Press release

Anemia in Cree infants

p. 323  Prevalence of anemia among James Bay Cree infants of northern Quebec — N.D. Willows, J. Morel, K. Gray-Donald [full article]

p. 343  Breast-feeding and anemia: Let's be careful — J.C. Godel [full article]

Authors of a study of 9-month-old Cree infants living in northern Quebec report that one-third of these children were anemic and that this was more of a problem among breast-fed babies than formula-fed infants.

Six Cree communities in the James Bay region introduced a screening program in 1995 to identify anemia in infants. Katherine Gray-Donald and colleagues reviewed the charts of 386 of these children and discovered 31.9% were anemic. To understand the cause of the anemia, Gray-Donald and her colleagues tested the association between hemoglobin (Hb) concentration and mean cell volume at 9 months of age, weight gain between birth and 9 months, and type of milk consumed when the infant visited the 9-month well-baby clinic.

The authors report that babies fed formula at 9 months had a higher mean Hb concentration (118.5 [standard deviation (SD) 9.9] g/L) than those exclusively breast-fed (109.9 [SD 10.0] g/L) or cow's milk (112.5 [SD 10.1] g/L).

Since research shows that iron-deficiency anemia is associated with psychomotor impairment, the authors warn the high prevalence among Cree infants should be considered a serious health problem.

In a related editorial, Dr. John Godel warns this study has important implications for public health and nutrition programs. While stating that "breast is best," he recommends supplying additional sources of iron to breast-fed infants after 6 months of age as a way to avoid the severe neurologic and developmental effects associated with iron-deficiency anemia.

p. 331  Gay and lesbian physicians in training — C. Risdon, D. Cook, D. Willms [full article]

Gay and lesbian medical students and residents often feel they must balance the risk of disclosing their sexual orientation against enduring homophobic attitudes or even damaging their career.

Cathy Risdon and colleagues' qualitative study of the experiences of 29 gay or lesbian physicians training in 4 cities paints a picture of trainees struggling between being honest and true to themselves and risking negative — and even hostile — reactions from peers. Those coping with their first awareness of themselves were found to be especially vulnerable.

Risdon and colleagues recommend more proactive training programs acknowledging and supporting diversity, and more use of professional and peer role models as methods to improve the situation.

p. 362  The Internet and evidence-based decision-making: a needed synergy for efficient knowledge management in health care — A.R. Jadad, R.B. Haynes, D. Hunt, G.P. Browman [full article]

This paper comments on the early signs of convergence between the evidence-based decision-making and the Internet. Dr. Alejandro Jadad and colleagues argue that more cooperation and rigorous evaluation is needed to ensure that Internet-related health initiatives reach their full potential.

The authors cite examples such as the Cochrane Collaboration, which uses the Internet to provide access to peer reviewed health studies, as positive "transition" steps from paper-based to electronic media. They argue that the true technological revolution will come with increases in bandwidth that will allow more multisensory modes of communication and "ubiquitous" computing.

p. 339  Use of physical and chemical restraints in medical teaching units — J.V. Kow, D.B. Hogan [full article]

In their retrospective review of the use of physical and chemical restraints, Janet Kow and David Hogan found that out of 156 patients admitted to a medical teaching units in an acute care hospital, 18 patients (11.5%) were either physically or chemically restrained, or both.

The authors found a general lack of documentation regarding restraints, and while physicians usually ordered their use, it generally became a nursing decision as to whether or not they were applied. They also recommend guidelines on the rational use of restraints be developed.

© 2000 Canadian Medical Association or its licensors