OBJECTIVE: To investigate determinants of the acceptability of isoflavone products among postmenopausal women with regard to social and lifestyle factors, dietary habits, health concerns, food beliefs, menopausal symptoms and therapies, and to elucidate preferences for specific products. METHODS: A consumer survey was conducted among postmenopausal women in four European countries (Germany, Denmark, Italy and the UK), including a total of 465 respondents. RESULTS: The declared acceptability of isoflavones was highest in Germany (80%), followed by Italy (75%), the UK (59%) and Denmark (55%; p
The College of Physicians and Surgeons of Alberta, in collaboration with the Universities of Calgary and Alberta, has developed a program to routinely assess the performance of physicians, intended primarily for quality improvement in medical practice. The Physician Achievement Review (PAR) provides a multidimensional view of performance through structured feedback to physicians. The program will also provide a new mechanism for identifying physicians for whom more detailed assessment of practice performance or medical competence may be needed. Questionnaires were created to assess an array of performance attributes, and then appropriate assessors were designated--the physician himself or herself (self-evaluation), patients, medical peers, consultants and referring physicians, and non-physician coworkers. A pilot study with 308 physician volunteers was used to evaluate the psychometric and statistical properties of the questionnaires and to develop operating policies. The pilot surveys showed good statistical validity and technical reliability of the PAR questionnaires. For only 28 (9.1%) of the physicians were the PAR results more than one standard deviation from the peer group means for 3 or more of the 5 major domains of assessment (self, patients, peers, consultants and coworkers). In post-survey feedback, two-thirds of the physicians indicated that they were considering or had implemented changes to their medical practice on the basis of their PAR data. The estimated operating cost of the PAR program is approximately $200 per physician. In February 1999, on the basis of the operating experience and the results of the pilot survey, the College of Physicians and Surgeons of Alberta implemented this innovative program, in which all Alberta physicians will be required to participate every 5 years.
Cites: J Gen Intern Med. 1993 Mar;8(3):135-98455109
Cites: CMAJ. 1990 Dec 1;143(11):1193-92224696
Cites: Fam Pract. 1996 Feb;13(1):52-88671104
Cites: CMAJ. 1995 Dec 15;153(12):1723-88529186
Cites: Acad Med. 1994 Mar;69(3):216-248135980
Cites: Acad Med. 1993 Sep;68(9):680-78397633
Cites: JAMA. 1993 Apr 7;269(13):1655-608240483
Comment In: CMAJ. 1999 Jul 13;161(1):44-510420865
Comment In: CMAJ. 2000 Jun 27;162(13):180310906910
There is increasing interest in examining the influence of the built environment on physical activity. High-resolution data in a geographic information system is increasingly being used to measure salient aspects of the built environment and studies often use circular or road network buffers to measure land use around an individual's home address. However, little research has examined the extent to which the selection of circular or road network buffers influences the results of analysis. The objective of this study is to examine the influence of land use type (residential, commercial, recreational and park land and institutional land) on 'walking for leisure' and 'walking for errands' using 1 km circular and line-based road network buffers. Data on individual walking patterns is obtained from a survey of 1311 respondents in greater Vancouver and respondent's postal code centroids were used to construct the individual buffers. Logistic regression was used for statistical analysis.
Using line-based road network buffers, increasing proportion of institutional land significantly reduced the odds of 'walking for leisure 15 minutes or less per day' no significant results were found for circular buffers. A greater proportion of residential land significantly increased the odds of 'walking for errands less than 1 hour per week' for line-based road network buffer while no significant results for circular buffers. An increased proportion of commercial land significantly decreased the odds of 'walking for errands less than 1 hour per week' for both circular and line-based road network buffers.
The selection of network or circular buffers has a considerable influence on the results of analysis. Land use characteristics generally show greater associations with walking using line-based road network buffers than circular buffers. These results show that researchers need to carefully consider the most appropriate buffer with which to calculate land use characteristics.
