Individual dietary counselling during and after pregnancy: Impact on diet and body weight

In Finland, maternity and child health clinics play a key role in promoting health in young families. Currently, obesity causes the greatest challenges to clinics. In obese pregnant women, an increased risk for metabolic diseases exist which can affect both the mother and child. The purpose of this thesis was to explore the role of dietary counselling: in Finnish health clinics; in the regulation of dietary intake; and in affecting the body weight of women. The main aim was to test the effect of dietary counselling and probiotic intervention on dietary intake and maternal body weight during and after pregnancy. In addition to dietary counselling, the effect of other factors, such as eating behaviour on dietary intake and body weight control after pregnancy was assessed. Another aim was also to evaluate dietary counselling practices by nurses (n = 327) in Finnish health clinics assessed by a questionnaire. At the beginning of the pregnancy, women (n = 256) enrolled in a dietary intervention study, were randomised into three groups. One group received dietary counselling with probiotics, one had counselling with placebo and the third group was the control group. The control group consisted of women whom did not receive counselling and took placebo. Probiotics and placebo supplements were used until the end of exclusive breastfeeding or six months after pregnancy. Women were followed from early pregnancy up to four years after pregnancy. Follow-up visits took place three times during pregnancy, at one and six months, and one, two and four years after pregnancy. Dietary counselling, provided by a nutritionist, aimed to influence the quality of dietary fat intake. Dietary counselling is important to provide in clinics, as determined by the nurses, and these nurses expressed a want to improve their own nutritional knowledge through education. The nurses had varying knowledge of current dietary recommendations. Dietary counselling for women during and after pregnancy resulted in beneficial changes in dietary intake up to one year after pregnancy and body weight and waist circumference up to four years after pregnancy. Probiotics had a beneficial effect together with dietary counselling on waist circumference until one year after pregnancy, but not throughout the long term, four years after pregnancy. Other factors, such as eating behaviour, associated with dietary intake and body weight control after pregnancy. Specifically, dietary recommendations are reached amongst women whom had high cognitive restraint in their eating behaviour and did not demonstrate uncontrolled eating. Overweight women more frequently emotionally ate compared to normal weight women and women with central adiposity related more frequently to having an uncontrolled eating behaviour than women with normal waist circumference. In addition, being overweight prior to pregnancy and excessive weight gain during pregnancy associated with increased body weight retention after pregnancy. This study showed that individual dietary counselling is useful in influencing dietary intake which adheres to dietary recommendations and this counselling influences, favourably, body weight after pregnancy. Especially, women with the risk for weight retention, such as women who have emotional and uncontrolled eating behaviours, who were overweight prior to pregnancy or those who had excessive weight gain during pregnancy, may benefit from individual dietary counselling. This study underscores the need to develop dietary counselling practices for pregnant women and their follow-up after pregnancy in Finnish health clinics. These practices include increasing the efficacy of the counselling such as collaboration with families, having knowledgable health professionals and having sufficient resources.

Exploring the Impact of Mental Health Education on Adolescents’ Perceptions About Mental Health and Mental Illness. Improving community health

The purpose of this study was to explore perceptions of mental health and mental illness as well as the perceptions towards people with mental illness among adolescents, and further to examine the impact that a mental health educational intervention has on these perceptions. The review of the literature revealed a small number of publications on mental health educational interventions among adolescents which aimed at increasing knowledge and affecting attitudes towards mental illness with positive results. Fifty nine pupils (13-16 years old) from two randomly selected secondary schools around Athens, Greece, participated in this study. These schools were randomly selected as the experimental group (n=28) which participated in the mental health educational intervention, and the comparison group (n=31), which did not receive any intervention. Data were collected using individual interviews with open-ended questions, drawings and a questionnaire (Opinions about Mental Illness - O.M.I. scale). The participants described mental health and mental illness before and after the intervention, using the same expressions for both terms. Among the experimental group, changes were seen within the same expressions after the intervention, although some descriptions did not change. However, after the intervention, participants in the experimental group did not confuse mental health with mental illness and they also included specific diagnostic examples or stated that mental illness can happen to anyone and it can be managed. Moreover, they expressed positive attitudes towards mentally ill people, which they had not done before the intervention. The analysis of the drawings before the intervention showed that mentally ill persons were drawn similarly in both groups. After the intervention, the drawings of the participants in the experimental group changed, including fewer negative elements, while the drawings of the comparison group did not change. Regarding the results on the O.M.I. scale, it was found that the score on the Social Discrimination factor significantly decreased from pre-test to post-test in both study groups. The experimental group had higher levels on Social Discrimination at pre-test compared to the comparison group, but this difference was not significant at post-test. No significant changes were found for the Social Restriction factor for either study group. Scores of the Social Care and Social Integration factors increased significantly only in the intervention group. Overall, the results of this study indicate that the mental health educational intervention had a positive impact on the perceptions about mental health and mental illness among adolescents, and (mental) health professionals can use these results for implementing similar interventions and further research.

