (IDA) as a health problem prevalent among certain racial/ethnic groups in Canada and other developed countries (2–4). Understanding the cultural and psychosocial risk factors linked to such ethnic differences can facilitate health professionals’ implementation of IDA prevention strategies (5). Infant feeding and toddler eating habits are developmental processes strongly influenced by the mother’s and other caregivers’ traditional beliefs and knowledge of optimal nutrition (6). For example, cultural practice has been associated with feeding infants southeast Asian diets low in iron bioavailability (7). Contributing psychosocial risk factors for iron deficiency among young children may include food insecurity (8), or maternal fatigue and emotional stress from child-caring leading to excessive bottle feeding of whole cow's milk or prolonged breast feeding (6), which may subsequently lead to the development of both nursing caries and IDA. These risk factors are of particular relevance among recent refugee and immigrant families adapting to life in a new country (1). Having observed a high prevalence of IDA among young Chinese children in my Montreal (Quebec) practice (6), I led a randomized controlled trial in the 1980s (9) to identify potential contributing risk factors, including feeding rice congee as a complementary food, prolonged breastfeeding and fecal blood loss associated with whole cow milk feeding. Periodic enquiry regarding nutritional practice at health visits and the use of a three-day dietary record provided by mothers at one year of age were effective in identifying risk factors for iron deficiency, including misunderstanding/noncompliance with nutrition advice. Selective screening for iron deficiency with blood tests is indicated when risk factors are identified (10). Physicians should also be vigilant about following up on blood test results to ensure that patients with iron deficiency receive timely iron replacement therapy (10). Cultural and psychosocial influences leading to suboptimal nutrition practices can be overcome with a comprehensive dietary review using a language-appropriate Canada Food Guide and WHO Growth Standard. Such routines have the potential to prevent not only nutrient deficiency, but also nursing caries (6), overweight (3,11) and other eating problems in young children. Nutrition counselling for at-risk ethnic groups should include discussion of infant feeding with iron-fortified cereals and/or pureed meat rather than home-prepared cereals. A recent randomized controlled trial investigating the introduction of complementary foods to infants at four months of age versus six months of age demonstrated significantly higher serum ferritin levels in the former group (12). Earlier introduction may facilitate infant adaptation to the taste and texture of complementary foods, thus ensuring optimum dietary iron consumption by six months of age. Finally, prevention of iron deficiency of nutritional origin in infants and toddlers requires a multifaceted approach including public health policy, and community resources to promote prenatal education regarding iron nutrition to expectant mothers and to identify risk factors for nutrient deficiency in young children (2,4). Development and evaluation of culturally effective prevention strategies for immigrant and refugee families are urgently needed. I encourage every health professional to consult the Caring for Kids New to Canada e-book, an excellent resource for culturally appropriate health care. Here are some relevant chapters: Iron Deficiency and Iron Deficiency Anemia: www.kidsnewtocanada.ca/conditions/iron How Culture Influences Health: www.kidsnewtocanada.ca/culture/influence Barriers and Facilitators to Health Care for Newcomers: www.kidsnewtocanada.ca/care/barriers Cultural Competence for Child and Youth Health Professionals: www.kidsnewtocanada.ca/culture/competence
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,003 | 0,022 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,001 |
| Méta-épidémiologie (sens large) | 0,001 | 0,001 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,005 | 0,002 |
| Communication savante | 0,004 | 0,002 |
| Science ouverte | 0,002 | 0,002 |
| Intégrité de la recherche | 0,036 | 0,024 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,015 | 0,009 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».