Cites: Am J Prev Med. 2007 Apr;32(4):298-30417383560
Cites: Public Health. 2006 Dec;120(12):1127-3217067646
Cites: Am J Public Health. 2007 Mar;97(3):486-9217267713
Cites: J Epidemiol Community Health. 2007 Feb;61(2):108-1417234868
Cites: J R Soc Promot Health. 2006 Nov;126(6):262-717152319
Cites: Obes Rev. 2007 Jul;8(4):307-2617578381
Cites: Obes Rev. 2007 Sep;8(5):425-4017716300
Cites: Am J Public Health. 2001 Nov;91(11):1783-911684601
Human T cell leukemia virus (HTLV) type II is endemic in certain American Indians, and high rates of infection occur in intravenous drug users (IVDUs). North American IVDUs are infected with two distinct variants, HTLV-IIa and -IIb. If IVDUs became infected as a result of interaction with members of an American Indian population, both viral forms should be demonstrable in such populations. Nucleotide sequence analysis of 630 bases of the env gene encoding the gp21 protein was done on DNA from 12 New Mexico Indians (8 Pueblo, 4 Navajo). All samples were typical subtype a or b viruses. Seven of the 8 Pueblo and 2 of 4 Navajo had subtype b; the rest had subtype a. The results are compatible with an indigenous New World origin for both subtypes of HTLV-II.
Serological and molecular analyses of a cohort of HIV-1-infected intravenous drug abusers (IVDAs) (n = 103) in Dublin, Ireland have demonstrated that 15 of 103 (14.6%) were infected with HTLV-II, which is the highest infection rate yet recorded for any European country. Restriction fragment length polymorphism (RFLP) analysis of the env region of the provirus demonstrated that the infection involved only the HTLV-IIa subtype; the HTLV-IIb subtype was not detected. Phylogenetic analysis of the nucleotide sequences of the long terminal repeat (LTR) confirmed infection with the HTLV-IIa subtype, and demonstrated that the viruses clustered closely with HTLV-IIa isolates from North American IVDAs. Previous observations that IVDAs in southern Europe, specifically Spain and Italy, appear to be infected predominantly with the HTLV-IIb subtype, along with the present report and evidence that IVDAs in Sweden are infected with the HTLV-IIa subtype, suggest different origins of HTLV-II infection in Europe.
Alcoholism is an illness that constitutes a major health problem at all levels of society. The physician should accept his responsibility to prevent it and to care for the alcoholic. If he knows that one of his patients is drinking immoderately, he should warn him of the outlook. A patient's acquired dependence on alcohol may be overt, or revealed only on examination for organic disease or emotional disturbance. The diagnosis may be accepted reluctantly, or denied despite positive evidence, but the patient should be persuaded to give up drinking. He may require psychiatric help or advice from a social worker. He may be so ill as to require treatment in hospital, and hospitals must recognize the urgency of such admissions. Discharge from hospital does not end treatment, for alcoholism is a chronic disease, requiring long-term planning, persistent follow-up and enduring sympathy by the physician, who must always be as available to his alcoholic patient as he is to his patient with diabetes, epilepsy or cardiac disease.
Human T-cell leukemia (or lymphotropic) virus type II (HTLV-II) was isolated from eight HTLV-seropositive patients, six of whom were also infected with human immunodeficiency virus, by cocultivation of peripheral blood mononuclear cells (PBMCs) with BJAB, a continuous B-cell line. Restriction endonuclease mapping of the proviruses demonstrated consistent differences among isolates, and two distinct physical map patterns were observed. The results suggest the existence of two closely related molecular subtypes of HTLV-II, which are tentatively designated HTLV-IIa and HTLV-IIb. This finding was supported by preliminary nucleotide sequence analysis of the env gene region encoding the transmembrane glycoprotein gp21, which showed consistent differences between the two proposed virus subtypes. Exploitation of differences in restriction endonuclease sites allowed polymerase chain reaction amplification to detect and differentiate the two subtypes in fresh PBMCs of HTLV-seropositive intravenous drug abusers (IVDAs). The results of these studies confirm that HTLV-II infection is the prominent HTLV infection in seropositive IVDAs and also show that infection with both subtypes occurs. The finding of genetic heterogeneity in the HTLV-II group of viruses may have important implications for studies on its role in human disease and will be useful in characterizing the viruses present in newly discovered endemic foci in New World indigenous populations.
Cites: Virology. 1990 Jul;177(1):391-52353464
Cites: Proc Natl Acad Sci U S A. 1982 Mar;79(6):2031-56979048
Cites: Proc Natl Acad Sci U S A. 1985 May;82(10):3101-52582407
Cites: J Virol. 1989 Apr;63(4):1578-862784507
Cites: Blood. 1989 Oct;74(5):1658-642790192
Cites: Science. 1988 May 20;240(4855):1026-92835813
Cites: Lancet. 1986 May 3;1(8488):1031-22871307
Cites: J Gen Virol. 1988 Jul;69 ( Pt 7):1695-7102899128