Impact of socio-cultural and economic factors on vegetable consumption behaviours: case of Giresun province, Turkey

Many factors impact on food consumption behaviours. The aim of the study is to determine the impact of socio-demographic and ecological factors on vegetable consumption. A 14-question questionnaire was applied on a voluntary basis to 200 individuals who accepted to participate in the study. Their socio-demographic attributes and the vegetable consumption habits of their families were determined. Their average monthly budget for vegetables is € 31.82±12.72. The two attributes of purchased vegetables with most demand are cleanliness (61.5%) and freshness (22%). The maximum price per 1 kg of vegetables, which individuals with an income of € 301-450 can afford, is € 0.96, but for individuals with an income of > € 450, it is € 1.25. It was observed that the amount of purchased vegetables increased with the increase in the budget allocated for vegetables.

Impact of Product-harm Crisis on Brand Equity: the Moderating Role of Corporate Social Performance

There is an increasing amount of product-harm crisis in the past few years; and the impact of a product-harm crisis becomes more and more influential due to the high increasing speed of globalization. And it is believed that the negative damages to a firm leading to a loss of the intangible assets is bigger than other costs such as the cost of the product recall. Brand equity is a very important and valuable intangible asset for a firm; and it is particularly vulnerable during the crisis. And CSP (CSP) is a hot concept associated with product-harm crisis and brand equity. The aim of this study is to understand how product-harm crisis influences by simultaneously involving CSP as a moderator in a consumer-based level. An experimental study was conducted through an online questionnaire among 198 students in Finland. The questionnaire mainly assessed the consumers’ attitudes towards CSP and brand before/after a fictional product-harm crisis. The results shows that the brand equity was negatively related to the product-harm crisis. And the extent level of crisis’s severity was positively related to the loss of the brand equity; whereas, acknowledged blame was more useful to compensate the loss of brand equity in the low-severity crisis. CSP acted as a moderator role which could compensate the loss of brand equity caused by the product-harm crisis. Managerial implications are also offered for crisis managers, brand managers, and CSR managers.

Implementing the OPTIMAL model : the impact on students' motivation in an elementary school games environment

Optimal challenge occurs when an individual perceives the challenge of the task to be equaled or matched by his or her own skill level (Csikszentmihalyi, 1990). The purpose of this study was to test the impact of the OPTIMAL model on physical education students' motivation and perceptions of optimal challenge across four games categories (i. e. target, batting/fielding, net/wall, invasion). Enjoyment, competence, student goal orientation and activity level were examined in relation to the OPTIMAL model. A total of 22 (17 M; 5 F) students and their parents provided informed consent to take part in the study and were taught four OPTIMAL lessons and four non-OPTIMAL lessons ranging across the four different games categories by their own teacher. All students completed the Task and Ego in Sport Questionnaire (TEOSQ; Duda & Whitehead, 1998), the Intrinsic Motivation Inventory (IMI; McAuley, Duncan, & Tanmien, 1987) and the Children's Perception of Optimal Challenge Instrument (CPOCI; Mandigo, 2001). Sixteen students (two each lesson) were observed by using the System for Observing Fitness Instruction Time tool (SOFTT; McKenzie, 2002). As well, they participated in a structured interview which took place after each lesson was completed. Quantitative results concluded that no overall significant difference was found in motivational outcomes when comparing OPTIMAL and non-OPTIMAL lessons. However, when the lessons were broken down into games categories, significant differences emerged. Levels of perceived competence were found to be higher in non-OPTIMAL batting/fielding lessons compared to OPTIMAL lessons, whereas levels of enjoyment and perceived competence were found to be higher in OPTIMAL invasion lessons in comparison to non-OPTIMAL invasion lessons. Qualitative results revealed significance in feehngs of skill/challenge balance, enjoyment and competence in the OPTIMAL lessons. Moreover, a significance of practically twice the active movement time percentage was found in OPTIMAL lessons in comparison to non-OPTIMAL lessons.

