Highlights
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**Diabetes among First Nations** 

The incidence and prevalence of diabetes in women from First Nations is about four times higher than that in women who are not from the First Nations. In men from First Nations, the corresponding figure is 2.5 times higher than that in other people. Dyck and colleagues studied administrative databases to do a population-based study of the epidemiology of diabetes. The rapid appearance of type 2 diabetes, particularly in First Nations people and other indigenous and developing populations, has been precipitated by environmental rather than genetic factors, they say. **See Research, page** [249](http://www.cmaj.ca/lookup/volpage/182/249?iss=3)

![Figure1](http://www.cmaj.ca/https://www.cmaj.ca/content/cmaj/182/3/221/F1.medium.gif)

[Figure1](http://www.cmaj.ca/content/182/3/221/F1)

Image courtesy of © 2010 Jupiterimages Corp.

**Birth outcomes in Inuit-inhabited areas** 

Inuit-inhabited areas had much higher rates of preterm birth, stillbirth and infant death compared to the rest of Canada and other rural or northern areas, finds a cohort study by Luo and colleagues. The risk ratios and absolute differences changed little over time. Maternal disparities accounted for only a small part of the differences in risk. **See Research, page** [235](http://www.cmaj.ca/lookup/volpage/182/235?iss=3)

**Food insecurity among Inuit preschoolers** 

Nearly 70% of Inuit preschoolers reside in households that rate as being food insecure. This is the finding of a cross sectional survey of health status of 388 randomly selected Inuit children from Nunavut. **See Research, page** [243](http://www.cmaj.ca/lookup/volpage/182/243?iss=3)

Research on indigenous populations needs to move past descriptive research to an understanding of the factors, environments and programs that yield the best outcomes for indigenous people — in scientific and indigenous terms. **See Commentary, page** [228](http://www.cmaj.ca/lookup/volpage/182/228?iss=3)

![Figure2](http://www.cmaj.ca/https://www.cmaj.ca/content/cmaj/182/3/221/F2.medium.gif)

[Figure2](http://www.cmaj.ca/content/182/3/221/F2)

Image courtesy of © 2010 Jupiterimages Corp.

**Severe disease in patients with pandemic (H1N1) influenza** 

Patients with pandemic (H1N1) 2009 influenza who require intensive care have a longer interval from the onset of symptoms to treatment with antiviral agents than patients who do not need intensive care. People of First Nations ethnicity also appear to be at higher risk of severe disease. **See Research, page** [257](http://www.cmaj.ca/lookup/volpage/182/257?iss=3)

**Acute asthma in the emergency department** 

Failure to recognize a potentially life-threatening exacerbation and to treat it aggressively could be a reason for death from acute asthma. This is one of the key messages in the review of asthma by Hodder and colleagues. A modified rapid sequence technique should be used to intubate patients with acute asthma, they add. **See Reviews, page** [265](http://www.cmaj.ca/lookup/volpage/182/265?iss=3)

**Individual-level data on vaccination** 

Nationally coordinated efforts to capture individual-level vaccination data can help in the fight against all diseases that can be prevented by vaccines. Such data are critical for the timely evaluation of vaccine coverage, effectiveness and safety at the population level and allow rapid response. **See Analysis, page** [273](http://www.cmaj.ca/lookup/volpage/182/273?iss=3)

![Figure3](http://www.cmaj.ca/https://www.cmaj.ca/content/cmaj/182/3/221/F3.medium.gif)

[Figure3](http://www.cmaj.ca/content/182/3/221/F3)

Image courtesy of © 2010 Jupiterimages Corp.

**D-lactic acidosis and reversible cerebellar ataxia** 

A 49-year-old man with Crohn disease presented with a short history of impaired concentration, blurry vision, unsteady gait and difficulty in speaking. He improved within 24 hours after treatment for D-lactic acidosis. **See Practice, [276](http://www.cmaj.ca/lookup/volpage/182/276?iss=3)**

**Iatrogenic atrial fibrillation** 

Arrhytmias can result from mechanical stimulation of the pericardium — as is exemplified in this report about a 54-year-old man whose atrial fibrillation was caused by a chest tube. **See Clinical images, page** [280](http://www.cmaj.ca/lookup/volpage/182/280?iss=3)