Changing roles of nurse educators employed in acute and chronic care settings : the impact of professional and statutory mandates in Ontario at four sites of one hospital corporation /

The role of the hospital-employed nurse educator is evolving. Factors influencing this change include the introduction of standards for nurse educators by the College of Nurses of Ontario (CNO), a change in the way nurses are educated, the emergence of nursing as a profession, and hospital restructuring as a result of budgetary constraints. Two of these influencing factors: the introduction of the updated Standards of Practice for Registered Nurses and Registered Practical Nurses (1996) and hospital restructuring occurred over the last 7 years at several hospitals in southern Ontario. Current literature as well as the Standards of Practice (1996) were utilized to examine the current roles and responsibilities of nurse educators and subsequently develop a questionnaire to study the impact of these influencing factors on the role of the nurse educator. This questionnaire was piloted and revised before its distribution at 4 hospitals in southern Ontario. Twenty-five of the 41 surveys (61%) distributed were returned for analysis. The data reflected that the Standards of Practice had a positive influence on the role of the nurse educator, while hospital restructuring had a negative impact. In addition, many of the roles and responsibilities identified in the literature were indeed part of the current role of nurse educators, as well as several responsibilities not captured in the literature. The predictions for the future of this role in its current state were not positive given the financial status of the health care system as well as the lack of clarity for the role and the current level ofjob satisfaction among practicing nurse educators. However, a list of recommendations were generated which, if implemented, could add clarity to the role and improve job satisfaction. This could enhance the retention of current nurse educators and the possibility of recruiting competent nurse educators to the role in the future.

Teaching Principled negotiation skills to parents and their children : the impact of parental involvement /

This study explored the impact of training parents and children concurrently in principled negotiation skills for the purpose of developing negotiation skills and problem solving abilities in children. A second experimental group was utilized to determine the viability of negotiation skills training of junior elementary students for the purpose of improving problem solving and conflict resolving abilities. The student population in each experimental group was trained using The Program for Young Negotiators (Curhan, 1996). A control group was also established using the remaining grade four and five students attending the participating school. These students did not receive training as part of this study. Student group distribution was as follows: Experimental group 1 (students with parent participant) consisted of 10 (5 grade five and 5 grade 4 students), Experimental group 2 students without parent participant) consisted of 48 (20 grade 4 and 28 grade 5 students), and the Control group 3 (55 grade 4 and 5 students). The impact of training was measured using the Five Factor Negotiation Scale developed for use with the Program for Young Negotiators (Curhan, 1996). This measure was employed as a pre- and post-test questionnaire to the total student population, (113 students) to determine levels of ability in each of the key elements of negotiation, personal initiative, collaboration, communication, conflict based perspective taking, and conflict resolution approach (Nakkula & Nikitopoulos, unpublished). This measure has a coefficient alpha of .75 which is acceptable for this type of affective instrument. As well, open ended ability questions designed to measure ability, knowledge, and behaviour as they relate to negotiation skill application were given to the total student population, (113 students). Finally, journals were maintained by the students in both experimental groups, and informal feedback discussions were held with students and parents participating in the study.The intent of using both qualitative and quantitative measures was to provide an overall perspective of student abilities as they related to principled negotiation skills. While the quantitative measures were from the student perspective, more qualitative information was sought from parents and teachers through informal interviews, discussions, and use of confidential feedback cards. For analysis purposes, the ability questions were randomly selected for Experimental group 2 and Control group 3 in an effort to balance the groups more equitably with Experimental group 1. The findings of this study indicate that students of the junior elementary school age can be taught how to perceive conflict in a more constructive way. However, they are not as likely to use their skills when the conflict is with a sibling as they are with a peer, a teacher, or a parent. While no statistically significant differences between mean scores for Experimental groups 1 and 2 exist some subtle differences are noted. Overall, increases in mean scores for grade 4 students exceeded the increases for grade 5 students within Experimental group 1 . The implication being that younger students benefit more from having a parent trained in principled negoUation skills than older students. The skill level of a parent in principled negotiation can not be underesUmated. Without a consistent and effective role model the likelihood of developing student skill level to a point of automaticity is greatly reduced. Enough so that perhaps the emphasis should be placed on training parents more so than the students.

Improving the use of the nursing process: the impact of charting methodology developed from King's conceptual framework on the use of the nursing process

The purpose of this study was to assess the effects of changing a nursing documentation system, developed from King's Conceptual Framework, on the use of the nursing process. The null hypothesis was that there would be no significant increase in the reflection of the use of the nursing process on the nursing care plan or nurses' notes, as a result of using a nursing documentation system developed using King's Conceptual Framework (1981). The design involved the development of a questionnaire that was used to review health records pre and post implementation of a documentation system developed based on King's Conceptual Framework and Theory of Goal Attainment (1981). A Record Completeness Score was obtained from some of the questions. The null hypothesis was rejected. The results of the study have implications for nursing administration and the evaluation of nursing practice. If the use of a documentation system developed from a conceptual framework increases the reflection of the nursing process on the patient's health record, nursing will have the means to measure patient outcomes/goal attainment. All health care organizations and levels of government are focusing on methods to monitor and control the health-care dollar. In order for nursing to clearly determine the costs associated with nursing care, measurement of patient outcomes/goal attainment will need to be possible. In order to measure patient outcomes/goals attainment nurses will need to be able to collect data on their practice. It will be critical that nursing have a documentation system in place which facilitates the reflection of the nursing process within a theoretical framework.

The impact of meaningfulness of and responsibility for work on the relationships among work values, organizational commitment, and job satisfaction for part- time faculty in a community college

One hundred and thirty four subjects participated in this survey. Quantitative data were obtained and correlational analyses were used to test a model to study the relationships among the achievement of work values and organizational commitment and job satisfaction and to identify the moderating effects of the meaningfulness of work and responsibility for work on these relationships. Part-time faculty in the Faculty of Continuing Education of a community college were mailed a questionnaire on all the variables of the model. Several reliable, valid instruments were used to test the variables. Data analysis through Pearson correlation and stepwise multiple regression analyses revealed that the achievement of the work values of recognition and satisfaction with promotions did predict organizational commitment and job satisfaction, although the moderating effects of the meaningfulness of work and responsibility for work was not supported in this study. This study suggests that the revised model may be used for determining the relationships between the achievement of work values and organizational commitment and job satisfaction in a community college setting.

The impact of the Canadian Standardized Test of Fitness and of health counselling on health attitudes and behaviour

The purpose of this research study was to determine whether or not the use of a single day of Personal Wellness Evaluations would be meaningful enough to change the attitudes of participants toward adopting a healthier lifestyle, or if it was necessary to include regular planned health counselling alon-g with the Personal Wellness Evaluations in order to'observe changes in beliefs, attitudes and behaviours toward active living and the adoption of a healthier lifestyle. Attitudes and behaviours toward physical fitness and healthy lifestyle choices were assessed through a questionnaire composed of the following instruments: Fishbein and Ajzen Attitude and Behaviour Questionnaire, Leisure Behaviour Questionnaire, Ten Centimeter Bipolar Health Continuum, Neugarten Life Satisfaction Assessment, Job Description Index, Selected questions from the Ontario Health Survey, and the Symptom Reporting Questionnaire. Physical fitness evaluation consisted of the Canadian Standardized Test of Fitness, measures of blood pressure, and total cholesterol. The participants were divided into three groups: Group 1- CSTF & health counselling, Group 2- CSTF only, and Group 3- a control group. All three groups received the questionnaire both at the beginning and at the end of the study. Group 1 and Group 2 also participated in fitness testing at these same times, with a three-month time interval between test times. Group 1 also received weekly one-hour health education sessions during the three months between fitness testing. While there were some differences found between the three groups in this study, the results of this study suggested that this three-month workplace wellness program had no impact on the participants' attitudes and behaviours toward health and physical activity. There were no significant differences in the physical fitness measures between Group 1 and Group 2 , nor in the participants' questionnaire responses. These results may be due to the participants' lack of compliance to this wellness program. Employees who 11 participate in a workplace weIlness program must be self-motivated to comply with the program in order to receive the full benefits the program has to offer. Some participants in this study did not have the internal motivation necessary to remain in the study for the three-month period. Future research may consider implementing a workplace wellness program for a longer duration as well as incorporating a specific physical fitness program for the participants to follow. An exercise program could improve the participants' physical fitness, while the health counselling would give the individuals the health education necessary to lead a healthy lifestyle.

The impact of social competence between physical activity and motor performance

Objective: To identify the association of low physical activity (PA) participation in children with various motor performances (MP) and to establish the impact of social competence (SC). Methods: Sixth grade children from PHAST study at Brock University (n=1958; 50.53% males) had MP test results from Bruininks-Oseretsky Test of Motor Proficiency, Participation Questionnaire (PQ) used for PA and Harter Social Competence Scale for self-perceived SC. Comparative tests, multiple and logistic regressions were performed. Results: Significant differences in PQ measures in MP quartiles and SCs. MP and SC are independent predictors of PA (p<.05) except with SES on free play activity, making MP not significant. Lower MP increased the odds of low total PA and organized sport participation but not for free play activities (OR~1). Higher SC reduced the risk of low participation in all PA measures. Conclusions: SC improves PA participation, including free play and organized sports, despite the child’s MP.

Huile de palme rouge au Burkina Faso: Qualité et consommation par les femmes de la zone de production et impact sur leur statut en vitamine A

Dans le cadre de la recherche d’appui à la phase III du projet huile de palme rouge (HPR) au Burkina Faso, une étude de base a porté sur 150 femmes de la zone de production échantillonnées par la méthode aléatoire géographique. Leur statut en vitamine A (VA) a été évalué par HPLC et leurs apports alimentaires par un questionnaire de fréquence de consommation. Les connaissances, les perceptions, les habitudes d’utilisation et de consommation de l’HPR ont été explorées par un questionnaire pré-testé administré au domicile des participantes. Une étude comparative sur la qualité nutritionnelle, physico-chimique, microbiologique et sensorielle de 13 échantillons d’HPR de différentes provenances a été également réalisée. La prévalence de faibles rétinolémies était de 10,7% et les apports en VA provenaient à 90% des aliments d’origine végétale. Seules 5,9% des femmes productrices présentaient une faible rétinolémie, comparativement à 20,8% des femmes non-productrices d’HPR. Les échantillons d’HPR présentaient un profil satisfaisant mais quelques-uns étaient limites au plan microbiologique. En outre, aucun échantillon ne se distinguait nettement selon tous les paramètres de qualité étudiés. Cette étude démontre que les aliments d’origine végétale riches en caroténoïdes provitaminiques A, dont l’HPR qui en est la meilleure source, peuvent permettre d’avoir un statut adéquat en VA. Les risques de contamination de l’HPR au stade de la vente au détail impliquent une sensibilisation et une formation aux pratiques exemplaires de manipulation. Mots clés : Huile de palme rouge, vitamine A, diversification alimentaire, qualité, Burkina Faso.

Impact des TIC sur le sentiment d’auto-efficacité des enseignants du secondaire au Niger et leur processus d’adoption d’une innovation

Cette recherche porte sur le renforcement des sentiments de compétence professionnelle et d’auto-efficacité des enseignants du secondaire envers les habiletés techniques dans la formation aux TIC. Elle fait suite à un projet d’intégration pédagogique des TIC au lycée initié par le Campus numérique de Niamey. Après une formation des enseignants de lycée participant au projet d’alphabétisation informatique, notre étude est venue par la suite pour apprécier l’impact de cette formation aux TIC, via le CNF, sur le processus d’adoption de ces technologies par les enseignants. Les objectifs de la recherche sont les suivants : 1) évaluer l’impact de la formation aux TIC des enseignants du secondaire sur le processus d’adoption de ces technologies ; 2) décrire et analyser le cheminement parcouru par les enseignants ayant atteint un niveau élevé d’adoption des TIC ; 3) mieux comprendre l’impact de la formation aux TIC sur le sentiment de compétence professionnelle des enseignants (sentiments de compétence personnelle et générale) ; 4) Valider le Computer Self-Efficacy Scale (CSE) en français ; 5) Comprendre l’impact de la formation aux TIC sur le sentiment d’auto-efficacité à l’égard de l’utilisation de l’ordinateur des enseignants. Une enquête par questionnaires auprès de 69 enseignants représentant l’ensemble des enseignants de trois lycées de Niamey, et par des entrevues semi-dirigées auprès de six enseignants a permis de réaliser les objectifs de recherche. La thèse se fonde sur un mode de présentation par articles. Chaque article est en lien avec un ou deux objectifs de la recherche, suivant l’ordre précité. Les résultats révèlent une absence de relation entre la formation aux TIC des enseignants dispensée par le Campus numérique et les niveaux de l’innovation technologique en milieu scolaire de la typologie de Hall et Hord (1987). Les disparités dans les utilisations que font les enseignants des TIC témoignent de ce manque d’association. Par ailleurs, il apparaît que l’adoption des TIC dans l’éducation est embryonnaire au Niger. Cela fait que seuls quelques-uns de nos participants ont atteint les niveaux de sensibilisation et d’utilisation professionnelle constituant les deux premiers stades de l’usage pédagogique de la typologie de Raby (2005) qui en compte quatre. À la lumière des résultats, le sentiment de compétence personnelle est différent dans les deux groupes (enseignants formés et non formés), mais celui de compétence générale est apprécié de la même façon. Entre les enseignants formés aux TIC par les soins du campus numérique de Niamey et les autres, les résultats montrent une différence significative dans les niveaux d’habiletés techniques à l’égard de l’usage de l’ordinateur. Les forces et les limites de la recherche sont analysées et différentes recommandations sont proposées aux responsables éducatifs.

La qualité de vie durant la période gestationnelle : impact et prise en charge des nausées et des vomissements de la grossesse

Thèse numérisée par la Division de la gestion de documents et des archives de l'Université de Montréal

Dietary supplement use and its impact on nutritional adequacy for British Columbia and Manitoba First Nations adults living on reserve.

Contexte: L'utilisation de suppléments alimentaires est répandue chez les populations américaines et canadiennes en général, mais on en sait peu sur la consommation de suppléments alimentaires dans la population autochtone canadienne. Objectif: L'objectif général de cette étude est de prendre en compte l'utilisation de suppléments alimentaires dans l'évaluation nutritionnelle des apports alimentaires des adultes des Premières nations vivant dans les réserves en Colombie-Britannique et Manitoba. Conception: Les données ont été recueillies par l’étude ‘First Nations Food, Nutrition, and Environment Study’ de 1103 (Colombie-Britannique) et 706 (Manitoba) adultes des Premières Nations âgés de 19 à 70 ans. L'étude a utilisé un rappel alimentaire des dernières 24 heures (avec un deuxième rappel pour un sous-échantillon) pour évaluer la diète alimentaire. L'utilisation de suppléments alimentaires et des antiacides ont été recueillis par un questionnaire de fréquence. En utilisant le logiciel SIDE pour tenir compte des variations intra-individuelles dans la prise alimentaire et la technique du bootstrap pour obtenir des estimations représentatives des différentes régions, l'utilisation de suppléments de la vitamine A, D, C et de calcium ont été intégrées aux estimations de la consommation alimentaire. Résultats: Environ 30% des adultes des Premières Nations de la Colombie-Britannique et seulement 13,2% des adultes des Premières Nations du Manitoba âgés entre 19-70 ans vivant dans les réserves ont déclaré utiliser au moins un supplément alimentaire durant les 30 jours précédents. Lors de l'examen des nutriments d'intérêt, un plus faible pourcentage de la population en a fait usage, de 14,8 à 18,5% en Colombie-Britannique et de 4,9 à 8% de la population du Manitoba. La prévalence de l'usage de tout supplément alimentaire était plus élevée chez les femmes que chez les hommes dans tous les groupes d'âge et augmente avec l'âge dans les deux sexes. La plus forte prévalence d'un apport insuffisant provenant de la nourriture a été observée pour la vitamine D et le calcium en Colombie-Britannique et Manitoba, variant de 75 à 100%, et de la vitamine A dans le Manitoba (73-96%). Après avoir examiné l'utilisation de suppléments alimentaires, plus des trois quarts des participants n’ont toujours pas réussi à répondre au besoin moyen estimatif pour ces nutriments. La vitamine C est l'oligo-élément avec le plus faible pourcentage sous le besoin moyen estimatif (avec au sans suppléments) pour la Colombie-Britannique et le Manitoba. Conclusion: La majorité des adultes des Premières nations de la Colombie-Britannique et du Manitoba, même après prise en compte de l'utilisation de suppléments alimentaires, avaient des apports en vitamines A, D et des apports de calcium sous les niveaux recommandés. L'utilisation de compléments alimentaires n'a pas contribué de façon significative à l'apport total en nutriments sélectionnés sauf pour la vitamine C dans certains groupes d'âge.